Colon & Rectal surgery
Colon and rectal surgery, also known as colorectal surgery, involves surgical procedures that address a wide range of conditions affecting the colon, rectum, and anus. These surgeries are aimed at treating diseases such as colon cancer, inflammatory bowel disease (IBD), hemorrhoids, diverticulitis, rectal prolapse, and other disorders affecting the lower gastrointestinal tract.
Here is a breakdown of the main types of surgeries performed in colon and rectal surgery:
Colorectal Cancer Surgery
Surgical treatment for colorectal cancer often involves the removal of the tumor and part of the surrounding tissue. Depending on the stage and location of the cancer, the surgery may be open or minimally invasive (laparoscopic).
- Colon Resection (Colectomy): Removal of a portion of the colon that contains cancer. The remaining healthy parts of the colon are reconnected (anastomosis).
- Right Hemicolectomy: Removal of the right side of the colon (ascending colon).
- Left Hemicolectomy: Removal of the left side of the colon (descending colon).
- Sigmoid Colectomy: Removal of the sigmoid colon (the last part of the colon before the rectum).
- Total Colectomy: Removal of the entire colon, which may be necessary in more extensive cases.
- Low Anterior Resection (LAR): A surgical procedure to remove cancer located in the upper or middle part of the rectum. The colon is then reconnected to the remaining part of the rectum.
- Abdominoperineal Resection (APR): A surgery for cancers located in the lower rectum or anus, where the anus, rectum, and part of the sigmoid colon are removed. A permanent colostomy is typically required in this procedure.
- Laparoscopic Colectomy: A minimally invasive surgery using small incisions and a camera to remove a portion of the colon. This technique offers benefits such as shorter recovery times and less postoperative pain.
Inflammatory Bowel Disease (IBD) Surgery
Surgical intervention is often needed for Crohn’s disease and ulcerative colitis when medications or other treatments do not provide relief, or if complications like strictures, fistulas, or perforations occur.
- Colectomy for Ulcerative Colitis: Removal of the colon for patients with severe or refractory ulcerative colitis. Depending on the case, a proctocolectomy (removal of both the colon and rectum) may be performed, followed by a ileoanal anastomosis (creating a pouch from the small intestine to act as a new rectum).
- Small Bowel Resection for Crohn’s Disease: Removal of the diseased portion of the small intestine. This may be necessary in Crohn’s disease when the disease is localized to one part of the intestines or when there are complications such as strictures (narrowing) or fistulas (abnormal passages).
- Strictureplasty: A technique used in Crohn’s disease to widen narrowed sections of the intestine without removing the affected portion.
Diverticulitis Surgery
Diverticulitis occurs when small pouches (diverticula) in the colon become inflamed or infected. Surgery is generally reserved for cases where there is recurrent or complicated diverticulitis, including perforation, abscess, or fistulas.
- Sigmoid Colectomy: Removal of the sigmoid colon, the most common site for diverticulitis. This is often performed when there is chronic or recurrent diverticulitis or complications such as perforation.
- Hartmann’s Procedure: In emergency situations where there is a perforation or rupture of the colon due to diverticulitis, a portion of the colon is removed, and a colostomy is created. The patient may later undergo a second surgery to reverse the colostomy.
- Laparoscopic Diverticulitis Surgery: Minimally invasive surgery used to remove the diseased portion of the colon in cases of uncomplicated diverticulitis or to treat perforations.
Colostomy and Ileostomy Surgery
An ostomy is a surgical procedure in which an opening (stoma) is created on the abdomen to allow waste to exit the body when the normal route of elimination (rectum and anus) is not possible or functional. This can be temporary or permanent.
- Colostomy: A surgical procedure in which a portion of the colon is diverted to an opening in the abdomen, allowing stool to be collected in a colostomy bag. This can be done after colon resection or in cases of obstruction, cancer, or traumatic injury.
- Ileostomy: A similar procedure to a colostomy, but the ileum (the last portion of the small intestine) is diverted to the abdominal wall. This is often done when the entire colon is removed (as in cases of ulcerative colitis or familial adenomatous polyposis).
- Ileoanal Pouch (J-Pouch): In some cases, after a colectomy, the surgeon may create a new “rectum” from the small intestine (ileoanal anastomosis or J-pouch) to allow for normal bowel movements without the need for an external bag.
Rectal Prolapse Surgery
Rectal prolapse occurs when the rectum slides down and protrudes from the anus. Surgery is required when symptoms are severe or persistent.
- Rectal Prolapse Repair (Proctopexy): A procedure to reposition the prolapsed rectum and secure it in place, often using sutures or mesh. This can be done via abdominal (laparoscopic or open) or perineal (through the anus) approaches.
- Perineal Prolapse Repair: A less invasive option performed through the perineum to repair a rectal prolapse without abdominal surgery.
Hemorrhoid Surgery
Hemorrhoid surgery is performed when hemorrhoids (swollen blood vessels in the anal canal) are symptomatic and do not respond to conservative treatments.
- Hemorrhoidectomy: The surgical removal of hemorrhoids, typically reserved for severe or prolapsed hemorrhoids that cannot be managed with non-surgical treatments.
- Stapled Hemorrhoidopexy: A minimally invasive procedure to treat hemorrhoids by stapling the hemorrhoidal tissue, repositioning it, and cutting off the blood supply, leading to the shrinkage of the hemorrhoids.
Anal Fistula Surgery
An anal fistula is an abnormal connection between the anal canal and the skin around the anus, often resulting from an abscess.
- Fistulotomy: The most common surgical procedure for treating anal fistulas, where the fistula tract is cut open to allow it to heal from the inside out.
- Seton Placement: In complex or high anal fistulas, a seton (a piece of surgical thread or rubber) is placed to help drain the fistula and promote healing over time.
- Flap Repair: For complex fistulas or when the sphincter muscles are involved, a flap of healthy tissue from nearby areas may be used to close the fistula.
Rectal and Colon Reconstruction Surgery
In cases where parts of the colon or rectum are removed, the surgeon may need to reconstruct or restore bowel function.
- Ileoanal Anastomosis (J-Pouch): Creation of a new anal reservoir from the small intestine after total colectomy, allowing the patient to have normal bowel movements without the need for a permanent ostomy.
- Colorectal Anastomosis: Reconnection of the remaining healthy parts of the colon after the removal of a diseased section, ensuring the continuity of the bowel.
Surgical Treatment of Colon and Rectal Trauma
Trauma to the colon and rectum can result from accidents, injuries, or surgery. Emergency surgery is required in some cases.
- Repair of Colon or Rectal Perforations: Immediate surgical intervention to repair damage to the colon or rectum due to trauma, such as lacerations, gunshot wounds, or blunt force trauma.
- Resection of Injured Colon: Removal of the damaged portion of the colon or rectum due to traumatic injury, often followed by a colostomy or ileostomy.
Minimally Invasive Surgery
In many cases, colon and rectal surgeries can now be performed using minimally invasive techniques, which result in smaller incisions, less postoperative pain, faster recovery times, and fewer complications.
- Laparoscopic Colectomy: Removal of portions of the colon with small incisions and the use of a camera.
Colon and rectal surgery covers a wide variety of procedures for treating benign and malignant conditions of the colon, rectum, and anus. The field has advanced significantly with the introduction of minimally invasive techniques like laparoscopy and robot-assisted surgery, allowing for quicker recoveries and less postoperative pain. Whether treating cancer, inflammatory bowel disease, diverticulitis, or hemorrhoids, colon and rectal surgeons aim to restore bowel function and improve
Online simple step for appointment
Make Appointment
Select Doctor