Large bowel resection

The large intestine (or colon, or large bowel) is the last structure to process food, taking the undigestible matter from the small intestine, absorbing water from it and leaving the waste product called feces. Feces are expelled from the body through the rectum and the anus.

Large bowel resection is surgery to remove all or part of your large bowel. This surgery is also called colectomy. The large bowel is also called the large intestine or colon.

• Removal of the entire colon and the rectum is called a proctocolectomy.
• Removal of part or all of the colon but not the rectum is called subtotal colectomy.

The large bowel connects the small intestine to the anus. Normally, stool passes through the large bowel before leaving the body through the anus.

Description

You will get general anesthesia before your surgery. This will make you sleep and keep you pain-free. The surgery can be performed laparoscopically or with open surgery.

Depending on what type of procedure you have, your surgeon will make one or more cuts in your belly.

With laparoscopic colectomy, the surgeon uses a tiny camera to see inside your belly and small instruments to remove part of your large bowel. You will have three to five small cuts in your lower belly. The surgeon passes the medical instruments through these cuts.

• You may also have a cut of about 2 to 3 inches if your surgeon needs to put a hand inside your belly to feel or remove the diseased bowel.
• During laparoscopy, your belly will be filled with gas to expand it. This makes the area easier to see and work in.
• Your surgeon will remove the diseased part of your large bowel.
• The surgeon will then sew the healthy ends of the bowel back together. This is called anastomosis.
• Then the cuts on the skin will be closed with stitches.

For open colectomy, your surgeon will make a 6- to 8-inch cut in your lower belly.

• The surgeon will find the part of your colon that is diseased.
• The surgeon will put clamps on both ends of this part to close it off.
• Then the surgeon will remove the diseased part.
• If there is enough healthy large intestine left, your surgeon will sew or staple the healthy ends back together. Most patients have this done.
• If you do not have enough healthy large intestine to reconnect, you may have a colostomy.

In most cases, the colostomy is short-term. It can be closed with another operation later. But, if a large part of your bowel is removed, the colostomy may be permanent.

Your surgeon may also look at lymph nodes and other organs, and may remove some of them.

Colectomy surgery usually takes between 1 and 4 hours.