Colorectal Surgery

Integrated, Surgical Care to Treat Colon, Rectal and Anal Conditions

Loyola Medicine’s experienced colon and rectal surgeons treat a variety of problems of the colon, rectum and anus—including benign conditions, such as hemorrhoids, as well as cancer.

Our colorectal surgeons work as part of a clinically integrated care team, partnering with gastroenterologists, anesthesiologists and other specialists to provide state-of-the-art surgical techniques and minimally invasive approaches for many types of surgery.

Our colorectal surgeons have specialized training and vast experience treating common and rare problems of the colon, rectum and anus, including:

Loyola’s colorectal specialists can also provide advice on cancer screening for average-risk individuals, as well as for those who are at a higher risk of cancer due to pre-existing conditions or a strong family history.

Loyola’s colorectal surgery program offers advanced surgical treatment in outstanding, conveniently located facilities. We offer multidisciplinary facilities at the Loyola University Medical Center campus, in addition to outpatient services at other locations.

Why Choose Loyola for Colorectal Surgery?

Loyola provides truly integrated clinical care for colon and rectal conditions, bringing together specialists in colorectal surgery, surgical oncology, gastroenterology, radiology and pathology to provide adults and children with advanced care in a compassionate environment.

As part of an academic medical center, Loyola’s expert clinicians perform and teach the latest surgical techniques and medical treatments in numerous locations across the Chicago area.

All of our colorectal surgeons are fellowship-trained; they provide training and education to surgeons at other hospitals through courses on our campus, as well as at national and regional meetings.

For patients with colorectal cancer and other cancerous conditions, Loyola’s highly skilled surgical oncology team specializes exclusively in the diagnosis, biopsy and surgical removal of many types of cancer.

In addition, our nurses have earned Magnet status, which means they have been recognized for delivering the highest level of care.

How are Colorectal Conditions Diagnosed?

Loyola’s colon and rectal surgeons are experts at diagnosing and treating benign (noncancerous) and malignant (cancerous) conditions.

In order to create your unique treatment plan, your doctor will take a detailed medical and family history and conduct an examination. We will also ask whether you have a history of colorectal cancer in your family, as this sometimes indicates you have higher genetic risk of colon and rectal cancer.

Additional screenings might be used to determine whether you have abnormal pouches inside the intestines, or a condition such as colitis or cancer of the colon or rectum.

Depending on your condition, your doctor may request imaging and other tests, including:

• Blood tests — Your colorectal surgeon may request blood tests to check for anemia, as well as signs of infection from bacteria or viruses.
• Capsule endoscopy — For patients suspected of having Crohn’s disease, your doctor may perform capsule endoscopy. In this procedure, a small camera capsule provides images of your gastrointestinal tract and then is expelled from the body painlessly through stool. 
• Colonoscopy — Using a thin, flexible, lighted tube, your doctor can view your colon, take tissue samples and detect ulcers, colon polyps, tumors and areas of inflammation or bleeding. 
• CT scan (computed tomography) — Your doctor may use CT technology to create images of the entire bowel, which provides more detail than X-ray images. For images of the small bowel, CT enterography is used. For patients unable to have a colonoscopy, CT colonography (also called virtual colonoscopy) may be recommended. 
• Double-balloon enteroscopy — For patients who have undergone a colonoscopy for evaluation of symptoms but not gotten a clear diagnosis, your doctor may recommend double-balloon endoscopy. This procedure allows your doctor to see your entire gastrointestinal tract in real time.  
• Fecal occult blood test — Your doctor may use fecal occult blood testing to evaluate blood in the stool, which may be caused by polyps, colorectal cancers and gastrointestinal disorders. This test may be followed by other tests, including colonoscopy or sigmoidoscopy, to determine the exact cause of blood in your stool. 
• MRI (magnetic resonance imaging) — An MRI scanner uses a magnetic field and radio waves to create detailed images of organs and tissues. MRI is particularly useful for evaluating a fistula around the anal area (pelvic MRI) or the small intestine (MR enterography). Unlike CT, MRI imaging uses no radiation. 
• Sigmoidoscopy — If you have been experiencing abdominal pain, blood or mucus in your stool, diarrhea, constipation or other bowel changes, your doctor may use flexible or rigid sigmoidoscopy to obtain clear images of your colon and rectum. Your doctor may also use this technology to screen for colorectal cancer and polyps and take tissue samples for testing. 
• Upper GI endoscopy — For patients experiencing difficulty eating or swallowing, nausea, vomiting, or upper abdominal pain, your doctor may use upper endoscopy to evaluate the first part of the small intestine (duodenum), esophagus and stomach. This imaging technique is more accurate than X-ray imaging in the detection of inflammation, ulcers and tumors. Your doctor can perform a biopsy to determine if suspicious tissue is benign (noncancerous) or malignant (cancerous). 
• X-ray — For patients with severe symptoms, your doctor may use X-ray imaging of your abdominal area to rule out serious complications, such as a perforated colon. To provide clearer images, this may be performed with a contrast medium such as barium.

Minimally Invasive Techniques to Treat Colorectal Disorders

Frequently, Loyola’s colorectal surgeons are able to offer minimally invasive procedures that result in smaller incisions for the patient—and, in some cases, no incision. Minimally invasive approaches mean less blood loss, less pain, less time in the hospital and shorter recovery times for our patients.

Loyola offers the following minimally invasive approaches for colon and rectal surgery:

• Laparoscopic surgery — Many colon and rectal surgeries may be performed by using small instruments which are inserted through small incisions in the abdominal wall. Loyola’s skilled surgeons are experienced in laparoscopic approaches to colon and rectal surgery. 
• Robotic-assisted laparoscopic surgery — Loyola’s surgeons often recommend robotic-assisted surgery for the removal of tumors in the lower colon (sigmoid) or rectum. In this approach, surgeons use imaging to perform precise surgical treatment using robotic arms, which eliminate tremor and provide for greater movement and control. 
• Transanal endoscopic microsurgery (TEM) — Loyola’s colorectal surgeons are skilled in using TEM for the removal of benign polyps, as well as early stage cancers. This approach is performed through the anus and rectum with no visible incisions. 
• Transanal minimally invasive surgery (TAMIS) — This less-invasive option is used for the removal of rectal tumors. During TAMIS, your doctor uses a scope to reach the tumor and laparoscopic tools to surgically remove the tumor. 

The gastrointestinal cancer risk assessment program at Loyola also helps our patients identify whether they have a higher genetic predisposition to developing cancer in the colon and rectum or elsewhere in the GI system. We will suggest additional screenings for patients who are at a higher risk because of genetic factors.

Colorectal Surgeries Performed at Loyola

Loyola’s colon and rectal surgeons specialize in the diagnosis, treatment and management of benign (noncancerous) and malignant (cancerous) conditions. If you have colorectal cancer, your healthcare team will collaborate with our highly skilled surgical oncologists for the best possible outcome.

Our colorectal surgery team has received specialized training to provide the most advanced treatment options for complex conditions.

Loyola offers state-of-the-art interventions that are not available at other medical centers. Your doctor will develop an individualized treatment plan for your condition, which may include:

• Abdominoperineal resection surgery (APR) — For cancer located close to the anus, APR is a common treatment in which all rectal cancer cells are removed, as well as the rectum, anal sphincter and surrounding lymph nodes. Following this procedure, patients will have a bag attached to the abdomen that collects stool outside the body (colostomy). 
• Cancer surgery — Loyola’s surgeons are skilled in the removal of cancerous lesions and tumors in the colon and rectum. Depending on the stage and location, your cancer may be removed through local excision. which is done with small instruments and without incisions. The removal of polyps in this fashion is called a polypectomy. For larger tumors, your doctor may perform resection surgery, which also removes some surrounding healthy tissue and nearby lymph nodes. 
• Colectomy — For the treatment of some conditions and diseases of the colon, your surgeon may recommend partial colectomy (removal of part of the colon), total colectomy (removal of the entire colon) or proctocolectomy (removal of the colon and rectum).  
• Colonic stent placement — For the treatment of blockages in the colon, your doctor may recommend stent placement prior to surgical tumor removal or to relieve symptoms and pressure for patients who are not suitable for surgery. The stent is a flexible, hollow tube that is designed to open the obstructed portion of the bowel, which may be caused by a tumor or outside pressure on the bowel wall.  
• Colostomy — For patients who have had a portion of the colon removed due to severe colon and bowel conditions and diseases, a colostomy may be required to facilitate excretion of stool. This is accomplished by creating an opening in the abdominal wall and attaching the colon to an external bag, which is used to collect stool outside the body.  
• Endoscopic mucosal resection (EMR) — Your doctor may recommend EMR for the removal of cancerous lesions or tumors from the digestive tract. This technique uses a long, narrow, lighted tube to remove tumors or lesions, sample tissue for biopsy and evaluate the spread of cancer in the digestive tract.  
• Hemorrhoidectomy — The removal of hemorrhoids can be accomplished through several approaches, including complete surgical removal of extensive or severe hemorrhoids or stapling the hemorrhoid to cut off blood flow. Another option is hemorrhoid banding, which uses a rubber band to cut off blood flow.  
• Ileostomy — For patients whose colon or rectum is not functioning properly, an ileostomy may be required to facilitate excretion of stool. This is accomplished by creating an opening in the abdominal wall and attaching the small intestine (ileum) to an external bag, which is then used to collect stool outside the body.  
• Ileal pouch-anal anastomosis (IPAA) — After the removal of the rectum and colon due to severe conditions such as cancer or chronic ulcerative colitis, an IPAA (also called a J-pouch) will allow you to excrete stool without an external waste collection bag. The end of the small intestine is used to create an internal pouch, which is then connected to the anal canal.  
• Low anterior resection surgery (LAR) — For patients with cancer located well above the anus, the entire rectal cancer, nearby normal tissue and surrounding lymph nodes are removed through an incision in the lower abdomen.  
• Pelvic exenteration — This uncommon surgery is used in the treatment of recurrent cervical cancer in the pelvis. This major operation removes all or some of the structures in the pelvis, including the cervix, uterus, ovaries, bladder, urethra and some parts of the vagina. This is a radical treatment aimed at eliminating cancer; in rare cases, the rectum and anus may also be removed.  
• Polypectomy — Your doctor may recommend that polyps of the colon and rectum be removed to prevent them from turning cancerous. These may be removed endoscopically or surgically, depending on the size, shape and location of the polyp. 
• Primary bowel resection — For patients with diseased portions of the intestine, your doctor may recommend removal of the diseased portion. The remaining healthy portions of the intestine are then reconnected, allowing you to have normal digestive and excretory function.  
• Sacral nerve stimulation (neuromodulation) — Your doctor may recommend sacral nerve stimulation for the treatment of urinary incontinence or fecal incontinence. This technique is used to stimulate the nerves that control bladder function and bowel movements through the use of a small device, which is implanted under the patient’s skin.  
• Sphincter-sparing treatment — For cancer located close to the anus, abdominoperineal resection surgery (APR) is a common treatment in which all rectal cancer cells are removed, as well as the rectum, anal sphincter and surrounding lymph nodes. This treatment has an undesirable permanent effect: stool is permanently excreted through a bag attached to the abdomen (colostomy). For this reason, Loyola’s surgeons offer sphincter-sparing surgery whenever possible, which does not remove the anal sphincter. preserves normal function and eliminates the need for a colostomy. This treatment is often paired with chemotherapy and/or radiation therapy. 
• Strictureplasty — For patients with Crohn’s disease, strictureplasty may be used to widen a segment of the intestine that has become narrow or blocked. This treatment is often paired with medication to minimize the risk of recurrence and colonoscopy to monitor disease progression.