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 . 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 • Rectum/Anus – Cancer – – – Anal and – Inflammatory Bowel Disease (Crohn, UC) – – Polyps – 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 . Rectum/Anus When to see a Colon and Rectal Surgeon

• Referral from another physician (, 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

• 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

• It is a collection of in the perianal area. Normal • Causes pain and rectal gland drainage, and if it progresses, fever and systemic Abscess . • Treated with incision and drainage. 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. Right hemicolectomy Left hemicolectomy

Transverse colectomy Sigmoid colectomy

A colectomy may be done anywhere within the shaded areas of the diagrams. 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