Description

Left hemicolectomy is a surgical procedure that involves the removal of the left side of the colon, which includes the descending colon and often a portion of the sigmoid colon. This surgery is performed for various medical conditions, primarily colorectal cancer and sometimes for diverticular disease. Here are the steps, indications, and a brief note on the importance of this surgical skill:

Steps:

1. Incision: The surgeon makes an abdominal incision, typically on the left side, to access the colon.
2. Mobilization: The surgeon carefully mobilizes the colon, isolating it from surrounding structures.
3. Identification and Ligation of Blood Vessels: Blood vessels supplying the left colon, including the inferior mesenteric artery and vein, are identified, ligated (tied off), and divided.
4. Resection: The affected portion of the colon is resected (removed), typically including the descending colon and part of the sigmoid colon.
5. Anastomosis: The remaining healthy portions of the colon are then reconnected (anastomosed) to restore intestinal continuity. This can be done using staples or sutures, depending on the surgeon’s preference and the patient’s condition.
6. Lymph Node Dissection: Lymph nodes in the region are often removed and examined for cancer spread.
7. Closure: The incisions are carefully closed, and the surgical site is assessed for any bleeding or leaks.

Indications:

Left hemicolectomy is indicated for various medical conditions, including:

1. Colorectal Cancer: It is a primary surgical treatment for cancer located in the descending colon or sigmoid colon.
2. Diverticular Disease: In cases of severe diverticulitis or complications such as abscesses or perforation, surgery may involve left hemicolectomy to remove affected segments.

Surgeons should be proficient in left hemicolectomy as it is a critical procedure for treating conditions like colorectal cancer and diverticular disease, which can significantly impact a patient’s health and quality of life. Mastery of this surgical skill enables surgeons to effectively remove disease or cancer-affected segments of the colon and restore normal digestive function, leading to improved patient outcomes and overall well-being.