A Complete Listing of the Most Common Colorectal Surgeries
The colorectal region is a complex part of the body. When problems arise, preserving the form and function of the area is important to both doctors and patients. That's why it is important to select the best treatment option for each colorectal concern.
This guide to the most common colorectal surgeries can help you become familiar with various conditions and their treatments.
Hemorrhoids
Internal hemorrhoids are swollen veins along the walls of the rectum. Severe hemorrhoids may prolapse out of the anal opening.
Rubber Band Ligation
The doctor uses a special ligator tool to slip a tiny rubber band around the base of an internal hemorrhoid. This restricts blood flow to the tissue, so it withers and falls off. The procedure has an effectiveness rate of approximately 60 to 80 percent.
Because of its high success rate and relatively short recovery time, rubber band ligation is currently the most common treatment for internal hemorrhoids.
Hemorrhoidectomy
Doctors sometimes treat advanced hemorrhoid cases with surgical removal. In a closed hemorrhoidectomy, the surgical wound is sewn shut. Recovery times can be extensive, but the procedure can be up to 95 percent effective. Open procedures are similar, but the wound is left open to heal.
Laser Coagulation
A newer treatment method than traditional hemorrhoid resolution, laser coagulation involves uses pulses of light to prevent blood flow to hemorrhoidal tissue. As with rubber band ligation, loss of blood flow causes the tissue to wither and fall off.
Laser coagulation can be one of the most effective treatments for mid-grade hemorrhoids, and the associated pain and recovery time are both quite minimal. In one study, the procedure helped 90 percent of recipients.
See the procedure performed in the video "neoLaser Laser Treatment of Hemorrhoids."
Pilonidal Sinus
Pilonidal disease involves a tunnel that forms at the skin near the cleft of the buttocks. The opening can fill with hair and become infected.
Excision
In a surgical procedure, part or all of the pilonidal abscess and sinus is removed. The doctor may take out all of the affected tissue, or he or she may unroof the cavity. With unroofing, the deeper half of the abscessed tissue remains in place, but the upper portion and the sinuses are taken off. Full healing can take four weeks or more.
Laser Surgery
To close off the sinus tract that is involved with pilonidal disease, the doctor can insert a laser fiber. The light energy coagulates the tissue to seal the tract. This approach repairs the pilonidal sinus without damaging surrounding tissue.
Laser coagulation is sometimes paired with a process known as pit-picking. In this procedure, the pilonidal cavity, sometimes referred to as a cyst, is removed. To finish the procedure, the doctor applies the laser to the sinus tract.
Anal Fistula
Unnatural tunnels from the rectum to the skin around the anus are fistulas, and they must be repaired surgically.
Fistulotomy
This is a common treatment in which the fistula tract is cut open. The wound is left open for healing. The recovery period for this surgery can last one to two weeks.
Fistulectomy
Another traditional surgical procedure for anal fistula, fistulectomy involves cutting out the entire fistula tract. Recovery can take longer than it does for fistulotomy.
Laser Coagulation
As with pilonidal sinuses, anal fistulas can be treated with laser coagulation. The doctor inserts a specialized laser into the fistula tract. Light energy collapses and seals the fistula tract. This heals the problem without damaging the anal sphincter, which is a potential complication of traditional fistula surgeries.
Watch an animation of the laser procedure in the video "Analfistula."
Colon Polyps
Polyps are bunches of abnormal cells along the colon walls. They are discovered during colonoscopies. Polyps can lead to cancer, so removal is prudent.
Polypectomy
Most polyps can be removed during a colonoscopy. The doctor may use wire forceps or an electric current to separate the polyp from the colon. This is an outpatient procedure, and recovery time is minimal.
Local Excision
Some polyps require surgical removal. The doctor takes not only the polyp but also part of the surrounding colon tissue. Recovery requires a hospital stay of at least three days.
Inflammatory Bowel Disease
Medication is usually the first line of treatment for IBD, but surgery is often required. IBD conditions include Crohn's disease and ulcerative colitis.
Strictureplasty
Crohn's disease can narrow sections of the bowel. Strictureplasty is a surgical procedure intended to widen these passages. It is sometimes coupled with resectioning, in which portions of the bowel are removed.
Ileal Pouch Anal Anastomosis
Also known as pelvic pouch, ileal pouch anal anastomosis is a surgery for treating ulcerative colitis. The doctor removes the large bowel and creates an internal pouch to take its place. This is a common surgical procedure for ulcerative colitis because it preserves a patient's ability to maintain normal bathroom functions.
Procedure Selection
Colorectal surgeons practice a range of surgical procedures to treat the variety of diseases that affect this part of the body. When possible, doctors should choose minimally invasive procedures, such as ligation and laser treatment, in order to improve outcomes and reduce recovery times.
