Surgery on the colon in most instances requires removal of part of the colon or large bowel. The part of the bowel that has been removed then gives the name to the operation. These names include right hemi-colectomy, transverse colectomy, left hemi-colectomy, sigmoid colectomy, high and low anterior resection, abdomino perineal resection, total colectomy with ileo rectal anastomosis or pan proctocolectomy. Cancer is the most common cause for a colectomy needing to be performed. Inflammatory conditions such as ulcerative colitis or diverticulitis are other common causes. The diagnosis of these conditions would be performed in most non emergency cases by the use of x-ray (barium enema or CT colonoscopy) or by the use of the colonoscope. Biopsies will usually be taken with small pieces of the significant area removed for examination by a pathologist. Before the operation is undertaken the bowel will need to be clean. Preparation used will be similar to that prior to a colonoscopy.Free fluids and clear fluids will be taken several days prior to the procedure. The drinking of a solution causing evacuation of all faecal material and cleaning the bowel is usually the final step. Some times just prior to surgery a bowel wash out through the anus may be performed. The reason for this cleaning of the bowel is that it lessens the risk of complications after surgery.
In most cases the operation will be performed open, though a laparoscopically assisted or fully laparoscopic procedure may be undertaken. A colostomy or bag is sometimes needed in surgery of the colon. Obviously if the anus is removed in an abdomino-perineal procedure then a permanent end colostomy is fashioned. Sometimes temporary colostomies are placed to protect the join in the bowel. This in most instances will be closed with a smaller procedure several months later.
Picture courtesy of RACS and MI-tec Publishing. The complete patient education pamphlet is available from your surgeon.