A colectomy is a surgical procedure that aims to remove a piece or all of the colon.
What is it?
A colectomy is a procedure that surgically removes part or all of the large intestine, or colon, in order to treat conditions of the colon such as cancer, bowel obstructions, or excessive bleeding. Different variations of colectomies include total colectomies, partial colectomies, hemicolectomies (removes only the right or left part of the colon), and proctocolectomies (removes the colon and rectum).
How to Prepare
If a patient is having a colectomy, the patient should stop taking blood thinners, aspirin, and nonsteroidal anti-inflammatory medications for one week prior to the surgery. These medications can increase the risk of bleeding during the surgery, which can be a major complication. Patients should check with their physicians before ceasing medications because other medical problems may determine whether or not they should be stopped. The doctor will likely order a laxative solution in order to clear the bowels at home prior to the surgery. The patient should not eat or drink starting from the midnight prior to the surgery in order to reduce the risk of aspiration, a rare but serious risk that occurs when the stomach’s contents enter the lungs during general anesthesia. Additionally, it’s possible that the doctor will prescribe antibiotics to take prior to the surgery in order to prevent infection during it.
What happens during the procedure?
During a colectomy, the patient receives general anesthesia, which consists of anesthetic drugs that put the patient to sleep for the duration of the procedure. Colectomies can proceed in two different ways: open and laparoscopic. An open colectomy involves making a large incision on the abdomen in order to work on the colon and perform the surgery. The colon is cut away from the surrounding tissue, and then the damaged or diseased portion is excised. The surgeon then reattaches the colon by stitching it back together. In the event of a total colectomy, which is when the entire colon is removed, the small intestine is connected to the anus. In other instances, the intestines are attached to an opening in the abdomen so that waste is removed via the opening. The type of operation the patient must undergo depends on their medical condition. A laparoscopic colectomy is minimally invasive, so only small incisions are made on the abdomen in order to allow a surgical camera and tools to enter the body. The surgeon can view the inside of the body using the camera instead of opening up the whole abdomen. The colon is removed from the abdomen through one of the small incisions, and then it is operated upon outside of the body. Afterwards, the colon is re-inserted through one of the small incisions. Just as with open colectomies, reattachment of the colon and repair of the digestive system can occur in different ways depending on the patient’s medical condition.
Risks and Complications
Risks associated with a colectomy include infection, bleeding, damage to internal organs near the surgery site, blood clots, and damage to the sutures that reattach the colon. Risks associated with general anesthesia include aspiration.
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