Colorectal surgery

Colorectal surgery can be performed using either open surgery or minimally invasive techniques. Open surgery involves making a large incision in the abdomen to access the colon and rectum, while minimally invasive techniques use small incisions and specialized surgical tools to access and remove the diseased tissue.

Colorectal surgeons at UCHealth are expertly trained to diagnose and treat a wide range of conditions affecting the colon, rectum and anus, including cancer, polyps, diverticulitis, inflammatory bowel disease (IBD) and fecal incontinence. They are supported by a care team of providers and staff dedicated to fostering superior patient outcomes.

Types of colorectal surgeries we perform

Types of colorectal surgery range from minimally invasive procedures to major operations. The type of procedure your physician recommends will depend on the specific condition being treated, as well as your overall health and individual circumstances.

Some of the most common types of colorectal surgery include:

Colectomy. In this procedure, a portion or the entire colon is removed. A colectomy may be necessary in cases of colon cancer, severe IBD (inflammatory bowel disease) or other conditions that affect the colon. A partial colectomy involves the removal of a section of the colon, while a total colectomy involves the removal of the entire colon.

Colostomy. A colostomy involves creating an opening in the abdominal wall and bringing the colon to the surface of the skin. This procedure may be necessary in cases where the colon is damaged or diseased and cannot function normally. A colostomy bag is used to collect waste products, which are then disposed of.

Proctectomy. A proctectomy is the surgical removal of all or part of the rectum. This procedure is typically performed to treat rectal cancer or IBD.

Rectal resection. In this procedure, a portion or all of the rectum is removed. A rectal resection may be necessary in cases of rectal cancer or other conditions that affect the rectum. Like a colectomy, a rectal resection may be partial or total.

Hemorrhoidectomy. A hemorrhoidectomy is the surgical removal of hemorrhoids. Hemorrhoids are swollen veins in the anus and rectum that can cause pain, bleeding and discomfort.

Anal fistula surgery. This surgery is used to treat anal fistulas, which are small “tunnels” that form between the anal canal and the skin surrounding the anus. Anal fistulas can become infected, causing pain and discomfort. The surgeon makes a small incision in the skin around the anus to drain the fistula.

Services provided may vary by location.

Colorectal surgery overview

Specific details of colorectal surgeries will vary depending on the goal of the surgery and the individual patient’s condition. Your surgeon will provide you with more detailed instructions to help you prepare for the surgery and what to expect during and after the procedure.

Here is a general overview of the steps involved in a colectomy, a common colorectal procedure:

Anesthesia. You will be given anesthesia to ensure that you are asleep and pain-free during the surgery.

Incision. The surgeon will make an incision in your abdomen to access the colon. The size and location of the incision will depend on the specific type of colectomy being performed.

Colon mobilization. The surgeon will carefully separate the colon from surrounding tissues and blood vessels to allow for safe removal.

Colon removal. The surgeon will remove the affected portion of the colon, which may include nearby lymph nodes if necessary.

Reconnection or stoma creation. If only part of the colon is removed, the remaining portions of the colon will be reconnected using stitches or staples. In some cases, a temporary or permanent colostomy may be necessary. This involves creating an opening in the abdomen through which waste can pass into a collection bag.

Wound closure. The incision in the abdomen will be closed using sutures, staples or surgical glue.

Recovery. After the surgery, you will be taken to a recovery room, where trained staff will closely monitor you for any complications. You will likely stay in the hospital for several days to a week to allow time for your body to heal.

After colorectal surgery

The recovery from colorectal surgery can vary depending on the type and extent of the procedure and your overall health. However, there are some general things that you can expect during the recovery process:

Your stay in the hospital. You will typically stay in the hospital for several days after colorectal surgery. During this time, providers will monitor your vital signs, provide pain management and administer antibiotics to prevent infection.

Managing post-op pain. Pain management is an important part of the recovery process. Depending on the type of surgery, you might experience discomfort, and your care team will provide medication to help you manage it.

Diet and nutrition. It’s likely that you will be on a clear liquid diet immediately following surgery. You will gradually transition to a regular diet as your body heals. Providers on your care team may recommend dietary changes, such as increasing fiber intake, to help with bowel function.

Physical activity. If you’re like most patients, you’ll be encouraged to get up and move around as soon as possible after surgery. Physical activity can help prevent blood clots, improve bowel function and promote overall healing.

Follow-up care. You will need to follow up with your care team after surgery so they can monitor your progress and address any complications that might come up. You might also need to undergo additional treatments, such as chemotherapy or radiation therapy, depending on the specific condition for which you’re being treated.

Physician conferring with older male patient

Playing your part

To ensure your smooth and successful recovery, it’s important that you follow your provider’s post-operative instructions. This may include avoiding certain activities, taking medication as prescribed and attending follow-up appointments as recommended. With proper care and attention, most patients fully recover from colorectal surgery and are able to resume their normal activities.

Frequently asked questions about colorectal surgery

What is colorectal surgery?

Colorectal surgery is a type of surgery performed on the colon, rectum or anus to treat a variety of conditions, such as colon cancer, Crohn’s disease, ulcerative colitis, diverticulitis and hemorrhoids.

What types of anesthesia are used for colorectal surgery?

Colorectal surgery can be performed under general anesthesia, which involves putting the patient to sleep, or under regional anesthesia, which involves numbing the area around the surgical site.

Is it risky to have colorectal surgery?

Like any surgery, colorectal surgery carries some risks, such as bleeding, infection, blood clots and damage to nearby organs or tissues. You should discuss the risks and benefits of a colorectal surgery with your physician.

How long is the recovery period after colorectal surgery?

The length of your recovery period will depend on the specific surgery performed and your overall health. In general, you can expect to stay in the hospital for several days after surgery, and you might need several weeks or months to fully recover.

Will I need to make any dietary changes after colorectal surgery?

Yes, you might, depending on the specific condition you’re being treated for. You might need to make dietary changes like increasing fiber intake or avoiding certain foods that irritate your digestive system. You should discuss any necessary dietary changes with your provider and care team.

Will I need additional treatments after colorectal surgery?

Additional treatments will depend on what you’re being treated for. You might need treatments such as chemotherapy or radiation therapy after surgery. You should discuss your post-operative treatment plan with your physician.

When can I return to work after colorectal surgery?

The length of time it takes to return to work will depend on the type of surgery you underwent and your job duties. Please discuss your return-to-work plan with your doctor and your care team.

References

The National Cancer Institute. Colorectal Cancer Patient Version (https://www.cancer.gov/types/colorectal)

MedlinePlus: National Library of Medicine. Colorectal Cancer (https://medlineplus.gov/colorectalcancer.html)

The American Society of Colon and Rectal Surgeons. ASCRS (https://fascrs.org/)