What Is Colectomy? Understanding Colon Removal Surgery

This content was reviewed and approved by Biruk Almaz, MD.

Colectomy is a surgical procedure to remove part or all of your colon, which is the major section of your large intestine. The colon extends from the cecum (where the small intestine meets the large intestine) to the rectum. The procedure might be needed to treat diseases affecting the colon or prevent disease from developing or spreading.

This article details colectomy surgery (also called colon resection), including the reasons surgeons perform the procedure, the types of colectomies and what to expect if you’re scheduled for this surgery.

Why a Colectomy Can Be Necessary

Partial or complete removal of the colon can be necessary for several reasons, including:

• Colon cancer. Colectomy might be needed to treat colon cancer.
• Ulcerative colitis or Crohn’s disease. These inflammatory diseases of the intestines can require the removal of some or all of the colon if medications aren’t treating them effectively or doctors observe precancerous changes in the colon.
• Diverticulitis. This condition causes bulging pouches to form in the colon and become infected and inflamed. Colectomy may be recommended for the affected part of the colon.
• Bowel obstruction. A blocked colon is a medical emergency that might require partial or total colectomy.
• Uncontrollable bleeding. If severe bleeding develops in the colon and can’t be controlled, colectomy may be needed.
• Colonic inertia. A "sluggish" colon that can result in significant constipation and related symptoms.
• Volvulus. Twisting of the colon.
• Colon Ischemia. Reduced blood flow to the colon.

Doctors also might recommend colectomy for people at high risk of colon cancer or who have other conditions like Lynch syndrome or familial adenomatous polyposis.

Types of Colectomy Surgeries

There are five primary types of colectomy:

• Partial colectomy. A portion of the colon is removed.
• Total colectomy. The entire colon is removed, up to the rectum.
• Hemicolectomy. The entire left or right side of the colon is removed. Transverse colectomy is where the upper section of the colon is removed.
• Sigmoid colectomy. The part of the colon nearest the rectum is removed.
• Proctocolectomy. The colon and rectum are removed.

Surgeons can perform colectomies as open surgery, minimally invasive laparoscopic surgery and minimally invasive robotic surgery. All are effective for achieving the desired results.

Minimally invasive options, when appropriate, can provide additional benefits, including smaller incisions, less scarring, lower infection risk and less post-surgical pain. Patients also have shorter hospital stays and recovery times, fewer post-operative complications and can return to normal life quicker.

In some cases, a procedure called a colostomy may be necessary. That’s where the surgeon creates an opening in your abdomen (called a stoma) and attaches your colon to it so you can use a bag outside your body to collect waste. This may be a temporary or permanent change.

What To Expect With Colectomy Surgery

If you’ll be having a colectomy, your doctor will explain how to prepare for the procedure. Generally speaking, you will:

• Stop taking certain medications as directed by your physician — specifically ones that can increase your risk of complications.
• Refrain from eating or drinking for several hours to a day before the procedure, as directed.
• Drink a solution that clears material from your bowels.
• Take antibiotics if needed to suppress bacteria in the colon and reduce the risk of infection.

You will typically spend a few days in the hospital following a colectomy, so you should be prepared with comfortable clothing, toiletries, etc.

Talk With Your Doctor About Colectomy Surgery

Colectomy is a significant surgery that can help treat or prevent disease. If you’re scheduled for this procedure, your doctor will provide details and can answer any questions you have. You can also learn more about colon resection on our website.

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