Hemicolectomy

Question 1

What is a right hemicolectomy?

Answer 1

Involves the removal of the terminal ileum, caecum (including the appendix), ascending colon, and hepatic flexure.

An extended right hemicolectomy further involves the removal of the transverse colon as well.

Question 2

What are reasons for performing a right hemicolectomy?

Answer 2

• bowel malignancy
• diverticular disease
• bowel ischaemia
• bowel perforation

Question 3

Pathophysiology of R hemicolectomy?

Answer 3

Can be done open, or laparoscopically (keyhole), and either electively or in an emergency.

Most cases - an anastomosis (surgical connection) from the ileum to the transverse colon is formed

Question 4

Typical physiotherapy problems

Answer 4

pain on abdomen, effects on the respiratory system.

• risk of retained secretions
• reduced mobility (reduced exercise tolerance)
• hypoxaemia (decreased lung volume)

Question 5

Treatment for a patient after a R hemicolectomy?

Answer 5

• Teach supported cough, huff, thoracic expansion
• Mobilise / pacing
• ACBT - thoracic expansion, incentive spirometry, sitting up straight