Dr. Krithika. M

Colorectal surgery is a specialized branch of medicine used to treat patients suffering from colon, rectum, and anus ailments (damage, obstruction, injury, ischemia, inflammation, or any other medical condition). The colorectal surgery involves varied procedures that, at times, require the assistance of many specialized and experienced surgeons, consultants, and nurses (colorectal nurses).

Colorectal surgery help patients with:

1. Crohn's disease: In this disease, there is weight loss, extreme fatigue, malnutrition, severe diarrhea, abdominal pain. Crohn's disease is mainly an inflammatory bowel disorder where the digestive tract (lining) gets inflamed.
2. Ulcerative colitis: In ulcerative colitis, there is inflammation and ulcer formation in the rectum and the colon.
3. Diverticulitis: In diverticulitis, there is inflammation of the diverticula or pouches (formed on the walls of the colon).
4. Colorectal Cancer: Also known as bowel cancer and colon cancer.

Colorectal surgery is also helpful in case of:

1. Anal fissures: In anal fissures, there is a tear in the anal canal (lining of the lower rectum). As a result, a person may experience extreme pain and discomfort in passing the stool.
2. Bowel or fecal incontinence: In bowel incontinence, there is an uncontrolled bowel movement, resulting in a sudden (unexpected and uncontrolled) passing of stool.
3. Hemorrhoids or Piles: It is a condition whereby the muscles and veins of the rectum and the anus (lower part) get swollen and inflamed. Piles are often accompanied by pain, bleeding, and itching. There is difficulty in sitting and in bowel movements.
4. Rectal prolapse: In rectal prolapse, the entire rectal wall or the rectal mucosa protrudes out (loses its attachment).

Anal fistula and Anal abscess

Colorectal surgery can be of different types:

1. Colostomy: It is a surgical procedure that links the colon to the abdominal surface through an opening called the stroma. This creates an alternative pathway for the removal of the feces. Colostomy comes in handy when the colon fails to function normally (due to a disease or an injury).​ A colostomy can be temporary or permanent:
   • In a temporary colostomy, the damaged part of the colon is removed temporarily. Once the condition improves, the colon (part removed) can be reattached through a colostomy reversal surgery.
   • In a permanent colostomy, the colon (damaged part) is removed permanently through surgery.
2. Hemorrhoidectomy: As the name suggests, Hemorrhoidectomy is used to treat hemorrhoids or piles. In this procedure, the hemorrhoids are surgically removed through an incision (around the anus).

In PPH (Procedure for prolapse and hemorrhoids), the hemorrhoidal tissue is repositioned back into its original position (in the anus). Once repositioned, the surgeon trims the tissue causing pain and discomfort--

1. Inflammatory Bowel Disease (IBD) Surgery: The surgery is an effective treatment for Crohn's Disease and Ulcerative Colitis. Here, the surgeon removes the colon to treat the condition.
2. Rectopexy: Rectopexy is beneficial for patients with rectal prolapse.
3. Internal Sphincterotomy: This is helpful in case of anal fissures. To reduce the pressure, the surgeon makes a small cut is made in the internal anal sphincter. In Internal Sphincterotomy, the patient is normally given a local anesthesia.
4. Colectomy: To treat diseases that may affect the colon, a surgeon may remove the entire colon (Total Colectomy) or just a part of it (Partial Colectomy). Colectomy may further be: 
   • Proctocolectomy: Both colon and rectum are removed.​
   • Hemicolectomy: The left or right portion of the colon is removed. If you wish to discuss about any specific problem, you can consult a General Surgeon.

Moles are the most common form of physical identification proof, but are often unwanted. Moles and freckles are common skin irregularities that make a person consider cosmetic surgery. Moles can be described as non-cancerous skin lesions that develop when dark skin cells are bound together in small clusters. Almost everyone has one or more mole on their body. However, freckles are simply skin discolorations that appear on light skinned people. There are a number of ways in which moles and freckles can be removed.

1. Dermabrasion: This is a procedure where a small wheel is run over your skin to remove the top layer. Dermabrasion is performed under anaesthesia and is a very effective way of removing freckles and flat moles.
2. Laser Surgery: Laser surgery involves the use of concentrated beams of light to remove the topmost layer of skin. As this top layer is removed, freckles and light, flat moles are also destroyed thus leaving you with a clear complexion. In some cases, multiple sessions may be required to completely remove moles and freckles. Laser surgery is not recommended for large moles or moles that protrude out of the skin.
3. Shave excision: This is a surgical procedure that involves cutting off the raised section of a mole with a sharp scalpel. It does not require any sutures, but may not remove the entire mole. This surgery is often suggested in cases where a mole had grown to protrude from the skin but the discolouration itself does not bother the person. There is a very low risk of scarring associated with this procedure but the mole may recur.
4. Punch Excision: Small protruding moles can also be removed with a punch excision procedure. Here, a doctor will use a small cutting apparatus in the form of a small, cylindrical punch to twist and remove the entire mole. One of two sutures may be required to close the skin in this area.
5. Surgical Excision: This procedure is suggested in cases of large moles. In such cases, the surgeon will remove the entire mole and close the skin with sutures. This procedure may leave a scar behind, but in most cases, this scar is not very prominent.

In rare cases, moles can be malignant and hence it is not recommended to try removing a mole at home. For this reason, you should always a consult a surgeon if a mole appears suddenly appears or begins to look suspicious.