Colorectal surgery is a field in medicine dealing with disorders of the

rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...

anus The anus (Latin, 'ring' or 'circle') is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, the residual semi-solid waste that remains after food digestion, which, d ...

, and colon. The field is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular. The word ''proctology'' is derived from the

Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...

words , meaning "anus" or "hindparts", and , meaning "science" or "study". Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, to become colorectal surgeons, surgical doctors have to complete a general surgery residency as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the

American Board of Colon and Rectal Surgery The American Board of Colon and Rectal Surgery (ABCRS) is a member of the American Board of Medical Specialties that issues certificates for practitioners of Colorectal surgery. The board was established in 1934 as the American Board of Proctology. ...

or the

American Osteopathic Board of Proctology The American Osteopathic Board of Proctology (AOBPR) is an organization that provides board certification to qualified Doctors of Osteopathic Medicine (D.O.) who specialize in the medical and surgical treatment of disorders of the anus, colon, a ...

. In other countries,

certification Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...

to practice proctology is given to surgeons at the end of a 2–3 year subspecialty

residency Residency may refer to: * Domicile (law), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship * Residency (medicine), a stage of postgrad ...

by the country's board of surgery.

Scope of the specialty

Colorectal surgical disorders include: * varicosities or swelling, and

inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...

vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...

s in the rectum and anus (

hemorrhoid Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''hemo ...

s) * unnatural cracks or tears in the anus (

anal fissure An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation, but with chronic ...

s) * abnormal connections or passageways between the rectum or other anorectal area to the skin surface (

fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

s) * severe

constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...

conditions *

fecal incontinence Fecal incontinence (FI), or in some forms encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents, both liquid stool elements and mucus, or solid feces. When this loss includes flatus (gas), it is referred ...

* protrusion of the walls of the rectum through the anus (

rectal prolapse A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depend ...

) *

birth defect A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...

s such as the

imperforate anus An imperforate anus or anorectal malformations (ARMs) are birth defects in which the rectum is malformed. ARMs are a spectrum of different congenital anomalies which vary from fairly minor lesions to complex anomalies. The cause of ARMs is unkno ...

* treatment of severe colic disorders, such as

Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension ...

* cancer of the colon and rectum (

colorectal cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel m ...

) * repositioning of the rectal area if fallen out *

anal cancer Anal cancer is a cancer which arises from the anus, the distal opening of the gastrointestinal tract. Symptoms may include bleeding from the anus or a lump near the anus. Other symptoms may include pain, itchiness, or discharge from the anus. ...

* any injuries to the anus * removal of objects inserted into anus

Surgical treatment and diagnostic procedures

Gross pathology of minimally invasive colorectal surgery of tubulovillous adenoma

Surgical forms of treatment for these conditions include:

colectomy Colectomy ('' col-'' + '' -ectomy'') is bowel resection of the large bowel ( colon). It consists of the surgical removal of any extent of the colon, usually segmental resection (partial colectomy). In extreme cases where the entire large intestin ...

, ileo/colostomy,

polypectomy In medicine, a polypectomy is the removal of an abnormal growth of tissue called a polyp. Polypectomy can be performed by excision if the polyp is external (on the skin). See also * Colonic polypectomy * Non-lifting sign The non-lifting sign i ...

strictureplasty Strictureplasty (also spelled Stricturoplasty) is a surgical procedure performed to alleviate bowel narrowing due to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn's disease. The scar tissue ac ...

, hemorrhoidectomy (in severe cases of

hemorrhoids Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''hemo ...

), minimally invasive surgery, anoplasty, and more depending on the condition the patient has. Diagnostic procedures, such as a

colonoscopy Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (''e. ...

, are very important in colorectal surgery, as they can tell the physician what type of diagnosis should be given and what procedure should be done to correct the condition. Other diagnostic procedures used by colorectal surgeons include:

proctoscopy Proctoscopy is a common medical procedure in which an instrument called a proctoscope (also known as a rectoscope, although the latter may be a bit longer) is used to examine the anal cavity, rectum, or sigmoid colon. A proctoscope is a short, stra ...

, defecating proctography,

sigmoidoscopy Sigmoidoscopy (from the Greek term for letter " s/ς" + "eidos" + "scopy": namely, to look inside an "s"/"ς"-like object) is the minimally invasive medical examination of the large intestine from the rectum through to the nearest part of the co ...

. In recent times, the

laparoscopic Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medli ...

method of surgery has seen a surge of popularity, due to its lower risks, decreased recovery time, and smaller, more precise incisions achieved by using laparoscopic instruments.

Mechanical bowel preparation

Mechanical bowel preparation (MBP) is a procedure lacking evidence in the literature, wherein fecal matter is expelled from the bowel lumen prior to surgery, most commonly by using

sodium phosphate Sodium phosphate is a generic term for a variety of salts of sodium (Na+) and phosphate (PO43−). Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhyd ...

In popular culture

In the ''

Seinfeld ''Seinfeld'' ( ) is an American television sitcom created by Larry David and Jerry Seinfeld. It aired on NBC from July 5, 1989, to May 14, 1998, over nine seasons and List of Seinfeld episodes, 180 episodes. It stars Seinfeld as Jerry Seinfeld ( ...

'' episode "

The Fusilli Jerry "The Fusilli Jerry" is the 107th episode of the sitcom ''Seinfeld''. Featuring the introduction of David Puddy, the episode also features Kramer receiving vanity plates that say "ASSMAN" as well as marital problems between George's parents. This ...

", Kramer erroneously gets the

vanity plate A vanity plate or personalized plate (United States and Canada); prestige plate, private number plate, cherished plate or personalised registration (United Kingdom); personalised plate (Australia, New Zealand, and United Kingdom) or custom pla ...

"ASSMAN". He later finds out the plate belongs to a proctologist. Kramer claims the proctologists he has met always talk about patients concocting absurd stories of how an item accidentally ended up in their colon to avoid admitting that they deliberately inserted the object into their anus.

References

{{DEFAULTSORT:Colorectal Surgery Rectum