Laparoscopic removal of the right side of the colon (Laparoscopic right hemicolectomy)

The right side of our colon is the approximately 30-40 cm section of the intestine from the cecum to the middle of the transverse colon (colon transversum).

Due to inflammatory, benign and malignant tumours of the colon, it may be necessary to partially or, in rare cases, completely remove it.

Laparoscopic right hemicolectomy is the complete removal of the right side of the colon. During laparoscopic surgery, the abdominal cavity is filled with CO2 gas, then 3-4 pcs of 5-12 mm incisions are made, where the camera and other instruments required for the surgery are introduced. Using special instruments, the affected intestinal segment and its associated lymph nodes are removed, the arteries and veins supplying the intestine are blocked, and then the intestine is raised to the level of the abdominal wall and removed through a small incision. The restoration of intestinal continuity is performed with a special intestinal suture machine or manual sutures.

Benign tumours or large polyps

Benign polyps are common in the colon, and their incidence increases after the age of 45.

It is recommended to remove all polyps, as they can continue to grow, and some of them may turn into malignant tumours.

Most polyps can be removed during a colonoscopy, but if this is not possible due to size or location, surgery is required.

Polyps located on the right side of the colon are more difficult to reach during a colonoscopy, therefore surgery is required more often.

Appendix tumours

The first section of the large intestine is the cecum and is connected to the vermiform appendix (appendix vermiformis).

Some rare tumours of the vermiform appendix require the removal of the right side of the colon.

Diverticulosis/diverticulitis

During diverticulosis, glove-like protrusions form on the intestinal wall, which can be considered as degenaration of the intestinal wall. It rarely occurs on the right side of the colon.

The advantages of laparoscopic surgery over open surgery:

• less surgical strain, pain
• shorter hospital stay and recovery period
• better cosmetic result
• faster onset of bowel function, earlier return to solid nutrition
• oncological radicality is the same as open surgery
• fewer postoperative adhesions

All procedures, including the removal of the right half of the colon, may carry risks, including:

• bleeding, intra-abdominal hematoma, vascular injury
• separation of intestinal sutures, infection of the abdominal wall wound
• formation of a fistula
• injury to other abdominal organs
• deep vein thrombosis

Colon surgeries may require complete emptying of the colon and rectum, therefore your surgeon may ask you to follow a liquid diet for a few days prior to surgery, and you may also need to take a stool softener/laxative before surgery. Your operating physician will provide you with detailed advice on this.

You can drink fluids a few hours after surgery, eat a few bites of crackers, and get out of bed. You can usually follow a normal diet the day after surgery. At this time, we also try to have you spend as much time out of bed as possible, walking.

We most often use absorbable sutures, and there is no need to remove them.

After surgery, it usually takes 2-3 days for bowel function to start. To avoid pain caused by constipation, it is recommended to drink plenty of fluids, eat vegetables, fruits, and foods rich in fibre. During your stay in the hospital, you can discuss the recommended diet in detail with our institution’s dietician.

Avoid heavy physical work, lifting weights, and intense sports activities in the first 6 weeks. Returning to work depends on the type of work and the extent of the surgery. In the case of laparoscopic surgery, you can expect to return to work within 1-2 weeks.