Dr. Samrat Jankar – Colorectal Surgery
Colorectal surgeries deal with the issues and disorders of the colon, rectum, and anus. Dr Samrat Jankar, a top gastroenterologist and colorectal surgeon in Pune offer the following surgeries such as Laparoscopic hemicolectomy, Laparoscopic anterior resection, laparoscopic APR, laparoscopic total proctocolectomy, Laparoscopic rectopexy, Laparoscopic diverticulitis surgery, Laparoscopic stoma creation and revision, stapler haemorrhoidectomy, LASER proctology and complex fistula surgery like LIFT.
When do you need colorectal surgery?
You may have to undergo a colorectal surgery if you are suffering from any of these diseases:
Mechanical bowel obstruction
Proctological disorders: piles, fissure and fistula
Different types of colorectal surgeries
1. Laparoscopic hemicolectomy: This surgery is generally done to treat bowel diseases such as Crohn’s disease or severe diverticulitis or colon cancer. In this procedure, the surgeon will remove the damaged or diseased section of the intestine and re-join the healthy parts.
During Laparoscopic hemicolectomy, the surgeon will operate through several small cuts made in the abdomen. It is also called keyhole surgery. As this is a major operation, you will need around 1-2 weeks to recover. Depending on your overall condition, you may require about 3-7 days stay at the hospital.
2. Laparoscopic anterior resection: This surgery is done to remove your diseased rectum(last part of large bowel). The surgeon will operate through small incisions to remove the diseased area of your bowel and rectum. If it is necessary, a temporary stoma is made to divert the stools from the surgical site until it heals. You may have to stay around 4 to 8 days in the hospital, depending on your health. However, the hospital stay may get prolonged. It will take more than 4 to 6 weeks to recover from surgery.
3. Laparoscopic rectopexy: You may have to undergo this procedure if you are suffering from rectal prolapse. It is a condition wherein your rectum slides out of your anus. This surgery can be done either through an abdominal incision or laparoscopically.
The surgeon will operate to put the rectum back in place and improve its functions. Your hospital stay will depend on your condition and the type of procedure you underwent. You will go home once you regain your bowel function. You will return to your normal activities within 4 to 6 weeks.
4. Laparoscopic diverticulitis surgery: Diverticulitis is a condition when the small pouches in the large intestine become inflamed. Generally, they are treated with medication and diet changes, but if the treatment fails and the condition causes severe pain and other symptoms, the doctor may recommend surgery.
The Laparoscopic diverticulitis surgery is done through small cuts as opposed to open surgery, where the surgeon has to make a big incision about 6 to 8 inches long. After the surgery, you may have to stay around 2 to 7 days in the hospital. Usually, most people return to their daily activities within two weeks.
5. Laparoscopic stoma creation and revision: Stoma is an opening that is created for faecal diversion. It may be temporary or permanent. A temporary one is made when a section of diseased bowel is removed, and it needs time to heal, whereas permanent stoma creation is needed if the anus and rectum have been removed.
In Laparoscopic stoma creation, the surgeon can perform the surgery through tiny incisions. You will be discharged after 3 to 4 days after your laparoscopic surgery. For complete recovery, you will need around 4 weeks.
Diagnosis of Colorectal Disorders
If you’re experiencing symptoms of a colorectal disorder, make an appointment with your surgeon. They can help detect the cause of your signs by ordering a variety of tests including,
Diagnosis of Stool
Rome criteria : The Rome process and Rome criteria are an international effort to create scientific data to help diagnose and treat functional gastrointestinal disorders, such as irritable bowel syndrome, functional dyspepsia, and rumination syndrome.
Computed Tomography (CT) scans
Magnetic Resonance Imaging (MRI)
Biopsy of the small intestine
Importance of Screening
Nearly all colorectal cancers begin as polyps, benign growths in the colon, and rectum's tissue lining. Cancer occurs when these polyps grow, and abnormal cells expand, invading the surrounding tissue.
Removal of polyps can stop the spread of colorectal cancer. It is possible to remove most non-cancerous polyps painlessly using a colonoscope, a lighted, flexible tube.
If not detected in the initial stage, colorectal cancer can grow throughout the body. More advanced cancer needs more complex surgical techniques.
Most early forms of colorectal cancer don't show symptoms, which makes screening particularly important. When symptoms do occur, cancer might already be quite advanced. Hence, early screening can help to cure in the initial stages.
Types of Colorectal diseases
Functional Colorectal Diseases
Structural Colorectal Diseases
Functional Colorectal Diseases
Functional disorders are those in which the GI tract looks normal but works poorly. These are the most common problems affecting the GI tract, including the colon and rectum.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a disease in which the colon muscle contracts more often than in people without IBS. Specific foods, medications, and stress are some factors that can trigger IBS.
Structural Colorectal Disorders
Structural disorders are conditions in which the bowel appears abnormal and also works incorrectly. If the condition worsens, your surgeon can remove the abnormality surgically.
Hemorrhoids are inflamed and enlarged blood vessels in the lining of the anal opening. The chronic excess pressure from stretching during a bowel movement, persistent diarrhoea, or pregnancy may cause haemorrhoids.
Anal fissures are cracks or gaps in the lining of the anal opening. The common cause of an anal fissure is the passage of very hard or watery stools. It is a most painful condition as the exposed muscles get irritated on exposure to stool or air, causing intense burning pain, bleeding or spasm after bowel movements.
Diverticulosis is the formation of small outpouchings (diverticula) in the muscular wall of the large intestine. They usually appear in the sigmoid colon, the high-pressure region of the lower large intestine.
Colon polyps and cancer
A colon polyp is a small cluster or mass of cells formed on the lining of the colon. Most colon polyps are naive, but some can develop into fatal colon cancer. They are of two types, non-neoplastic and neoplastic.
Symptoms of Colorectal disorders
Discomfort or pain in your abdomen
Gas and abdominal bloating
If you observe blood in your stool, contact your doctor immediately. Other signs of a potentially critical condition include fever and sudden weight loss.
Causes of Colorectal disorders
Environmental factors, such as diet
Microbial and immunologic factors
Family history of Crohn’s disease
If you experience any of the discussed symptoms, may sure to plan a consultation with our expert Gastroenterologist Dr. Samrat Jankar. He will offer you the best suitable and productive treatment.
Frequently asked questions
When should one have a bowel movement after the surgery?
After colon surgery, most patients have a bowel movement within four to five days. It may need five to seven weeks or more after the procedure for your bowel habits to settle down to normal. After anorectal surgery, you may feel some discomfort with bowel movements, mainly if they are hard. Hence, it is essential to keep your stools soft by drinking plenty of liquids and taking a stool softener as required.
Will my bowel habits change after surgery?
After rectal surgery, it is not uncommon to go through an adjustment phase where patients report diarrhoea, leakage of stool or gas, an urgency to excrete, or partial evacuation. These are signs of rectum spasticity that is getting used to its new role.
Often these symptoms reduce with time, though it may take six months to a year to recover completely. Be calm, and consult with your surgeon. There are medicines to speed up, slow down, or change the stool consistency to help you through this adjustment phase.
What is the recovery period after colorectal surgery?
Most patients spend between 1 to 5 days in the hospital. A typical average for laparoscopic procedures is 1-3 days, whereas it is slightly longer, i.e., 3-5 days for open surgery.