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Colorectal surgery refers to a variety of procedures used to repair damage to the colon, rectum, anus and pelvic floor caused by diseases of the lower digestive tract, such as cancer, diverticulitis and inflammatory bowel disease. We also offer minimally invasive outpatient alternatives to surgery using our endoscopy and colonoscopy facilities. A selection of the extensive range of services provided by our colorectal surgery team are outlined below.
Upper GI endoscopy
An examination involving the passing of a small, fibreoptic tube (the endoscope) through the mouth into the stomach, allowing the doctor to look directly at the lining of the oesophagus (gullet), stomach and duodenum (the first section of the small intestine). If a sample of tissue needs to be taken for analysis (a biopsy), it will be removed painlessly through the endoscope, using miniature forceps.
A fibre-optic camera examination of the rectum, sigmoid and left colon. Often performed without sedation, a Flexible Sigmoidoscopy is commonly used to look for bleeding or noncancerous growths (polyps) and is one of the main screening tests for colorectal cancer.
A long flexible tube about the thickness of a finger (the colonoscope) is inserted into the rectum and gradually advanced through the colon, allowing the physician to examine the lining of the rectum, diagnose colon and rectal problems, perform biopsies and remove noncancerous growths (polyps).
Proctology is the medical speciality that deals with the diagnosis and treatment of disorders affecting the colon, rectum and anus.
Banding of haemorrhoids
This outpatient procedure involves the surgeon taking hold of the haemorrhoid with forceps or a suction device and placing a rubber band around the base of the haemorrhoid. This cuts off the blood supply and causes the haemorrhoid to wither and drop off after a few days.
A new technique for treating haemorrhoids that removes the excess lining of the bowel, raising the haemorrhoidal tissue back to its regular position and thus reducing the blood supply to the haemorrhoids causing them to shrink. The procedure is relatively painless and can be performed as a day case in most instances.
The surgical removal of haemorrhoids, where the anal cushions are excised using diathermy (high frequency electric current to produce heat). Performed as a day case.
Pilonidal sinus surgery for primary and recurrent disease
A treatment for ingrowing hair follicles at the base of the spine. Hairs grow inwards through tiny holes in the skin (sinuses) where the germs on the hairs can cause pain, swelling and discharge. Surgical techniques include excision, Bascom's procedure and Limberg flaps.
An anal fissure is a small tear in the skin, just inside the anus, usually towards the back. Treatments include the use of GTN (a drug used to relax the internal anal sphincter) and a sphincterotomy which involves cutting out that part of the internal sphincter to relieve the tension. A similar effect to the sphincterotomy can be achieved using non-surgical methods such as diltiazem for a chemical sphincterotomy and botulinum toxin (BOTOX®). A Botox fissurectomy lasts approximately 3 months, until the nerve endings regenerate. This 3-month period may allow acute fissures to heal – if not, a surgical sphincterotomy may be recommended.
Perianal abscess and anal fistula surgery
A perianal abscess is a gathering of pus that forms next to the anus, often causing swelling and pain. An anal fistula is a narrow channel running from the skin near the anus to further up the anus, often occurring after there has been an abscess in the area. Surgery to treat these problems can involve draining the sepsis, laying open of fistulae, seton insertion and rectal advancement flaps.
Inflammatory Bowel Disease
Inflammatory bowel disease is a chronic condition in which the lining of the digestive tract becomes inflamed and covered with ulcers. Two common types of inflammatory bowel disease are Crohn's disease and ulcerative colitis.
Surgery for Crohn's disease
Crohn’s disease can occur along the entire digestive tract and spread deep into the bowel wall. Although surgery can relieve the symptoms of Crohn’s disease, it cannot cure it. Surgery may involve the resection of diseased segments of Crohn's and strictureplasty of short strictures to preserve bowel length. Some cases are done laproscopically (using minimally invasive surgery and micro-video cameras).
Pouch surgery for ulcerative colitis
Ulcerative colitis typically affects the top layer of the large intestine (the colon) and rectum. Pouch surgery involves taking the very end of the small intestine (the ileum) and creating a pouch that is then connected to the anus to allow waste to leave the body through the anus.
Colorectal Cancer surgery
Although harmless in themselves, if noncancerous growths (polyps) continue to grow they may develop into a cancerous tumour. If this occurs, colorectal surgery may be necessary to treat the subsequent colon and rectal cancer.
Primary colorectal cancer surgery
This form of surgery includes all colonic and rectal resections including low anterior resection of the rectum (where the tumour is removed without affecting the anus) and abdomino-perineal excision (where the rectum and anus are both removed) with myocutaneous flap repair of the perineum. Some cases are performed laparoscopically, involving minimally invasive surgery and micro-video cameras.
Recurrent rectal cancer surgery
This form of surgery can involve multivisceral resection (surgery involving numerous organs) including total pelvic exenteration (the removal of removes the bladder, urethra, rectum, anus and supporting muscles and ligaments, together with the reproductive organs) and abdominosacral resection (which treats midrectal cancer while preserving the function of the anal sphincter).
The pelvic floor is the supportive muscular structure located in the pelvis that extends from the pubic bone to the tailbone with openings for the urethra and anus as well as the vagina in women.
Rectal prolapse surgery
When the lining of the rectum collapses through the anal opening surgery may be necessary to repair the prolapse. Our surgical team can provide perineal and abdominal surgical repair of full thickness rectal prolapse.
A rectocoele repair procedure involves restoring the supportive tissue between the vagina and rectum to treat a prolapse of the rectum through the vaginal wall. In some cases, the surgery may be performed laparoscopically, involving minimally invasive surgery and micro-video cameras.
Anal sphincter repair
Damage to the anal sphincter is a relatively common problem, occurring in up to a third of women at their first vaginal childbirth. Subsequent problems can include faecal incontinence. This surgical procedure repairs the anal sphincter so that it functions as normal.
Consisting of the herniation of mucosa through the thickened colonic muscle, the number of diverticula can vary from one to many hundreds. Diverticular resection is used to treat complicated diverticular diseases such as colovaginal (where stools are passed via the vagina) and colovesical fistulae (where the urinary bladder and the bowel become connected).