Right hemicolectomy

An operation to remove the right side of the large bowel — usually for a cancer, large polyp or other disease — and join the remaining bowel back together.

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

In short

It removes the right side of the colon (and usually the end of the small bowel) and joins the remaining bowel back together.
It usually does not need a stoma, because the bowel ends can normally be rejoined — but this cannot be promised in every case.
The most serious specific risk is a leak from the join (anastomotic leak), which is uncommon but 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 2–3 hours

Hospital stayOften around 3–7 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 right 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 3–7 days)

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

First few weeks at home

Increase walking and gentle activity gradually. Avoid heavy lifting and strenuous activity. You may have looser or...

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 Right 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 right hemicolectomy?

A right hemicolectomy is an operation to remove the right side of the large bowel (colon). This includes the caecum and the ascending colon, and usually the last part of the small bowel (the terminal ileum) and the nearby lymph nodes. The two healthy ends — the small bowel and the remaining colon — are then joined back together (an anastomosis).

It is most often done for a cancer or a large or worrying polyp in the right side of the colon, but it is also used for some other conditions affecting that area, such as severe Crohn's disease or, occasionally, an emergency such as a blockage. When the cancer is in the middle part of the colon, a slightly larger version called an extended right hemicolectomy may be needed.

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. A right hemicolectomy usually does not need a stoma, because the ends of the bowel can normally be joined, but this is not guaranteed in every case.

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) right 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.

Open right 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 needs to be converted to open.

Robotic right hemicolectomy

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

Extended right hemicolectomy

Removes a little more of the colon (towards the middle) when the cancer is in the transverse colon, with the same general aims.

Keyhole vs open right 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 tumour, 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 (usually not for this operation) and what would make one necessary.
Attend pre-assessment, blood tests, scans and fitness checks, and take up prehabilitation (improving fitness before surgery) 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 right side of the colon, usually with the end of the small bowel and the nearby lymph nodes and their blood supply. The healthy small bowel is then joined to the remaining colon, either inside the tummy or through a small cut, using stitches or staples. A stoma is usually not needed.

The operation commonly takes around two to three 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.
Very early cancers within a polyp that may be fully treated by local removal at colonoscopy.
Situations where the MDT advises a different operation or treatment before surgery.

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).
Blood-thinning or other medicines need adjusting first.
The person is medically unstable and needs optimisation before surgery.

Alternatives to discuss

Local removal at colonoscopy for some very early cancers within a polyp.
Chemotherapy, radiotherapy or targeted treatment when surgery is not the right option.
Medical treatment for non-cancer causes such as Crohn's disease where appropriate.
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 right side of the colon
Removes nearby lymph nodes so they can be examined to help stage a cancer
Usually avoids the need for a stoma
Can relieve or prevent a blockage caused by a tumour
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 or more frequent 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 small bowel, ureter or other organs
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 between the small bowel and colon (anastomotic leak). It is uncommon — reported at around 4% for laparoscopic right hemicolectomy — but it can make you very unwell and sometimes needs further surgery and a stoma. Risks are higher in emergencies and in people who are older, frailer or have other illnesses. Ask your surgeon about your personal risk and the signs of a leak.

Published figures to discuss

Risks depend on whether the operation is planned or an emergency, the technique used, 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 4% for laparoscopic right hemicolectomy	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	Usually none in planned surgery; occasionally required	More likely in emergencies or if the bowel ends are unhealthy.	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 3–7 days)

Many people go home within a week, sometimes sooner with keyhole surgery. You may still feel sore and tired and your bowel habit may be unsettled.

First few weeks at home

Increase walking and gentle activity gradually. Avoid heavy lifting and strenuous activity. You may have looser or more frequent stools, and you may not have a bowel movement for the first few days after surgery.

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 or more frequent bowel movements early on
No bowel movement for the first few days, then a gradual return
Some wound soreness and a feeling of being easily tired
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 watch for signs of infection.
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 or support services if you need it.

Before-surgery checklist

Understood the reason for surgery and the plan
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
Light food and plenty of fluids planned for home
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. Scars fade over months but remain visible. A stoma is usually not needed for this operation.

⚠ 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
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, which is why follow-up is part of the plan.

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 non-cancer conditions, removing the diseased segment usually deals with the immediate problem, though the underlying condition (such as Crohn's disease) may still need ongoing care.

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. If a right hemicolectomy is done for Crohn's disease, medical treatment for the condition usually continues afterwards to reduce the chance of it returning.

Follow-up & long-term care

You will usually be reviewed after surgery to check your recovery and wounds. 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.

Attend all planned follow-up appointments, scans, blood tests and any surveillance colonoscopy.
Report new or returning symptoms — such as bleeding, a change in bowel habit, pain or weight loss — without waiting for the next appointment.
Continue any treatment for an underlying condition such as Crohn's disease as advised.
Look after general health with a balanced diet, activity and not smoking.

Revision and secondary surgery reality

If an anastomotic leak or other serious complication occurs, a return to theatre and sometimes a stoma may be needed.
If the operation is for cancer, further treatment such as chemotherapy may be advised once the pathology is known.
A hernia at a wound site may occasionally need repair later.
For Crohn's disease, the condition may recur and need further medical or surgical treatment.

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).
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
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
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 or further surgery is needed
How care links with the NHS multidisciplinary team and follow-up if for cancer

On the NHS? A right 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.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

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

Why is a right hemicolectomy the right operation for me, and can it be done by keyhole or robotic surgery?
Is a stoma likely, 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 right hemicolectomy?

Usually not. The ends of the bowel can normally be joined together, so most people do not need a stoma. Occasionally, for example in an emergency or if the bowel is unhealthy, a stoma may be needed; your surgeon will explain if this is a possibility for you.

Why do I need part of my small bowel removed too?

The blood supply is shared between the end of the small bowel and the right colon, so the last part of the small bowel is usually removed with it. Most people manage well afterwards, though stools can be looser at first.

How long will I be in hospital?

Often around three to seven days, and sometimes less with keyhole surgery and an enhanced recovery programme. A longer stay may be needed after open surgery 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 or more frequent 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). It is uncommon, around 4% for keyhole right hemicolectomy, but can make you very unwell and sometimes needs further surgery and a stoma.

What should I do if I get a warning sign or feel very unwell after going home?

Trust your instincts. If the situation could be life-threatening — for example severe or worsening tummy pain, a hard, swollen, very tender tummy, sudden breathlessness or chest pain — call 999 or go straight to your nearest A&E (emergency department). For urgent advice that is not an emergency, contact your surgical team or specialist nurse first. Out of hours you can use NHS 111 if you are in England, Scotland or Wales; in Northern Ireland, contact your GP out-of-hours service or your HSC Trust's Phone First service. It is always fine to get in touch if you are worried.

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 NHS — Bowel cancer: treatment Bowel Cancer UK — Types of surgery Definition and grading of anastomotic leak after right hemicolectomy (BJS) NICE NG151 — Colorectal cancer: diagnosis and management nidirect — urgent and emergency care services nidirect — GP out-of-hours service

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.