Colorectal Cancer Awareness

Colorectal cancer is the second most common cancer in the U.S. and all Americans are at risk with some having higher susceptibility than others. Screening has been shown to prevent colorectal cancer and all of our surgeons are skilled in both screening colonoscopy and polypectomy. Screening also has been shown to diagnose colorectal cancer at an early, more curable stage, and we along with our gastroenterology colleagues, first and foremost, emphasize the benefits of screening.
When cancer is diagnosed, we offer expert, comprehensive management of the patient with colon and rectal cancer. When appropriate, we offer laparoscopic surgery for colon cancer, and in the case of rectal cancer we provide state of the art techniques in sphincter preservation (avoidance of permanent colostomy). We work alongside specialists in medical and radiation oncology to provide the best in colorectal cancer care.

Noncancerous Colon Polyps

• Polyps are one of the most common conditions affecting the colon and rectum. They occur in 15 to 20 percent of adults, according to the American Society of Colon and Rectal Surgeons (ASCRS).
• Polyps are mushroom-shaped abnormal growths that line the large intestine and protrude into the intestinal canal.
• Ninety percent of colon and rectal cancers occur from polyps that are initially noncancerous.1 Therefore, polyps are usually removed after being discovered.
• Discovery and removal of polyps can be achieved with a colonoscopy or sigmoidoscopy. An x-ray (barium enema) is also used.
• The majority of polyps can be removed with a wire loop, and small polyps can be destroyed just by touching them with an electrical current. Removing larger polyps, however, may require surgery.

Crohn's Disease/Inflammatorty Bowel Disease

As fellowship trained colorectal surgeons, we have a special commitment to care for patients suffering with Crohn’s disease and chronic ulcerative colitis. We collaborate with our colleagues in gastroenterology to make sure that all medical therapies have been attempted prior to recommending surgery. When surgery is necessary, we offer laparoscopic technique when appropriate, and we try to avoid the use of stomas if possible. We also are trained to perform the “J-pouch” procedure for ulcerative colitis. Collectively, we offer patients with inflammatory bowel disease the most experience in the area to care for their challenging and unique problems.

Ulcerative Colitis

• The disease affects 500,000 people in the United States, predominantly under age 30.1
• Ulcerative colitis is an inflammation that affects the innermost lining (mucosa) of the colon and rectum.
• Symptoms may include rectal bleeding, abdominal pain, bloating, constipation or diarrhea, weight loss or fevers. Diagnosis is done through sigmoidoscopy or colonoscopy.
• Anti-inflammatory drugs are usually the first step in the treatment of the disease.
• Surgery is necessary for patients who have life-threatening complications, including massive bleeding, perforation, or infection. The standard operation for ulcerative colitis is the removal of the entire colon, rectum and anus, called a proctocolectomy.

Diverticular Disease

Diverticulitis is a common disease in this country and surgery is necessary when a person has recurrent attacks or when they develop a complication of the disease (fistula, abscess, stricture or perforation). Whenever possible we try to avoid emergency surgery as temporary colostomies often are necessary in those cases. In the elective situation laparoscopic technique often is successful and a colostomy is a rare necessity.

Hand-assisted Laparoscopic Surgery (HALS)

• HALS is used to surgically repair many colon conditions.
• During HALS, the LAP DISC allows surgeons to place their hand inside the abdomen through an incision no larger than the surgeon's glove size for various colorectal procedures requiring whole or partial removal of the colon.
• Colon surgeries with the LAP DISC require a 3- to 4-inch-long incision in the abdomen; about one fourth the size used in traditional open surgery. Three other small abdominal punctures are also made for a laparoscope (telescope connected to a video camera) and laparoscopic instruments.
• Patients can leave the hospital in a few days, experience less pain and return to normal activity in about a week, as compared to six to eight weeks in traditional open surgery.

Hemorrhoids, anal fissures, anal fistula/ abscess

Hemorrhoids, anal fissures and fistula/ abscess disease can be among the most painful and annoying diseases, and patients suffer both from the disease itself as well as the embarrassment of having to seek help. We understand and we are especially sensitive to those who walk through our door with such problems. We provide non-operative treatment (rubber-band ligation) for the vast majority of hemorrhoids, and when conservative measures fail, we offer the most innovative operation for hemorrhoids which does not require any incisions on the anus and therefore results in much less discomfort. We provide the latest medical therapies for anal fissures and surgery can be avoided in the vast majority of cases. Fistula surgery remains one of the most challenging clinical problems for surgeons and our additional training enables us to offer patients the best chance of cure while preserving fecal continence (bowel control).

Incontinence, Constipation, and Defecation Disorders

Loss of bowel control, severe constipation and inability to eliminate stool – these are rare but devastating problems that result in considerable discomfort and disability. We are trained in the physiologic and radiographic evaluation of such disorders. The majority of patients can be helped with dietary measures, fiber supplementation, and on occasion physical therapy. In the rare cases that surgery is necessary, nothing is more gratifying to us than to restore to the patient a sense of control and well-being.

Summary

The physicians of Tidewater Surgical Specialists Colon Rectal Surgery Division provide state of the art medical therapies and surgical techniques for the treatment of patients suffering from diseases of the anus, rectum and colon. Most importantly, we are committed to the special needs of our patients and strive to treat each person with dignity, compassion and expert care. Please call us for a consultation.