It's normal to feel a little scared and nervous when your doctor tells you that you need to have colon surgery, a colectomy. We all get a little nervous when we hear the word "surgery." But once you know exactly what it is, why it's done, and how it's done, your fear will go away. So today, let's talk about it simply, in a way that you can understand.
What is colectomy?
Simply put, a colectomy is the surgical removal of part or all of your large intestine (colon). The large intestine is a very important part of our digestive system. When this part is damaged due to a medical condition, it stops working properly. That's when doctors decide to perform this surgery.
This surgery is generally recommended in the following conditions:
- Colon cancer: Remove the part of the colon that contains cancer cells.
- Diverticulitis: This is a condition in which small pouches form in the wall of the large intestine, which become infected and inflamed.
- Gastrointestinal bleeding: If you have uncontrollable bleeding from the intestines.
- Large bowel obstruction: If the intestine is completely blocked for some reason.
- Severe inflammatory bowel disease: When conditions such as Crohn's disease or ulcerative colitis become severe.
Sometimes, if there is a very high risk of developing cancer in the future due to inherited genetic conditions (for example, Lynch syndrome), this can also be done as a preventive colectomy to reduce that risk.
Are there different types of this surgery?
Yes, this surgery is divided into several types depending on the part of the intestine that is removed. This is decided by the surgeon who treats you based on your medical condition.
| Type of surgery | Simply put, what happens? |
|---|---|
| Total Colectomy | Your entire colon will be removed. |
| Partial Colectomy | Only the diseased part of the colon is removed. There are other types of this too. |
| Hemicolectomy | One side of the large intestine, either the right or left side, is removed. |
| Proctocolectomy | Both the large intestine and rectum are removed. |
| Sigmoid Colectomy | The last part of the large intestine, the sigmoid colon, which connects to the rectum, is removed. |
How do you prepare before surgery?
Since this is a major surgery, it is very important to prepare for it.
First, your surgeon will talk to you and explain the type of surgery you will have, how it will be done (whether it will be done through a large incision or with a camera). Then, they will do some tests to see if your body can handle the surgery.
- Blood tests
- Colonoscopy
- An EKG (Electrocardiogram) test that checks the functioning of the heart
- Imaging tests, such as CT scans or MRI scans
In addition, the medical team will also inform you about the things you need to follow a few days before the surgery. These include:
- Arrange for someone to drive you home from the hospital: You will not be able to drive yourself after surgery.
- Start a liquid diet: You will be asked to drink only liquids such as soup and fruit juice for a few days before surgery.
- Bowel prep: The day before surgery, you will be given a special liquid to drink to completely empty your bowels. This is a bit uncomfortable, but it is very important for the success of the surgery.
- Fasting: You cannot eat or drink anything from midnight on the day of surgery.
What happens during and after the surgery?
During the surgery, you will be completely anesthetized, so you will not feel anything. The surgeon will make a single long incision in your abdomen (Open Colectomy) or several small incisions with the help of a camera (Laparoscopic Colectomy). They will remove the diseased part of your colon and reconnect the two healthy parts. This is called an anastomosis .
However, sometimes it is not possible to connect the two healthy parts together. For example, if the gap between the two remaining parts is too large, or if it is not possible to connect them immediately due to an infection, the surgeon may decide to create an ostomy .
What is an Ostomy?
An ostomy involves bringing the healthy end of the intestine to the surface of the skin on the abdomen, creating a new opening (stoma) for stool to pass through. The stool is then collected in a special bag (ostomy bag) attached to that opening.
We know this is a big change in your life. But you will receive all the advice and training you need to manage this and still live a normal life at the hospital. So don't be afraid of it.
After surgery, you will need to stay in the hospital for a few days or a week. You will be limited to liquids and soft foods for the first few days. You can return to normal eating as you recover. It can take up to 6 weeks to fully recover after you go home. However, most people can return to most of their normal activities within two weeks.
When should you talk to the doctor?
It is very important to be aware of any warning signs that may arise when you return home after surgery. If you have any of the following symptoms, tell your doctor or surgeon immediately.
| Warning feature | Description |
|---|---|
| High fever | Increased body temperature, feeling of weakness. |
| Signs of infection at the incision site | Redness, swelling, severe pain, or pus around the incision. |
| Gradually increasing abdominal pain | If the stomach pain gradually increases instead of decreasing. |
| Difficulty defecating | No bowel movements or flatulence for several days. |
A colectomy can be a life-changing experience. It can relieve your painful symptoms, cure your cancer, or help you live longer with cancer. Talk openly with your doctor about any questions or concerns you may have. They are always ready to help you.
Take-Home Message
- Colectomy is the surgical removal of a damaged part of the large intestine.
- This surgery is performed for serious medical conditions such as cancer and diverticulitis.
- It is very important to follow medical instructions, including bowel cleansing, before surgery.
- You may need an ostomy bag to pass stool, but you will receive all the support you need to live with it.
- It takes time to heal, so be kind to yourself and take your time to heal.
- If you develop warning signs such as fever or severe pain after surgery, contact your doctor immediately.
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