Colectomy Surgery in Ankara, Turkey

Colectomy is the surgical removal of all or part of the colon. It is generally performed in cases such as colon cancer, diverticulitis, inflammatory bowel diseases, or polyps. Surgery aims to remove diseased tissue and maintain healthy bowel function.

In partial colectomy operations, only the diseased section is removed, and the remaining bowel segments are reconnected. In total colectomy, the entire colon is removed and the small intestine is connected directly to the rectum. Both techniques are selected according to the indication and the patient’s general condition.

Laparoscopic colectomy is performed with smaller incisions compared to open surgery and shortens patients’ recovery time. While this method reduces the rate of postoperative complications, it also allows for a shorter hospital stay.

Post-colectomy patient management is important in terms of dietary regulation, infection control, and monitoring bowel functions. Possible postoperative complications and the need for a stoma should be closely monitored with patient education and regular medical follow-ups.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Colectomy Surgery in Ankara, to get information about Colectomy Surgery prices, the process, and the hospital where Colectomy Surgery is performed.

What is colectomy surgery?

Colectomy, in its simplest definition, is the surgical removal of the large intestine. The large intestine is a vital organ in our body that maintains water and mineral balance, shapes and stores digestive waste. This surgery is performed when part or all of this organ loses its function due to various diseases or begins to harm the body. However, this procedure is not merely a simple act of “cutting and removing.”

The scope of this surgical procedure varies greatly depending on the location and severity of the disease. As surgeons, our goal is not only to remove diseased tissue from the body but also to ensure the continuity of the digestive system and keep the patient’s postoperative comfort at the highest level. During surgery, not only intestinal tissue but also the vessels supplying that region and the lymph nodes accompanying the intestine are removed as a whole. This approach is vital especially in cancer surgery to prevent the disease from recurring.

The scope of the operation may include:

• Ascending colon
• Transverse colon
• Descending colon
• Sigmoid colon
• Rectum

Which diseases and conditions require colectomy surgery?

The reasons for performing this surgery span a wide range. In the decision-making process, many factors are taken into account, such as whether the disease can be treated with medication, the patient’s overall health status, and the risk of disease progression. One of the most common reasons we encounter is colon cancer. To prevent the spread of cancerous tissue and restore the patient’s health, the tumor-bearing area must be removed with safe margins.

In addition, non-cancerous, benign conditions that seriously impair quality of life may also require surgery. Especially disorders in the group of Inflammatory Bowel Diseases (IBD) may lead to surgery when they do not respond to medical treatment. Diverticulitis, which is the inflammation of pockets formed in the intestinal wall, may also require surgical intervention if it causes frequent attacks or perforation. Moreover, some emergency situations make surgery mandatory without leaving room for deliberation.

The main conditions requiring surgery are as follows:

• Colon cancer
• Large polyps with a risk of cancer
• Genetic cancer syndromes
• Ulcerative Colitis
• Crohn’s Disease
• Complicated diverticulitis
• Bowel obstruction
• Bowel twisting
• Uncontrollable bleeding
• Bowel perforations

How is the term colectomy used when naming types of surgery?

In surgery, the name of the procedure changes according to which part of the intestine is removed. This naming is important both for the planning of the surgical team and for the patient to know what to expect. In general, we divide operations into two main groups as “partial” or “total.” In partial surgeries, only the diseased segment is removed, while in total surgeries, the entire large intestine is removed.

The procedure performed for diseases on the right side is called “Right Hemicolectomy.” Here, the beginning part of the intestine and the last section of the small intestine are removed. For problems on the left side, “Left Hemicolectomy” is performed. For diseases in the sigmoid colon, which is the last curved part of the intestine, a “Sigmoidectomy” is performed. If the problem is in the rectum and it is possible to preserve the anal sphincter muscles, a technically more delicate procedure called “Low Anterior Resection” (LAR) is performed.

More extensive surgeries are as follows:

• Total Colectomy
• Total Proctocolectomy
• Abdominoperineal Resection

Why is the relationship between lymph nodes and colectomy critical in cancer surgery?

In cancer surgeries, the surgeon’s main goal is not only to remove the tumor visible to the eye. The real success is clearing the pathways through which cancer may have spread at the microscopic level. For this reason, cutting the tumor-bearing bowel segment at least 10 cm above and below is essential to obtain “clear margins.” However, even more important than this is the clearance of lymph nodes.

Cancer cells migrate from the tumor first to the lymph nodes right next to the intestine, and from there to the central lymph nodes around the main vessels. Studies in right-sided colon cancers have shown that cancer spreads to these central, root-area nodes at a rate of approximately 4%. Therefore, during surgery we apply a special technique called “Complete Mesocolic Excision” (CME). In this technique, all fatty and lymphatic tissue surrounding the intestine like an envelope is removed en bloc, without fragmentation, by dissecting down to the root of the main vessels.

The advantages provided by this approach:

• Harvesting more lymph nodes
• Reduced risk of recurrence
• Prolonged survival time
• Accurate staging of the disease

How is the decision for colectomy made in patients with Ulcerative Colitis and Crohn’s disease?

In inflammatory bowel diseases, surgery is generally considered a last resort, but sometimes it is the most effective treatment method. In patients with Ulcerative Colitis, since the disease affects only the large intestine, removing the entire large intestine technically “cures” the disease, meaning it eliminates it completely. However, this is a major decision and usually comes to the agenda when medications no longer work, side effects increase, or cancer risk emerges.

Especially in the setting of “acute severe colitis,” if the patient does not improve despite hospitalization and high-dose steroids, the decision for surgery should be made without waiting. Otherwise, the intestine may perforate or a life-threatening dilation called “toxic megacolon” may develop. In Crohn’s disease, the situation is somewhat different. Since the disease can affect anywhere from the mouth to the anus, surgery is performed only to resolve complications and the goal is to remove as little bowel as possible.

The complications requiring surgery are as follows:

• Intestinal strictures
• Fistulas
• Non-healing abscesses
• Cancer development
• Non-response to medications
• Growth retardation (in children)

Does colectomy and the use of a stoma change in patients with diverticulitis?

In the past, the standard approach in patients with intestinal perforation or severe intra-abdominal inflammation due to diverticulitis was quite traumatic. In this method, called the “Hartmann Procedure,” the diseased segment is removed, the end of the intestine is sutured to the skin to create a bag (colostomy), and the patient is expected to get rid of this bag months later with a second surgery. This was a physically and psychologically challenging process for patients.

However, modern surgical understanding and recent studies have changed this approach. Now, if the patient’s general condition is good, meaning they are not in shock, it is possible to repair in a single session even if there is inflammation in the abdomen. After the diseased segment is removed, the bowel ends are sutured together (primary anastomosis) and, to increase safety, a temporary protective stoma is created from the small intestine. This method reduces the risk of a permanent bag and speeds up the patient’s return to normal life.

The benefits of this modern approach:

• Reduced risk of permanent stoma
• Prevention of a second major surgery
• Faster return to social life
• Less surgical trauma

What does minimally invasive surgery mean in modern colectomy techniques?

Today, the notion of “big incision, big surgeon” in abdominal surgery has completely become history. The gold standard is now “Minimally Invasive Surgery,” meaning closed methods. These methods include laparoscopic or robotic surgery. While open surgery involves a large incision across the abdomen, closed methods allow the entire procedure to be performed through only a few small openings.

In laparoscopic surgery, the abdomen is inflated with gas and the operation is performed with long instruments accompanied by high-resolution cameras. The comfort this method provides to patients is undeniable. Pain is much less, scarring is almost absent, and the risk of infection is minimized. From an oncologic perspective, the success of surgeries performed with the closed method is completely equivalent to open surgeries. In fact, thanks to the magnified view, the surgeon can see tissues much more clearly.

Advantages of minimally invasive surgery:

• Less pain
• Shorter hospital stay
• Lower risk of infection
• Early return to work
• Cosmetic superiority
• Less blood loss

What is the difference between robotic colectomy and the laparoscopic method?

Robotic surgery is the next technological step above laparoscopic surgery. Although both methods fall under the category of “closed surgery,” the possibilities offered by the robotic system to the surgeon differ. In robotic surgery, the surgeon sits at a console rather than at the patient’s bedside and controls the robot’s arms. This system provides a three-dimensional image with depth perception.

The biggest difference is range of motion. Laparoscopic instruments are straight and cannot bend, but the robot’s arms have a much greater ability to rotate than the human wrist (540 degrees). This feature provides a great advantage especially when working in narrow and deep areas such as the pelvis. In these regions where vessels and nerves are dense, the precision of robotic arms helps protect tissues.

The technical advantages of robotic surgery are as follows:

• High range of motion
• Tremor-filtering technology
• Three-dimensional imaging
• Ergonomic comfort
• More precise suturing
• Reduced risk of conversion to open surgery

What is the difference between intracorporeal and extracorporeal colectomy in bowel anastomosis?

One of the most critical stages during colectomy is the anastomosis stage, in which the remaining ends are connected after the diseased segment is removed. Where this procedure is performed is an important technical detail that affects the patient’s recovery process. In right-sided colon surgeries, this procedure can be performed in two different ways.

In the “extracorporeal” method, the intestines are pulled out of the abdomen through a small incision, sutured or stapled outside, and then pushed back in. In the “intracorporeal” method, everything is done entirely inside the abdomen in a closed manner; the intestine is not brought out. In recent years, we have preferred the intracorporeal method more because there is less tissue damage since the intestine does not need to be pulled. Also, since the incision site is much smaller, the risk of hernia decreases and the intestines start working sooner.

Benefits of the intracorporeal method:

• Smaller incision
• Less pain
• Early bowel function
• Lower hernia risk
• Fewer adhesions

What does the Enhanced Recovery Protocol (ERAS) offer colectomy patients?

In the past, patients who underwent surgery were not allowed to get out of bed for days, were kept fasting for a long time, and were left alone with their pain. However, with the “Enhanced Recovery Protocol” (ERAS), this process has changed from top to bottom. ERAS is an evidence-based modern care package designed to minimize the stress that surgery creates in the body.

This protocol begins before surgery. We no longer keep patients fasting for days; we allow them to drink water or clear liquids up to 2 hours before surgery. We even perform carbohydrate loading in non-diabetic patients to replenish the body’s energy stores. During surgery, we maintain body temperature and avoid unnecessary fluid loading. Most importantly, we start mobilizing and feeding the patient immediately after surgery.

The cornerstones of the ERAS protocol are as follows:

• Preoperative education
• Carbohydrate loading
• Short fasting period
• Opioid-sparing analgesics
• Early mobilization
• Early nutrition
• Early removal of catheters and drains

Why are antibiotics and bowel preparation important in preoperative colectomy preparation?

In elective, planned colon surgeries, one of the complications we fear most is surgical site infection. Since the intestine is naturally an organ with a high bacterial load, the risk of infection is higher compared to other surgeries. To minimize this risk, it is necessary to strictly adhere to preoperative preparation protocols.

Current medical guidelines strongly recommend the use of “Oral Antibiotics” together with “Mechanical Bowel Preparation” (use of laxatives) one day before surgery. Emptying the bowel alone is not sufficient; however, antibiotics taken after bowel cleansing significantly reduce the bacterial load inside. When combined with prophylactic intravenous antibiotics, this method can reduce infection rates by half.

Components of the preparation process:

• Dietary regulation
• Mechanical cleansing medications
• Oral antibiotics
• Intravenous antibiotic prophylaxis

What are the complications that may develop after colectomy?

As with any major surgical procedure, colectomy also carries certain risks. No matter how experienced the surgeon and how advanced the technology used, factors such as the patient’s tissue healing capacity can affect the outcome. The most serious complication and the one that concerns surgeons the most is “anastomotic leakage.” This is the leakage of intestinal contents into the abdominal cavity from the joined sites.

If a leak develops, action is taken according to the severity of the situation. If the leakage is small and has only formed an abscess, it can be treated without surgery by placing a drain using radiological methods. However, if the patient develops fever, the general condition worsens, and peritonitis spreads (Grade C), an urgent reoperation is required. In this situation, the priority is to save life; usually the leaking area is not attempted to be repaired, instead the intestinal content is diverted outside via a temporary stoma (bag) and the area is allowed to heal.

Other possible complications:

• Wound infection
• Bowel obstruction
• Bleeding
• Parastomal hernia
• Difficulty urinating
• Lung problems
• Blood clots

How are stoma-related problems and parastomal hernia prevented after colectomy?

A stoma, meaning bringing the intestine out to the abdominal skin, can be life-saving in some cases but also brings its own specific problems. The most common long-term problem is “Parastomal Hernia.” This is the herniation of intra-abdominal organs outward from the edge of the stoma. Factors such as obesity, advanced age, and diabetes increase this risk.

The most effective way to reduce the risk of hernia is surgical technique. Passing the stoma through the exact center of the abdominal muscle (rectus muscle) significantly prevents hernia formation. This detail is especially important in laparoscopic surgeries. In addition, receiving education on stoma care is essential to prevent skin irritation and other problems.

Risk factors for parastomal hernia:

• Obesity
• Advanced age
• Smoking
• Poor nutrition
• Technical errors
• Large stoma opening

Can colectomy be a solution for functional disorders?

Although cancer or inflammation first comes to mind when colectomy is mentioned, this surgery can also be an option in cases where the structure of the intestine is normal but its function is impaired. Especially in cases of “Slow-Transit Constipation,” where the intestine is sluggish and the patient cannot have a bowel movement for weeks, surgery may be considered if all medical treatments, diets, and exercises have failed.

We are very meticulous when making this decision. On colonoscopy, the finding we call “Melanosis Coli,” which is the darkening of the intestinal color, is a guiding sign for us. If this finding is present and the patient is suitable for surgery, a more extensive operation may be required in which the small intestine is connected directly to the sigmoid colon. These surgeries can improve patients’ quality of life, but since it is a functional disorder, results may not be as definitive as in other diseases.

What we look for in functional surgery candidates:

• Resistance to medical treatment
• Normal rectal function
• Normal gastric emptying
• Psychological stability

How are quality of life and fertility affected after colectomy?

The issue patients wonder about most after surgery is whether their lives will return to normal. In general, quality of life increases significantly after surgery in individuals who are freed from cancer or a severe painful disease. Although issues such as frequent bowel movements may be experienced in the first few months until bowel habits settle, generally everything returns to normal within a year.

However, for young patients, especially women, fertility is a very sensitive point. Surgeries performed due to Ulcerative Colitis and known as the “J-Pouch” can reduce the chance of natural pregnancy because they can cause adhesions within the pelvis. This does not affect IVF success but can make the natural process more difficult. Therefore, for young female patients who have not yet had children, it is necessary to discuss in detail alternative methods (Ileorectal Anastomosis) in which the rectum is preserved and to weigh the risks.

Factors affecting quality of life:

• Frequency of bowel movements
• Gas control
• Sexual functions
• Fertility status
• Psychological adjustment
• Social support

Frequently Asked Questions

For which diseases is colectomy surgery performed?

Colectomy is performed to remove the diseased colon segment in conditions such as colon cancer, Crohn’s disease, ulcerative colitis, diverticulitis, polyposis syndromes, and various lesions that cause bowel obstruction.

How does the small intestine start functioning after colectomy?

After the colon is removed, the small intestine is connected directly to the rectum or brought out through a stoma. Over time, the small intestine partially takes over the colon’s function of absorbing water. However, stool may be more frequent and more watery.

Does colectomy require a permanent stoma?

It depends on the scope of the surgery. Permanent ileostomy may be required in total colectomy and some emergency situations. In segmental colectomies, bowel continuity is usually preserved and a stoma is either not created at all or is temporary.

How is nutrition arranged after colectomy surgery?

A liquid diet is started first, followed by a soft diet. In the early period, fibrous, gas-forming, and hard-to-digest foods should be avoided. The dietary plan is gradually shaped according to the patient’s tolerance.

How does bowel habit change after colectomy?

Bowel movement frequency may increase and stool consistency may become softer. After right colectomy, more watery stool is seen, while after left colectomy, more formed stool is seen. Over time, the body adapts to this new routine.

How high is the risk of infection after colectomy?

There is a risk of infection due to contact with intestinal contents. The risk increases especially if an anastomotic leak occurs. With appropriate surgical technique, antibiotics, and hygiene rules, this risk can be reduced.

Are gas and bloating problems experienced after colectomy?

Yes. In the first weeks, gas, bloating, and irregular bowel movements are common complaints. A proper diet, plenty of water intake, and light walks help reduce these problems.

Why is skin care important after colectomy?

If a stoma has been created, the skin that comes into contact with stool becomes sensitive and prone to irritation. Regular cleaning, skin-protective products, and the use of appropriate stoma appliances are necessary to protect skin health.

When can one return to normal life after colectomy?

After open surgery, returning to daily activities is possible within 4–6 weeks, and after laparoscopic surgery within 2–4 weeks. However, full recovery may vary depending on personal factors.

How is quality of life affected after colectomy?

In the early period, quality of life may temporarily decrease. However, when the disease is controlled and stoma care is learned correctly, most patients can lead an active and normal life. Psychological support plays an important role in this process.

How Long Does Colectomy Surgery Take?

Colectomy surgery generally takes between 2 and 5 hours, depending on the extent of the colon segment to be removed and the surgical technique.

Which Doctor or Department Should Be Consulted for Colectomy?

For this type of surgical intervention, a general surgery specialist should be consulted, especially a surgeon experienced in colorectal surgery.