Colectomy

"Laparoscopic surgery allows for a smaller incision and faster post-operative recovery".

DR. GABRIEL N. ZOZAYA LAREQUI
SPECIALIST. GENERAL AND DIGESTIVE SURGERY DEPARTMENT

Colectomy is the surgical removal or resection of a diseased part of the large intestine or colon.

The surgery is intended to remove:

  • The tumor, with sufficiently wide margins
  • The main arterial and venous vessels that nourish the intestinal segment in which the tumor is located
  • Regional lymph nodes

The resection can be performed by conventional means or by laparoscopic surgery, with a smaller incision and a faster post-operative period.

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When is colectomy indicated?

This surgery is recommended as a treatment for various pathological processes.

Among them, the most common are cancer, diverticulitis, intestinal obstruction, ulcerative disease such as ulcerative colitis that does not respond to treatment, etc.

Most frequent indications:

Do you have any of these diseases?

You may need to have a colectomy

How is a colectomy performed?

Right hemicolectomy
If the tumor is located in the cecum or in the ascending colon, a right hemicolectomy is performed.

This consists of the removal of 10-15 cm of terminal ileum to the proximal third of the transverse colon, including the corresponding blood vessels and lymph nodes. To restore intestinal transit, an ileocolic anastomosis is performed with manual or mechanical suture.

Left hemicolectomy
If the tumor is located in the descending colon or sigma, a left hemicolectomy is performed.

This consists of the removal of the descending colon and sigma to the rectosigmoid junction, including the inferior mesenteric artery and vein. The anastomosis can be performed manually or mechanically.

Usually, it is done mechanically by means of a stapler that, from the anus, reaches the area of the colon section and crimps with a head that is introduced in the other end of the colon.

Segmental colectomies
For tumors located in the transverse colon or splenic angle, it is possible to perform less extensive resections, but always with adequate margins and removing the main vascular pedicle.

Regarding the post-operative period, most patients remain in the hospital for five to seven days, while complete recovery from surgery can take one to two months.

This recovery time is generally shorter when the resection of the intestine is performed using the laparoscopic technique as opposed to traditional open surgery.

During the first days after surgery, food is restricted. The patient will then start with a liquid diet first and then a soft diet.

It should be noted that by removing all or part of the colon, bowel habits may be modified and a tendency to diarrhea may appear. On other occasions, constipation occurs.

After removal, if it is necessary to free the bowel from its normal digestive work while it recovers, a temporary opening of the colon into the abdominal wall, called a colostomy, can be created.

It is performed by passing the proximal end of the colon through this wall, to whose skin it is sutured. An adhesive drainage bag, or stoma device, is then attached to the skin and placed around the opening.

In most cases, depending on the disease being treated, colostomies are temporary and can be closed with subsequent surgery.

However, when a large part of the intestine is removed or there are difficulties in joining the intestine, the colostomy may be permanent.

Where do we do it?

IN NAVARRA AND MADRID

The Department of General Surgery
of the Clínica Universidad de Navarra

The Department of General and Digestive Surgery is made up of specialists dedicated to the surgical treatment of endocrine, breast, gastrointestinal, hepatobiliary, pancreatic, colorectal and abdominal wall diseases, with special dedication to oncological surgery.

The application of laparoscopic surgery in the interventions reduces the hospital stay, the post-operative discomfort and shortens the patient's recovery.

We have a great experience in laparoscopic colorectal surgery, of the adrenal gland, liver and pancreas, as well as in obesity surgery.

Treatments we perform

  • Colorectal surgery.
  • Breast surgery.
  • Surgery of the hemorrhoids.
  • Pelvic floor surgery.
  • Endocrine and obesity surgery.
  • Esophageal and gastrointestinal surgery.
  • Hepatobiliary and pancreatic surgery.
  • Abdominal wall surgery.
  • Liver transplant.
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Why at the Clinica?

  • Center of Excellence in Obesity Surgery by the International Federation for Bariatric Surgery.
  • 90% survival rate in liver transplants.
  • We are the private hospital with the largest technological equipment.

Our team of professionals

Specialists in General Surgery with experience in performing colectomies