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

Rectum

The rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...

, anus

Anus

The anus 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, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...

, and colon

Colon (anatomy)

The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...

. The field is also known as proctology, but the term is outdated in the more traditional areas of medicine. The word proctology is derived from the Greek

Greek language

Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

 words Proktos, meaning anus or hindparts, and Logos meaning science or study.

Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, in order to become colorectal surgeons, these 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 or the American Osteopathic Board of Proctology. In other countries, certification

Certification

Certification refers to the confirmation of certain characteristics of an object, person, or organization. This confirmation is often, but not always, provided by some form of external review, education, assessment, or audit...

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

Residency (medicine)

Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...

 by the country's board of surgery.

Scope of the specialty

Colorectal surgical disorders include:

• varicosities or swelling, and inflammation
  Inflammation
  Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
  
   of vein
  Vein
  In the circulatory system, veins are blood vessels 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 blood to the heart...
  
  s in the rectum and anus (Hemorrhoid
  Hemorrhoid
  Hemorrhoids or haemorrhoids , are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their physiological state they act as a cushion composed of arterio-venous channels and connective tissue that aid the passage of...
  
  s)
• unnatural cracks or tears in the anus (Anal fissure
  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 the toilet paper, sometimes in the toilet. If acute they may cause severe periodic pain after defecation but with chronic fissures pain intensity is often less...
  
  s)
• abnormal connections or passageways between the rectum or other anorectal area to the skin surface (Fistula
  Fistula
  In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...
  
  s)
• severe constipation
  Constipation
  Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
  
   conditions
• fecal incontinence
  Fecal incontinence
  Fecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation...
  
  
• protrusion of the walls of the rectum through the anus (Rectal prolapse
  Rectal prolapse
  Rectal prolapse normally describes a medical condition wherein the walls of the rectum protrude through the anus and hence become visible outside the body.-Types:There are three chief conditions which come under the title rectal prolapse:...
  
  )
• birth defects such as the imperforate anus
  Imperforate anus
  An imperforate anus or anal atresia is a birth defect in which the rectum is malformed. Its cause is unknown.-Features:There are several forms of imperforate anus:* A low lesion, in which the colon remains close to the skin...
  
  
• treatment of severe colic disorders, such as Crohn's disease
  Crohn's disease
  Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
  
  
• cancer of the colon and rectum (Colorectal cancer
  Colorectal cancer
  Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....
  
  )
• repositioning of the rectal area if fallen out.
• anal cancer
  Anal cancer
  Anal cancer is a type of cancer which arises from the anus, the distal orifice of the gastrointestinal tract. It is a distinct entity from the more common colorectal cancer. The etiology, risk factors, clinical progression, staging, and treatment are all different. Anal cancer is typically a...
  
   (rare)
• any injuries to the anus
• removal of objects deliberately inserted into anus

Surgical treatment and diagnostic procedures

Surgical forms of treatment for these conditions include: colectomy

Colectomy

Colectomy consists of the surgical resection of any extent of the large intestine .-History:Sir William Arbuthnot-Lane was one of the early proponents of the usefulness of total colectomies, although his overuse of the procedure called the wisdom of the surgery into question.-Indications:Some of...

, ileo/colostomy, polypectomy

Polypectomy

The method used to perform colonic polypectomies during colonoscopy depends on the size, shape and histological type of the polyp to be removed. Prior to performing polypectomy, polyps can be biopsied and examined histologically to determine the need to perform polypectomy.Gastrointestinal polyps...

, strictureplasty

Strictureplasty

Strictureplasty is a surgical procedure performed in response to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn's disease. The scar tissue accumulates as a result of repeated damage and healing, with the scarring causing a stricture...

, hemorrhoidectomy (in severe cases of hemorrhoids), anoplasty, and more depending on the condition the patient suffers from. Diagnostic procedures, such as a colonoscopy

Colonoscopy

Colonoscopy 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 may provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected...

, 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

Proctoscopy is a common medical procedure in which an instrument called a proctoscope is used to examine the anal cavity, rectum or sigmoid colon. A proctoscope is a short, straight, rigid, hollow metal tube, and usually has a small light bulb mounted at the end...

, defecating proctography

Defecating proctogram

The defecating proctogram or defecography is an imaging study performed by a radiologist in which the mechanics of a patient's defecation are visualized in real time using a fluoroscope.-History:...

, sigmoidoscopy

Sigmoidoscopy

Sigmoidoscopy From Greek Sigma - eidos - scopy, to look inside an s-like object, is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. There are two types of sigmoidoscopy, flexible sigmoidoscopy, which uses a flexible endoscope,...

. In recent times, the laparoscopic 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.

See also

• The proctoscope (an instrument for visualizing the rectum)
• The sigmoidoscope (an instrument for visualizing the rectum and sigmoid colon)
• Enhanced Recovery

External links

• Anal Fissure Diagram
• American Board of Colon and Rectal Surgery
• American Osteopathic Board of Proctology.
• American Society of Colon and Rectal Surgeons