Colorectal Surgery

Many Americans have difficulty moving their bowels. Some causes that contribute to bowel issues include diet and activity level. You need to refer to the proctologist anytime you are experiencing any of the following symptoms:

• bloating
• bowel obstruction
• diarrhea
• difficulty in bowel movement (constipation)
• pain during bowel movements
• mucus and pus from the anus
• pain in the anus
• rectal bleeding

The symptoms of many diseases involving the rectum and the colon are similar, so it is very important to seek medical attention as soon as you notice something is wrong. Some of the conditions treated by our surgeons at Marina Del Rey Hospital include the following:

• anal abscess, anal fistula, and anal fissure
• bowel incontinence
• colorectal cancer (colon cancer, rectal cancer, anal cancer)
• colorectal polyps
• diverticular disease (diverticulitis)
• hemorrhoids
• inflammatory bowel disease (IBD; Crohn's disease, ulcerative colitis)
• irritable bowel syndrome (IBS)
• pelvic floor dysfunction
• rectal prolapse (rectocele, proctocele)

Diagnostic procedures, such as a colonoscopy, are very important in colorectal surgery, as they can tell the physician what type of diagnosis should be given and what procedure should be done to correct the condition. Colorectal surgeons perform a number of screening and diagnostic tests, including:

• colonoscopy
• defecating proctography
• flexible sigmoidoscopy
• proctoscopy
• sigmoidoscopy
• ultrasound
• virtual colonoscopy

A sigmoidoscopy is similar to, but not the same as, a colonoscopy. During this procedure, the surgeon only examines up to the sigmoid, the most distal part of the colon, while during colonoscopy, the whole large bowel is examined. Detection methods for colorectal cancer include a digital rectal exam (an exam of the rectum by a physician with his or her finger) and a chemical test of the stool for blood. Other tests may include a physical examination, a review of symptoms and family history and, in addition, testing may include barium x-rays of the upper and lower intestinal tract.

This table shows the most common treatment methods used for a few disorders that we normally encounter in our patients.

Medical treatment with anti-inflammatory or immunosuppressive medication to control symptoms is the preferred initial form of therapy when dealing with some disorders. However, surgery often provides long-term relief from symptoms and limits or eliminates the need for medication. The symptoms of IBS closely resemble those of other, sometimes life-threatening diseases, such as colon cancer, Crohn's disease or ulcerative colitis, so it is imperative to seek medical attention so that these disorders may be ruled out.

Surgical treatment options include:

• abdominoperineal resection (APR)
• laparoscopic-assisted colectomy
• local transanal resection (full thickness resection)
• low anterior resection
• open colectomy
• pelvic exenteration
• polypectomy and local excision
• proctectomy with colo-anal anastomosis
• rectal surgery
• transanal endoscopic microsurgery (TEM)

If you have been diagnosed with a colorectal condition and surgery is imminent, ask your surgeon about the da Vinci surgery. As a result of da Vinci technology, da Vinci surgery for colorectal conditions offers the following benefits:

• low rate of complications
• precise removal of cancerous tissue
• low blood loss
• low conversion rate to open surgery
• quick return of bowel function
• better cosmetic result compared to open surgery
• quick return to a normal diet
• short hospital stay