A surgical procedure performed to remove the large intestine is called a colectomy or a large bowel resection. A colectomy may be required to remove the organ that sits at the end of the digestive system in order to prevent the spread of disease or to treat a condition that affects the colon, report doctors at the Mayo Clinic. A colectomy can be partial or total. Colectomy operative procedures include preparation for the procedure, the surgery and additional surgery required to reconnect the digestive system.
Preparation
Preparing for a colectomy is a vital piece of the surgical procedure. The colon must be cleaned out completely, usually through use of a laxative. Patients drink a prescribed solution over a period of a couple hours. The laxative promotes diarrhea, necessary to cleanse the intestines. Various medications that can cause complications during the surgery must be discontinued, and patients must fast from eating for up to 24 hours before the operation. Since bacteria are present in the colon, many people take an antibiotic prior to surgery to avoid infections.
Surgery
A colectomy is performed under general anesthesia. Surgeons have two options for performing the procedure and often base their decision on the severity of the disease, the patient's overall health and the viability of the colon. An open colectomy requires an incision in the abdomen. The surgeon can then reach in and inspect the colon to remove as much as is necessary to treat the patient. The damaged intestines are cut and removed through the incision. A laparoscopic colectomy is a minimally invasive procedure that only requires several small incisions on the abdomen. The surgeon then runs a video camera into the incision, which produces pictures on a screen in the operating room from which the doctor operates. The infected or diseased colon parts are pulled through the incisions and cut off. The remaining colon is then pushed back in through the same incisions.
Rejoining
Following the removal of part or all of the colon, the doctor continues operating to rejoin the remaining colon or ends to the digestive system so the patient can effectively process waste. The remaining portions of the colon may be stitched together, allowing the digestive system to operate as it did before the colectomy. When there is no large intestine left, the doctor may attach the end of the small intestine to a colostomy bag through an incision in the abdomen. Patients must wear the bag on the outside to carry waste that is eliminated through the hole. A third option is when the remaining intestines are attached to the anus, allowing waste to leave in much the same way as it did prior to the surgery.
Recovery
A colectomy is a major operation and usually requires at least two to three days of hospital confinement. Patients cannot leave the hospital until they have a bowel movement to make sure everything is working properly. For some patients, that process can take up to a week. Liquids and food are slowly introduced as the patient can tolerate them. Patients receive instructions on how to care for their bag and hole if they've been fitted with a colostomy bag. Most people are very weak following a colectomy and require a week or two of continued rest at home to regain their strength.
