Colorectal Surgery

What is a Rectovaginal Fistula A rectovaginal fistula is an irregular link in between the lower part of your large intestine– your rectum– and also your vagina. Digestive tract components can leak via the fistula, enabling gas or stool come out through your vagina. The problem may create psychological distress and also physical pain, which can influence self-confidence and affection. Cause of Rectovaginal Fistula • Injury during childbirth• Obstructed labour• Rectal or Anal canal cancer• Ovarian or Uterine Cancer• Cervix cancer• Crohn’s disease or various other inflammatory bowel condition• Radiation therapy or cancer in the pelvic location• Complication arising with surgical treatment in the pelvic location• Faecal Impaction• Vaginal Injuries• Perineal injuries Clinical Presentation of a Rectovaginal Fistula Passage of gas, stool or pus from your vaginal canal Smelly vaginal discharge Recurrent vaginal or urinary tract infections Irritability or pain in the vulva, vagina and also the location between your vaginal canal and also anus (perineum). Pain during intercourse. Anal Incontinence Perianal Abscess Pelvic Abscess Diagnosis of Rectovaginal Fistula Physical examination Your physician will certainly execute a physical examination to attempt to locate the rectovaginal fistula as well as look for a any tumour mass, infection or abscess. It includes checking your vaginal canal, rectum as well as the location in between them (perineum) with a gloved hand. Unless the fistula is really low in the vaginal area as well as easily visible, your medical professional might make use of a speculum to see inside your vagina. A tool similar to a speculum, called a proctoscope, may be inserted into your rectum and also anus to check. A biopsy might be taken at the same time. If you want to explore what actually causes this condition and the treatment options available, you can check our detailed guide on rectovaginal fistula causes, symptoms, and treatment. Investigations for location Rectovaginal Fistula One might not locate a fistula through the physical exam. Other tests might be required to find and also assess a rectovaginal fistula. These examinations can additionally help your clinical team in preparing for surgical treatment. Contrast tests for Rectovaginal fistula A vaginogram or a barium enema can aid determine a fistula situated in the upper potion of rectum. These examinations make use of a dye material to show the vagina or the bowel on an X-ray image. Blue dye examination. This test includes placing a tampon right into your vagina, after that infusing blue color dye into your rectum. Blue staining on the tampon shows a fistula. CT Scan. A CT scan of your abdomen and pelvis gives a lot more information than does a conventional X-ray. The CT check can help situate a fistula as well as establish its reason. Magnetic vibration imaging (MRI). This examination can show the place of a fistula, whether other pelvic body organs are included or whether you have a lump. Anorectal manometry. This examination measures the level of sensitivity and also feature of your anus and can give information about the rectal sphincter as well as your capacity to control stool passage. This examination does not locate fistulas, yet may help in planning the fistula repair service. Anorectal ultrasound. This procedure uses sound waves to produce a video clip image of your anus as well as rectum. Your physician inserts a slim, wand-like instrument into your rectum and rectum. This examination can examine the structure of your anal sphincter and may reveal childbirth-related injury. Other examinations. If your physician believes you have inflammatory digestive tract illness, he or she may get a colonoscopy to see your colon. During the treatment, your medical professional can take small examples of tissue (biopsy) for laboratory evaluation, which can aid validate Crohn’s illness. Treatment of Rectovaginal Fistula Treatment for the fistula depends upon its reason, dimension, area and also effect on bordering tissues. Surgery is the mainline of treatment. Surgery has to be planned meticulously. Antibiotics or chemotherapy may have to be given before definitive surgery is planned. There are high chances of failure of repair of rectovaginal fistula in the presence of infection or residual cancer. Surgical procedures for Rectovaginal Fistula Prior to a procedure can be done, the skin and also various other cells around the fistula have to be healthy and balanced, without infection or swelling. Your doctor might recommend waiting 3 to six months prior to having surgical treatment to ensure the surrounding cells is healthy and also see if the fistula closes on its own. Surgery to shut a fistula is usually done by a colorectal surgeon as well as a gynaecologist. The objective is to remove the fistula tract and close the opening by stitching healthy and balanced layers of tissues. Surgical options consist of: Diversion stoma or colostomy: Carrying out a colostomy before repairing a fistula to divert stools via an opening in your abdominal area rather than with your rectum. This is temporary in nature but may be required for up to 6 months or more. The type of surgery is dependent on the cause of the fistula. It may involve utilizing a tissue graft taken from a neighbouring part of your body or folding a flap of healthy and balanced tissue over the fistula opening, repairing the anal sphincter muscles if they’ve been harmed by the fistula and removal of the cancer. Outcome after surgery for Rectovaginal Fistula The outcome will depend on many factors. It is a complex surgery and may be done in stages. The repair is not done in the presence of infection or cancer. At time radiotherapy has damaged the surrounding tissues so much that there are high chances of the surgery to fail. Thus lot of discussion and counselling of the surgery are required with the patient and family. Good outcomes are expected in cases of trauma, childbirth related injuries and non-malignant conditions. Success rates can vary between 50 to 80 percent in the best of situations. Surgery should be done by a team of experienced colorectal and gynaecologists.

Colorectal Surgery, Laparoscopic Surgery, Robotic Surgery

Minimally Invasive Surgery for Colorectal Diseases

Colorectal Surgery, Laparoscopic Surgery, Robotic Surgery / kapoorcmc

Minimally Invasive Surgery for Colorectal Diseases – It is also known as Key Hole Surgery. Many diseases as well as conditions of the colon and anus are treated surgically. A surgeon may use typical (open) or minimally invasive strategies relying on the specific situation. Minimally invasive colon and also rectal surgical treatment is a consistently evolving field. Each year brings new info based on additional improvements and raising use of these methods. Open versus minimally invasive colon and rectal surgery In typical open abdominal surgical treatments, doctors generally make a cut 6 to 12 inches in length, big sufficient to supply adequate visibility, offer accessibility to the abdominal organs and also allow the use of hand-held surgical instruments. Minimally invasive surgeries have been created to do operations via smaller incisions, minimizing the pain and also healing complications associated with lengthy incisions. Minimally invasive surgery can be made use of to effectively treat a range of common benign and also malignant colon and also anal conditions. All minimally invasive methods require advanced surgical skills as well as customized equipment. Colorectal surgeons have had progressed training in minimally invasive surgical procedure. All minimally invasive surgical procedures are executed with the patient asleep under an aesthetic. All the techniques listed here are considered “minimally invasive,” however might differ somewhat in their total benefits and also negative aspects. Laparoscopic surgery The doctor makes numerous tiny cuts about half inch in dimension. Throughout laparoscopic procedures, an electronic camera is positioned inside one of the cuts, allowing the doctor to check out the within the abdominal area on monitors or tv displays For many colon and also anal operations, 2-4 small cuts are needed. Co2 gas is utilized to blow up the abdominal area in order to give the specialist area to work. To perform the surgical procedure, unique instruments are put via the various ports inserted through these small incisions, permitting the surgeon to operate inside the abdomen by checking out the electronic cameras. For lots of colon and also rectal procedures, one a little larger incision (about 2-4 inches in size) need to be made in order to remove a piece of intestinal tract which has the disease and has been resected. When a part of the surgical treatment is done with this smaller sized laceration this may be called “laparoscopic-assisted surgery.” IT can be effectively used for colon and rectal cancers. Robotic surgical treatment or robotic-assisted surgical procedure This method permits a colorectal surgeon to control a robot that holds the surgical instruments. Similar to laparoscopic surgery, a camera as well as specialized instruments are placed through small incisions. The doctor works from a console in the operating room where they have a 3D sight of the surgical area and also control instruments attached to the robot. An innovative computer system translates the activities of the surgeon’s hands to the robot, which then moves the surgical tools. Robot surgical treatment is gaining popularity primarily for rectal operations since the robotic tools are well equipped to operate in the narrow pelvis where laparoscopic surgery is more difficult. Advantages of minimally invasive surgery. Cuts are a lot smaller sized than those made use of in traditional surgical procedure. Decreased postoperative discomfort. Shorter hospital remains. Lowered requirement for prescription pain drugs. Earlier go back to regular tasks. Much less noticeable scarring. It is very important to note that outcomes are similar between open and minimally invasive procedures. Nevertheless, minimally invasive surgery uses potential advantages in the early post-surgery recuperation period. Dangers of minimally invasive surgery. The danger of complications is similar to that of traditional open surgery. Every surgery, whether minimally invasive or traditional, brings some risk of problems. Risks usual to both open and minimally invasive colon and anal surgical treatment include blood loss, infection, post-operative digestive tract obstruction as well as leak from a intestinal anastomosis (reconnection). Other threats, such as heart problems, pneumonia and embolism exist with any major surgical procedure requiring general anaesthesia. Periodically, a specialist will experience conditions throughout surgery that would certainly make proceeding with minimally invasive surgical treatment dangerous. In this scenario, the incision is enlarged to permit traditional surgical strategies to be made use of to complete the operation. This is referred to as a “conversion” to typical or “open” surgery. Minimally invasive surgical procedure is not appropriate for all clients or problems. Conclusion: Technology has brought about changes in how surgery is done. Laparoscopic surgery has been around for almost 30 years now. Robotic Surgery is a newer modality and been around for almost five years. Considerable training and experience are required for these procedures like for any other surgical experience. Open surgery is still the backbone of any procedure especially when minimally invasive surgery is difficult or not possible. However, majority of cancers of the colon and rectal tumours are nowadays operated with minimally invasive techniques. Also See Colectomy Surgery in Chandigarh Cervical Cancer Surgery in Chandigarh

Colorectal Cancer, Colorectal Surgery, General Surgery, Rectal Bleeding, Rectal Cancer

There is Blood in my Stools … What should I Do

Colorectal Cancer, Colorectal Surgery, General Surgery, Rectal Bleeding, Rectal Cancer / kapoorcmc

What is rectal bleeding? Looking down right into a toilet and seeing blood can be alarming. If you’re experiencing rectal bleeding, you might see blood in a couple of various means– on your toilet paper as you wipe, in the water of the commode bowl or in your stools. It can be various shades, ranging from bright red to a dark maroon to black. The shade of blood you see can actually show where the bleeding might be originating from. Bright red blood usually indicates bleeding that’s low in your colon or rectum. Dark red or maroon blood can indicate that you have hemorrhaging from right colon or small intestine. Melena (dark, smelly as well as tar-like stool) typically indicates hemorrhaging in the stomach. In some cases, rectal blood loss isn’t noticeable to the naked eye and can only be seen through a microscope. This type of blood loss is typically discovered during a laboratory test of a faeces sample as a part of screening or test stone to diagnose anemia. Is rectal bleeding of concern? In some cases, anal blood loss can be a small symptom of a problem that can be conveniently dealt with. Piles, as an example, can cause you to experience rectal bleeding. This usually doesn’t last long and piles are frequently very easy to treat. Rectal blood loss can sometimes be a sign of a significant problem like colon or rectal cancer. It’s vital to track any kind of blood loss you are experiencing. If it’s hefty, frequent or triggering you to worry, call your doctor to check it out. How does anal bleeding appear? You may see or experience anal bleeding in a couple of different means, including: Seeing blood on your toilet paper when you clean. Seeing blood in the toilet water of the bathroom when you are making use of the restroom– the water in the bowl may look like it’s been dyed red. Noticing dark red, black or tarry poop while you are having a bowel movement. What are the signs and symptoms of anal bleeding? The symptoms of anal bleeding can differ depending upon what is creating the bleeding. Some signs and symptoms you may have with rectal blood loss can include: Feeling anal discomfort and/or pressure. Seeing bright red blood in or on your stool, undergarments, toilet paper or in the toilet dish. Having stool that’s red, maroon or black in shade. Having stool that has a tar-like appearance. Experiencing fatigue or restlessness. Feeling lightheaded or lightheaded. Fainting. In some very severe instances, anal bleeding can result in shock. The signs and symptoms of shock can include: Experiencing an unexpected decrease in your blood pressure. Having a rapid heart rate. Not being able to urinate. Slipping into unfamiliarity. What creates rectal bleeding? There are several reasons why you might experience rectal blood loss. The sources of rectal blood loss can differ from usual and also moderate conditions to much more severe as well as unusual problems that require immediate clinical therapy. Causes of rectal bleeding can include: Hemorrhoids Anal Fissure Anal abscess Anal Fistula Diverticulosis/Diverticulitis Inflammatory digestive tract condition (IBD) Large polyps Colon Cancer Rectal Cancer Can foods transform the shade of my stool in a similar way to rectal blood loss? There are certain foods that can make your stools an unusual colour. Foods like black licorice, beetroots, dark berries (blueberries and also blackberries) and red jelly can all make your stools appearance extremely dark. This can easily be confused for blood in your stool. If you observe extremely dark poop throughout a bowel movement, think back to what you consumed lately. There’s a chance that what you consumed could be the cause for the usually dark stool. Can constipation and straining result in anal bleeding? Yes it can. Straining can trigger rectal bleeding. This is commonly related to bowel constipation. Really hard faeces can actually cause the skin around your anus to tear, creating you to see blood. Dealing with constipation can aid prevent this from happening. What are the tests required to diagnose the cause of rectal bleeding? There are a number of means your doctor can utilize to review rectal blood loss to help determine the cause. These are: A physical exam of the rectum as well as anus. A colonoscopy. A sigmoidoscopy. A faecal occult blood examination Haemoglobin and other lab tests CT Scan Exactly how do I deal with rectal blood loss? For you, the only instruction is to go and consult a surgeon. For the most part, rectal bleeding can be dealt with by taking care of the cause of the blood loss. Once that condition has actually been dealt with, the bleeding usually quits. Treatment options can vary relying on the condition. Will anal bleeding vanish by itself? Depending on the cause of the bleeding, your rectal blood loss can in fact quit on its own. You need to pay attention to your body and maintain track of the blood loss. If it occurs one-time and then quits, remember of it, yet it more than likely isn’t an emergency. If you have heavy rectal blood loss or are on a regular basis seeing blood, connect to your doctor to get prompt care. Conclusion Blood in your stool could just be due to piles, but it could also be a sign of something more sinister and dangerous. The only way to be sure is to consult your doctor or a surgeon. People tend to be shy about talking of blood in ones stools or giving a stool sample and that may cause significant loss of blood as well as delay in diagnosing the cause. To develop the right treatment plan, a correct history should be provided. Nip the evil in the bud before it can create havoc.

blog, Colorectal Surgery

Anal Fistula Surgery in Chandigarh | Anal Fistula Symptoms, Treatment and Management

blog, Colorectal Surgery / kapoorcmc

Anal Fistula: Symptoms and Management Anal Fistula Surgery in Chandigarh – Anal fistula is a small connection, which is established between the lumen of the rectum and the external opening lies on perianal skin. There is pus discharge through the passage. It can present in many ways. Anal Fistula Symptoms Pain and swelling around the area Frequent abscesses Bloody or foul-smelling drainage (pus) from an opening around that area. Irritation of the skin around the perianal area. Pain with bowel movements Bleeding Fever, chills and a feeling of fatigue Also See: Fistula Doctor in Chandigarh Anal Fistula Treatment and Management Surgery is almost always necessary to cure a fistula. The surgery is performed by a colorectal surgeon. The goal of the surgery is a fine balance between getting rid of the fistula while protecting the sphincter muscles, which could result in incontinence if damaged. Fistulas in which there is no or little sphincter muscle involved are treated with a fistulotomy. In this procedure, the skin and muscle over the tunnel are cut open to convert it to an open groove. Hence the wound heal from inside. Anal Fistula Seton Surgery In the case of a more complex fistula, a special drain called a seton is placed, which remains in place for at least 6 weeks. Once a seton is placed, a second operation is almost always performed. Complex fistulae may require multiple surgeries at variable intervals. Most of the fistulas respond well to surgery. But the healing process takes time. At times, fistula are associated with lot of pus in the form of abscess. Then too staged surgery is performed. At time draining setons are used to drain the pus. The type of surgery and number of surgeries required will depend on the complexity of the disease. Clinical examination is the key to making these decisions. MRI fistulogram is almost always required to assist in making plans for the surgery, Also See Colon Cancer Surgeon in Chandigarh Conclusion This disease is associated with lot of morbidity and needs plenty of patience, as it is in a dirty area of the body, which has to function daily. However, correctly treated, patients do very well. Aim is to make sure that in first instance infection is controlled, which reduces pain before proceeding for definitive surgery. Almost always, the surgery needs one night admission and subsequently patients can join work within a week of surgery. Dressing the surgical site is simple and patient can be followed up in the out patients department once a week or once in a fortnight.

Rectovaginal Fistula: Diagnosis and Management

Minimally Invasive Surgery for Colorectal Diseases

There is Blood in my Stools … What should I Do

Anal Fistula Surgery in Chandigarh | Anal Fistula Symptoms, Treatment and Management

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