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A right hemicolectomy removes the right side of the colon for cancer of the caecum, the ascending colon or the bend near the liver. This page explains the operation itself: what is removed, where its blood vessels are tied, what the robot changes, how the join is made inside the abdomen, and what the days after look like. Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad.
Last updated: 9 October 2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Robotic Cancer Surgeon (GI)
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
★★★★★ Google: 4.9 from 53 reviews (Gota clinic) · 5.0 from 25 reviews (Apollo, Bhat)
Shah’s Gastro, Cancer & Robotic Surgery Centre. Super-specialty training in surgical gastroenterology, two higher degrees in it, and 18 years of experience in GI and cancer surgery. Every colon cancer is discussed at the tumour board once staging is complete, and Dr Harsh Shah performs the operation himself.
In short
A right hemicolectomy removes the caecum, the ascending colon, the last part of the small bowel and the fatty fold that carries their blood vessels and lymph nodes. The vessels are tied at their root, so the nodes along them come out in one piece with the bowel.
With the robot, that dissection is done along the large vein that drains the small bowel, where precise, steady instruments matter most. The robot also makes it easier to stitch the join inside the abdomen, so the specimen can come out through a short cut low on the abdomen.
Keyhole surgery is the established standard for this operation, and the robot is used where its precision helps. Open surgery is chosen for a bulky tumour stuck to other organs or a scarred abdomen. Most patients eat the next day and go home within the week.
The operation removes the segment of colon that carries the cancer together with the fatty fold, called the mesocolon, that holds its blood vessels and lymph nodes. Which segment is removed, and which vessels are tied, depends on exactly where the tumour sits on the right side.
| Where the tumour is | Operation | Vessels tied at their origin |
|---|---|---|
| Caecum or ascending colon | Right hemicolectomy | The ileocolic vessels and the right colic vessels |
| The bend near the liver (hepatic flexure) or the first part of the transverse colon | Extended right hemicolectomy | The same, plus the middle colic vessels |
| Further along the transverse colon, towards the spleen | Extended right or left hemicolectomy, planned on the scans | The middle colic vessels, with or without the left colic |
The last part of the small bowel is removed with the caecum because they share a blood supply. The small bowel is then joined to the remaining transverse colon. Food continues to pass in the normal direction, so there is no bag after an elective right hemicolectomy in almost every patient.
A tumour that is too small to feel from the outside is found by the tattoo of dark ink placed beside it at colonoscopy. That is why the tattoo is asked for before surgery.
Four rules apply whatever the approach: the vessels are tied at their origin, the mesocolon is removed whole in its own plane, the bowel margins are wide, and any organ the tumour is stuck to is removed with it rather than peeled off.
These rules, not the instruments, decide how well the operation treats the cancer. The robot is chosen when it helps carry them out with precision.
The robot changes how the deepest part of the dissection is done. The vessels to the right colon arise from the large vein and artery that run to the small bowel, close to the pancreas and the duodenum. The robot’s steady magnified three-dimensional view and wristed instruments let the surgeon trace and tie them at their root precisely.
There is no sense of touch through the robot’s instruments. Tumour edges and margins are judged by sight, by the tattoo and by the scans, which is one reason the tattoo is placed at colonoscopy.
A robotic right hemicolectomy suits a patient whose colon cancer can be removed with its fatty fold and whose heart and lungs tolerate a few hours with gas in the abdomen and the table tilted. A heavy build, where stitching inside through straight keyhole instruments is hardest, is where the robot helps most.
Fitness is checked, not assumed. Anaemia is corrected before surgery, with iron through a drip if there is not time for tablets; sugar is controlled; smoking and alcohol stop at least four weeks before; and a patient who has lost weight or is eating poorly sees a dietitian first.
Some patients are better served differently. Severe heart or lung disease may make a long operation with gas in the abdomen unsafe. A tumour pressing into the duodenum or the pancreas may need a combined operation planned with the pancreas team. A blood thinner that cannot be stopped needs a bridging plan. Each of these is discussed at the tumour board before a date is set.
The patient lies on the back, tilted so the small bowel falls away from the right side. Four small robotic ports are placed in a line across the lower abdomen, with one more port for the assistant. The robot is docked once, and the camera can be moved between ports to reach the bend near the liver without undocking.
Docking direction is planned before the operation, because undocking and re-docking in the middle of a case adds time. The robotic arms are angled towards the root of the vessels for the first part and towards the liver for the bend of the colon.
The ports are small. The specimen comes out through one short cut, chosen in advance: low across the abdomen, below the bikini line, when the join is made inside; or around the navel when the join is made outside. A low cut is less painful and less likely to develop a hernia later.
| Stage | What is done |
|---|---|
| Entry and inspection | Camera port placed; liver and lining of the abdomen inspected for any spread before the plan is confirmed |
| Vessel root | The ileocolic vessels are found, traced to their origin and tied; the plane behind the mesocolon is opened |
| Mesocolic plane | The right colon is lifted off the duodenum and the back wall with its covering intact |
| Hepatic flexure | The bend near the liver is freed; for an extended operation the middle colic vessels are tied |
| Division and join | The bowel is divided with staplers, the perfusion is checked with dye, and the small bowel is joined to the colon inside the abdomen |
| Removal | The specimen goes into a bag and comes out through the short cut; the cut is closed in layers |
When the join is made inside the abdomen, the end of the small bowel and the colon are laid side by side, opened, and joined with a stapler; the remaining opening is closed with stitches. Only then is the specimen removed, through a cut chosen for comfort, not for reach.
The alternative is to bring the bowel out through a cut around the navel and join it outside the abdomen. Both are accepted. The join made inside allows a smaller, lower cut and less pulling on the bowel, and the robot makes the stitching inside easier. The choice is made for each patient.
A join between the small bowel and the colon heals well in most patients. Even when the colon is blocked by the tumour, removing the right colon and joining it at once is usually safe, so a stoma is rarely needed on this side.
Whether to close the gap left in the mesentery is decided by the surgeon according to how much was removed.
All three remove the same bowel, the same fatty fold and the same lymph nodes. Keyhole surgery is the established standard. They differ in the cuts, in how the vessels near the main vein are reached, in where the join is made, and in the speed of recovery.
| Open | Keyhole | Robotic | |
|---|---|---|---|
| Cut | A long cut on the abdomen | Ports and a short cut | Ports and a short, often low cut |
| Vessels near the main vein | Direct | Magnified, straight instruments | Magnified three-dimensional view, wristed instruments |
| Join | Outside the abdomen | Outside, or inside | Usually inside, stitched with wristed instruments |
| Blood-supply check | By eye | Dye where available | Dye built into the camera |
| Blood loss | Higher | Lower | Lower |
| Lymph nodes removed | The same | The same | The same |
| Hospital stay and return to work | Longest | Shorter | Shorter |
| Cost | Lowest | Similar to open | Higher, for the robotic instruments |
When to return to work and to lifting depends on the job and on the cut, and is planned with you at discharge.
Open surgery is chosen for a bulky tumour that has grown into neighbouring organs and needs a larger en-bloc removal, for an abdomen scarred by several previous operations, and when the heart or lungs cannot tolerate gas in the abdomen for a long operation.
Choosing open surgery in these situations is an appropriate operative judgement, not a failure. If bleeding cannot be controlled at once, or the plane is lost, a robotic operation is converted to open, and that is part of the consent.
A colon so swollen behind a blockage that it is close to bursting needs relief first, and the approach for that operation is decided on the day.
Patients sit out of bed on the day of surgery, eat a normal diet from the next day, and walk several times a day. There is no tube through the nose and usually no drain. Most go home around the fourth or fifth day after an uncomplicated operation.
| When | What happens |
|---|---|
| Day of surgery | Out of bed a few hours after the operation; clear fluids; chewing gum; pain relief with minimal opioids; drip off once drinking |
| Next day | Normal diet as tolerated; walking four times; catheter out; drip off |
| Second day | Full diet; walking more; tablets for pain; wind is expected |
| Third day | A bowel action; discharge criteria reviewed |
| Fourth or fifth day | Home, once eating, walking and pain on tablets are steady |
The team watches for warning signs and acts the same day: a fast pulse, fever or worsening abdominal pain between the third and seventh days can mean a leak at the join and is investigated at once, never watched overnight. Bloating with vomiting may be a slow bowel. Milky fluid from a drain after this operation is a lymph leak, treated with a low-fat diet.
These complications, and the figures that apply to you, are discussed at the consent visit.
The pathology report is discussed at about two weeks. It must state the number of lymph nodes examined, the margins, the mismatch-repair result and any high-risk feature. Those four facts decide whether chemotherapy is advised; if it is, it starts within six to eight weeks of surgery.
If the tumour shows a mismatch-repair defect, genetic counselling is offered, because it can run in families. How colon cancer is found and staged before surgery is explained on the colon cancer pages of this site; this page begins where the decision to operate has been made.
| When | Follow-up |
|---|---|
| Two weeks | Wound check, the pathology report, the chemotherapy referral if needed, and a dietitian |
| Every three months for three years | Symptoms, weight, examination and the tumour-marker blood test |
| Every six months in the fourth and fifth years | The same visit |
| Every year | CT scan of the chest, abdomen and pelvis |
| At one year | Colonoscopy; if normal, again at three years, then every five years |
★★★★★
“I am writing to express my sincere gratitude for the exceptional care provided by Dr. Harsh Shah and his team. Dr. Harsh Shah is an outstanding expert in intestinal surgery, executing complex procedures with remarkable calm and precision. Dealing with gastrointestinal diseases is incredibly stressful for both patients and their families. In my experience, what sets Dr. Harsh Shah apart is his incredible patience; he takes the time to listen to every question and provides clear, reassuring answers to every concern. As a grateful patient, I highly commend Dr. Harsh Shah and the entire team at Apollo Hospital. They did not just treat our physical condition—they truly cared for our mental and emotional well-being”
— Dipen Shah, Google review, Apollo Hospital, Bhat listing
★★★★★
“Dr harsh operated my sister for liver cancer .we came for follow up .Now she is good. Thank u so much sir”
Natu Vadalia · Google review
★★★★★
“I had a truly positive experience with Dr. Harsh Shah. He is not only highly knowledgeable but also very compassionate and patient in explaining every detail. I underwent CRS HIPEC surgery under his care, and I couldn’t have asked for a better doctor. The entire process was smooth, and his expertise made a complex procedure feel manageable. Post-surgery recovery was well-monitored, and he was always available for any concerns. Highly recommend Dr. Harsh Shah for anyone needing advanced surgical oncology care.”
Akram Khan · Google review
Quoted exactly as written on the centre’s Google listings: a family whose relative had robotic surgery for colon cancer, and two patients of Dr Harsh Shah treated for other cancers, followed by a patient speaking after a keyhole right hemicolectomy.
A robotic right hemicolectomy costs more than an open or keyhole one, because of the robotic instruments and staplers. An extended operation, a longer stay or a complication changes the total. The office prepares a written estimate once the approach is decided.
Cashless admission is arranged at Apollo Hospital, Bhat where your policy allows it, and the office prepares the pre-authorisation papers; allow a day or two for robotic approval. Ask whether your policy covers robotic surgery and up to what limit. Bring the policy documents, photo identity, every report with the scans on disc, and a list of current medicines.
No. Keyhole is the established standard and the robot is used where its precision helps. Bulky tumours stuck to other organs, or a scarred abdomen, are operated open.
Almost never after a planned operation. The small bowel is joined to the colon, and this join heals well, even after a blockage.
The bowel is joined with a stapler and stitches through the ports, before the specimen is removed. It allows a smaller, lower cut.
The robot gives no sense of touch, so a small tumour is found by the ink beside it.
A normal diet from the next day, if you feel like it. There is no tube through the nose.
It depends on the pathology report: the lymph nodes, the margins, the mismatch-repair result and any high-risk feature.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of scans and pathology reports, second opinions, follow-up and surveillance.
Google: 4.9 · 53 reviews
Apollo Hospital, Bhat, Gandhinagar
Admission, robotic and open surgery, and inpatient care.
Google: 5.0 · 25 reviews
Patients travel for colon cancer surgery from across Gujarat, southern Rajasthan and western Madhya Pradesh.
Send the colonoscopy report, the biopsy report and the CT report ahead of your appointment, so the consultation starts with them already read. Whether your operation is robotic, keyhole or open is decided at the consultation after examination, and by the tumour board. Call +91-63590-11009 WhatsApp the office
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