Coloproctology

• Rectoscopy / Proctoscopy
• Endorectal ultrasound.
• Pelvic magnetic resonance imaging (MRI).

Anal ultrasonography has gradually benn incorporated in the study of various anorectal diseases, curently being routine tool and almost indispensable in many of them, capable of providing valuable and immediate information in the consultation room, with little discomfort to the patient and practically without any risks.

The results of endorectal surgery using the circular stapler for the treatment of symptomatic hemorrhoids of an advanced degree offer advantages over conventional surgical techniques in terms of postoperative and results.

• Less postoperative pain.
• Minor analgesic requirements.
• Early discharge and outpatient surgery.
• Early incorporation to normal activity.
• No cures are needed as there are no skin wounds.
• Better functional and aesthetic results.
• Increased patient satisfaction.
• Improved quality of life.

¿What does this technique consists of and why does it improves the results?

The technique consists of making a rectal mucosal resection, above the pain threshold, unlike conventional surgery that causes severe postoperative pain.

This repositions the prolapsed tissue in its anatomical position, improving in most cases defecation impaired function in patients with advanced hemorrhoids.

Pelvic floor pathology is becoming more frequent due to increased life expectancy. It encompasses a multitude of pathologies, such as rectocele, rectal or genital prolapse, incontinence, etc. Of multifactorial causes, where concepts and treatments employed are in ongoing discussion.

The diagnosis study of pelvic floor disorders often requires specific techniques such as defecography or a pelvic dynamic MRI scan.

There are multiple techniques described for surgical correction of pelvic floor disorders. Among them, as with the surgical treatment of hemorrhoids, recently endorectal techniques have been incorporated with many advantages over conventional techniques in terms of postoperative and with encouraging results so far.

Identifying the degree of complexity of the fistula, as well as the risk factors of the patient to the development of complications, are the two key principles to decide the type of treatment, which makes it advisable for those patients with complex anal fistula to be treated by the Coloproctological specialised Surgery unit.

Often specific diagnostic techniques such as endorectal ultrasound and MRI scans are required.

The appropriate treatment depends on the type of fistula and circumstances of each patient, there are multiple surgical options.

Also called colon cancer, includes any type of neoplasms of colon, rectum and appendix. It is thought that many colorectal cancers arise from adenomatous polyps in the colon.

These growths in fungus shapes are usually benign, but occasionally they become cancerous over time. In most cases, the diagnosis of localized cancer is by colonoscopy. Treatment is usually surgical, and in many cases followed by chemotherapy.

Dr. Pérez Vicente, a Specialist in General Surgery at the Hospital IMED, specialises in this technique, involving local transanal resection with mechanical sutures.

Doctor Pérez told us that: “Localised surgery for cancer of the rectum, generally carried out transanally, is suitable for cases of cancer of the rectum that are detected early and which have not spread to neighbouring organs or achieved distant metastasis, as well as for other benign tumours. If the procedure is successful, it avoids the need for abdominal surgery or a colostomy in the case of tumours close to the anal margin, offering instead a much less invasive procedure, which can be carried out under a local anaesthetic (epidural or intradural), associated with a lower rate of complications, shorter hospital stay, earlier post-operative recovery and greater quality of life.”

In the near future, IMED Hospitales also intends to expand the range of services available in the field of Coloproctology by introducing TEM (Transanal Endoscopic Microsurgery), a minimally invasive surgical technique that is more precise and allows for intraluminal surgery to be performed on rectal tumours and other pathologies up to 20-25 cm above the anal margin. This will make it the first Private Centre in the province of Alicante to have access to this technology.

TEM offers various advantages over a traditional transanal resection, by offering improved visualisation and exposition, allowing for more precise tumour resection. Although the technique is used primarily for selected cases of rectal tumour, both benign and malignant, TEM can also be used for palliative surgery on patients who are not suitable for a more invasive procedure and for very advanced tumours where radical surgery is not feasible as a cure.