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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Operative

Right / Left Hemicolectomy

Removal of the right or left portion of the colon and reconnection of the healthy ends — most often for colon cancer, large polyps, or diverticulitis.

Request a consultationSurgery is arranged with a coordinator by phone.
Setting
Operative
Anesthesia
General anesthesia, in the operating room
Back to work
2-4 weeks
Success rate
Greater than 95%
Recurrence
5-15% (for cancer)

What it is

What is a Hemicolectomy?

A hemicolectomy is the surgical removal of a portion of the colon (large intestine). A right hemicolectomy involves removal of the cecum, ascending colon, and the hepatic flexure, followed by an anastomosis between the terminal ileum and the transverse colon. A left hemicolectomy involves removal of the descending colon and sometimes the splenic flexure, followed by an anastomosis between the transverse colon and the sigmoid colon or rectum. These procedures are most commonly performed for colon cancer, but also for other conditions such as large polyps, diverticulitis, or inflammatory bowel disease.

Am I a candidate?

Who is a Good Candidate for a Hemicolectomy?

Ideal candidates are patients with diseases localized to a specific segment of the colon that require surgical removal. This includes:

  • Colon Cancer: Patients with adenocarcinoma of the ascending colon (right hemicolectomy) or descending colon (left hemicolectomy).
  • Large Polyps: Patients with large, benign polyps that cannot be safely removed endoscopically.
  • Diverticulitis: Patients with complicated or recurrent diverticulitis, most commonly affecting the left colon.
  • Inflammatory Bowel Disease: Patients with Crohn's disease or ulcerative colitis with disease limited to a resectable segment.

How it's done

  1. 1Under general anesthesia, usually through small keyhole (laparoscopic or robotic) incisions.
  2. 2The diseased portion of the colon is removed — the right side for right-sided disease, the left side for left-sided disease — along with its lymph nodes when cancer is the reason.
  3. 3The two healthy ends of bowel are reconnected (an anastomosis), and the connection is checked during surgery.
  4. 4A short hospital stay follows to make sure the bowel wakes up and you can eat and move.

What to expect

  1. Days 1–3

    In hospital — walking early, gradually returning to eating.

  2. Home

    Usually within a few days, depending on how the bowel recovers.

  3. 2–4 weeks

    Most people return to light activity and work.

  4. About 6 weeks

    Heavy lifting can usually resume. Some change in bowel habit is common early on and usually settles.

Risks & considerations

What are the Risks?

A hemicolectomy is a major abdominal operation with potential risks, including:

  • Anastomotic Leak: The new connection between the bowel segments can leak, leading to a serious intra-abdominal infection that may require further surgery and a stoma.
  • Bleeding: Intra-abdominal bleeding can occur, sometimes requiring blood transfusions or reoperation.
  • Infection: Surgical site infections, including wound infections and intra-abdominal abscesses, are possible.
  • Injury to Adjacent Structures: The ureters, duodenum (during a right hemicolectomy), or spleen (during a left hemicolectomy) can be injured during the dissection.
  • Postoperative Ileus: A temporary paralysis of the bowel is common after surgery, but a prolonged ileus may require a nasogastric tube and bowel rest.

The risks that matter

Every operation carries a long list of possible complications. These are the ones that are serious enough — and common enough — to understand in real numbers before you decide.

Anastomotic leak

observational

Where the two ends of bowel that were reconnected don't fully seal, letting intestinal contents escape into the abdomen.

about 1–3% for right-sided (ileocolic) connections in most series — one large international audit found about 7% — and about 6–12% for left-sided connections, which sit closer to the rectum— from roughly 1 in every 30 to 100 operations on the right side to about 1 in every 8 to 15 on the left
Why it happens
The new connection has to heal in a demanding environment, and even in expert hands a small fraction won't seal fully. Connections closer to the rectum have a more delicate blood supply, which is why left-sided joins leak more often than right-sided ones. It is a recognized complication of the operation itself — not a sign that anything was done carelessly.
If it happens
It's watched for closely afterward with exams, blood tests, and a CT scan if there's any concern. If it happens, treatment ranges from antibiotics and a drain to a return to the operating room and, sometimes, a temporary stoma to let the bowel rest and heal.
How we lower the odds
The odds are reduced by building a tension-free, well-perfused connection, testing it during surgery, optimizing your health beforehand (nutrition, blood sugar, stopping smoking), and monitoring closely in recovery.

Lowering the odds is not the same as removing them. Even when everything is done right, this can still happen — that is the nature of the operation, not a failure of your care.

Source: Stamos MJ, Brady MT, Annals of Laparoscopic and Endoscopic Surgery (2018); European Society of Coloproctology international snapshot audit — 2,444 anastomoses after right colectomy for cancer (Diseases of the Colon & Rectum, 2020).

Sources

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