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Surgical removal of any extent of the colon

Colectomy (col + ectomy) is bowel resection of the large bowel (sometimes referred to as the colon which more precisely denotes a part of the large bowel). It consists of the surgical removal of any extent of the colon, usually segmental resection (partial colectomy). In extreme cases where the entire large intestine is removed, it is called total colectomy, and proctocolectomy (procto + colectomy) denotes that the rectum is included.

Right hemicolectomy and left hemicolectomy refer to the resection of the ascending colon (right) and the descending colon (left), respectively. When part of the transverse colon is also resected, it may be referred to as an extended hemicolectomy. Transverse colectomy is also possible, though uncommon. Sigmoidectomy is a resection of the sigmoid colon, sometimes including part or all of the rectum (proctosigmoidectomy). When a sigmoidectomy is followed by terminal colostomy and closure of the rectal stump, it is called a Hartmann operation; this is usually done out of impossibility to perform a "double barrel" or Mikulicz colostomy, which is preferred because it makes "takedown" (reoperation to restore normal intestinal continuity by means of an anastomosis) considerably easier. When the entire colon is removed, this is called a total colectomy, also known as Lane's Operation. If the rectum is also removed, it is a total proctocolectomy. Subtotal colectomy is resection of part of the colon or a resection of all of the colon without complete resection of the colon.

As of 2012, more than 40% of colon resections in United States are performed via laparoscopic approach. To begin laparoscopic surgery for a colectomy typically 4 ports are placed in the abdomen to gain access to the peritoneal cavity. The next step is to mobilize the portion of the bowel that is to be resected. This is done by ligation of the mesentery and other peritoneal attachments. A stapler is used to resect the bowel and an anastomosis between the remaining bowel is created.

Sir William Arbuthnot Lane was one of the early proponents of the usefulness of total colectomies, although his overuse of the procedure called the wisdom of the surgery into question.