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Colectomy (bowel resection surgery)

Surgery to remove all or part of the large bowel (large intestine)

An abdomen of adult Asian female patient with Waterproof Transparent Dressing after Cholecystectomy
A colectomy is an operation to remove all or part of the colon. It can be performed in one of two ways.

  • Open surgery - the operation is performed through a large incision (cut) in the abdomen
  • Laparoscopic (keyhole) surgery - the surgery is performed through several small incisions using a flexible camera (laparoscope) and small instruments

If you have been advised that you might need a colectomy or that you need to speak to a specialist about problems with your colon, call or book online today to arrange a consultation to discuss private colectomy with a consultant of your choice at Circle Health Group.

This page explains what a colectomy is, what happens during the procedure and what to expect during your recovery.

What is the colon?

The colon is a part of your large intestine and, along with the rectum and anus, makes up the last part of your bowel. It starts at the caecum, a pouch that connects to the small intestine, and consists of five parts:

  • Ascending colon - travels upwards from the caecum in the lower right side of the abdomen
  • Transverse colon - goes across the abdomen
  • Descending colon - travels down the left side of the abdomen
  • Sigmoid colon - is the last part of the colon
  • Rectum - the last part of the intestine before the anus where waste is eliminated

The main function of the colon is to receive digested food from the small intestine and remove water and electrolytes to make a solid stool that can be excreted as waste (poo). It is possible to live without all or part of your colon.

There are several different types of colectomy. Which type you will have depends on which areas of your colon are affected.

Total colectomy

During a total colectomy, the entire colon is removed, and the small intestine is attached directly to the rectum.

Hemicolectomy

A hemicolectomy is the removal of either the descending colon (left hemicolectomy) or the ascending colon (right hemicolectomy).

Sigmoidectomy

During sigmoidectomy, the last part of the colon, the sigmoid colon, is removed.

Subtotal (partial) colectomy

This is where the colon is removed, but the rectum remains in place.

Proctocolectomy

During proctocolectomy, the entire colon and rectum are removed.

A colectomy may be performed to treat several conditions affecting the colon including:

  • Colon cancer
  • Precancerous changes in the colon
  • Severe inflammatory bowel disease like Crohn’s disease or ulcerative colitis that hasn’t improved with other treatments
  • Severe diverticulitis that hasn’t responded to other treatments
  • Elective colectomy may be performed due to some inherited conditions with a high risk of developing colon cancer
  • Large bowel obstruction
  • Uncontrolled bleeding due to injury

At your first consultation, you will usually be seen by a consultant gastroenterologist, a doctor specialising in conditions affecting the gastrointestinal tract.

Your consultant will ask you about your symptoms, and medical history and perform a physical examination. They may order tests to look at your colon and check you are fit enough to have surgery. These may include blood tests, electrocardiogram (ECG), X-ray, urine tests and a procedure to examine your colon called a colonoscopy.

At the end of your appointment, your consultant will decide if a colectomy is a suitable treatment for you based on your diagnosis, medical history and general health. They will discuss the type of colectomy you will have and how your surgery will be performed as well as any risks and complications, and what to expect during your recovery.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice.

Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have, and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners or non-steroidal anti-inflammatory drugs (NSAIDs) for a few days before your operation. This is to reduce the risk of bleeding during and after your surgery.

Your bowels need to be empty before your surgery. Your consultant will give you instructions on what to eat and drink in the days before your surgery. You will also need to have bowel prep (a laxative or enema to empty your bowels) the day before your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

  • Follow a healthy, balanced diet
  • If you smoke, try to stop at least eight weeks before your surgery
  • Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
  • Take regular exercise

Colectomy surgery is performed under general anaesthetic which means you'll be asleep for the procedure. The operation normally takes between one and four hours.

For a laparoscopic colectomy, your consultant will begin by making between three and five small incisions (cuts) in your abdomen.

A flexible tube with a light and camera is inserted into one of the incisions to allow your consultant to see inside your abdomen. Your abdomen is filled with gas to expand it and make it easier for your consultant to examine your internal organs.

The diseased part of the bowel is located and removed, often along with some of the surrounding lymph nodes.

If possible, the healthy ends of the bowel are joined together. This is called anastomosis. If there isn't enough healthy tissue, your consultant will make an external opening in your abdominal wall called a stoma. Your colon is then diverted to the stoma and faecal waste passes through it into a bag attached to your abdomen (a colostomy). This may be temporary or permanent.

What happens during open colectomy surgery?

If you are having an open colectomy, your consultant will make an approximately fifteen to twenty cm (six to eight inch) incision in your abdomen.

Your colon and surrounding structures are examined for signs of disease and any diseased areas will be removed.

As with laparoscopic colectomy, your consultant will either join the ends of your bowel together with an anastomosis or create a stoma in the abdominal wall.

Recovery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery or initial recovery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your surgery, you will be taken to the recovery room where your breathing, heart rate and blood pressure will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room.

It's normal to experience some post-operative pain in the days following your surgery. You will be given medication to manage this, but please tell a member of your healthcare team if you have any pain.

You will need to eat a soft diet for the first two weeks after your colectomy. Your healthcare team will advise you on which foods you can eat and which to avoid.

Your incision wounds will have dressings in place for the first forty-eight hours after surgery. After this, the outer dressings can be removed, but leave the steri strips in place until they fall off by themselves. Keep your wounds clean and dry and avoid submerging your wounds in water for the first two weeks. Take showers instead of baths, gently clean your incisions with a mild soap, pat dry and leave open to the air.

How many nights will I need to stay in hospital?

You can expect to stay in hospital for around seven days after your colectomy.

Will I be able to drive home?

You will not be able to drive yourself home from hospital, or for at least two weeks after your colectomy. Please make arrangements for someone to come and collect you, or we can organise a taxi if you prefer. Get the all-clear from your consultant and inform your insurance company before driving after your surgery.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on the type of surgery you had, your individual recovery, and the type of job you do. Most people return to work around four to six weeks after colectomy surgery.

When will I be back to normal?

Recovery from colectomy surgery is different for everyone and depends on factors such as the type of surgery, your general health and whether there were any complications during your surgery.

Follow your consultant's instructions carefully during your recovery and call the hospital if you have any questions or are worried about anything after your surgery.

Most people can resume normal daily activities between four and eight weeks after colectomy surgery. You will need to avoid heavy lifting for at least six weeks.

Like all types of surgery, there is a small risk of complications associated with colectomy surgery. Your consultant will explain all the possible risks and complications and answer any questions you may have before your colectomy. Please ask as many questions as you need to ensure that you are fully informed before your surgery and able to make an informed decision.

Possible complications of any surgery include:

  • Bleeding
  • Infection
  • Blood clots
  • Adverse reactions to the anaesthetic

Possible complications specific to laparoscopic colectomy include:

  • Hernia
  • Adhesions (scar tissue that can block the intestines)
  • Damage to nearby organs
  • Anastomotic leak (a leak where the ends of the bowel are joined together)
  • Ileus (when the bowels take longer than normal to start working again after surgery)

Call your healthcare provider immediately if you experience:

  • Swelling, redness, bleeding, or strong-smelling discharge from the incision site
  • Severe pain or pain that is getting worse or not relieved by medication
  • Fever (a temperature over 38C)
  • Vomiting
  • Shortness of breath
  • Not having a bowel movement since returning home

We answer some of your most commonly asked questions about colectomy.

Do you need a colostomy bag after a colectomy?

Whether you need a colostomy bag after your colectomy depends on whether there is enough healthy bowel to join the cut ends together (anastomosis) during your surgery. If there is not enough healthy bowel, your consultant will divert the bowel to an opening in the abdominal wall and attach a colostomy bag. This may be temporary or permanent. Talk to your consultant about whether they expect you will need a colostomy bag after your colectomy.

Does a colectomy cure ulcerative colitis?

Yes. For ulcerative colitis that doesn't improve with other treatments, a total colectomy provides a cure for ulcerative colitis.

How long after a colectomy can you drink alcohol?

Avoid alcohol for at least two weeks after your colectomy. After this, talk to your consultant about when you can safely drink alcohol after your surgery.

How long does a colectomy take?

A colectomy takes between one and four hours and depends on the type of surgery you have (open or laparoscopic) and what is done during your surgery.

What can you eat after a colectomy?

For the first two to three days after your colectomy, you will be given intravenous fluids (fluids into a vein) only. This will gradually progress to drinking clear liquids such as water, black tea, black coffee and clear soups and juices.

When you can start eating solid food, you'll begin with easy-to-digest foods like applesauce, pears, bananas, white rice and pasta before gradually returning to your normal diet. Your healthcare team will advise you on what foods to eat and what to avoid after your colectomy.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

  • Flexible appointment times and locations that are convenient for you
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Private ensuite rooms as standard
  • A range of delicious healthy meals
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about colectomy surgery, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

  1. Colectomy, John Hopkins
  2. Surgery to remove all or part of your bowel (colectomy), Cancer Research UK
  3. Colectomy (Bowel Resection Surgery),  Cleveland Clinic
  4. Large bowel resection, Medline Plus

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