Removal of diseased part of the colon is referred to as hemi colectomy. Left hemi colectomy describes the procedure to remove the left side of the colon. Hemi colectomy is usually conducted when there are symptoms of colon cancer. The colon are categorized as three parts namely ascending colon (right side), transverse side and descending side( left side). In left hemi colectomy the left side of the colon that is the descending colon and small portion of small intestine along with the connected blood vessels and lymph nodes are removed. This is to prevent the spread of disease to other parts of the colon.
The major reasons to have a hemi colectomy surgery is the presence of cancer or tumor cells in the colon. The left hemi colectomy surgery can be performed in open or laparoscopic methods depending on many factors of the patient including the patient medical history and mediations. Other medical conditions that leads to hemi colectomy include Crohn’s disease, perforation, bleeding, carcinoid of the left colon etc.
In left hemi colectomy surgery, the surgeon removes the left side of the colon and the last portion of the small intestine including the blood vessels and the lymph’s nodes from the affected area. Then a joint is made using staples or sutures between the remaining part of the colon and the small intestine. This method is referred to as anastomosis. Normally the surgery lasts for around 2 hours.
In rare cases, after the removal of the left colon and portions of the intestine, it will be difficult to join the two new ends. In such cases the last portion of the intestine is turned around outwards and forms a stoma and gets attached to the abdominal wall. The stoma is temporary or permanent depending in the requirement of the patient. Now the feces are collected through the stoma to the external pouch attached.
In open left hemi colectomy, the major portion of the intestinal organs that are removed include the cecum, descending colon and a portion of ileum and all the blood vessels and lymph nodes that are surrounding the area. In open hemi colectomy a large incision is made in the abdomen and the organs are removed and abdominal walls are stitched and closed. In laparoscopic left hemi colectomy, the surgeon makes 3-4 small incision in the abdomen. First a laparoscope (a tube with a camera attached to its end) is inserted to view the internal cavity from the screen. Then surgical instruments are inserted through other incision and the affected organs are removed, stitched and closed. The main advantage of laparoscopic hemi colectomy is that the patients need to stay very few days in the hospital and experience less pain compared to open surgery. In some cases during laparoscopic surgery, if the surgeon finds it difficult to remove the organ, then the surgery will be converted to open surgery depending on many factors that aids in the smooth completion of the surgery.
After the surgery patients are provided with meditation to relieve the pain and discomfort. Ice chips are provided first followed by liquid food and the bowel movements are inspected to avoid any complications.