A colectomy is a surgery performed to remove part or all of a patient's colon. The procedure may be necessary to treat colon cancer, irritable bowel syndrome, a ruptured colon, or any of a number of other conditions that cannot be managed with medication. A colectomy generally takes about three hours to perform and requires an extended hospital stay. The success rate is very high, though patients may need to adjust their diets or lifestyle habits to cope with changes to their intestinal tracts.
Total colectomies typically involve open surgery, in which a long cut is made in the lower abdomen to give the surgical team access to the intestines. Careful cuts are made to excise the colon while preserving surrounding tissue. Depending on the patient's age, preference, and other health conditions, surgeons may be able to connect a section of the small intestine to the anus so that future bowel movements are possible. Most patients, however, are fitted with temporary or permanent external colostomy bag.
In order to secure a colostomy bag, a surgeon forms a deep hole in the abdomen called a stoma. He or she attaches the remnants of the colon to the stoma so waste can be expelled directly, instead of traveling down the intestines to the anus. A patient who undergoes a total colectomy often needs to use the colostomy bag for life.
A skilled surgeon may be able to perform a partial colectomy without opening the entire abdominal cavity. Instead, several small incisions are made in what is called a laparoscopic procedure. A tiny, lighted camera is inserted though an opening to help the surgeon identify different sections of the colon. Precision surgical tools are manipulated through other incisions to excise pieces of the intestine. With the damaged section removed, the surgeon can mend the remaining pieces together, realign the colon in the body, and suture the abdominal incisions.
Following an open or laparoscopic colectomy, a patient can expect to spend several days in the hospital so doctors can monitor recovery. He or she is typically given pain medications, anti-inflammatory drugs, and antibiotics to combat post-surgical symptoms. Patients are often placed on soft food or liquid diets to give the intestine time to heal. Once bowel movements are possible or the efficacy of a colostomy procedure is confirmed, a patient is usually allowed to go home. Frequent checkups are important in the first few weeks following a colectomy to make sure the procedure was a success.