Total abdominal colectomy is the removal of the large intestine from the ileum (lowest part of the small intestine) to the rectum. After it is removed, the end of the small intestine is sewn to the rectum.
You will receive general anesthesia right before your surgery. This will make you unconscious and unable to feel pain.
During the surgery:
Your surgeon will make a surgical cut in your belly. Then your surgeon will remove your large intestine. Your rectum and anus will be left in place.
Your surgeon will sew the end of your ileum to your rectum.
Always let your doctor know about any cold, flu, fever, herpes breakout, or other illnesses you may have before your surgery.
Eat high fiber foods and drink 6 to 8 glasses of water every day.
The day before your surgery:
Eat a light breakfast and lunch.
You may be asked to drink only clear liquids such as broth, clear juice, and water after noon.
Do NOT drink anything after midnight, including water. Sometimes you will not be able to drink anything for up to 12 hours before surgery.
Your doctor or nurse may ask you to use enemas or laxatives to clear out your intestines. They will give you instructions.
On the day of your surgery:
Take the drugs your doctor told you to take with a small sip of water.
Your doctor or nurse will tell you when to arrive at the hospital.
After the Procedure
You will be in the hospital for 3 to 7 days. By the second day, you will probably be able to drink clear liquids. Your doctor or nurse will slowly add thicker fluids and then soft foods as your bowel begins to work again.
After this procedure, you can expect to have 4 to 6 bowel movements a day. You may need more surgery and an ileostomy if you have Crohn's disease and it spreads to your rectum.
Most people who have a total abdominal colectomy recover fully. They are able to do most of the activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.
Scriver G, Hyman N. Ileostomy construction. Operative Techniques in General Surgery. 2007;9(1): 43-49.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.