Overview
Removing the right colon with same-operation reconnection.
Right hemicolectomy is the operation that removes the right side of the colon — the cecum, the ascending colon, and the hepatic flexure — along with the last few inches of the small intestine (the terminal ileum). It is the standard operation for cancer of the right colon and for large polyps in this segment that cannot be removed by colonoscopy. It is also used for ileocolic Crohn's disease and for complicated right-sided diverticulitis. After removal, the small bowel is sewn or stapled directly to the remaining transverse colon during the same operation, so the great majority of patients leave the hospital without any stoma.
We perform the great majority of right hemicolectomies minimally invasively — robotically or laparoscopically — through four to five small incisions in the abdomen. The specimen is removed through one slightly larger incision (typically 3–4 cm), often hidden in the umbilicus. For cancer, we follow strict oncologic principles: high ligation of the feeding vessels at their origin, complete mesocolic excision, and removal of at least 12 lymph nodes for accurate staging. The final pathology guides the decision about chemotherapy, made together with our medical oncology partners.
Who is a candidate?
Most adults with right-sided colon disease are candidates. For cancer, we obtain a staging CT of the chest, abdomen, and pelvis along with carcinoembryonic antigen (CEA) before surgery. Large polyps with high-grade dysplasia or invasive features on biopsy are operative indications. For Crohn's disease, surgery is offered when medical therapy has failed or when a stricture causes obstruction. Patients with significant cardiac or pulmonary disease, very large tumors, or extensive prior abdominal surgery sometimes require an open approach.
How we perform it
Under general anesthesia, four to five small ports are placed in the abdomen. We mobilize the right colon off the duodenum and the retroperitoneum, taking care to protect the right ureter, the duodenum, and the gonadal vessels. The feeding vessels — the ileocolic, right colic, and right branch of the middle colic — are divided at their origins for oncologic completeness. The bowel is divided in the terminal ileum and the transverse colon, and a stapled or sewn anastomosis is created between them. The specimen comes out through a small protected incision. Operations typically take 2–3 hours.
Recovery
Most patients stay 2–4 nights. You will walk the evening of surgery, sip clear liquids the next morning, and advance to a regular diet over the next day or two as bowel function returns. Expect looser, more frequent stools for several weeks — this is the right colon's job of reabsorbing water being temporarily missed. We send you home with simple diet guidance and stool-bulking strategies. Desk work resumes at 2–3 weeks; lifting and full activity at 4–6 weeks. For cancer cases, the first surveillance visit is at 2 weeks with the operating surgeon, and a longer-term plan with medical oncology starts shortly after.
Why Florida Surgical
Dr. Shaw is fellowship-trained in surgical oncology and performs right colon resection robotically as a high-volume part of his Coral Springs practice. We coordinate the workup, the operation, and the post-op surveillance ourselves — the same surgeon who reviews your colonoscopy is the surgeon who operates and the surgeon who sees you back in clinic. For cancer cases, we present pathology at multidisciplinary tumor board and coordinate any needed chemotherapy with medical oncology partners in Broward County.
Frequently asked questions
Will I need a colostomy?
Almost never. A standard right hemicolectomy reconnects the small bowel to the transverse colon during the same operation, so the great majority of patients leave the hospital without any stoma. A temporary ileostomy is only used in rare emergencies — for example, an unprepped colon with perforation and contamination.
How long is recovery?
Hospital stay is typically 2–4 days. Desk work resumes in 2–3 weeks; lifting and full activity in 4–6 weeks. Most patients describe the recovery as easier than they expected, especially after robotic surgery — the small port incisions are much less painful than a midline open incision.
Will my bowels work normally after?
Most patients have looser, more frequent stools for several weeks and then return to baseline. The right colon's role in reabsorbing water and bile salts is partially compensated by the rest of the colon over time. A high-fiber diet, adequate hydration, and a simple stool-bulking strategy usually do the trick.
Is robotic better than open?
For appropriate patients, robotic and laparoscopic right hemicolectomy give less pain, smaller scars, less blood loss, and faster recovery than open, with equivalent cancer outcomes. We use the minimally invasive approach whenever it is safe and oncologically appropriate, and reserve open surgery for very large tumors or complex re-operations.
What about chemotherapy?
Chemotherapy is recommended for stage III colon cancer (lymph node positive) and for selected stage II cases with high-risk features. We review the final pathology with you and your medical oncologist, and we present cases at tumor board so the decision is multidisciplinary rather than ours alone.