Description

Right hemicolectomy is a surgical procedure that involves the removal of the right side of the colon (the ascending colon), some portion of transverse colon and the terminal ileum, along with associated lymph nodes and blood vessels. This procedure is performed for various medical conditions, primarily colorectal cancer, and sometimes for certain cases of inflammatory bowel disease (IBD) or diverticulitis. Below 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 in the lower right quadrant, 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 right colon, including the ileocolic artery and vein, are identified, ligated (tied off), and divided.
4. Resection: The affected portion of the colon, along with the terminal ileum, is resected (removed).
5. Anastomosis: The remaining healthy portions of the colon and the ileum 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:

Right hemicolectomy is indicated for several medical conditions, including:

1. Colorectal Cancer: It is one of the primary surgical treatments for cancer located in the ascending colon or cecum.
2. Crohn’s Disease: In cases of severe Crohn’s disease affecting the right colon or ileum, surgical resection may be necessary to remove diseased portions.
3. Diverticulitis: For complications of diverticulitis, such as abscesses or perforation, surgery may involve right hemicolectomy to remove affected segments.

Surgeons should be proficient in right hemicolectomy as it is a vital procedure for treating various conditions, including colorectal cancer, which is one of the leading causes of cancer-related deaths worldwide. Mastery of this surgical skill allows surgeons to remove cancerous or diseased portions of the colon and restore digestive function, improving the patient’s quality of life and long-term outcomes.