Left Hemicolectomy

A Left Hemicolectomy is primarily recommended for treating colon cancer, but it is also used for ischaemic colitis and severe inflammatory bowel disease. By removing the descending colon and re-establishing a connection between the remaining segments, surgeons aim to restore healthy bowel function. Current surgical standards often utilise laparoscopic methods, which are associated with less pain and a quicker return to daily activities. Gaining a thorough understanding of the surgery helps patients and their carers manage the preparation and recovery process effectively.

A left hemicolectomy is the surgical procedure to remove the left side of the colon. This procedure is used to treat colon cancer, diverticulitis or inflammatory bowel disease. The procedure is usually performed laparoscopically. During the procedure, the infected or diseased portion of the colon is excised, and the remaining healthy portion of the bowel is reconnected. It usually involves removing the descending colon and, in some cases, parts of the transverse and sigmoid colon.

A left hemicolectomy can be suggested by your doctor under the following medical conditions:

• Colorectal Cancer- A left hemicolectomy is often performed to treat cancer in the descending colon. This surgery involves removing the tumour and the nearby lymph nodes together. This is a necessary step for determining the stage of the cancer and for preventing the disease from returning after the operation.
• Diverticular Disease- The condition occurs when small pockets in the colon become inflamed, causing discomfort and sickness. For patients with severe or recurring cases, a left hemicolectomy may be advised. Surgery is typically necessary if complications develop, such as an abscess, a perforation in the colon, or a fistula.
• Inflammatory Bowel Disease- In instances of severe disease, malformations or complications of toxic megacolon, in conditions like ulcerative colitis may require the patient to undergo colectomy.
• If there are any blockages in the colon due to cancerous tumours or abdominal adhesions, this procedure can be recommended to remove them.
• When the blood flow of the colon is disrupted, leading to deterioration of the bowel wall, removal of the affected segment is imperative.
• In cases of large precancerous polyps or benign tumours in the colon that cannot be removed endoscopically.

Before the surgery, patients undergo various diagnostic tests and evaluations. This is to ensure the appropriate technique and procedure are followed and to identify the damaged part of the colon. These might include blood tests, imaging studies such as CT scans, and a colonoscopy. In cases involving cancer or tumours, a staging workup is essential before surgery. Bowel preparation on the day of or the day before surgery may be required to reduce faecal content.

Left hemicolectomy can be performed in the following ways:

• Open Surgery- This traditional surgical approach involves a large abdominal incision, providing an unobstructed view and access to the colon.
• Laparoscopic Surgery- It’s a minimally invasive procedure that involves a tiny incision and a camera. It is associated with less postoperative care and a quicker recovery.
• Robotic-Assisted Surgery- A far more advanced technique of a minimally invasive surgery, allowing greater flexibility, finesse and control.

Here are the steps generally performed by the surgeon during Left Hemicolectomy.

• The patient receives general anaesthesia.
• An incision is made to access the abdominal cavity.
• A laparoscope is inserted to get a view of the colon. The abdominal cavity is inflated to get a better view and for the surgeon to identify the left colon and the part that needs to be removed.
• The blood vessels supplying blood to the affected area are closed.
• Removal of the diseased or infected part of the colon. In cases of cancer, the lymph nodes are removed.
• A joint between the remaining ends of the colon is created. The abdomen is closed.

In high-risk cases, instead of immediate reconnection, a temporary or permanent colostomy may be created. The surgery usually takes two to three hours to complete.

After the surgery, the patients are kept in the hospital for a few days and closely monitored. The patient is given pain medication, and their fluid balance and preliminary mobilisation are monitored. The patient’s fluid and solid intake is monitored as bowel function slowly returns to normal.

The patient is also encouraged to start moving around slowly after a few days. The recovery time after the patient leaves the hospital depends on the surgical procedure they underwent. It could take anywhere from 4 to 8 weeks. The patients are strongly advised to avoid heavy lifting and to adhere to the dietary recommendations to prevent disruption of bowel function. Most patients regain normal bowel function, although temporary changes such as loose or softer stools may occur.

Left Hemicolectomy is a fairly standard and common procedure. It still carries a few risks, such as leakage at the connection site, which can lead to sepsis or infection. There could be excessive bleeding or the formation of blood clots in the legs that may travel to the lungs.. It is very important that the patient is observed and that any risks are identified and managed at an early stage.

Gleneagles Hospitals offer left hemicolectomy surgery through their advanced gastrointestinal department. This procedure is performed by experienced surgeons specialising in colorectal health and surgery.

Facilities include:

• Modern surgical suites are equipped with cutting-edge technology
• Availability of laparoscopic (keyhole) surgical options
• Dedicated teams of surgeons and anaesthetic specialists
• Full postoperative care and clinical monitoring
• On-site diagnostic testing and laboratory facilities
• Organised follow-up care and recovery support

Patients are given clear guidance before their operation to ensure they are fully prepared. During the healing process, our clinical staff maintains close supervision and provides constant support as part of our standard care.

Left hemicolectomy is a standard surgical procedure used to treat diseases or infections affecting the left side of the colon. It is an important procedure in both curative and preventive cases, as it removes diseased tissue while preserving intestinal function. Known for its effectiveness and minimal invasive surgical options, this procedure is a standard choice for ensuring a faster recovery with reduced postoperative complications. Success is underpinned by high-quality preoperative care. To achieve the best results, surgeons must conduct a detailed patient review, employ the optimal surgical technique, and provide diligent postoperative monitoring to prevent any complications and ensure patient well-being.