A colorectal surgeon is a specialist surgical consultant whose area of expertise is in assessing, diagnosing, and performing surgery to treat disorders relating to the large intestine (colon), rectum, and anus. Colorectal medicine is sometimes known as proctology.
Any consultant surgeon has been through extensive general medical training, gone into surgery and then specialized in a particular area of surgery, in this case, colorectal surgery. They become consultants after a number of years working under the supervision of more experienced surgeons.
Colorectal surgeons work in hospitals with gastro-intestinal surgical facilities and in emergency surgery. Bowel surgery can range from a minimally invasive, completely curative procedure requiring only short-term follow up to life-changing and serious surgery requiring long-term care and monitoring. Colorectal surgeons work in the surgical theatre with a team of theatre practitioners including nurses, doctors, and anesthetic specialists. On the ward and in a clinic, colorectal surgeons work with a large multidisciplinary team including specialist stoma and gastrointestinal medicine nurses and doctors, dietitians, and counsellors.
There are many disorders of the large bowel, rectum and anus that can require surgical treatment. A colorectal surgeon can perform a bowel resection or colectomy (removal of a diseased part of the bowel) to remove cancers or for serious inflammatory conditions such as Crohn’s disease. A colorectal surgeon may also be required to treat severe hemorrhoids and other less serious conditions which can still have a huge impact on a person’s quality of life.
Colorectal surgeons perform or work with medical colorectal specialists who perform lower gastrointestinal endoscopies – colonoscopies, sigmoidoscopies or anal-rectal exams to visualize the inside of the lower bowel. This can help diagnose disorders of the bowel, and also help to guide surgery. Some procedures such as polyp removal or hemorrhoid banding can be done internally during the endoscopy.
Some disorders of the bowel requiring the removal of some of the bowel, or where part of the bowel needs time to heal, may require the creation of a stoma. This can be temporary or permanent, and it is performed when part or all of the lower intestine or rectum can’t be used for conveying faeces to the anus. A stoma is where an opening is created in the abdominal wall and the bowel surgically attached to create an outlet for faeces, which is collected in a bag.
Laparoscopic, or ‘keyhole’ surgery is increasingly used for surgery requiring incisions in the abdominal wall. This is where a number of small incisions are made and instruments inserted and used through these small holes, with one incision for a viewing tube. This method has generally better outcomes for the patient than traditional surgery using larger incisions. Keyhole surgery has a quicker recovery time, leaves less scarring, and is associated with a reduced risk of the long term problems that can come after abdominal surgery, such as hernias or adhesions (internal scarring which can affect the normal movement of the organs).