Rectal Cancer Surgery

Rectal Advancement Flaps for Complex Anal Fistulas : A Surgical Approach An anal fistula is a challenging and often painful condition that requires careful consideration and surgical management. One of the surgical techniques employed in treating complex anal fistulas is the Rectal Advancement Flaps for Complex Anal Fistulas procedure. This approach has proven to be effective in many cases. Understanding Anal Fistulas An Anal Fistulas is an abnormal connection or tunnel that forms between the anal canal (the end of the large intestine) and the skin near the anus. It typically results from an infection or abscess near the rectum. Anal fistulas can cause persistent pain, discharge, and recurrent infections, significantly affecting a patient’s quality of life. Several surgical techniques are available to manage these fistulas, and the choice of procedure depends on the type as well as complexity of the fistula. Here are some of the surgical options: Fistulotomy: This is a straightforward surgical procedure in which the surgeon cuts open the entire length of the fistula tract, allowing it to heal from the inside out. It’s typically used for simple, low-risk fistulas. Seton Placement: A seton, which is a special elastic thread, can be placed through the fistula tract. This helps in gradual drainage as well as allows the surrounding tissues to heal. Seton placement is often used when there’s a high risk of incontinence with other procedures. Seton can be used as a cutting seton too. LIFT Procedure (Ligation of the Intersphincteric Fistula Tract): This technique involves identifying and ligating the internal opening of the fistula tract while leaving the rest intact. It’s suitable for certain complex fistulas. Advancement Flap Surgery: As previously discussed, advancement flap surgery involves creating a flap of healthy tissue to cover the internal opening. This is ideal for complex fistulas near the sphincters. Plugs as well as Fillers: Special plugs or biologically derived materials can be used to seal the internal opening. These act as a barrier to encourage healing. This has not proved to be very successful as well as has high recurrence rates. Other Factors Of Anal Fistulas Fibrin Glue: Fibrin glue is injected into the fistula tract to seal it. This technique is suitable for some low to moderately complex fistulas. Again it is not used these days as the recurrence rates are very high. Video-Assisted Anal Fistula Treatment (VAAFT): VAAFT is a minimally invasive procedure in which a small endoscope is inserted into the fistula tract. It’s used to locate as well as close the internal opening with glue or sutures. This procedure can be used in very simple fistula; it too has high recurrence rates. Staged Procedures: In complex or recurrent cases, surgeries may need to be staged, where several procedures are performed over multiple sessions. Colostomy: In severe cases or when all other methods fail, a colostomy may be considered. This involves diverting the fecal stream to allow the area to heal. The choice of surgery depends on individual factors, such as the type and location of the Anal Fistulas, the patient’s overall health, as well as the surgeon’s preference and expertise. A thorough evaluation by a colorectal surgeon is necessary to determine the most suitable surgical approach for each patient. While these surgical techniques have their own advantages as well as considerations, the primary goal is to treat the fistula effectively while preserving anal function and minimizing the risk of complications such as incontinence. Consulting with a specialist is crucial to ensure the best possible outcome for patients dealing with Anal Fistulas. The Role of Rectal Advancement Flaps The Rectal Advancement Flap procedure is a surgical technique designed to treat complex anal fistulas. Complex anal fistulas are those that are associated with a high risk of recurrence or have multiple tracts, making them challenging to manage with simple procedures like fistulotomy. How The Procedure Works? Patient Preparation: The patient is placed under general anaesthesia and positioned on special contraption, called yeloow fin stirrups. Identifying the Fistula: The surgeon carefully identifies the fistula’s tract or tracts, often using specialized tools as well as techniques. Creating a Flap as well as suturing the internal opening: A flap of healthy rectal tissue is created. This flap is designed to close the internal opening of the fistula, which is usually situated within the rectal lining. Flap Advancement: The created flap is advanced as well as sutured over the internal opening, effectively sealing it. Drainage: n some cases, a seton or drain may be placed to ensure proper drainage while the fistula heals. Closure: The external opening of the fistula is left open or may be partially closed depending on the specific case. Advantages of Rectal Advancement Flaps Low Risk of Incontinence: One significant advantage of the Rectal Advancement Flap procedure is its low risk of causing faecal incontinence. This makes it a preferred choice for many complex fistulas, especially those close to the anal sphincters. Effective Closure: By creating a flap of healthy tissue, this procedure effectively closes the internal opening of the fistula, reducing the risk of recurrence. While the Rectal Advancement Flap procedure offers many advantages, there are also potential considerations as well as complications: Healing Time: Healing can take several weeks to months. It’s essential for patients to follow post-operative care instructions carefully. Recurrence: While the risk of recurrence is low, it can still occur, particularly in challenging cases. Infection: As with any surgical procedure, there is a risk of infection, which needs to be managed with appropriate antibiotics. Conclusion The Rectal Advancement Flap procedure is a valuable surgical approach for treating complex Anal Fistulas, providing effective closure while minimizing the risk of incontinence. It’s essential for patients to consult with experienced colorectal surgeons to determine the most suitable treatment for their specific condition. For More Information Stay Updated With : drrajeevkapoor.com Also Read: Latest Surgical Management of Left Colon Cancer The Technology Behind Robotic Surgery Is Bowel Content Leakage A Sign Of Cancer? Fecal Incontinence can be cured: A real life story The Rising

Rectal Cancer Surgery

Understanding Divarication of Recti: Symptoms, Causes, and Treatment

Rectal Cancer Surgery / kapoorcmc

Understanding Divarication of Recti: Symptoms, Causes, and Treatment Divarication of Recti, also known as Diastasis Recti, is a condition characterized by the separation of the midline abdominal wall muscles called Recti Abdominis, which are two in number and lie parallel in the midline one on each side. It commonly occurs during or after pregnancy but can also affect men and women who are not pregnant. This blog aims to provide a comprehensive understanding of Divarication of Recti, including its symptoms, causes, and available treatment options. Symptoms: The primary symptom of Divarication of Recti is the visible separation of the abdominal muscles. Other common symptoms include: Bulging or protrusion of the abdomen: A noticeable bulge or ridge running vertically along the midline of the abdomen, particularly when straining or engaging the abdominal muscles. Weakness in the core muscles: Difficulty with activities that require core strength, such as sitting up from a lying position or carrying heavy objects. Lower back pain: Many individuals with Divarication of Recti experience discomfort or pain in the lower back due to inadequate core muscle support. Digestive issues: Some people may develop digestive problems like bloating or constipation, as the separated abdominal muscles are less efficient in supporting proper digestion. Urinary incontinence: In severe cases, Divarication of Recti may contribute to urinary leakage or stress incontinence, especially when coughing, sneezing, or lifting heavy objects. At times divarication is associated with with ventral or umbilical hernia. Causes: Divarication of Recti typically occurs due to excessive pressure on the abdominal muscles. The most common causes include: Pregnancy: The growing uterus during pregnancy puts significant strain on the abdominal muscles, leading to their separation. Rapid weight gain: Sudden and substantial weight gain can stretch the abdominal muscles, resulting in diastasis. Incorrect exercise techniques: Performing exercises that excessively strain the abdominal muscles, such as improper crunches or sit-ups, can contribute to the development of Divarication of Recti. Multiple pregnancies: Women who have had multiple pregnancies are more susceptible to developing this condition due to repeated stretching and straining of the abdominal muscles. Treatment Options: Fortunately, there are various treatment options available for Divarication of Recti, depending on the severity of the condition. Patients with small divarications are offered no surgical treatment listed below: Physical therapy: A specialized physical therapist can provide exercises and techniques to strengthen the abdominal muscles and promote proper alignment of the core. Physical therapy can be highly effective, especially for mild cases. Core-strengthening exercises: Specific exercises, such as pelvic tilts, transverse abdominis activations, and kegel exercises, can help strengthen the abdominal muscles and improve core stability. However, it’s crucial to perform these exercises correctly to avoid further exacerbating the condition. These are not very effective in curing the problem. Supportive garments: Wearing abdominal binders or support belts can provide temporary relief by offering additional support to the weakened abdominal muscles. Surgical intervention: In most of the symptomatic cases or when conservative treatments fail, surgical repair is almost always recommended. This procedure is called repair of divarication of Recti and may also need repair of the hernia associated if any. This procedure is routinely performed laparoscopically. Mesh is invariably used to reinforce the repairs. If the patient also has extra abdominal skin, then the above are associated with some form of abdominoplasty or tummy tuck. See Also: Understanding Diastasis Recti: Unveiling the Causes Conclusion: Divarication of Recti is a common condition, particularly among pregnant women, but it can affect anyone. Recognizing the symptoms and understanding the causes can help individuals seek appropriate treatment options. Physical therapy, core-strengthening exercises, and supportive garments are non-surgical approaches offered but not very effective. Surgery remains the main treatment option. Almost always the repair can be done by the minimal access method, especially if abdominoplasty is not required. It’s important to consult with surgeons, to develop a personalized treatment plan that addresses individual needs. With the right approach, individuals with Divarication of Recti can regain abdominal strength and improve their overall quality of life. Book Your Appointment or Call at +91-9876-507-444 to get the best treatment.

Rectal Cancer Surgery

Understanding Diastasis Recti: Unveiling the Causes

Rectal Cancer Surgery / kapoorcmc

Understanding Diastasis Recti: Unveiling the Causes Divarication of Recti, also known as Abdominal Rectus Divarication, is a condition characterized by the separation of the abdominal muscles in the abdominal wall in the midline. While it is commonly associated with pregnancy, it can also affect individuals. In this blog, we will delve into the various causes of Divarication of Recti, shedding light on the factors that contribute to this condition. Pregnancy: One of the primary causes of Abdominal Rectus Divarication is pregnancy. As the fetus grows, the uterus expands, exerting significant pressure on the abdominal muscles. Hormonal changes during pregnancy also lead to the softening of connective tissues, making them more susceptible to stretching and separation. Multiple pregnancies increase the likelihood of developing Diastasis Recti, as the abdominal muscles have experienced repeated stretching and strain. Rapid Weight Gain: Sudden and excessive weight gain can put stress on the abdominal muscles, leading to their separation. This can occur due to factors such as significant weight fluctuations, unhealthy dietary habits, or sedentary lifestyles. When weight is gained rapidly, the abdominal muscles may struggle to accommodate the increased volume, resulting in the widening of the midline. Incorrect Exercise Techniques: Improper exercise techniques, particularly those that overly strain the abdominal muscles, can contribute to the development of Divarication of Recti. Exercises such as traditional crunches or sit-ups, which place excessive pressure on the midline, can lead to muscle separation. It is important to perform exercises under proper guidance, focusing on engaging the core without compromising the integrity of the abdominal muscles. Genetic Predisposition: Some individuals may have a genetic predisposition to developing Divarication of Recti. Certain connective tissue disorders, such as Ehlers-Danlos syndrome, can weaken the abdominal muscles and make them more prone to separation. Genetic factors can play a role in determining the strength and elasticity of the connective tissues, influencing the likelihood of Diastasis Recti. Lifestyle Factors: Lifestyle choices can also contribute to the development of Divarication of Recti. Factors such as poor posture, excessive strain from heavy lifting or intense physical activity, and inadequate core muscle engagement can all place stress on the abdominal muscles. These cumulative factors weaken the muscles over time, increasing the risk of muscle separation. Conclusion: Divarication of Recti can have various causes, with pregnancy and rapid weight gain being the most common culprits. However, incorrect exercise techniques, genetic predisposition, and lifestyle factors can also contribute to this condition. Recognizing these causes can help individuals take preventive measures and seek appropriate treatment options to address Diastasis Recti effectively. See Also: What is Abdominal Rectus Divarication Frequently Asked Questions Q: What is divarication of recti? A: Divarication of recti, also known as diastasis recti, is a condition characterized by the separation or widening of the rectus abdominis muscles along the midline of the abdomen. This separation creates a visible bulge or gap between the muscles. Q: What causes divarication of recti? A: Divarication of recti often occurs as a result of the stretching and weakening of the linea alba, the connective tissue that runs along the midline of the abdomen. It is commonly associated with pregnancy and abdominal muscle stretching during pregnancy, but it can also occur due to obesity, repetitive heavy lifting, or abdominal muscle strain. Q: What are the symptoms of divarication of recti? A: The most common symptom of divarication of recti is the visible bulge or gap in the midline of the abdomen, particularly when the person performs certain movements like sitting up or contracting the abdominal muscles. Some individuals may also experience lower back pain or a feeling of weakness in the core muscles. Q: Can divarication of recti be treated without surgery? A: In many cases, conservative measures can help improve the symptoms of divarication of recti. Physical therapy, specifically exercises that target the transverse abdominis and pelvic floor muscles, may be recommended to strengthen the core and provide support to the abdominal muscles. The use of abdominal binders or splints can also aid in providing support and promoting proper alignment of the muscles. However surgery remains the mainstay of treatment for this condition. Q: When is surgery recommended for divarication of recti? A: Surgery may be recommended for individuals with severe or persistent symptoms that significantly impact their daily activities, quality of life, or self-esteem. It is generally considered when conservative measures have not provided satisfactory results. Surgery aims to repair and tighten the separated muscles, restoring abdominal muscle integrity. Q: What does the surgical procedure for divarication of recti involve? A: The surgical procedure for divarication of recti typically involves repair of the defect and reinforcement of repair with a mesh. During the procedure, the surgeon sutures or brings the separated rectus abdominis muscles together, tightening the abdominal wall. The excess skin and fat may also be removed, resulting in a flatter and more toned appearance of the abdomen. Sometimes abdominoplasty (tummy tuck) with rectus plication and a mesh is required. Q: What is the recovery process after surgery for divarication of recti? A: Recovery after surgery for divarication of recti varies from person to person. It may involve a period of restricted activities, pain management, and wearing a compression garment to support the healing process. Physical therapy may be recommended to gradually strengthen the abdominal muscles and restore function. Full recovery can take several weeks to months, depending on the individual and the extent of the procedure. Q: Are there any risks or complications associated with surgery for divarication of recti? A: As with any surgical procedure, there are potential risks and complications, including infection, bleeding, scarring, asymmetry, seroma (fluid accumulation), nerve damage, and unfavorable aesthetic outcomes. It is essential to discuss these risks with the surgeon and follow post-operative care instructions to minimize complications. Q: Can divarication of recti recur after surgery? A: While surgery aims to repair and strengthen the abdominal muscles, there is a possibility of recurrence, particularly if proper post-operative care, including exercise and maintaining a healthy lifestyle, is not followed. Adhering to the recommendations

Cancer, Colorectal Cancer, Rectal Cancer, Rectal Cancer Surgery

What is sphincter preservation surgery for Rectal Cancer?

Cancer, Colorectal Cancer, Rectal Cancer, Rectal Cancer Surgery / kapoorcmc

Surgeons frequently remove both the rectum and the anus from patients who have colorectal cancer in the lower portion of the colon. The patient usually requires a permanent colostomy if the anus is removed; permanent colostomy is an opening from which faeces is collected in a bag that is fastened to the abdominal wall. Surgery that “spares” the anal sphincter while safely removing the rectal cancer is known as sphincter-sparing surgery. The rectum can be completely or partially removed during Low Anterior Resection, a surgical option for low rectal cancer. Rectal cancer treatment frequently necessitates the removal of entire rectum. The final component of digestive system is the large intestine, which is composed of colon and rectum. The rectum and anal region make up the final 18 cm of the large intestine. Sphincters are located along the anal canal, which is the 3.8 cm portion lying next to the anal opening. Principles of cancer surgery includes removing a minimum of 2 cm of rectum below the edge of the cancer to ensure complete removal of rectal cancer. Advantages of Sphincter-sparing Surgery This surgery allows a patient with low rectal cancer retain control over the bowel movements; it also helps to Enhances the quality of life Provides cancer cure rates equal to more extreme surgery Eliminates the need to remove the sphincter muscles and anus, which allows you to eventually return to passing bowel movements through your anus What Happens During Sphincter-sparing Surgery? In this surgery, the surgeon mobilizes the rectum beyond the tumour till the edge of the sphincter. He tries to get beyond the tumour by a minimum of 2 cm and creates a space to place the stapler. If possible, it is called sphincter sparing surgery and prevents the patient from having a permanent stoma. What are these surgeries called These surgeries are called Low Anterior Resection or Ultra Low Anterior Resection What are the special requirement for sphincter saving surgery? There are many requirements for this surgery. The most important is availability of stapling devices. As we know that pelvis is a very small narrow area located in the lower part of the abdominal cavity. The rectum is located in the pelvis. Along with rectum, the pelvis also has a urinary bladder as well prostate in males and uterus and both ovaries in females. Once the rectum is removed, precise stapling instruments help the surgeon to join back the cut end of the lower rectum as well as the cut end of the left colon. The include circular stapling devices as well as flexible right angles stapling devices. There are many variants available to choose from. The choice will depend upon the kind of surgery as well as the patients’ habitat. What are the precautions required for sphincter saving surgeries? Oncologic principles of cancer removal have to be followed. Can sphincter saving surgeries be done with minimal access? Yes. These surgeries can be done with a robotic or laparoscopic approach. However, a small incision will have to be given to remove the excised part of colon. Conclusion Thus, if one has a low rectal cancer, there is a probability that sphincter saving procedure can be done. Patient should consult a colorectal surgeon and discuss the possibility.

Colon Cancer Surgery, Colorectal Cancer, Colorectal Surgery, Colostomy, Ileostomy, Permanent Stoma, Rectal Cancer, Rectal Cancer Surgery

Avoid Permanent Colostomy or Ileostomy

Colon Cancer Surgery, Colorectal Cancer, Colorectal Surgery, Colostomy, Ileostomy, Permanent Stoma, Rectal Cancer, Rectal Cancer Surgery / kapoorcmc

Colon and rectal cancer survivors can lead an energetic way of life after surgical treatment, and also most can avoid the need for a colostomy bag with innovative operations available There is an increase in colon and rectal cancer in people those in their 20s to 40s; millennials have actually seen a 1.3% annual boost in colon cancer as well as a 2.3% annual rise in rectal cancer from the mid-1990s. This is an extremely active population that is in prime of their lives, building families and also occupations. When they get cancer, they are worried about getting an ileostomy or a colostomy — a surgically created opening in the body that directs faeces into an external waste collection receptacle called a colostomy bag. Both colostomy or ileostomy are also referred to as a stoma Contrary to common belief, about 80% to 90% of patients who have surgical procedure to get rid of a rectal or colon cancer will not require a permanent ileostomy or colostomy. The mix of advanced imaging technology as well as sophisticated investigation permits us to identify cancers earlier and also remove them with even more accuracy, typically eliminating the need for a colostomy bag. For colon cancer, it is rare that a person will require a permanent ileostomy or colostomy. Those at greater risk can consist of people in bad general health and wellness prior to surgery as well as those that need emergency surgical treatment. How sophisticated rectal cancer surgery can avoid a permanent stoma Sphincter-sparing surgical treatment is an innovative procedure in which we remove a cancer that is close to the anus without needing to operate on the sphincter. One research study showed that from 1990 onward for 20 years, 67% to 73% of people who had rectal cancer cells got sphincter-sparing surgical treatment. Executing this technique calls for knowledge, skill and dexterity far beyond a general surgeons skills. Colorectal surgeon have that requisite skill. Before performing the sphincter-sparing surgery for rectal cancer, we need to initially find the cancers relationship to the anal sphincters. If there is a chance to go beyond the tumour for 2 cm without damaging the sphincter, permanent colostomy is avoided. Once the part of rectum containing the cancer is eliminated, along with the fat as well as lymph nodes that surround the anus, the colorectal surgeon will reconnect the colon to the cut end of the rectum. This avoids cutting into the sphincter and removes the requirement for an irreversible colostomy in most patients. Special equipment to connect the two ends is used, which is called stapling devices. Multiple kind of these stapling devices are available and are chosen according to the patients requirement. Ileostomy may be required, but it is temporary and reversed after 12 weeks. It will depend on the patient’s anatomy and how much rectum we got rid of, a short-term ileostomy typically is required as the body heals. Timing to connect back will also depend upon on whether the person needs to receive further chemotherapy treatment and when the person feels strong sufficient to undertake a 2nd surgery. Living an active life with an ileostomy or colostomy If you are among the little percent of individuals who do need a permanent ileostomy/colostomy, we’ll review your current activity level before surgical treatment and also give thorough guidelines on exactly how to keep your way of life with a stoma. To help attain these outcomes, a team strategy along with a stoma therapist is utilized to plan each person’s care. Looking after a temporary or permanent ileostomy or colostomy Dealing with a stoma takes some getting used to, but everyone gets used to it. One of the greatest problems is whether a stoma be apparent to others; in the majority of scenarios, it is not visible. Stoma nurses are professionals in ileostomy care. They’ll educate you in correct cleaning and also upkeep methods, along with offer suggestions to adjust your wardrobe and regular activities as you accommodate to your new routine. When you return house, you will have accessibility to Stoma Care nurse who will certainly help you in taking care of the ileostomy or colostomy. A colostomy irrigation protocol followed daily removes the need for wearing a colostomy bag for almost all patients with a permanent colostomy. Highlights

Rectal Advancement Flaps for Complex Anal Fistulas : A Surgical Approach

Understanding Divarication of Recti: Symptoms, Causes, and Treatment

Understanding Diastasis Recti: Unveiling the Causes

What is sphincter preservation surgery for Rectal Cancer?

Avoid Permanent Colostomy or Ileostomy

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