Home > Blog, Cancer Update > Hemicolectomy – Instructions on how to do one.

Hemicolectomy – Instructions on how to do one.

In case you wondered what a hemicolectomy was, i thought i would enlighten you. 🙂

Firstly, it helps to know what exactly the colon is, and where it lies. The colon is the large part of the bowel, the final 5 – 6 feet of bowel that food travels through before it is excreted. The bowels primary function is to absorb fluid from its contents prior to excretion. Theoretically, all the digestion and absorption of nutrients have been done in the small intestine prior to the bowel. Figure 1 demonstrates the basic layout of the colon or large intestine. It omits the surrounding organs in order to get a clear view of the colon.

Fig. 1. Colon as it lies in the body (Courtesty of UpToDate Online)

Fig. 1. Colon as it lies in the body (Courtesy of UpToDate Online)

Note the Hepatic Flexure labeled in the diagram, this is where adenocarcinoma was located in myself. In my case, a right hemicolectomy was performed… so what is one? Essentially, its the removal of a section of colon that can be divided into three broad categories, Left Hemicolectomy, Right Hemicolectomy (what i had) and a sigmoid colectomy. Each term refers to the section of colon that is the excised. There are other types of colectomy that can be performed, but for the sake of simplification it helps to think in terms of these three categories. Figures 2 – 4 demonstrate which parts of the colon are removed for each procedure.

Right Hemicolectomy

Fig. 2. Right Hemicolectomy

Fig. 3. Sigmoid Colectomy

Fig. 3. Sigmoid Colectomy

Fig. 4. Left Hemicolectomy

Fig. 4. Left Hemicolectomy

In my situation, a right hemicolectomy was performed, because the location of the tumour, in the hepatic flexure, is in the region of the of the right ascending colon. The reason they remove that entire section, rather than just the section that contains the tumour is due to blood supply. Blood is supplied to the colon by the superior and inferior mesenteric arteries, which branch off the Aorta. These arteries then branch into smaller arteries, each supplying a segment of the colon. Often, a resection will be based on what parts of the colon are supplied by each of these arteries in order to prevent bleeding, and also to make the life the surgeon easier. It is easier to occlude one or two arteries upstream than to try to occlude many smaller arteries individually down stream. Think of it like a river than divides into many tributaries. Figure 5 shows a basic layout of mesenteric arteries.

Fig. 4. Blood supply to the colon

Fig. 4. Blood supply to the colon

The John Hopkins Colon Cancer Centre provides a good summary of how different resections work with the blood supplies and the location of the lesion to be removed.

Finally, comes the anastamosis of the now two ends of bowel after the resection. There are number of techniques in which anastomoses can be done, the specific one that was performed on me remains a mystery. But suffice it to say, the distal ilium and my transverse colon are joined and functioning well. 🙂

That is a VERY simplified version on what a hemicolectomy is.

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  1. Jared
    January 29, 2009 at 11:25 am

    By the way, i have linked to all the pages that i stole images from so that its clear i didn’t come up with them myself 🙂

  2. Nigel
    January 29, 2009 at 1:46 pm

    You have always had a real gift for explaining complicated procedures and concepts in ways a lay person can understand. Good stuff bro.

  3. Peter Yeates
    July 4, 2009 at 7:45 pm

    Having had a left-hemi colectomy I am much interested in other’s experiences of the same condition, and I thank you for explaining it all to me. I found this page so interesting and want to know how you are now ?
    Cornelius Ryan the Canadian author of “Bridge Too Far” and other books wrote a book on his, I beleive, prostrate cancer and his journey until his passing away of this final battle with Cancer. That always interested and inspired me, thus I want to be informed as much as possible about my possibilities of survival and to seek others experiences with the same condition. I have after one month many pain twinges, aches, stabbing pains, and pain problems throughout my tummy and lower rectum area.My appetite is very good. My bowel movements are fine. I take few painkillers now, some tramadol at night, one table gets me to sleep. Movement without pain and discomfort inmcreaesy day. I do want to know what others have experienmced.So I imagine what the future holds for me as I struggle to come to terms with having cancer, and how this major operation affects others and their experiences further down the recovery time.
    I was subject to what they call Enhanced Recovery program which meant that I was out of bed and dressed within a day of the Operation and walking within two days. I am intriqued to know whether pushing oneself now into physical training program will furhter enhance my recovery. I am 72 years old, with a busy life involved in organising veterans affairs.
    Peter Yeates

  4. Dyana Parore-Connell
    October 28, 2011 at 8:41 pm

    Thanks for the information on sigmoid Colectomy. Very much appreciated I had a right hemiocolectomy done 21years ago.

  1. January 4, 2011 at 5:30 pm

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