Colorectal Surgery - Bhatwal Hospital

Colorectal surgery is a vast field of medical surgery that deals with treating the disorders of rectum, anus, and colon. Also recognized as proctology about a decade ago, it dealt with treating disorders related to rectum and anus only. Diagnostic procedures, such as colonoscopy are highly important before colorectal surgery is performed. It gives a clear idea of what should be done to correct the condition. Other diagnostic procedures used by colorectal surgeons are proctoscopy, defecating proctography, sigmoidoscopy, etc.

What we treat and How?

Self-illuminating Proctoscope is performed for the detailed assessment of problems related to anal canals such as anal fistula,hemorrhoids , and anal fissures.
For patients with hemorrhoidsof first and second degree who also show bleeding, rubber band ligation of hemorrhoids is performed.
For patients suffering from fecal excretion problems and incontinence, are evaluated with Anorectal manometry. Based on the findings and observations, patients are carefully selected for further procedures.
For patients with anorectal symptoms, we recommend Flexible Sigmoidoscopy.
For patients with colonic and rectal polyps we recommend colonoscopy and polypectomy.

With Colorectal surgery techniques in place, we at Bhatwal Surgical and Maternity Hospital also excel in the treatment of pelvic floor diseases and colorectal cancer. Our colorectal surgeons are keen experts in the surgical and non-surgical treatment of diseases of the colon, rectum, and anus. With full-fledged pieces of training and technology at assistance, we perform colorectal surgeries with ease and efficiency.

The colon and rectum is a hollow tube that passes from the small intestine to the anus. About 5 to 6 feet long, the function of the colon is to absorb water and store the waste products of digestion until a person’s body is ready to excrete it out. The ending of the colon is the rectum. At the bottom of the rectum are the sphincter muscles that prevent the rectum from emptying out accidentally.

Any disturbance, pain, abnormality, or unusual symptoms in the above-mentioned process are colorectal diseases or disorders. Colon and rectal diseases comprise a broad range of conditions. Its severity usually varies from slightly disturbing to even life-threatening conditions. The recent researches in the field recommend that the early identification and treatment of colon and rectal diseases dramatically improve the treatment outcomes and survival rates. Research also highlights that the patients surgically treated for colon and rectal diseases are more likely to survive colorectal cancer.

Our team of experts at Bhatwal Surgical and Maternity Hospital are armed with solutions to get you through all the colorectal disorders by offering you the safest advice.

The following surgical procedures need to be performed according to the condition and complexity of the patient’s disease:

Colectomy Surgery

Basically, Colectomy is a surgery performed so as to remove all or a single part of the colon i.e. the large intestine. But, there are diferent types of colectomy surgeries. The type of surgery to be performed, and the amount of the colon that is to be removed, depends upon what disease is the patient suffering from and the amount of damage that is caused to the colon. Colectomy surgery differs from one another and classified into several different categories, based on how much of the colon is
removed.

Right Hemicolectomy – In this surgical procedure, there is the removal of the right colon and a variable portion of the terminal (last part) of the ileum and that of the transverse colon.
Left Hemicolectomy– In this surgical procedure there is the removal of the left, or descending, part of the colon. Further the right and middle parts of the colon are attached to the rectum.
Transverse Colectomy– This surgical procedure is usually performed to remove a tumor in the middle of the transverse colon. It is performed when the cancer is not spread to any other parts of the colon.
Anterior Resection– In this surgical procedure, it becomes necessary to remove the area of the bowel that is affected or diseased.
Low anterior Resection– In this surgical procedure, there is the removal of the diseased portion of the rectum and the sigmoid colon. This surgery is performeddeep in the pelvis, so the patients may be at a higher risk of anastomotic leaks and fecal incontinence . To reduce the risk, there might be a need to create a temporary ostomy to divert fecal matter away from the newly created anastomosis.
Abdominoperineal Resection– The Abdominoperineal resection is done for cancer of rectum less than 5cm from the anal verge and anal canal cancer. A permanent colostomy is needed after this surgery. It is a life altering surgery
Subtotal Colectomy– The subtotal colectomy is also called as partial Colectomy. In this type of surgery, any part of the colon might be removed. It is usually done for treating colon cancer and Crohn’s disease. When the subtotal Colectomy is performed, a part of the colon is removed and hence the diseased is removed. Here, the healthy colon on either side is connected.
Total Colectomy– In this type of Colectomy Surgery, the colon is removed but the rectum is still in place. It is usually done in the case of ulcerative colitis or Crohn’s disease. A total colectomy requires the creation of an ileostomy where there is a bag worn outside of the stomach. The ileostomy may be temporary or even permanent
depending upon the conditions of the patient.
Total Proctocolectomy– In this type of colectomy surgery, the colon is removed along with the rectum. The rectum is present at the end of the colon. The function of the rectum is to hold the stools before it is excreted from the body. When Total Proctocolectomy is performed, there is an absence of rectum. Therefore there is a need to have a new way to dispose-off the stools from the body. Ileum is anastomosed to distal most 2cm of rectum after creating a ileal pouch. In most cases, an proximal ileostomy is created. This procedure is usually done as staged procedure.

Fistula Surgery

A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue which connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple. The type of surgery a patient might need depends on where the fistula is present. The different positions of the fistula may be below the sphincter muscle, through the sphincter muscle or above the sphincter muscle.

If the fistula is below or crosses the lower part of the sphincter muscles, there is a need to cut the fistula open to the skin and leave the wound open so that it can heal with healthy tissue.
If the fistula has branches that pass through the upper part of the sphincter muscles, there might be a need to place a special stitch (called a seton stitch) in the fistula to allow pus to drain easily. We specialise in doing LIFT (Ligation of Fistulous Tract), it is single staged procedure with least recurrence rate and negligible changes of anal sphincter damage. So our patient always continent.
If the fistula reaches above the sphincter muscles, their might be a need to have a temporary colostomy (bowel opening onto the skin).

Rectal Prolapse Surgery

Rectal prolapse surgery is a surgical procedure to repair rectal prolapse. It occurs when the last part of the large intestine (the rectum) stretches and protrudes from the anus. The rectal prolapse surgery puts the rectum back in place. The rectal prolapse surgery is performed in people suffering from chronic symptoms of rectal prolapses, such as leakage of stool, inability to control bowel movements (fecal incontinence), or obstructed bowel movements.

Pelvic floor repair

The pelvic floor is a group of muscles in the pelvic floor that support the organs in the pelvis and forms a sling around the urinary bladder (anterior compartment), vagina (central compartment) and rectum (posterior compartment) in females. Functions of pelvic floor muscles include pelvic organ support, pregnancy and childbirth. Bladder and bowel control which in turn help in maintaining continence, sexual function and breathing. Pelvic floor dysfunction symptoms include constipation, urine or stool leakage and a frequent need to urinate. Pelvic floor repair is offered to the patients when all the conservative treatment modality fails to suffice the problems. It is always tailor-made approach to pelvic floor dysfunction.

Armed with technology, we majorly use laparoscopy as our method of surgeries. It leads to less blood loss and pain for the patients. It also offers them a shorter hospital stays and a considerably lower infection rate. Additionally, patients undergoing minimally invasive surgery have a lower risk of abdominal complexities and a better post-surgery life.

With the use of Laparoscopy, we make the surgical procedure more cost-effective compared to open surgery. Fast Track Surgery/ Early Recovery After Surgery (ERAS) is our motto!

Today in the era of technology and high-efficiency surgical instruments and trainers, our team of colorectal surgeons has developed expertise in their field. With a spectrum of highly skilled doctors, we at Bhatwal Surgical and Maternity Hospital carry decades of experience for our efficient and effective service. In our history of serving people’s disorders to in turn offer them a better quality of life, we overcome their challenges with extreme care and belongingness.

With the use of Laparoscopy, we make the surgical procedure more cost-effective compared to open surgery. Fast Track Surgery/ Early Recovery After Surgery (ERAS) is our motto!