WHAT IS COLORECTAL SURGERY?
Colorectal surgeons specialize in treating diseases of the small and large intestine (colon), rectum, and anus. A primary focus of their work is caring for people with colorectal cancer, a leading cause of cancer in the United States.
Colorectal surgeons at University of Utah Health have extensive training and experience with intestinal and anorectal surgeries. Patients travel from throughout the Mountain West to benefit from their high-quality expertise. Our colorectal surgeons work closely with medical oncology and radiation oncology (cancer) specialists, gastrointestinal specialists and other health professionals to ensure that patients receive comprehensive, team-based care.
Our surgeons perform hundreds of colorectal surgeries every year, while using the latest surgical procedures to promote healing and recovery. They also participate in national and international research studies to improve surgical outcomes for people with colorectal cancers, diverticulitis, and inflammatory bowel disease.
CONDITIONS TREATED WITH COLORECTAL SURGERY
Colorectal surgeons care for patients with the following conditions affecting the colon, rectum, and anus:
- Abscess (a pocket of pus caused by infection);
- Anal itching
- Anal stenosis (a narrowing at the end of the anal canal caused by scar tissue);
- Blockages of the colon (bowel obstructions);
- Cancer and precancerous conditions;
- Diverticulitis (small, bulging pouches that form in the lining of the digestive system);
- Fecal incontinence (an inability to control bowel movements);
- Fissures (small tears in the anal tissue);
- Fistulas (a small, abnormal passageway between the end of the large intestine and skin near the anus);
- Hemorrhoids (swollen veins in your anal canal);
- Polyps (precancerous growths in the lining of the large intestine or rectum);
- Pelvic floor conditions, including rectal prolapse and severe constipation; and
- Pilonidal disease (a skin infection that starts in a hair follicle in the crease of the buttocks near the tailbone).
- Rectal bleeding
TYPES OF COLORECTAL SURGERY
Colorectal surgeons offer a wide range of surgeries. Some are minor and can take place in the office setting, while others are more complex and may involve a hospital stay.
Types of colorectal surgery include:
- Colectomy—This procedure involves removal of some or all of the colon with options for reconnection or an ostomy
- Colostomy/Ileostomy—Creates an opening in the abdomen to allow waste to pass through the intestine into a bag outside the body. This can be temporary or permanent.
- Polypectomy—A surgery to remove polyps from the inside of the colon.
- Strictureplasty—This surgery relieves narrowing in the intestinal wall that is typically caused by inflammation from Crohn’s disease.
- Hemorrhoid treatment procedures — These include rubber band ligation and surgical removal.
COLORECTAL CANCER TREATMENT USING SURGERY
Our colorectal surgeons are part of a multidisciplinary team that provides care for patients with cancer. They work closely with radiation oncologists, medical oncologists, radiologists, pathologists, and other specialists to develop a comprehensive treatment plan best suited for each individual patient.
Most people with cancer of the colon or rectum undergo surgery to remove the tumor while sparing healthy tissue. Our surgeons use techniques such as:
- Abdominoperineal resection (APR) — This may be needed if the cancer has grown into the sphincter (the muscle that prevents stool from leaking out of your body).
- Low anterior resection (LAR) — This procedure removes tumors in the rectum, which allows people to have normal bowel movements again.
Whenever possible, our surgeons use minimally invasive surgical techniques, which can result in less pain and blood loss as well as a shorter recovery time. Our surgeons are experts in sphincter-sparing surgery for cancer which allows more options to avoid a permanent colostomy bag.
WHAT TO EXPECT AT YOUR FIRST APPOINTMENT
Most of our patients are referred to one of our colorectal surgeons by their primary care provider, gastrointestinal specialist, or cancer doctor (oncologist). Referrals are welcome but not necessary to meet with our team.
Before your first appointment, a member of our staff will call you to ask about your condition and what tests or imaging studies you have already had. We will obtain any test results and imaging reports that are not already in the U of U Health electronic medical record system.
We want your first visit with the colorectal surgeon to be as efficient and helpful as possible. To save time, the surgeon may ask you to have additional tests before your appointment.
During your initial appointment, the surgeon will discuss your condition with you and conduct a physical exam. We may require you to have an endoscopy, which uses a small, rigid, instrument called an endoscope to see inside the anus or the rectum. This procedure is not painful and only takes a few minutes.
Your colorectal surgeon may provide a treatment plan during this first appointment, if there is no need to order additional tests.
PREPARING FOR COLORECTAL SURGERY
Your colorectal surgery will take place at either Huntsman Cancer Institute or U of U Hospital in Salt Lake City. Our office will provide you with written materials so you can prepare.
Being in the best overall shape before surgery will give you the best chance for a quick recovery. Proper nutrition and regular exercise are essential in the weeks before surgery. If you smoke, please avoid doing so for at least a week before your procedure.
You may need to do “bowel prep” before surgery to remove stool and bacteria from your intestine. This can minimize the risk of infection following surgery. If you need to do bowel prep, the care team will provide instructions.
We not want you to eat or drink after midnight the day before surgery. We may even need you to discontinue some of your regular medications before surgery.
COLORECTAL SURGERY PROCEDURE
Most colorectal surgeries require general anesthesia to help put you to sleep. During surgery, the nurses in the operating room will call out to the waiting room with updates. The length of your surgery will depend on many factors, however, the surgeon will give you a general idea beforehand of how long it should take.
Once the surgery is complete, you’ll stay in a recovery room for 30 minutes to an hour. The surgeon will come out and speak to your family and answer any questions they have.
After your initial recovery, you will either go home or recover on the surgical floor or in the intensive care unit. If you are returning home the same day, someone else must drive you.
Complications are rare following colorectal surgery. However, they can and do happen. The surgeon will discuss the risks of these complications with you and how they relate to your surgical procedure.
COLORECTAL SURGERY RECOVERY
If your surgery requires an overnight stay at the hospital, keep in mind that recovery progresses at a different pace for everyone. If you had minimally invasive surgery, you can expect to stay in the hospital for two to four days. Open surgeries typically require a hospital stay that lasts for four to six days.
Our colorectal surgery care team will see you at least once a day while you are in the hospital. The purpose of these visits is to see how you are doing and make any changes to your care plan as needed based on your progress.
The care team will make sure you have good pain control. After you arrive on the surgical floor, we will get you up and moving because walking is essential to a quick recovery.
Before we discharge you to go home, you will need to be able to:
- eat and drink enough to stay hydrated,
- take care of yourself at home, and
- have some bowel function (signs include passing gas or stool).
When you return home, you won’t be able to drive for two weeks after surgery.
Follow-Up Care
You will see your colorectal surgeon three to four weeks after your surgery to make sure everything is going well with your recovery. If you live a significant distance from U of U Health, we may be able to offer a virtual care visit so that you don’t have to travel for this appointment. You are welcome to contact our office with questions or concerns at any time.
MAKE AN APPOINTMENT WITH A COLORECTAL SURGEON
Referrals are welcome but not necessary when making an appointment with a member of the U of U Health colorectal surgery team. To request an appointment, call 801-587-5854 or request an appointment online.