Colorectal Surgeon Phoenix performs surgical procedures that treat issues affecting your lower digestive tract. Many colorectal surgeries can be performed using minimally invasive techniques.
Your doctor may recommend surgery if nonsurgical treatments such as diet changes and medications are not providing relief from inflammatory bowel disease (IBD). During the procedure, your surgeon will remove a portion of your colon and rectum and reconnect the healthy sections.
Fistulas develop when your tissues are inflamed for a long time, and the inflammation and infection can erode tissue and create an opening through which pus can flow. Fistulas can occur throughout your body, but are most common in the rectum and anal canal. They can be caused by inflammatory bowel disease, radiation or surgery in your abdomen, pelvic cancer, hernias and other surgeries, or a rare condition called hidradenitis suppurativa (pseudomycosis).
Treatment depends on what caused the fistula and how well you’re able to heal. It may include draining the area of the fistula, reducing pain and discomfort, and improving your quality of life. It can also involve a procedure to close the internal opening of the fistula.
Your doctor may need to diagnose the condition by examining your symptoms and conducting other tests. These may include a colonoscopy or other types of endoscopy to examine the area. You may have to undergo a biopsy of the tissue for more information about what caused your fistula.
Fistula treatments include draining infections and abscesses, minimizing pain and discomfort, improving your quality of life, and restoring or replacing the fistula when possible. They can also include medications, such as anti-inflammatory and antibiotics, and physical therapy.
In some cases, your doctor might need to remove the entire fistula if it is causing damage to your tissue or is preventing other tissues from healing. This type of surgery is usually done under general anesthesia.
The most common surgery to treat anal fistulas is a fistulotomy. Your surgeon will insert a seton, a thin surgical cord, into the anal fistula. This will widen the tract and allow it to heal. This can be performed using open or laparoscopic surgery. For complicated anal fistulas, your surgeon can perform the LIFT procedure, which accesses the fistula between the sphincter muscles.
Rectum prolapse
Rectal prolapse is when a part of the colon or the small intestine pushes through the anal opening (the anus). Symptoms include pain in the rectal area, not being able to have bowel movements and fecal incontinence. The condition may be diagnosed by a physical exam, blood work or imaging tests.
Often the prolapse can be pushed back into place with gentle pressure. If the prolapse can’t be pushed back in, surgery is required to prevent a serious complication called strangulation. The surgeon will repair the prolapse with a mesh sling to protect it. Surgery can be done through the abdomen, or with minimally invasive laparoscopic techniques. The surgical approach depends on your age, the severity of the prolapse and your surgeon’s experience.
A rectal prolapse can be treated with non-surgical methods, such as using stool softeners to help you have bowel movements without straining and putting pressure on the rectum with a pillow. Some people can also benefit from taking a course of pelvic floor exercises and losing weight to reduce stress on the anal area.
If the rectum prolapse is severe, surgery is needed to treat it and prevent the bowel from coming out of the anus. Depending on your health condition, your doctor will recommend either an abdominal surgery called rectopexy or a procedure done through the area around the anus, called perineal rectosigmoidectomy.
In both operations, under anesthesia, your surgeon will use a small incision in the abdomen or perform the surgery using laparoscopy with a small camera and surgical tools placed through a series of smaller incisions. The surgeon will repair the rectum with a mesh sling to protect the area and fix it to the back wall of the pelvis, called the sacrum. In patients who have a history of constipation, your surgeon may remove a portion of the colon during rectopexy.
Before your surgery, you will be asked to fast and drink a special preparation to empty your bowels. You will need to arrange for someone to drive you home after the operation because you won’t be able to drive yourself. You will be given medications to prepare for the operation and to make you drowsy. Showering with antiseptic soap is also recommended before the operation to prevent infection.
Diverticulosis
Diverticulitis is a digestive condition that happens when pouches that form in the wall of your large intestine become inflamed and infected. Many people can have an attack that resolves on its own with oral or intravenous antibiotics, a liquid diet and pain relievers. However, in severe cases that don’t respond to treatment or repeated attacks that can cause long-term symptoms, surgery may be needed to remove part of your colon.
The symptoms of diverticulitis aren’t specific enough to make the diagnosis by themselves, but a careful history and physical exam can help your doctor narrow down the possible causes. Symptoms include abdominal pain, tenderness and fever. Complicated diverticulitis can also present with a hole in the colon (perforation) or a collection of pus called an abscess. Abscesses can usually be drained with the help of an interventional radiologist, but a perforation may require emergency surgery.
Symptoms of complicated diverticulitis are more serious and can lead to severe complications, including infections in other parts of the body, such as the lungs, heart or brain, or in other organs, such as your bladder or uterus. A ruptured diverticulum can leak fecal material into the abdominal cavity, causing peritonitis. A perforation may also lead to shock, which can require hospitalization and emergency surgery.
Recurrent or chronic diverticulitis is common in patients who have a history of one or more episodes of acute diverticulitis. It may be related to a problem with your colon’s regular bacterial balance, or it may happen because the scar tissue left behind after an episode of diverticulitis doesn’t heal properly.
The most effective treatment for recurrent or chronic diverticulitis is to have surgery to remove part of your colon, known as a sigmoidectomy. This procedure can be done laparoscopically. In most cases, you’ll be home in a few days. You’ll need to avoid solid foods and drink only clear liquids until you have a complete recovery, and then reintroduce your food slowly as your doctor instructs you. You’ll also need to follow instructions for caring for a stoma and an odor-proof bag that collects your stool while you recover.
Colostomy
A colostomy is when one end of your colon (bowel) is diverted to another opening in your abdomen. This is called a stoma, and you can put a pouch on it to collect your poop. You can get a colostomy because of cancer, an illness, injury or problem with your digestive system.
The surgery may be open or laparoscopic. It is a major operation, so you’ll be in hospital for several days. A specialist stoma nurse can visit you on the ward to help you. This nurse can also show you how to care for your stoma and how to change your colostomy bag.
Before the surgery, your surgeon will check you are fit for the operation. You’ll be given an EKG and blood tests. You’ll need to drink lots of fluids to prepare your bowels. They might also recommend you have a bowel prep before the surgery, which is like an enema.
Colostomy surgery is done under general anesthesia. The surgeon will mark a point on your abdomen for the new opening (stoma). They’ll remove the diseased portion of your colon and pull out the healthy part through the stoma. Then they sew the healthy bowel portion to the stoma and attach a pouch to collect your poop.
You can have a permanent or temporary colostomy. Your surgeon might create a temporary colostomy to give your colon a rest, then reverse it at a later date. It’s more common to have a permanent colostomy because of cancer or other illnesses that require removing large parts of the colon.
You’ll need to learn how to care for your colostomy, including changing your stoma bag and cleaning it. You’ll also need to make sure you have enough liquids to prevent dehydration. It’s important to manage your pain after surgery. You can take painkillers if needed. But it’s important to talk to your doctor before you decide to take painkillers. Using too many can harm your bowels.
