What Is a Colorectal Surgeon? Common Procedures & Treatments

A colorectal surgeon specializes in diagnosing and surgically treating conditions affecting the colon, rectum, and anus, such as colorectal cancer, Crohn’s disease, and hemorrhoids, using both minimally invasive and traditional methods. These specialists undergo extensive training and certification, often completing a fellowship after medical school and residency, and provide essential care to improve patients’ quality of life through various surgeries and treatment options. 

The term colorectal surgeon is relatively new in healthcare, but the role itself isn’t. These surgeons have always been around, under the term “proctologist.” But what is a colorectal surgeon, and what do they do? Keep reading to find out!

What Is a Colorectal Surgeon?

Colorectal surgeons belong to a specific field of surgery that deals with colon and rectal diseases (colorectal), including the small bowel and anus. They perform surgical procedures for diseases like colorectal cancer, inflammatory bowel disease, and hemorrhoids, using techniques ranging from minimally invasive surgeries to more complex open procedures, depending on the condition. 

These surgeons undergo a demanding academic path along with training before becoming the experts we know them to be. With their knowledge and expertise in surgery, colorectal surgeons are essential in managing colorectal and related diseases effectively. 

Qualifications of a Colorectal Surgeon

Becoming a colorectal surgeon requires years of extensive training and specialized education. 

Medical school

The journey begins with medical school, a four-year program split between classroom-based learning (pre-clinical) and hands-on experience (clinical). 

Key concepts for future colorectal surgeons are covered during medical studies, such as the gastrointestinal system (anatomy), colon and rectal diseases (pathology), and surgical techniques. This builds the groundwork for practical training moving forward. 

At AUA, an elective rotation in Colorectal surgery gives students exposure to effective disease management, helping them decide if this specialty aligns with their career goals. 

Residency

Following medical school, aspiring surgeons undergo a 5-7 year general surgery residency, where they develop a broad range of surgical skills, including emergency and gastrointestinal surgeries. 

Residents receive hands-on training while being supervised by senior doctors, which is important considering the sensitivity of the field. Skills like precision, manual dexterity, and stress management are developed during this phase. 

Fellowship

Next is a 1-2 year colorectal surgery fellowship, focused on minimally invasive techniques (such as laparoscopy and robotic surgery) and the management of complex colorectal conditions. This stage further refines the surgeon’s expertise and experience.

Certification

Getting certified marks the final destination. Colorectal surgeons are required to be certified by the American Board of Surgery (ABS) first before attaining certification from the American Board of Colon and Rectal Surgery (ABCRS). When a surgeon is certified by the ABCRS, it means they’re qualified to treat anorectal conditions, colorectal and anal tumors, and inflammations, among others. 

What Conditions Do Colorectal Surgeons Treat?

Colorectal surgeons treat many conditions affecting the colon, rectum, and anus. 

Common conditions treated are: 

• Hemorrhoids
• Anal fissures
• Diverticulitis
• Rectal ulcers
• Constipation and fecal impaction

Complex conditions include: 

• Colorectal cancer (colon, rectal, anal, appendix)
• Inflammatory bowel diseases (IBD)
• Crohn’s disease
• Ulcerative colitis

Colorectal surgeons also handle conditions like rectal prolapse (where the rectum slips out of place), anal fistulas, and bowel obstructions. They use both minimally invasive and open surgical techniques to address these problems. As such, they help restore normal function and improve the patient’s quality of life.

Types of Surgeries Performed by Colorectal Surgeons

Colorectal surgeons perform a variety of procedures to treat various colorectal conditions, ranging from simple (minimally invasive) techniques to more complex surgeries. 

Minimally invasive procedures

To expedite the recovery process post-surgery, many surgeons nowadays are steering away from traditional surgical techniques and embracing minimally invasive procedures. Instead of making large incisions to treat patients, it’s now become more common to use tubes for small incisions, with the end goal being the same. 

Colorectal surgeons typically turn to laparoscopy or robotic surgery as the main minimally invasive procedures. Using such procedures for conditions like diverticulitis or hernia repairs has proven effective. Besides leading to quicker recovery and less pain, minimal incisions are ideal to preserve healthy tissue while addressing the underlying problem.

Common surgical procedures

Some common surgical procedures used by colorectal surgeons are: 

• Colonoscopy: A diagnostic procedure using a camera to examine the colon for abnormalities or cancer.
• Polypectomy: Polyps are removed from the colon during a colonoscopy, preventing them from turning cancerous.
• Ostomy Creation: It is a surgical opening in the abdomen (colostomy or ileostomy) to divert waste when part of the bowel is damaged or removed.
• Bowel Resection: It refers to the removal of diseased sections of the colon, commonly for cancer or severe diverticulitis.
• Anastomosis: It involves the reconnection of healthy sections of the bowel after resection to restore normal digestive function.

While surgeries like bowel resection carry risks such as infection, bleeding, and bowel leaks, they often provide life-saving benefits by removing disease and restoring function, improving long-term health and quality of life.

Specializations of Colorectal Surgeons

Colorectal surgeons can specialize in areas like colorectal cancer, inflammatory bowel disease (IBD), and pelvic floor disorders, allowing them to provide precise diagnoses and effective treatment plans tailored to patients’ unique needs.

Colorectal cancer

Colorectal cancer (CRC) is one of the most common cancers worldwide, affecting both men and women. It develops in the colon or rectum and often begins as a small polyp, which can turn cancerous over time. The good news is that when caught early, with the help of a colorectal surgeon, the survival rates are remarkably encouraging.

According to the American Cancer Society, the five-year survival rate for when colorectal cancer is localized (not spread outside of the colon or rectum) can be as high as 90%. This statistic underscores the importance of regular screenings and vigilance in recognizing symptoms.

However, the journey through colorectal cancer is not just about statistics; it’s also about the individuals behind the numbers. Patients often face a range of emotions, from fear and anxiety to hope and determination. Early diagnosis can lead to less invasive treatments, such as polypectomy during a colonoscopy, sparing patients from more aggressive surgeries down the line.

IBD management

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, can significantly impact daily life. Individuals with IBD often suffer from abdominal pain, diarrhea, fatigue, and weight loss, which can be challenging to manage and may lead to anxiety about when and where these symptoms will occur.

When medications no longer control symptoms or when complications arise, surgery might provide relief. For instance, surgery for Crohn’s disease typically involves removing affected parts of the intestine, while ulcerative colitis might require removing the colon altogether. 

Many patients find relief and improved quality of life after surgery, allowing them to return to their daily routines. This underscores the value of surgical intervention in effectively managing IBD and providing timely medical support, which is critical in healthcare.

Pelvic floor disorders

Pelvic floor conditions, such as pelvic organ prolapse and fecal incontinence, are often not openly discussed, leaving many unaware of available treatments. Colorectal surgeons play a vital role in diagnosing and addressing these disorders.

They perform surgeries to repair pelvic floor issues, such as sacrocolpopexy for prolapse or sphincter repair for fecal incontinence, restoring normal function and alleviating discomfort.

Understanding the risk factors such as pregnancy, aging, obesity, and chronic coughing is essential for prevention. Many patients may first explore non-surgical options, such as pelvic floor exercises or physical therapy, to strengthen the supporting muscles. However, when these methods prove inadequate, surgical intervention becomes necessary.

Conclusion

With colon and rectal conditions affecting many patients today, colorectal surgeons are considered vital in healthcare. These are qualified, trained professionals who can put an end to any colorectal disease using proper surgical procedures and complementary treatments. And if you’re having any issues that need immediate attention, now is the time to act! Schedule a screening appointment with your local colorectal surgeon today and avoid the inevitable.

Frequently Asked Questions (FAQs):

Why choose a career as a colorectal surgeon?

Choosing a career as a colorectal surgeon offers the opportunity to perform life-saving procedures, tackle complex diseases like cancer, and dramatically improve patients’ quality of life through specialized care.

How does a colorectal surgeon differ from a gastroenterologist?

Colorectal surgeons perform surgeries to treat conditions of the colon, rectum, and anus, while gastroenterologists focus on diagnosing and managing gastrointestinal diseases without surgery.