Colectomy Explained: Types of Colon Surgery
What Is a Colectomy? Types of Colon Surgery Explained
A colectomy is an operation to remove all or part of the colon (large bowel). The name of the operation tells you which part is removed – for example, a right hemicolectomy removes the right side of the colon. Colectomies are done for bowel cancer, inflammatory bowel disease, diverticular disease and some emergencies, and many are now performed with keyhole or robotic techniques.
Why a Colectomy Is Performed
- Bowel cancer – to remove the tumour with its lymph nodes; see bowel cancer diagnosis and treatment
- Polyps that cannot be removed safely at colonoscopy
- Ulcerative colitis and Crohn’s disease not controlled with medication; see IBD and diverticulitis and Crohn’s disease treatment
- Diverticular disease with repeated or complicated attacks; see diverticular disease explained
- Emergencies – bowel obstruction or perforation
Types of Colectomy
| Operation | What is removed | Common reasons |
| Right hemicolectomy | The right side of the colon | Right-sided colon cancer; Crohn’s disease |
| Extended right hemicolectomy | The right colon plus part of the transverse colon | Cancer near the hepatic flexure or transverse colon |
| Transverse colectomy | The transverse (middle) colon | Transverse colon cancer |
| Left hemicolectomy | The left side of the colon | Left-sided colon cancer; diverticular disease |
| Extended left hemicolectomy | The left colon plus part of the transverse colon | Cancer near the splenic flexure |
| Sigmoid colectomy | The sigmoid (S-shaped) colon | Diverticular disease; sigmoid cancer |
| Subtotal colectomy | Most, but not all, of the colon | Severe colitis; some emergencies |
| Total colectomy | The entire colon | Ulcerative colitis |
| Panproctocolectomy | The colon, rectum and anus | Ulcerative colitis in selected patients |
Operations that involve the rectum – such as anterior resection and abdominoperineal resection – are closely related. The rectum raises different challenges, explained in rectal cancer vs colon cancer
Anal Fistula Surgery in Mumbai
Open, Laparoscopic and Robotic Colectomy
A colectomy can be performed through one larger incision (open surgery), through small ports with a camera (laparoscopic surgery), or with robotic assistance. Laparoscopic colorectal surgery reduces blood loss and pain, and speeds recovery of bowel function. Robotic colorectal surgery adds 3D magnified vision and wristed instruments, most useful for pelvic operations. For a comparison, read robotic vs laparoscopic colorectal surgery
Joining the Bowel, and When a Stoma Is Needed
After the diseased segment is removed, the two healthy ends are usually joined together. Sometimes joining is not safe straight away – for example, in an emergency or when the bowel is inflamed. The surgeon then brings one end out onto the abdomen as a stoma. In a Hartmann’s procedure, the diseased colon is removed and a colostomy is formed, with the option of reconnection later. Many stomas are temporary; see whether a permanent stoma is always needed .
Recovery After a Colectomy
Recovery depends on the type of operation and the surgical approach. Minimally invasive colectomy usually means a shorter hospital stay and a faster return to normal activities than open surgery. Walking early, gradual return to eating and follow-up appointments are the foundations of recovery. Our guide to recovery after robotic colorectal surgery describes each stage.
Life After Colon Surgery
Most people return to a normal diet and active life. Removing part of the colon can make stools looser or more frequent for a period while the bowel adapts; this usually settles. Building good habits helps – see how lifestyle and diet affect colon health. After surgery for cancer or polyps, regular surveillance is important; read why regular colonoscopy can save your life .
Choosing a Colon Surgeon
Colectomy is specialist surgery. Look for a surgeon with dedicated colorectal training who performs open, laparoscopic and robotic operations, so the approach is chosen for your needs. Dr. Husain Gheewala is a colon surgeon in Mumbai with a two-year colorectal fellowship from York NHS Hospital, UK, and robotic certification from Severance Yonsei Hospital, Seoul. Read about his training and hospital affiliations, or book a consultation