Colon & Rectal Surgery
The Section of Colon and Rectal Surgery provides expertise in the diagnosis and treatment of benign and malignant anal, rectal and colonic diseases, including:
- Sphincter-sparing surgery for rectal cancer
- Ileoanal pouch surgery for inflammatory bowel disease or familial polyposis
- Laparoscopic colon surgery
- Anorectal diseases
- Anorectal physiology testing for constipation and fecal incontinence
- Pelvic floor motility disorders
- Enterostomal Therapy
- Colonoscopy and sigmoidoscopy
We offer a comprehensive evaluation of low rectal cancers including transrectal ultrasonography for accurate preoperative tumor staging. Treatment is based on preoperative tumor stage. Early stage tumors are treated with local excision avoiding a permanent colostomy. Most larger tumors can be treated with a coloanal anastomosis that also avoids a permanent colostomy.
We participate actively in new research treatment protocols for both early and late stage tumors. A number of protocols are available for interested patients with rectal cancer.
We offer all operations for patients with inflammatory bowel disease including pouch surgery for patients with ulcerative colitis or familial adenomatous polyposis. In these patients ileoanal pouch surgery is curative and allows them to live without a stoma. Learn more about one of the surgical procedures called ileal pouch-anal anastomosis.
Other specialized operations are also available for patients with inflammatory bowel disease including intersphincteric proctectomy for Crohn’s disease, anal fistula surgery for patients with Crohn’s disease, and rectal advancement flaps for patients with rectovaginal fistulas.
Laparoscopic colon surgery is performed for a wide variety colorectal diseases. This new technique allows for the exact same operations to be performed through much smaller incisions. This results in less postoperative pain, shorter hospitalization and a better cosmetic result.
A comprehensive evaluation of common anorectal conditions including hemorrhoids, fissure, abscess and fistula is performed for all patients. Most patients can undergo in-office treatment using medications and/or hemorrhoidal banding (if needed). Outpatient, limited surgery using newer minimally invasive techniques is possible for other patients.
We offer a comprehensive anorectal physiology laboratory which can investigate the cause of chronic constipation and fecal incontinence. Testing available in our anorectal physiology laboratory includes anorectal manometry, anal electromyography, pudendal nerve terminal motor latency, dynamic proctography (defecography), colon transit time studies and endoanal and endorectal ultrasonography. Also available is biofeedback therapy for both incontinent and constipated patients.
Using these tests, specific disorders causing chronic constipation and fecal incontinence can be identified and treated appropriately. All treatments are offered including dietary, biofeedback, medical and surgical therapies.
Our Center for Pelvic Floor Disorders integrates the expertise of a number of physicians and surgeons to treat patients with constipation, fecal or urinary incontinence, rectal, vaginal or bladder prolapse, diarrhea and pelvic floor pain.
Specialists in gastroenterology, colorectal surgery, urology, gynecology, and radiology comprehensively evaluate these patients utilizing standard and specialized testing techniques. Specialized tests available include anorectal manometry, anal electromyography, pudendal nerve terminal motor latency testing, defecography, urodynamic testing and transanal/transrectal ultrasonography. This thorough, integrated evaluation not only identifies the causes of fecal incontinence and constipation, but also identifies all associated disorders (e.g., bladder dysfunction) that should be treated concomitantly. Treatment plans usually involve the integration of dietary, medical, biofeedback and surgical therapies.
The Enterostomal Therapy Clinic provides multimodality consultation for the acute and rehabilitative care of individuals with select gastrointestinal and skin disorders. Urological consultation for urostomy patients is also available.
For the patient who has or may need the creation of an ostomy, the following are available:
- Pre-operative teaching and stoma site selection
- Postoperative stoma and peristomal skin assessment and initiation of an effective pouching system
- Postoperative counseling in adjusting to living with an ostomy, including dietary, sexual and vocational issues
- Evaluation and treatment of stomal and peristomal skin complications
- Sterile catheterized samples from urostomy patients
- Surgical expertise in ostomy revision or relocation
- Management of fistula/wound care, dermal ulcer care and skin breakdown related to urinary and/or fecal incontinence
These two diagnostic procedures are offered for screening, diagnosis, and treatment for colorectal polyps and cancer as well as other lower gastrointestinal disorders.