All of the following structures are removed in right hemicolectomy except
**Core Concept**
A right hemicolectomy is a surgical procedure that involves the removal of the right side of the colon, including the cecum, ascending colon, and a portion of the transverse colon. This procedure is typically performed to treat cancer, inflammatory bowel disease, or other conditions affecting the right colon. The surgical approach and extent of resection can vary depending on the underlying pathology and the surgeon's preference.
**Why the Correct Answer is Right**
The correct answer, **C. Transverse colon**, is chosen because the right hemicolectomy primarily involves the removal of the cecum, ascending colon, and the hepatic flexure, which is the junction between the ascending colon and the transverse colon. However, the transverse colon itself is not removed during a standard right hemicolectomy. The surgeon may choose to resect a portion of the transverse colon if the tumor or disease process extends into this area, but this is not a routine part of the procedure.
**Why Each Wrong Option is Incorrect**
**Option A:** The cecum is indeed removed during a right hemicolectomy, as it is the first part of the large intestine and is often affected by conditions such as cancer or inflammatory bowel disease.
**Option B:** The ascending colon is also removed during a right hemicolectomy, as it is part of the right colon and is often involved in the disease process.
**Option D:** The hepatic flexure is removed during a right hemicolectomy, as it is the junction between the ascending colon and the transverse colon and is often affected by conditions such as cancer or inflammatory bowel disease.
**Clinical Pearl / High-Yield Fact**
It is essential for surgeons to carefully evaluate the extent of disease and the patient's overall condition before deciding on the extent of resection during a right hemicolectomy. This may involve additional imaging studies, such as CT scans or MRI, to determine the extent of tumor involvement or the presence of metastatic disease.
**β Correct Answer: C. Transverse colon**