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Open Colectomy Surgery Description

An open colectomy is a surgical procedure to remove all or part of the colon through a lengthy incision in the abdominal wall. The colon makes up the biggest portion of the large intestine and connects the cecum to the rectum. The colon extracts moisture from the food residue that passes through on its way to excretion. "Open" refers to the large size of the incision through which the procedure is conducted; partial and complete colectomies are also performed laparoscopically through multiple small incisions.

  1. Reasons for Surgery

    • The removal of a portion or all of the colon may be indicated in the treatment of a variety of conditions, according to the Health Library website of the UT Medical Group. These include inflammatory bowel disease, including Crohn's disease and ulcerative colitis; colorectal cancer; diverticular disease; bowel obstruction; perforation of the colon; bleeding of the colon; and intestinal trauma.

    Preoperative Preparations

    • If you are to undergo an open colectomy, there are a number of important preparatory steps that your doctor will order, according to Kaiser Permanente's Patient Handbook for Colectomy. These may include: stopping all blood-thinning medications, including aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), as much as two weeks prior to the procedure; following a special diet; drinking large quantities of water; taking a bowel-cleansing preparation the day before surgery; and stopping all food and drink a specific number of hours before surgery is scheduled.

    Anesthesia

    • On the day your surgery is scheduled, you will check into the hospital at the appointed hour and be prepped for the procedure, which will be performed under general anesthesia. An intravenous line will be started to allow the anesthetist and/or surgeon to administer whatever medications may be indicated.

    Surgical Procedure

    • In an open colectomy, according to MedlinePlus, the surgeon will make a single incision of roughly six inches in length in the abdominal wall to give the surgical team easy access to the colon. If this is to be a partial colectomy, the affected portions of the colon will be excised, after which the surgeon will stitch together the open ends of the large intestine. If the entire colon is to be removed, the surgeon will make new provisions for the excretion of waste. This is done through either a colostomy or ileostomy. In both procedures, a small incision called a stoma is created in the abdominal wall, through which the open end of the remaining intestine is drawn and then stitched to the skin. Waste will then pass through this opening into an ostomy bag outside the body.

    Postoperative Outlook

    • Your post-surgery recovery time in the hospital will depend on the amount of the intestine that was removed and should average between three and seven days, barring unforeseen complications, according to MedlinePlus. Even with a large bowel resection, most patients recover completely from the surgery and are eventually able to return to normal activity.

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