Colectomy is surgical resection of any extent of the large intestine (colon).

• Colon cancer
• Diverticulitis and diverticular disease of the large intestine
• Trauma
• IBD (inflammatory bowel disease), e.g.
  • uclerative colitis → neither cures nor eliminates Crohn's, but removes part of the diseased large intestine only 
  • Crohn's disease → cure for ulcerative collitis because the disease attacks only the large intestine, and won't flare up if the entire large intestine (cecum,a scending colon, transverse colon, descending colon, sigmoid colon) and rectum are removed
• Prophylactic colectomy → for some forms of polyposis, Lynch syndrome, and certain cases of IBD because of high risk for developing colorectal cancer
• Bowel infarction
• Typhlitis (i.e. inflammation of the cecum, part of the large intestine)

• Incision by either:
  • Laparotomy (abdominal incision), traditionally
  • Laparoscopy (minimally invasive) is growing in both indications and popularity
• Resection of any part of the colon entails mobilizationa nd ligation of the corresponding blood vessels
• Lymphadenectomy is usually performed through excision of the fatty tissue adjacent to these vessels (mesocolon), in operations for colon acncer
• When the resection is complete, the surgeon can immediately restore the bowel, by:
  • Stitching or stapling together both the cut ends (primary anastomosis), which carries the risk of dehiscence (breakdown of stitches), which can cause contamination of the peritoneal cavity, peritonitis, sepsis and death
  • Creating a colostomy (i.e. alternative channel for feces to leave the body), which is safer, but place a societal, psychological and physical burden on the Pt

• Right and Left hemicolectomy, which refer to resection of the ascending colon (right) and descending colon (left) respectively. Extended hemicolectomy is when part of the transverse colon is also resected
• Transverse colectomy alone is possible, but uncommon
• Sigmoidectomy is resection of the sigmoid colon. Hartmann operation (aka proctosigmoidectomy) is when it includes part or all of the rectum, i.e. when sigmoidectomy is followed by terminal colostomy and closure of the rectal stump. Hartmann is usually performed when a double barrel (aka Mikulicz) colostomy is impossible, which is preferred because the reoperation to restore normal intestinal continuity by means of an anastomosis is considerably easier
• Total colectomy (aka Lane's operation) is when the entire colon is removed. Total proctocolectomy is if the rectum is also removed [in conjunction with the entire large intestine]
• Subtotal colectomy is resection of part of the colon or resection of all of the colon without complete resection of the rectum

• 40% of colon resections in the USA are performed via laparoscopy (i.e. minimally invasive)

• Colostomy