Right hemicolectomy

A right hemicolectomy operation removes the right-hand part of the colon. This is approximately half the colon. This will include the caecum, ascending colon, and part of the transverse colon. It is necessary to remove this much because of the way the blood supply supports the colon, rather than because the disease has spread.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What is the colon?

The colon refers to the large intestine or bowel. It forms the lowest part of the digestive system after the small bowel, and it ends with the rectum and the anus.

What happens during a laparoscopic / robotic (keyhole) operation?

Laparoscopic surgery is also known as ‘keyhole’ surgery. It allows the surgeon to carry out operations through three or four small (1cm) cuts in the abdomen. The surgeon places a telescope camera into one of these small cuts. The camera shows an enlarged image (picture) of the abdominal organs on a television screen.

The surgeon then uses the other cuts to insert the special instruments needed to carry out the surgery. In some cases, the surgeon can make one of the cuts longer (8 to 10cm). This allows the surgeon to remove a bowel specimen (sample).

Sometimes it is not possible or safe to finish the operation by laparoscopic surgery. If this happens your surgeon will change to an ‘open’ operation. Open surgery involves one large incision (cut).

Will I have any tests before my surgery?

You will have investigations and tests to prepare you for your operation. These are to:

• confirm your diagnosis

• see how far the disease has spread

• assess how fit and well you are for the proposed treatment

Will I need to have a stoma (bowel bag)?

It is very unlikely that you will need a stoma. However, sometimes it is not possible to join the bowel back together during surgery. If this happens, the surgeon will bring the end of the bowel out onto the abdomen (tummy). This forms an opening outside the body, known as a stoma. The surgeon will fit a stoma bag around this opening, to collect bowel contents.

The stoma may be permanent or temporary.

If you need a stoma or it is possible that you may need a stoma, you will discuss this with a stoma nurse. These nurses are skilled in caring for patients who have a stoma. They will answer any questions you may have.

Are there complications with this operation?

The risks of having this operation are small, and are much less likely to affect you than the risk of doing nothing. However, this is a major operation and some people (less than 1 in 20) do not survive the surgery.

There are sometimes complications. These may include:

• bleeding

• infection

• a leak from the anastomosis (the join where the surgeon joins the bowel back together)

• injury to other abdominal organs (for example, the small intestine, ureter, or bladder)

• deep vein thrombosis (blood clots in the veins in the legs)

• pulmonary embolisms (blood clots in the lungs)

if you have any concerns about the above risks, please speak to your surgeon.

What should I expect after surgery?

For the first 24 to 48 hours after surgery you will need the following.

• Oxygen through a face mask.

• Intravenous (IV) fluid using a cannula (drip) into a vein in one of your arms.

• A catheter in your bladder to drain urine.

• Medication to deal with mild pain. This may be given as an epidural or through the drip. An epidural is where the medicine is given through a fine tube in your back.

Over the next few days you will need to:

• start eating a modified diet, starting with liquids, gradually followed by solid foods

• move round as soon as possible

After laparoscopic surgery, most patients recover more quickly and go home sooner.

When you first start going to the toilet again, your faeces (poo) will be liquid. Sometimes it takes several weeks to get back to normal. You may need to make changes to your diet.

How long will I need to be in hospital?

You will stay in hospital for as little time as necessary, usually between 3 and 7 days. Your surgeon or specialist nurse will discuss with you daily achievements, which you should try to meet. This programme is called ‘enhanced recovery after surgery’ (ERAS).

After you leave hospital, you may have new concerns or problems. For example, you may have severe abdominal pain, a raised temperature, or bleeding. If so, please contact your GP or the hospital. We will give you the hospital's contact numbers before you go home after your surgery.

This leaflet is produced with grateful acknowledgement to The Association of Coloproctology of Great Britain and Ireland (ACPGBI).

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

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