Everything You Need to Know About Colorectal Surgery

Many people mistakenly think that general surgeon are qualified to operate on all the abdominal organs in both easy cases, such as hernia, and difficult diseases, such as colon cancer. But in reality surgeries on colon, rectum and the anus should only be performed by a specially qualified surgeon certified for colorectal procedures.

What Conditions Does a Colorectal Surgeon Treat?

A colorectal surgeon performs operations on the colon, rectum, and anus in cases of:

• Hemorrhoids
• Anal fissure
• Anal abscess
• Incontinence
• Colon and rectal cancer

How Is a Colorectal Surgeon Different from Other Specialists?

Often patients with such common conditions as hemorrhoids and anal fissure turn to general surgeons and even gastroenterologists for medical help. Usually, those specialists receive and treat the patient, performing at first glance routine and simple procedures, even though they are not really qualified for it. But the truth of the matter is that surgical treatment of both hemorrhoids and anal fissure (not to mention colorectal cancer) requires very high qualification and deep understanding of the human anatomy in that part of the body.

The anal area is full of important nerves and muscles, responsible for the sphincter control. Without a proper understanding of the anatomy, a general surgeon or a gastroenterologist can cause the patient irreversible damage, not only leaving the primary problem untreated but leading to such complications as incontinence, impotence, bleeding, etc.

Interview with Leading Colorectal Surgeon – Dr. Arie Pelta

Hemorrhoids and anal fissure are actually quite common conditions. Unfortunately, many patients are too ashamed to seek medical attention, causing them to suffer in silence. Israel’s leading colorectal surgeon – dr. Arie Pelta has answered a few questions regarding these hemorrhoids and anal fissure.

1) In what cases is surgery needed to treat hemorrhoids?

Surgery is needed at 2-nd, 3rd and 4th stages in case of internal hemorrhoids and in any case of external disease. In some cases, conservative therapy can help avoid surgery, but in others (i.e. 4th stages hemorrhoids) urgent surgery is necessary.

2) What methods of hemorrhoids treatment do colorectal surgeons use today?

The treatment method depends on the stage and symptoms of the disease. One of the least invasive procedures is rubber band ligation, suitable for 2-nd and 3-rd stages of internal hemorrhoids. This method has proven to be effective in 80% of the cases. Additional relatively advanced and minimally invasive treatment methods of internal hemorrhoids are radiofrequency and HAL Doppler. Each method has its merits and disadvantages, but both are equally effective. There are also several treatment options for external hemorrhoids, all require general anesthesia. Regardless of the stage of the disease it is important to seek professional help from a colorectal surgeon, certified and qualified to perform the necessary procedure with minimal damage risk.

3) How effective can conservative treatment of anal fissure be?

Conservative treatment of anal fissure, meaning ointments, can be effective in certain cases, but the effect should take place within the first two weeks of treatment. If after two weeks the patient experiences no improvement, we can almost surely state that he needs surgery. When surgically treating fissure the surgeon should take into consideration that it can be a manifestation of other conditions, such as Krohn’s disease or a chronic infection. If the described symptoms are in any way suspicious, the surgeon should refer the patient to additional tests in order to determine the exact origin of the problem and avoid unnecessary surgery. And just like in case of hemorrhoids, fissure surgery should only be performed by a certified colorectal surgeon, who knows where and how to make the incisions.

4) What does contemporary medicine has to offer patients who are suffering from incontinence as a result of a bad surgery or after colorectal cancer treatment?

Currently, there is two treatment option offered to such patients: implantation of an electrostimulation that activates the sphincter muscles or surgical correction of the previously done damage. Each case is individual and the treatment is decided upon considering such factors as whether or not there are still anal muscles left, have the nerves been damaged, has the patient received radiotherapy and others.

HMC’s medical consultants will gladly answer any additional questions you might have. Please fill out the contact form and we’ll get back to you.