Right Colectomy

What is a Right Colectomy?

A right colectomy is a surgical procedure that involves surgical removal of the diseased part of your right colon or large intestine located on the right side of the abdominal cavity and a small segment of the surrounding tissues followed by a connection between the healthy ends of your colon to allow proper waste removal from your body. The surgery may be performed either as an open procedure or by using a minimally invasive laparoscopic technique.

Anatomy of the Colon

The colon is the long tube-like organ which forms the end of the digestive tract. It is involved in the reabsorption of fluids and provides passage for waste removal from your body. The parts of the colon are:

Caecum: The beginning of the colon which is connected to the small intestine.
Ascending colon: The part of the colon on the right side of the abdominal cavity.
Transverse colon: The middle part of the colon.
Descending colon: The part of the colon on the left side of the abdominal cavity.
Sigmoid colon: The last part of the colon which is connected to the rectum.

Indications for Right Colectomy

A right colectomy may be indicated in case of abnormal findings in the sections of the colon on the right side of the abdominal cavity such as:

Cancerous lesions
Non-cancerous growths
Inflammation caused by Crohn’s disease
Uncontrolled bleeding

Pre-operative Preparation for Right Colectomy

You will be asked to come for a health check-up where your blood tests, blood pressure, and other health parameters will be reviewed. Your surgeon will give you specific instructions before your surgery. These may include:

Discontinue certain medications.
Avoid eating and drinking several hours to a day before your procedure.
Take an oral bowel preparation which includes a laxative solution that causes diarrhoea to expel stools and empty your colon.
Take antibiotics to suppress the natural bacteria in your colon.

Procedure for Right Colectomy

You will be placed on the operating table with the help of stirrups.
You will be administered general anaesthesia and intravenous antibiotics through a vein in your arm.
The right colectomy can be performed in two different ways. This depends on your health and your surgeon’s discretion:
- Open Right Colectomy: In the open right colectomy, a single long incision is made in your abdomen to access your colon. Your surgeon uses surgical tools to separate your right colon from the surrounding tissues, then cuts and removes it.
- Laparoscopic Right Colectomy: In laparoscopic right colectomy, a few small incisions are made in your abdomen. Your surgeon introduces a laparoscope: a thin tube with a camera attached to one end to view the interior organs and locate the colon. Special surgical tools are inserted through the other incisions which help in cutting and removing the part of the colon and the surrounding diseased tissues.
After the diseased colon is removed, the remaining healthy ends of your colon can be sutured back together.

Post-operative Care after Right Colectomy

You will be required to stay in the hospital for a few days to a week after your right colectomy to monitor your recovery.
You will be put on a liquid diet first which will be slowly replaced with solid food. In the beginning, you may be given intravenous nutrition through veins in your arms.
You may require some time to regain your bowel function, after which you can resume oral consumption of food.

What are the Risks and Complications of Right Colectomy?

A right colectomy may be associated with the following risks and complications:

Infection
Bleeding
Blood clots in the legs (deep vein thrombosis) and the lungs (pulmonary embolism)
Injury to surrounding organs such as the small intestines and urinary bladder
Tears in the sutures at the site where the healthy ends of the colon are joined together