Medical Oncologist
CION Cancer Clinics
Colectomy: what the operation involves | CION Cancer Clinics
A colectomy removes the part of your large bowel (the colon) that holds the cancer, together with its blood supply and the nearby lymph glands. The two healthy ends are then usually joined back together. You are asleep throughout. Most people are up and walking the next day and eating soft food before they leave hospital. This page walks through what happens before, during and after, and what it cannot tell you about your own case. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What does a colectomy actually do?
- What happens once you are asleep?
- What exactly is taken out, and why each part matters
- What families expect, and what usually happens
- Words you will see, in plain language
- Four things families tell us before a colectomy
- Who this operation may not suit, and what this page cannot tell you
- Common questions about colectomy surgery
The short answer
What does a colectomy actually do?
A colectomy removes the part of your large bowel (the colon) that holds the cancer, along with the blood vessels that feed that part and the lymph glands that drain it. The surgeon then joins the two healthy ends back together, or, less often, brings one end out through the skin as a stoma.
Why more than the lump is removed
The tumour is never cut out on its own. Cancer cells can sit in the bowel wall beyond what the eye can see, and they travel to the lymph glands along the blood vessels. Taking the whole segment with its vessels and glands is how nothing is left behind, and how the pathologist can later tell you the stage, meaning how far the cancer has spread.
Who does the operation
A surgical oncologist or colorectal surgeon operates, with an anaesthetist who keeps you asleep and pain-free throughout. You meet both before the day. The anaesthetist wants to know about your heart, lungs, sugar levels and every medicine you take, including ayurvedic and homeopathic ones.
This page describes a planned colectomy. An emergency operation for a blocked or burst bowel follows a different path, and there is a separate page for it.In the operating theatre
What happens once you are asleep?
Going to sleep
You are given a general anaesthetic through a drip in your hand. A breathing tube is placed once you are asleep and removed before you wake. A urine catheter goes in at the same time.
The cuts
With keyhole surgery there are several small cuts and a camera. With open surgery there is one longer cut down the middle of the abdomen. Your surgeon will have told you beforehand which is planned, and why.
Freeing the bowel
The surgeon separates the affected part of the colon from the tissue around it, seals the blood vessels that feed it, and lifts it out together with the fatty tissue that carries the lymph glands.
The join, or the stoma
The two healthy ends are joined with stitches or a stapling device. This join is called an anastomosis. If a join is not safe on the day, one end is brought out through the skin as a stoma instead.
Closing and waking
The cuts are closed with stitches or clips, sometimes with a small drain tube left in. You wake in the recovery area, then go to the ward, or to intensive care for a night of closer watching.
Not sure whether this applies to you?
Ask an oncologistInside the specimen
What exactly is taken out, and why each part matters
Everything removed goes to the pathologist in one piece. Each part answers a different question about your cancer.
The segment of colon
The length of bowel holding the tumour, with a rim of healthy bowel on either side. The pathologist checks that rim, called the margin, to confirm no cancer cells reach the cut edge.
The blood vessels
Each part of the colon has its own artery and vein. They are tied off close to their origin, which is why the segment removed is defined by blood supply and not by the size of the tumour.
The lymph glands
Small glands in the fatty tissue beside the bowel. Lymph glands are the first place bowel cancer travels to. Counting how many were removed and how many contain cancer is what sets the stage.
On the report as
- Lymph node yield
- Nodes positive or negative
Anything stuck to the tumour
If the cancer has grown into a neighbouring structure, such as part of the abdominal wall or a loop of small bowel, the surgeon removes that with it rather than peeling it off.
This is decided on the scan beforehand where possible, and explained to you as part of consent.Side by side
What families expect, and what usually happens
What people expect
What usually happens
Lying flat in bed for a week
Sitting out of bed and walking a few steps the day after surgery
Nothing to eat or drink for days
Sips of water the same evening, and soft food within a few days
Waking up with a bag for life
Most planned colectomies end in a join, not a stoma
Severe pain for weeks
Pain is controlled with an epidural or a pump, and eases most after the first few days
Chemotherapy starts as soon as you are home
The pathology report comes first, and only some people need chemotherapy at all
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On your discharge summary
Words you will see, in plain language
- Hemicolectomy
- Removal of roughly half the colon. "Right" means the part near the appendix, "left" means the part on the way down to the rectum.
- Anastomosis
- The join between the two healthy ends of bowel. It is made with stitches or staples and heals over the following weeks.
- Stoma
- An opening on the abdomen where a bowel end is brought to the skin and a bag collects the motion. It may be temporary or permanent.
- Lymph node
- A small gland in the fat beside the bowel. The report counts how many were removed and how many contain cancer.
- Margin
- The rim of normal tissue around what was removed. A clear margin means no cancer cells were found at the cut edge.
- Histopathology
- The examination of the removed tissue under a microscope. This report, not the operation, decides the final stage.
Commonly believed
Four things families tell us before a colectomy
"Opening the abdomen makes the cancer spread."
This is the most common reason families delay, and it is not what happens. Air and light do not make cancer travel. The operation removes the cancer with its lymph glands, which is the opposite of spreading it. Delay is what allows spread.
"Everyone comes out with a bag."
Most planned colon operations end with the bowel joined back together. A stoma is more likely in an emergency, when the join is very low near the rectum, or when the person is unwell on the day. If one is likely for you, you will be told beforehand.
"Once the tumour is out, the treatment is over."
Surgery is the main treatment for colon cancer, and for many people it is the only one. But the pathology report decides whether chemotherapy is advised afterwards. That conversation happens a week or two after the operation, once the report is back.
"An older person cannot survive such a big operation."
Age on its own is not the deciding factor. Heart, lung and kidney fitness, nutrition and how active the person is matter far more. The anaesthetist assesses all of this before a date is fixed.
Being straight with you
Who this operation may not suit, and what this page cannot tell you
A planned colectomy is not offered to everyone with colon cancer. If the cancer has already spread widely to the liver or lungs, chemotherapy may come first. If the heart or lungs cannot safely take a long anaesthetic, the team may look at other options. Only your treating team can weigh this for you.
What the page cannot tell you
It cannot tell you your stage, whether you will need a stoma, how long your own recovery will take, or whether you will need chemotherapy. Those answers come from your scans, your fitness and, above all, the pathology report after surgery. A description of the operation carries no forecast about how you will do.
What to ask at your consent appointment
Ask which part of the colon is being removed and why. Ask whether a stoma is possible, and whether it would be temporary. Ask whether the plan is keyhole or open, and what would change it once inside. Bring the family member who will be with you afterwards.
If you have a report and are not sure what it means, call the helpline. A surgical oncologist will read it with you and say what the next step is.Questions we are asked
Common questions about colectomy surgery
How long does the operation take?
Usually a few hours, and longer if the tumour is stuck to nearby tissue or the surgery is keyhole. Families waiting outside should expect the total time away, including anaesthesia and recovery, to be longer than the surgery itself.
Will I wake up with a bag?
For most planned colon operations, no. The bowel is joined back together inside. A stoma becomes more likely when the join is very low, when the bowel was blocked, or when the person is unwell on the day. Your surgeon will tell you beforehand if there is a real chance.
How long will I be in hospital?
Several days for most people, often less after keyhole surgery and more after open surgery or a complication. You go home once you are eating, passing wind or motion, walking and managing pain with tablets, not on a fixed day.
When can I eat normal food again?
Sips of water usually start the same evening, then liquids, then soft food over the next few days. Once home, most people build back to a normal diet over a few weeks. Soft rice, curd, dal water and well-cooked vegetables are the usual starting points.
Will the cancer be gone after surgery?
The operation removes the cancer that can be seen and the glands beside it. Whether anything remains is answered by the pathology report and by your follow-up scans over time. Your surgeon will explain the report with you once it is back.
Is keyhole surgery available for bowel cancer?
Often, yes, and the cancer operation inside is the same. Whether it suits you depends on the tumour size, previous operations, your build and the surgeon's judgement. Ask your centre which approach they are planning and why.
Will I need chemotherapy afterwards?
Only some people do. It depends on the stage shown in the pathology report, mainly on whether cancer was found in the lymph glands. If it is advised, it usually starts a few weeks after surgery once the wound has healed.
Does Aarogyasri or insurance cover a colectomy?
Colon cancer surgery is covered under Aarogyasri, CGHS, ECHS and EHS, and most cashless insurers cover it with prior approval. The package and any shortfall depend on your card and the ward you choose. Call the helpline and we will check before you travel.
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
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Sources
- NHS — Bowel cancer: treatment
- Cancer Research UK — Surgery for bowel cancer
- American Cancer Society — Surgery for Colon Cancer
- National Cancer Institute — Colon Cancer Treatment (PDQ), patient version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Right, Left, Sigmoid and Total ColectomyWhich part of the colon is removed, and why the name changesWill I Wake Up With a Stoma?When a join is made and when a bag is saferOpen vs Laparoscopic vs Robotic ColectomyWhat differs between the approaches, and what to askICU and the First Days After SurgeryWhat the first days on the ward look likeThe Pathology Report After SurgeryThe report that decides the stage and the next step
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Been told you need bowel surgery?
Send us the colonoscopy and scan reports, or call the helpline. A surgical oncologist will explain what is being planned and what to ask. One helpline serves every CION centre.