Left hemicolectomy

An operation to remove the left side of the large bowel — usually for a cancer, diverticular disease or a large polyp — and join the remaining bowel back together, sometimes with a temporary stoma.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

It removes the left side of the colon and joins the remaining bowel back together, and is used for cancer, diverticular disease or large polyps.
Most people do not need a stoma, but a temporary one is sometimes made to protect the join, especially in emergencies or higher-risk situations.
The most serious specific risk is a leak from the join (anastomotic leak), reported at around 2–5%, which can need further surgery.
When done for cancer it is part of an MDT plan; surgery offers the best chance of removing the cancer but cannot guarantee it will not return.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMajor bowel operation (open, keyhole or robotic)

AnaestheticGeneral anaesthetic, often with additional pain relief such as a spinal or epidural

How long it takesCommonly around 2–4 hours

Hospital stayOften around 4–7 days, sometimes less with enhanced recovery, longer if complications

Time off workOften around 6–12 weeks before feeling recovered

When you'll see resultsIf for cancer, the pathology report usually follows within a couple of weeks

On the NHS?Commonly performed on the NHS; also available privately

A general guide. Your surgeon will give you advice for your situation.

Best fit

Removes a cancer, large polyp or diseased segment from the left side of the colon

Pause if

People too unwell or frail to safely undergo major surgery and a general anaesthetic.

Main recovery point

You are monitored closely with drips and pain relief and encouraged to sit up, move and start drinking and eating early. Bowel function may take a few...

Good aftercare

Care within an enhanced recovery programme and a named contact (such as a colorectal nurse specialist).

First few days in hospital

You are monitored closely with drips and pain relief and encouraged to sit up, move and start drinking and eating...

Leaving hospital (often around 4–7 days)

Many people go home within a week, sometimes sooner with keyhole surgery. You may still feel sore and tired. If...

First few weeks at home

Increase walking and gentle activity gradually. Avoid heavy lifting and strenuous activity. Bowel habit is often...

About 6–12 weeks

Many people feel much closer to normal, though bowel habit and energy can take longer to settle. Driving, work and...

Medical line illustration of lower gi colonoscopy for Left hemicolectomy. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a left hemicolectomy?

A left hemicolectomy is an operation to remove the left side of the large bowel (colon) — typically the descending colon, and often the sigmoid colon — along with the nearby lymph nodes. The two healthy ends are then usually joined back together (an anastomosis). When mainly the lower, S-shaped part is removed, the operation may be called a sigmoid colectomy.

It is most often done for a cancer on the left side of the colon, but it is also commonly used for diverticular disease (small pouches in the bowel wall that can become inflamed, bleed or cause narrowing) and for large or worrying polyps. Sometimes it is needed as an emergency, for example for a blockage or perforation.

The operation can often be done by keyhole (laparoscopic) or robotic surgery, using several small cuts and a camera, or by open surgery through one larger cut. Most people do not need a permanent stoma, but a temporary stoma is sometimes made to protect the join while it heals — particularly in emergencies, if the bowel ends are unhealthy, or if there is a higher risk the join will not heal.

When it is done for cancer, it is part of a wider plan agreed by a specialist team (MDT). Surgery aims to remove the cancer completely, but it cannot guarantee the cancer will never return, so the pathology results and follow-up matter.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Laparoscopic (keyhole) left hemicolectomy

Done through several small cuts using a camera and instruments. Often allows a quicker recovery and shorter hospital stay, with similar cancer outcomes in suitable people. Not possible in every case.

Open left hemicolectomy

Done through one larger cut in the tummy. Used for large or complex tumours, in emergencies, or where keyhole surgery is not suitable, and sometimes when keyhole surgery is converted to open.

Robotic left hemicolectomy

A keyhole approach using surgeon-controlled robotic instruments, with similar benefits and risks to standard keyhole surgery in suitable cases.

Sigmoid colectomy

Removes mainly the lower, S-shaped (sigmoid) part of the colon, commonly for sigmoid cancers or diverticular disease, with the same general aims.

Keyhole vs open left hemicolectomy

Point	Keyhole	Open
Cuts	Several small cuts	One larger cut
Recovery	Often quicker	Often slower
Hospital stay	Often shorter	Often longer
Cancer outcome	Similar in suitable cases	Similar
When used	Many planned cases	Large tumours, emergencies

Keyhole and robotic surgery suit many but not all people. The choice depends on the disease, your anatomy and safety, and an operation can be converted from keyhole to open if needed.

Preparing for your surgery

Make sure you understand why the operation is recommended and, if it is for cancer, the stage and the MDT plan.
Ask whether a stoma is likely, whether it would be temporary or permanent, and what would make one necessary; ask to meet a stoma nurse beforehand if a stoma is possible.
Attend pre-assessment, blood tests, scans and fitness checks, and take up prehabilitation if offered.
Tell the team about all medicines, especially blood thinners, diabetes medicines and steroids, and follow advice on stopping or adjusting them.
Stop smoking and cut down alcohol to lower the risk of complications.
Follow any bowel preparation, diet and fasting instructions for the day of surgery.
Arrange help at home for several weeks, including with lifting and shopping.
Ask about the enhanced recovery programme so you know what to expect afterwards.

What happens

The operation is done under a general anaesthetic, often with an epidural or spinal injection for pain relief afterwards. It may be done by keyhole, robotic or open surgery.

The surgeon frees and removes the left side of the colon, along with the nearby lymph nodes and their blood supply. The healthy ends are then joined back together using stitches or staples. In most planned cases a stoma is not needed, but sometimes a temporary stoma is made higher up to divert stool away from the new join while it heals; this can usually be reversed later.

The operation commonly takes a few hours. Afterwards you are cared for on a ward, with drips, pain relief and monitoring, and most units use an enhanced recovery programme to help you start drinking, eating and moving early.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

People too unwell or frail to safely undergo major surgery and a general anaesthetic.
Cancer that has spread so widely that this operation is not the right approach.
Diverticular disease that can be managed without surgery, where the risks of an operation outweigh the benefit.
Very early cancers within a polyp that may be fully treated by local removal at colonoscopy.

Delay surgery if…

There is an active, untreated infection or another acute medical problem increasing surgical risk.
Staging is incomplete and important scan or biopsy results are awaited (for cancer).
An episode of diverticulitis has not yet settled, where planned surgery is often best delayed.
Blood-thinning or other medicines need adjusting first.
The person is medically unstable and needs optimisation before surgery.

Alternatives to discuss

Medical treatment, diet and monitoring for diverticular disease where surgery is not yet needed.
Local removal at colonoscopy for some very early cancers within a polyp.
Chemotherapy, radiotherapy or targeted treatment when surgery is not the right option for cancer.
A stent or stoma to relieve a blockage when immediate major surgery is not possible.
Best supportive (palliative) care focused on symptoms when cure is not possible.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

You are fully asleep for the operation.

Epidural or spinal pain relief

A tube or injection in the back can give strong pain relief during and after surgery, helping recovery.

Nerve and local blocks

Local anaesthetic techniques may be added to reduce pain and the need for other painkillers.

Benefits

Removes a cancer, large polyp or diseased segment from the left side of the colon
Removes nearby lymph nodes so they can be examined to help stage a cancer
Can treat the problems caused by diverticular disease, such as repeated infection, bleeding or narrowing
Can relieve or prevent a blockage caused by a tumour or narrowing
Keyhole or robotic approaches can mean a quicker recovery for suitable people

Risks & complications

More common

Pain, tiredness and reduced appetite for some weeks
Looser, more frequent or more urgent stools, especially in the early weeks
The bowel being slow to wake up after surgery (ileus)
Wound discomfort while healing

Less common

Wound, chest or urinary infection
Bleeding needing treatment or, rarely, a return to theatre
Blood clots in the legs or lungs (DVT or pulmonary embolism)
Leaking of the join in the bowel (anastomotic leak), which can need antibiotics, drainage or further surgery and a stoma

Rare but serious

Damage to nearby structures such as the ureter, bladder, spleen or other bowel
A serious complication needing intensive care or further operations
A hernia at a wound site later on
Death — uncommon for planned surgery but higher in emergencies or in people who are frail or very unwell

The most serious specific risk is a leak from the join (anastomotic leak), reported at around 2–5%. It can make you very unwell and sometimes needs antibiotics, drainage or further surgery and a stoma. Because of where the operation is, there is also a small risk of injury to the ureter (the tube from the kidney to the bladder) or the spleen. Risks are higher in emergencies and in people who are older, frailer or have other illnesses. Ask your surgeon about your personal risk, the chance of a stoma, and the signs of a leak.

Published figures to discuss

Risks depend on whether the operation is planned or an emergency, the technique used, the underlying disease, and the person's age and general health. If it is for cancer, the long-term outlook depends mainly on the stage at diagnosis. The figures below are broad indications from UK sources and large series, not a prediction for any individual.

Figure	Reported range	How to interpret it	Source / confidence
Anastomotic leak (leak from the bowel join)	Around 2–5%	A serious complication that can need antibiotics, drainage or further surgery and a stoma.	StatPearls (NCBI) — Hemicolectomyncbi.nlm.nih.govPublished figure
Need for a stoma	Most planned cases none; a temporary stoma is sometimes used	More likely in emergencies or if the bowel ends are unhealthy; usually reversible.	Guide sourcesClinical context
Overall 5-year survival for bowel cancer (all stages, UK)	Around 50–60%	Strongly stage-dependent; given here only as context for cancer cases.	StatPearls (NCBI) — Hemicolectomyncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery takes weeks rather than days. Many people leave hospital within about a week and feel much better within six weeks, but full recovery often takes up to around three months, and longer if there are complications or further treatment.

First few days in hospital

You are monitored closely with drips and pain relief and encouraged to sit up, move and start drinking and eating early. Bowel function may take a few days to return.

Leaving hospital (often around 4–7 days)

Many people go home within a week, sometimes sooner with keyhole surgery. You may still feel sore and tired. If you have a temporary stoma, you should be confident managing it before discharge.

First few weeks at home

Increase walking and gentle activity gradually. Avoid heavy lifting and strenuous activity. Bowel habit is often looser, more frequent or more urgent at first.

About 6–12 weeks

Many people feel much closer to normal, though bowel habit and energy can take longer to settle. Driving, work and exercise restart gradually as advised.

Pathology results (if for cancer)

The pathology report is usually discussed within a couple of weeks, and the MDT advises on any further treatment and follow-up.

What's normal — and not a worry

Tiredness and a reduced appetite that improve over weeks
Looser, more frequent or more urgent bowel movements early on
Some wound soreness and being easily tired
If you have a temporary stoma, a learning period to manage it confidently
Gradual return of energy and stamina over a couple of months

Aftercare

Take pain relief as prescribed and build up gentle walking day by day.
Eat regular, balanced meals and drink plenty of fluids; ask for dietitian advice if eating is difficult.
Avoid heavy lifting and strenuous activity for the time your surgeon advises, to reduce the risk of a hernia.
Look after your wounds and, if you have a stoma, follow your stoma nurse's advice on care and supplies.
Take any prescribed blood-clot prevention (sometimes injections for a few weeks) as directed.
Report signs of a leak, infection or blood clot promptly.
Attend follow-up appointments and, if the operation was for cancer, any planned tests or treatment.
Ask for help from specialist nurses, stoma nurses or support services if you need it.

Before-surgery checklist

Understood the reason for surgery and the plan
Met a stoma nurse if a stoma is possible
Pre-assessment, scans and fitness checks completed
Help at home arranged for several weeks
Medicines, including blood thinners, reviewed with the team
Stopped smoking and reduced alcohol where possible
Clear plan for follow-up, results and who to contact with problems

Scars and how they heal

Keyhole (laparoscopic) and robotic surgery leave several small scars on the tummy, often with one slightly larger scar where the bowel is removed. Open surgery leaves a longer scar, usually down the middle of the tummy. If you have a temporary stoma, there is an opening on the tummy wall, and reversing it later leaves a further small scar. Scars fade over months but remain visible.

⚠ Get urgent help if…

Worsening or severe tummy pain, or a hard, swollen, very tender tummy
A high temperature, chills or feeling very unwell (possible infection or leak)
Redness, swelling, heat or discharge from a wound
A swollen, hot or painful calf, or sudden breathlessness or chest pain (possible blood clot)
Persistent vomiting, or being unable to pass wind or stool
No output into the stoma for a prolonged time, or heavy bleeding
Heavy rectal bleeding or passing large clots

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is removal of the diseased part of the colon and a recovery without major complications. If the operation is for cancer, the pathology report on the removed bowel and lymph nodes — usually discussed within a couple of weeks — shows the type and stage of the cancer, whether it was fully removed (clear margins) and whether the lymph nodes were affected. This guides whether further treatment such as chemotherapy is recommended.

When done for cancer, surgery offers the best chance of removing it, but it cannot promise the cancer will never return. Outcomes depend on the stage at diagnosis. For diverticular disease, the operation usually settles the problems it was causing, though general bowel health still needs looking after.

How long it lasts

If the operation is for cancer, the long-term outlook depends mainly on the stage at diagnosis, whether the cancer was fully removed, and whether further treatment is needed. Follow-up over several years with scans, blood tests and sometimes colonoscopy aims to detect any recurrence early. For diverticular disease, removing the affected segment usually resolves the immediate problem, although the rest of the bowel can still develop diverticula over time.

Combining with other procedures

If the operation is for cancer, chemotherapy is sometimes recommended afterwards depending on the stage, decided once the pathology is known. A temporary stoma made to protect the join is reversed in a separate, later operation once the bowel has healed. For diverticular disease, your team will advise on diet and bowel health afterwards.

Follow-up & long-term care

You will usually be reviewed after surgery to check your recovery and wounds (often at around six weeks). If the operation was for cancer, the MDT discusses the pathology results and recommends any further treatment and a follow-up plan, which typically includes regular check-ups, blood tests, scans and sometimes colonoscopy over several years. If you have a stoma, your stoma nurse provides ongoing support.

Attend all planned follow-up appointments, scans, blood tests and any surveillance colonoscopy.
If you have a temporary stoma, keep up reviews with your stoma nurse until it is reversed.
Report new or returning symptoms — such as bleeding, a change in bowel habit, pain or weight loss — without waiting for the next appointment.
Look after general bowel health with a balanced, higher-fibre diet and plenty of fluids, and avoid smoking.

Revision and secondary surgery reality

A temporary stoma needs a second, later operation to reverse it, and not all stomas can be reversed.
If an anastomotic leak or other serious complication occurs, a return to theatre and sometimes a new stoma may be needed.
If the operation is for cancer, further treatment such as chemotherapy may be advised once the pathology is known.
Diverticular disease can recur elsewhere in the bowel, and a hernia at a wound site may occasionally need repair.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Care within an enhanced recovery programme and a named contact (such as a colorectal nurse specialist).
Stoma-nurse support before and after surgery for anyone who may have a stoma.
A clear plan for pathology results, any further treatment and structured follow-up if for cancer.
Written warning signs for leak, infection and blood clots, with advice on when and how to seek urgent help.
Dietitian and emotional support where needed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether the operation is keyhole, robotic or open, and its complexity
Surgeon's and anaesthetist's fees and the theatre and hospital stay
Higher-dependency or intensive care if needed
Stoma care, supplies and stoma-nurse support if a temporary stoma is formed
Pathology, scans and other tests, particularly if it is for cancer
Any additional treatment such as chemotherapy
Management of any complications, which can extend the hospital stay

Make sure your written quote includes

The surgeon's and anaesthetist's fees and the hospital or theatre fee
The expected length of stay and the cost if it is longer than planned
Stoma supplies and stoma-nurse support if a temporary stoma is likely
Pathology, scans and follow-up appointments
How any further treatment such as chemotherapy is arranged and funded
What happens, and what it costs, if a complication, stoma or further surgery is needed
How care links with the NHS multidisciplinary team and follow-up if for cancer

On the NHS? A left hemicolectomy is commonly performed on the NHS; private treatment is also available, with the multidisciplinary team and follow-up central to care when it is done for cancer.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Why is a left hemicolectomy the right operation for me, and can it be done by keyhole or robotic surgery?
Is a stoma likely, would it be temporary or permanent, and what would make one necessary?
What is my personal risk of a leak from the join, and how would it be detected and managed?
If this is for cancer, what stage is it and will I need chemotherapy?
How long should I expect to be in hospital and off work?
What does my follow-up involve and what symptoms should prompt me to seek help?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Will I need a stoma after a left hemicolectomy?

Most people do not need a permanent stoma. Sometimes a temporary stoma is made to protect the join while it heals, especially in emergencies, if the bowel ends are unhealthy, or if there is a higher risk the join will not heal. It can usually be reversed later. Your surgeon should explain what is likely for you.

Why is a left hemicolectomy done for diverticular disease?

It is used when diverticular disease causes repeated infections, bleeding, an abscess, a narrowing or a hole in the bowel. Removing the affected segment usually settles these problems, though it does not remove diverticula elsewhere in the bowel.

How long will I be in hospital?

Often around four to seven days, and sometimes less with keyhole surgery and an enhanced recovery programme. A longer stay may be needed after open surgery, in emergencies, or if there are complications.

How long does recovery take?

Many people feel much better within about six weeks, but full recovery often takes up to around three months. Bowel habit and energy can take time to settle, and recovery is longer if there are complications.

Will my bowels be normal afterwards?

Stools are often looser, more frequent or more urgent at first and usually settle over weeks to months. Some people have a lasting change in bowel habit, which your team can help you manage.

What is the main serious risk?

A leak from the join in the bowel (anastomotic leak), reported at around 2–5%. It can make you very unwell and sometimes needs further surgery and a stoma. There is also a small risk of injury to the ureter or spleen because of where the operation is.

Can I have it done privately?

Yes, it is available privately as well as on the NHS. If it is for cancer, the MDT discussion, staging and follow-up remain just as important in either setting.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: StatPearls (NCBI) — Hemicolectomy Gloucestershire Hospitals NHS FT — Left hemicolectomy (patient leaflet) Bowel Cancer UK — Types of surgery NHS — Bowel cancer: treatment NICE NG151 — Colorectal cancer: diagnosis and management

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.