Colectomy is the surgical removal of all or part of the colon and is performed for any of the following reasons.

• To remove large Stage I colon cancer lesions
• To cure colon cancer
• To treat diverticulitis, ulcerative colitis and benign colon polyps

Colectomy is the preferred therapy for colon cancers that can be cured. This is done under general anesthesia and involves removing the cancerous part of the colon, a margin of normal bowel and any tissue or lymph nodes affected by the disease and reconnecting the healthy segments of the colon (anastomosis). If infection or obstruction make it impossible to reconnect the colon, the surgeon creates an opening (stoma) in the abdominal wall (colostomy) through which feces passes from the body into a disposable collection bag.

Colostomy may be:

Temporary, with the ends of the intestines being reconnected at a later time, orpermanent in patients whose cancer cannot be completely removed. Laparoscopic colectomy requires only a few small incisions, enables doctors to view the internal organs and results in a shorter hospital stay and fewer side effects.

Types of Colectomy

Left Radical Hemicolectomy

Doctors perform left radical Hemicolectomy to remove cancer and other abnormal tissue in the:

• Descending colon, which extends from the pelvis to the spleen
• Splenic flexure, the place where the descending colon joins the part of the large intestine that extends across the middle of the abdomen (transverse colon)

When cancer is found in the splenic flexure, the surgeon removes the splenic flexure, the first half of the descending colon and about one-third of the transverse colon.

Right Radical Hemicolectomy

Doctors perform this procedure to remove tumors and other abnormalities of the:

• Section of large intestine nearest the appendix
• Portion of the large intestine that extends along the right side of the body from the small intestine to the transverse colon (ascending colon)

This procedure involves removing the cecum, descending colon, the hepatic flexure where the ascending colon joins the transverse colon and the first one-third of the transverse colon. These procedures are considered radical because they involve removing nerves, blood vessels and lymph nodes near the tumor.

Transverse Colectomy

Performed to remove disease in the transverse colon, this procedure includes removing the transverse colon and hepatic and splenic flexures.

Sigmoid Resection

Used to remove cancer in the part of the colon between the descending colon and rectum, this procedure involves removing the sigmoid colon bottom two-thirds of the descending colon

Rectosigmoid Resection

Used to remove tumors in the part of the colon (rectosigmoid) just above the rectum (sigmoid flexure) and this procedure removes the sigmoid colon most of the rectum and surrounding rectal tissue (mesorectum). Because tumors in this part of the colon usually involve the bladder, uterus, or other organs, the surgeon may insert drainage tubes or a catheter to draw urine from the bladder.

Abdominoperineal Resection (APR)

This extensive procedure, which may be performed in two parts or by two surgical teams operating at the same time, involves removing the:

• Lower sigmoid colon
• Rectum
• Anus
• Nearby lymph nodes, blood vessels and nerves

Sphincter-saving APR is designed to minimize loss of bowel control by removing only the tumor and preserving nerves and blood vessels near the tumor.

After completing any of these procedures, the ends of blood vessels are tied before closing the incision.

A patient who has had an open colectomy will spend at least a week in the hospital and experience significant postoperative pain.

A patient who has had a laparoscopic colectomy will spend 4–5 days in the hospital, experience less pain and resume normal activities within two weeks.

Side effects of colectomy include bladder complications, diarrhea, bowel irregularities, urinary urgency and sexual dysfunction.

The other Gastro procedures are:

• Colonic Gastric Polypectomy
• Laparoscopic Duodenal Closure
• Treatment for Liver Cysts … etc

Few Major Hospitals for Laparoscopy Assisted Hemicolectomy are:

• Wockhardt Hospitals
• Apollo Hospitals
• Max Healthcare
• Piyavate Hospital
• Florence Nightingale Hospital

Thailand, Malaysia, Singapore, Turkey and India are the most cost effective locations that offer up to almost 80% savings in comparison to the US.

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