Colon and Rectal Surgery

Mohammed Bayasi, MD

Department of Surgery Colon and Rectal Surgery

What is a Colon and Rectal Surgeon?

• Fully trained General Surgeon.

• Has done additional training in the diseases of colon and rectum.

Why Colon and Rectal Surgery?

• Surgical and non surgical therapy for multiple diseases.

• Chance to help cancer patients by removing tumor, potentially curing them.

• Variety of cases, ages and patient populations.

• Specialized area.

Colorectal Diseases

• Colon

– Cancer– Diverticulitis – Inflammatory Bowel

Disease (Crohn, UC)– Polyps

• Rectum/Anus

– Hemorrhoids– Anal fistula and

abscess– Anal fissure– Prolapse

Symptoms/Signs

• Pain

• Itching

• Discharge

• Bleeding

• Lump

Anatomy Lesson

Colon

• Extracts water and nutrients.

• Helps to form and excrete waste.

• Stores important bacteria flora.

• Length: 1.5 meters long = 4.9 feet = 59 inches

Colon

Rectum/Anus

• The final portion of the colon.

• Area contains muscles important in controlling defecation and flatulence.

Rectum/Anus

When to see a Colon and Rectal Surgeon

• Referral from another physician (Gastroenterology, PCP).

• Treatment of anorectal diseases.

• Blood with stool, abdominal pain, rectal pain.

Hemorrhoids

• Internal and external.

• Cushions of blood vessels.

• When enlarged, they cause bleeding and pain.

• Treatment of symptomatic hemorrhoids is directed by the symptoms themselves. It can broadly be categorized into four groups:− Medical therapy− Office-based procedure− Operative therapies− Emergent interventions

Treatment

Anorectal Abscess

• It is a collection of pus in the perianal area.

• Causes pain and drainage, and if itprogresses, fever and systemic infection.

• Treated with incision and drainage.

Normal

rectal gland

Abscess

Anorectal Fistula

• A tunnel between the inside of the anus and the skin.

• Causes discharge, pain, and formation of abscess.

• Multiple surgical options depending on fistula complexity.

Abdominal Surgery

• Colectomy: removal of part or all of the colon

• Low Anterior Resection (LAR): removing the lower portion of the colon, the rectum by making an abdominal incision

• Abdominoperineal Resection (APR): removing the rectum and anus.

A colectomy may be done anywhere within the shaded areas of

the diagrams.

Right hemicolectomy Left hemicolectomy

Transverse colectomy Sigmoid colectomy

Right Colon Resection

Ostomy

• An opening of the intestinal tract at the level of the skin.

• Allows passage of stool or enteric content.

• Temporary or permanent.

Colostomy

Colostomy

Minimally Invasive Surgery

• Performed through small incisions• Less pain• Shorter hospital stay• Faster recovery

Laparoscopic

Laparoscopic Surgery

Robotic Surgery

• Minimally invasive surgery.

• Improved visualization of tissues.

• NOT artificial intelligent.

Minimally Invasive Surgery

• Laparoscopic: inside the abdominal cavity

• Endoscopic: inside the colon or rectum

Enhanced Recovery After Surgery

• Decreases surgical stress through evidence based measures.

• Results – Less complications– Improved “well being” state– Faster recovery

Bloodless Surgery

• Optimizing blood level prior to surgery.

• Using state-of-the-art technologies to minimize blood loss.

• Minimally invasive surgery.

• Enhanced recovery after surgery.

Why Surgery at Georgetown?

• Comprehensive Care.

• Bloodless Medicine program, ostomy nurses, and experienced staff.

• Medical Oncology, Radiation Oncology, Gastroenterology, Surgeons.

Why Surgery at Georgetown?

• Premiere group of subspecialty doctors available if necessary: Cardiology, Nephrology, Pulmonary, Critical Care, etc.

• Cura Personalis: care of the whole person mind, body, and spirit.

Thank you