A colorectal surgeon is a specialist in the lower digestive tract including the colon, rectum and anus. Your doctor may refer you to one if you have gastrointestinal symptoms.

Your surgeon may also create a “pouch” from intestinal tissue to replace your colon or rectum if it’s cancerous. They might also repair a permanent colostomy with other surgical methods. Visit their Website to learn more.
Colorectal surgeons perform surgery on the colon, rectum and anus to treat cancer and other diseases that affect these parts of the gastrointestinal tract. They also treat benign diseases like diverticulitis, inflammatory bowel disease (Crohn’s and ulcerative colitis) and anorectal disorders such as abscesses, fistulae and pilonidal disease. Physicians specializing in this field are called colorectal surgeons or proctologists.
They may use laparoscopic or robotic techniques to perform surgery. These procedures allow them to use smaller incisions, resulting in less pain and a shorter hospital stay. They also have expertise in traditional surgical methods that require a larger incision.
For patients with severe fecal incontinence, the surgeon can insert an artificial bowel sphincter to improve function and reduce leakage. The surgeon can also perform a procedure called stricturoplasty, which corrects a narrowing of the rectum caused by scar tissue that limits intestinal activity. The surgeon can also place an ileostomy to redirect the bowels and a cecostomy for hernia repair.
Because they have extensive training in the lower GI, colorectal surgeons work closely with specialists from gastroenterology and other fields, including radiation oncology, urology and gynecology. This multidisciplinary approach helps ensure that patients receive comprehensive care and the best outcomes for their condition.
Because gastroenterologists and colorectal surgeons often share patients, some people assume there’s no difference between the two specialties. However, there are significant differences in education, training and understanding of the conditions they treat. While both can treat irritable bowel syndrome, for example, colorectal surgeons don’t deal with medical treatments for the condition; that’s a gastroenterologist’s area of expertise. They do, however, perform surgeries to treat complications of irritable bowel syndrome such as hemorrhoids and anal fistulas.
Laparoscopic
Colorectal surgery is the specialty that treats the lower bowel (colon and rectal area). These surgeons use a tube called an endoscope to explore the intestinal lining, looking for cancers or precancerous growths. They also treat hemorrhoids and anal fissures (tunnels that develop between the inside of your colon and the outside skin around your anus).
During laparoscopic colorectal surgery, surgeons operate through small cuts in your abdomen. A camera and special instruments are used to guide the procedure. A minimally invasive method of surgery, laparoscopy allows for faster recovery and less pain than open surgery.
Some of the most common procedures include sigmoidoscopy and colonoscopy. Sigmoidoscopy is an endoscopic examination of your sigmoid colon, rectum and anus. Colonoscopy is an endoscopic examination of the large intestine, which allows the surgeon to perform minor interventions.
The majority of patients undergoing LCRS have private insurance, and HMO coverage is the primary payer type. The most common surgical procedure is sigmoidectomy, accounting for 42.2% of LCRS in 2007. The least common surgical procedure is right hemicolectomy, accounting for 24.5% of LCRS in 2007.
Laparoscopic colorectal surgery can be complicated by the presence of a hernia or abdominal wall adhesions. When this occurs, a resection may be performed to correct the problem. This operation typically involves removing the hernia or adhesions, along with a portion of the colon.
Several studies have shown comparable oncologic outcomes between laparoscopic and open colon and rectal cancer surgeries. Despite these findings, some physicians still prefer to perform open surgery. This is mainly due to the perception that laparoscopic techniques are not as safe as open surgery. However, it is important to find a highly trained colorectal surgeon with experience performing both types of procedures.
Minimally Invasive
Minimally invasive surgery uses new techniques and technologies that reduce patient pain and recovery time. It involves smaller or no incisions to treat benign and malignant conditions of the colon and rectum. It can be performed with laparoscopy or robot-assisted surgery. However, all surgical procedures have some risks. Some minimally invasive colorectal surgery complications can include bleeding, infection and post-operative bowel blockage from intestinal anastomosis (reconnection).
Laparoscopic colorectal surgeries use small incisions in the abdomen to insert the surgical tools. The surgeon works with the help of a high-definition 3D camera and a remote console. This enables the surgeon to have enhanced dexterity, precision and vision during the operation.
This type of surgery is used to treat a variety of conditions including colon polyps, inflammatory bowel diseases such as Crohn’s Disease and Ulcerative Colitis, hernias and rectal prolapse. It is also useful for treating certain stages of colon cancer. However, it is important for surgeons to carefully evaluate whether a patient is suitable for this surgery.
Robotic-assisted surgery is a more recent development of minimally invasive technology. It is a type of laparoscopic surgery, but it enables the surgeon to work with greater dexterity, precision and vision. It is useful for patients who are not suitable for laparoscopic surgery or if the surgery requires more complicated procedures.
Despite its advancements, minimally invasive colon and rectal surgery is still an emerging field. Many research studies have shown that when performed by a surgeon with adequate training and following accepted cancer surgery principles, minimally invasive colon and rectal cancer surgery can be just as effective as traditional abdominal colon and rectal surgery. This is especially true in patients with early-stage and lower-risk colon cancer.
Robotic
Most colorectal cancer and other diseases of the colon and rectum can now be treated with robotic surgery. This involves the surgeon sitting at a console three or four metres away from the patient, manipulating hand and foot controls to control the robot’s arms. Three of the arms have small surgical instruments at their tips and a fourth has a fibre-optic camera that relays three-dimensional images to the console’s viewfinder and large screens in the operating room.
The technology is particularly useful for rectal cancer, sigmoid colectomy, and hernia repair (rectopexia). However, the greatest advantage of robotic surgery may be its ability to treat conditions previously unsuitable to laparoscopic approaches. For example, it has been possible to perform complete mesocolic resection with central ligature and disconnection of the rectum in patients with significant abdominal wall adhesions using the robotic technique. This would have been impossible using the standard laparoscopic approach, which requires extensive abdominal wall dissection.
It has also been feasible to carry out complex rectal resections in patients with prior pelvic surgeries and inflammatory bowel disease using the robot. The improved ergonomics of the robot allow the surgeon to maneuver in difficult-to-access pelvic spaces and improve 3D visualization. Additionally, the wristed instrumentation provides greater degrees of dexterity than standard laparoscopic tools for precise dissection and manipulation.
Although the evidence supporting the use of the robotic system for colon and rectal surgery is relatively sparse, it is promising. Studies have consistently shown equivalent perioperative outcomes and comparable short-term oncologic results when compared to laparoscopy. Furthermore, the use of the robotic system has been associated with reduced rates of conversion to open surgery and shorter lengths of stay.
Open
While minimally invasive laparoscopic and robotic procedures are now the preferred method for most colorectal cancers, open surgery is still needed in some cases. For example, when a colon tumor is located near the rectum or anus in the lower pelvis, surgeons can use a procedure called a low anterior resection to remove part of the rectum and a portion of the colon along with the surrounding lymph nodes. Then, the surgeon reattaches the healthy ends of the colon to the remaining rectum or anus in the lower abdomen and closes the wound.
In a laparoscopic colon cancer operation, surgeons make several small incisions in your abdominal wall and insert a camera and surgical tools through those incisions. This allows your doctor to see more clearly and use smaller surgical instruments, which may reduce blood loss and allow you to recover faster. The surgeon can also perform a laparoscopic partial colectomy to remove just the section of the colon that contains cancerous cells.
For an open colon cancer surgery, doctors will make a large incision in your abdomen. They will then remove the affected portion of the colon, which might include nearby lymph nodes, and reattach or create a stoma if necessary to allow waste to pass through. They will then close the incision and apply a dressing.
In general, patients who undergo an open colorectal procedure stay in the hospital for a few days or up to a week until they have fully recovered bowel function. During this time, your care team will monitor you for complications and help you manage any post-op pain.