The large intestine, or colon, is the lower part of the digestive tract. Diseases of the colon are very common, and more than one-half million surgical procedures are performed in the United States every year to treat them. Indications for colon resections include:

Colon cancer
Diverticular disease
Gastrointestinal bleeding
Inflammatory bowel disease, such as Ulcerative Colitis and Crohn's Disease
Intestinal polyps
Large bowel obstruction
Trauma
Bowel Rupture

Open and Laparoscopic Colon Resections

There are two types of colon resection or colectomy: open surgery and laparoscopic. The appropriateness of the procedure depends on the diagnosis and the individual patient�s anatomy. For example, and extremely obese patient or a patient who has a great deal of abdominal adhesions would make a poor candidate for laparoscopic colectomy.

Open colon surgery is typically accomplished via a laparotomy (a type of abdominal incision). This has been the "traditional" type of colon surgery performed. However, laparoscopic colon surgery is growing in popularity and is becoming more and more common.

In laparoscopic-assisted colectomy, instead of 1 long incision in the abdomen, the surgeon makes several small ones. Special long instruments are put into these small openings and used to remove part of the colon and sometimes lymph nodes (such as in surgery for colon cancer). Patients usually recover faster from laparoscopic colectomies than they do after open colectomy operations.

During a colon resection, the diseased part of the bowel is removed and the two healthy sections of the colon are reattached. This is called an end-to-end anastomosis. If an anastomosis is not possible because of the extent of the disease or its location, the surgeon creates a colostomy. A temporary colostomy is made when the colon needs longer to heal after surgery and the anastomosis is performed later. Temporary colostomies are most common in emergency surgeries, because they are safer for the patient.

Types of Colectomies

-Right hemicolectomy and left hemicolectomy refer to the resection of the ascending (right) colon and the descending (left) colon. When part of the transverse colon is also resected, it may be referred to as an extended hemicolectomy

-Transverse colectomy is also possible, though uncommon. It involves the resection of the transverse colon, which runs crosswise across the pelvis.

-Sigmoidectomy is a resection of the sigmoid colon, sometimes including part or all of the rectum. When a sigmoidectomy is followed by terminal colostomy and closure of the rectal stump, it is called a

-Hartmann's operation is a sigmoidectomy followed by terminal colostomy and closure of the rectal stump. This is usually done out of impossibility to perform a "double-barrel" or Mikulicz colostomy, which is preferred because it makes "takedown" (reoperation to restore normal intestinal continuity by means of an anastomosis) considerably easier.

-Total colectomy involves the removal of the entire colon is removed. If the rectum is also removed, it is a total proctocolectomy.

-Subtotal colectomy is resection of part of the colon or a resection of all of the colon without complete resection of the rectum.