Lower Gastrointestinal (GI) Surgery

Prior to treatment, a number of investigative steps are taken. This may include laboratory, radiology, endoscopic and GI physiology tests or procedures. Fortunately, all of these can be undertaken on site.

Treatment may include lifestyle changes, medication and/or surgery. Minimally invasive procedures using laparoscopy and robotic surgery are used where possible when surgery is required. This provides the benefit of a quicker recovery, less pain, better healing and aesthetic and a shorter hospital stay. Robotic surgery can offer excellent views of the pelvic nerves ensuring it is a useful adjunct to rectal cancer surgery. All of the colorectal surgeons at Mater Private Hospital (Dublin) are skilled in robotic surgery.

There are a number of surgical procedures used to treat both cancerous and benign conditions.

• Segmental colectomy: part of the colon is removed ‘right hemicoloectomy’, ‘left hemicolectomy’.
• Total abdominal colectomy : all of the colonic removed except for the rectum. This can occur if the patient has a number of different colon tumours identified at the same time and it is deemed appropriate for a specific patient. It can also be appropriate for patient with polyposis syndromes.
• Anterior resection: removal of part of the rectum for rectal cancer
• Abdominoperineal resection +/- myocutaenous reconstructive flaps: removal of the rectum and the anus for low rectal cancer. Myocutaeous flaps are often used to reconstruct the vagina and allow replacement of the pelvic muscle bulk when the anus is removed. It is performed by our plastic surgical colleagues.
• Haemorrhoids: formal open heamorrhoidectomy, Rafello procedure.
• Fistulas: setons, LIFT procedure, advancement flaps.
• Rectal prolapse: robotic rectopexy, perineal procedures through the anus.
• Incontinence: conservative management, neuromodulation, stoma formation.
• Tamis procedure: management of polyps.
• Colostomy: a surgical procedure that brings a portion of the large intestine through the abdominal wall, creating an opening, also known as a stoma, to carry faeces out of the body to a pouch. 
• Ileostomy: when part of the small bowel comes onto the skin. This is often used to defunction a join between the colon and the rectum further downstream for the small bowel. It can divert stool away for the join. This is often used in cancer surgery. The stoma can then be reversed via a small operation at the stoma site six months after the main surgery.  Ileostomies are also used if the full colon has been removed. The lower end of the small intestine (the ileum) becomes the stoma. A pouch will generally be placed around the stoma on the patient’s abdomen during surgery. During the hospital stay, the patient and his or her caregivers will be given advice regarding the care of the stoma and the ostomy pouch. The majority of patients become independent in the use of the stoma. Stoma therapist can also visit patients outside of the hospital setting.