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Total colectomy

A total colectomy is an operation to remove the colon but not the rectum. This is often carried out using laparoscopic or keyhole surgery, but open surgery is also an option in some cases. Recovery times are usually shorter with keyhole surgery and there is less scarring. The procedure is done under general anaesthetic.

Total colectomy is used to treat conditions including:

  • Inflammatory conditions of the intestine, such as Crohn's disease and ulcerative colitis.
  • Familial polyposis - an inherited condition with many polyps forming inside the large intestine.

One main incision is made in the abdomen for the laparoscope and additional incisions will be made for other surgical instruments to be passed through.

Images from the laparoscope camera can be seen on monitors by the surgeon.

The colon is a large organ (about 1.5 metres long) stretching from the small intestine (ileum) to the rectum.

The large intestine is divided into four main sections:

  • Ascending (right)
  • Transverse
  • Descending (left)
  • Sigmoid colon attached to the rectum.

The parts of the colon are freed in sections beginning with the rectum and sigmoid colon, and finishing with the ascending (right) colon.

Blood vessels (arteries) supplying blood to the colon are cut and closed off during the operation.

Once the whole of the large intestine is freed, the surgeon will identify where to join the ileum to the rectum, called an anastomosis.

In some cases, a stoma waste tube will need to be created as part of the operation.

Aftercare instructions will be given before leaving hospital, including when to resume usual activities, and what to do in the event of problems or concerns. A follow-up appointment will also be made.

Complications of this procedure include infections, temporary stoppage in bowel movements, leaking from the bowel, damaged bowel, bladder damage and damage to nearby nerves.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on September 19, 2016

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