A right hemicolectomy is done to remove a tumour located on the right side of the colon, and attaching the small intestine to the remaining portion of the colon to restore functioning of the bowel. Dr Heyns is a general surgeon with a particular interest in laparoscopic colorectal surgeries so when possible, this surgery will be performed using keyhole techniques
This surgery is done as the primary treatment for colon cancer. Radiation and chemotherapy are often part of the treatment plan but surgery is generally advised.
While a right hemicolectomy is generally done for colon cancer, it may also be done for treatment of inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease; polyps, growths or diverticulitis.
A right hemicolectomy is performed under general anaesthesia using laparoscopic techniques when possible. A few small incisions are made into the right side of your abdomen and a thin tube-like instrument, a laparoscope, is inserted into the incision. This tools is fitted with a light and camera and will allow Dr Heyns to view inside the abdomen without the need for larger incisions. From there small surgical tools are inserted to remove the right section of the colon. The cecum and ascending colon along with a small margin of the surrounding tissue and the nearby lymph nodes are removed. An anastomosis is then done to join the remaining healthy ends of the large intestine with the small intestine.
The images below show what a Right Hemicolectomy involves.
Whether you have open or laparoscopic surgery will depend on many aspects. If surgery cannot be performed laparoscopically, an "open" operation may be done through a larger incision into the abdomen.
To allow the bowels to heal without risking infection, a colostomy is created. This involves an incision being made through the abdomen and connecting the intestine to it. Through this opening (stoma) the colon is connected to a bag on the outside of the body so that waste can be removed from the body. This is generally temporary and reversed after surgery, but if it's not possible to join the bowel back together, this colostomy may be permanent.
You can expect some pain near the incisions when waking from anaesthesia. A colostomy may have been placed to aid healing, so a dietician will come and speak to you about dietary precautions and caring for your stoma – be it temporary or permanent. In some cases, you may need to stay in the hospital for one to two weeks before being discharged. Pain medication and anti-constipation medication will be prescribed. Once home, you will need to rest and avoid heavy lifting for another 2-3 weeks. Bowel functioning and movements may take a few weeks to go back to normal. Depending on how the surgery was done, recovery may take 3 to 6 weeks
If surgery was done for treatment of colon cancer, radiation and chemotherapy may be necessary after surgery.