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Why do you need a colonoscopy?
There are a few reasons why you might need a colonoscopy:
To look for polyps or cancer in the colon and rectum.
This test can be used to detect colorectal cancer. The purpose of screening tests is to look for cancer in people who have no symptoms.
If abnormal areas are seen during a colonoscopy, they may be removed (biopsied) and tested for cancer. If you have had colon or rectal cancer, a colonoscopy can also be used to look for new tumors.
You have a problem in your colon or rectum that requires treatment.
Constipation, abdominal pain, bloating, increased gastrointestinal noises, sudden changes in stool consistency, rectal pain or rectal bleeding.
Internal hemorrhoids
Internal hemorrhoids are located inside the rectum. They are usually not seen or felt, and they rarely cause discomfort. But straining or irritation during bowel movements can cause:
External hemorrhoids
They are located under the skin surrounding the anus. Symptoms may include:
Thrombosed hemorrhoids (this is a medical emergency)
Blood can collect in an external hemorrhoid and form a clot, called a thrombus. A thrombosed hemorrhoid can cause:
What treatment do we offer?
Let’s talk a little about minimally invasive surgery or Laser
The use of the laser is a tool for the proctologist surgeon that allows working in a more precise way, since the cut is less than a millimeter deep and the transmission of heat to the surrounding tissues is minimal, which makes it a very attractive surgery for the patient.
The laser technique is usually performed in the operating room without general anesthesia, on an outpatient basis, meaning without hospitalization. The patient is discharged within a few hours after the intervention, and can return to their normal daily activities. This translates into:
Hemorrhoidectomy with Diode Laser
Relatively painless and minimally invasive treatment for grade 2-4 hemorrhoids. Hemorrhoidectomy consists of the resection of the hemorrhoids, and with the laser the venous epithelium is destroyed and the hemorrhoidal packet is simultaneously obliterated, thermally closing the veins that feed this abnormal growth, thus ending this problem.
Hemorrhoidectomy with elastic ligation
Rubber band ligation, a minimally invasive procedure in which one or two tiny rubber bands are placed around the base of an internal hemorrhoid to cut off its blood flow. This causes the hemorrhoidal tissue to die off and fall off within a week.
It occurs when irregular, inflamed sacculations or bulging bags appear in the wall of the large intestine. These bags are known as diverticulums, which can group together and form several bags, which are called diverticula.
These are common, especially after age 50. They are usually found in the lower part of the colon. Most of the time, they do not cause problems. The presence of diverticula is known as diverticulosis.
When these pouches become inflamed, the condition is called diverticulitis. The inflammation is caused by immune system activity that increases blood and fluid flow to an area of the body and sends disease-fighting cells. Inflammation of the diverticula can cause severe pain, fever, nausea, and changes in bowel habits. Mild diverticulitis is usually treated with rest, dietary changes, and possibly antibiotics.
Severe diverticulitis usually requires treatment with antibiotics in the hospital. In cases of recurrent or severe diverticulitis, surgery may be necessary.
It is a proliferation of cells that begins in a part of the large intestine called the colon. The colon is the first and longest part of the large intestine. The large intestine is the last part of the digestive system.
Colon cancer usually affects older adults, although it can occur at any age. It usually begins as small clusters of cells called polyps that form inside the colon. Polyps are usually benign, but some can develop into colon cancer over time.
Polyps usually don’t cause symptoms. For this reason, doctors recommend regular screening tests to help find out if there are polyps in the colon. Finding and removing them helps prevent colon cancer.
If colon cancer develops, there are many treatments that can help control it. Some of these include surgery, radiation therapy, and medications such as chemotherapy, targeted therapy, and immunotherapy.
Colon cancer is sometimes called colorectal cancer. This term combines colon cancer and rectal cancer, which begins in the rectum.
Minimally invasive video laparoscopic hemicolectomy
A video laparoscopic hemicolectomy is a type of surgery that is performed with small incisions as opposed to open surgery, it is used to remove part of the large intestine called the colon. Using small incisions and a camera to guide the surgeon in viewing and manipulating the internal tissues. This procedure is performed if your colon has been affected by a condition or has become cancerous.
Some common conditions treated by a hemicolectomy include:
What are the advantages of this surgery?
Types of hemicolectomies
Right hemicolectomy: The ascending colon (the part of your colon that is attached to the end of the small intestine) is removed. The small intestine is then attached to the transverse colon.
Left hemicolectomy: The descending colon is removed. This is the part of your colon that is attached to your rectum. After it is removed, the surgeon connects the transverse colon directly to your rectum.
What is Human Papillomavirus Infection?
It is a viral infection that commonly causes growths on the skin or mucous membranes (warts). There are more than 100 varieties of the human papillomavirus. Some types of human papillomavirus infection cause warts, and others can cause different types of cancer.
Most HPV infections do not lead to cancer. However, some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (cervix). Other HPV-related cancers include cancer of the anus, penis, vagina, vulva, and back of the throat (oropharynx).
These infections are often transmitted sexually or through other types of skin-to-skin contact.
What treatment do we offer?
Cauterization under local anesthesia and sedation WITH LASER
This is undoubtedly the most effective and innovative treatment, allowing the treatment of both external and internal lesions, regardless of the type, location and degree of involvement. In addition, it allows for the taking of samples and biopsies to assess the HPV serotype, as well as the presence of cellular dysplasia. The use of laser minimizes collateral damage from burns to healthy tissues, shortening postoperative recovery periods.
HIGH RESOLUTION ANORECTAL ULTRASOUND
It is the most commonly used technique to evaluate anorectal function and thus detect functional abnormalities of the anal sphincter and anorectal coordination. It also helps us to identify intrarectal lesions caused by the human papillomavirus that are not visible on simple inspection. This is innovative and accurate in identifying abnormal growths or lesions that cannot be identified with the naked eye, which is why it is of utmost importance in the proper care of the patient.
What are Anal Abscesses and Anal Fistulas?
An anal abscess is an infected, pus-filled cavity near the anus or rectum. There are several types of abscesses depending on where they form in relation to the rectum and anus:
An anal fistula is a small tunnel that originates from an opening inside the anal canal and ends at an external opening near the anus. An anal fistula is the result of a previous anal abscess. Up to 50% of people with an abscess develop a fistula. However, a fistula can also occur without an abscess. As with abscesses, there are several types of fistulas depending on the portion of the rectum and anus they affect. This drainage tunnel remains open, and connects the infected anal gland or anal canal to an opening in the outer skin surrounding the anus.
Surgery is usually required to treat an anal fistula.
Types of Anal Fistulas
A patient with an abscess may have pain, redness, or swelling around the anus or anal canal. Other common symptoms include feeling sick or tired, fever, and chills.
Patients with fistulas have similar symptoms, as well as drainage from a hole near the anus. A fistula is suspected if these symptoms recur in the same area repeatedly.
What treatment do we offer?
Minimally invasive treatment and laser surgery
An abscess can be surgically drained through a simple procedure. An incision is made in the skin near the anus to drain the infection. This can be done in your surgeon’s office under local anesthesia or in an operating room under general anesthesia. Some patients with more severe disease may require several surgeries to resolve the problem.
Laser surgery for the treatment of fistulas: anal and perianal fistulas can also be treated with laser techniques, whether in the case of simple fistulas (conventional fistulotomy) or in complex fistulas (which involve a significant amount of the anal sphincter).
Laser fistula surgery consists of a sealing and sphincter-preserving technique where a probe is used, which is introduced into the anal fistula and laser energy is applied, this will cauterize the entire fistulous tract, closing it permanently, thus preventing its future appearance.
What is an Anal Fissure?
A tear in the thin, moist tissue that lines the anus. Common causes of anal fissure include constipation and straining or passing large or hard stools. Anal fissures often cause pain and bleeding during bowel movements. You may also feel spasms in the ring of muscle at the end of the anus, called the anal sphincter.
What treatment do we offer?
Laser technique for anal fissure surgery: anal fissure can be treated by performing laser curettage of the bloody area of the fissure, or a controlled sphincterotomy with greater precision and hemostasis, which gives us better healing with this innovative treatment.
Treatment of anal fissure with botulinum toxin
The treatment consists of injecting Botox into the internal anal sphincter, which causes relaxation of the sphincter without requiring an incision, as occurs in operations, facilitating healing of the tear. The patient will notice rapid improvement during the first 48 hours.
What is a Pilonidal Cyst?
A pilonidal cyst is a rare sac in the skin that usually contains skin and hair debris. In most cases, the cyst is located near the tailbone, at the top of the buttocks.
Pilonidal cysts usually occur when a hair pierces the skin and then becomes ingrown. If they become infected, they can be very painful. The cyst can be removed through a small cut in the skin. Sometimes surgery is needed.
Pilonidal cysts are more common in young adult men and the problem often recurs. People who sit for long periods of time are at higher risk for developing these types of cysts.
A pilonidal cyst may not cause any symptoms. But if it is infected, the skin around the cyst may become swollen and painful. Symptoms of an infected pilonidal cyst may include:
What treatment do we offer?
Laser surgery
In some cases, the laser is also used for surgery on sacral cysts, performing curettage of the cyst pathways with a radial probe or a controlled resection with a longitudinal probe.
En bloc resection of pilonidal cyst
En bloc resection of the cyst and closure, whether primary or secondary. These are the most common techniques.
What are Ostomies?
Various diseases can prevent intestinal transit, either due to obstruction of the lumen of the intestine or narrowing of the tube that makes passage difficult, so the affected parts of the intestine will have to be cut in order to reconstruct it. The creation of a stoma is necessary to isolate a part of the intestine from the passage of feces, promoting the healing of this new union.
It is surgically constructed by suturing the intestine to the skin of the abdomen, diverting the passage of intestinal contents into a bag that collects them. The presence of an ostomy always involves isolating the anal sphincter, so that the exit of contents is continuous and cannot be controlled by the patient.
This requires learning new skills and knowledge. Simple techniques whose purpose is the best possible quality of life, with the least interference in daily life.
Parts of an Ostomy
Exteriorized intestinal mucosa
The stoma is pink, moist and shiny. It is similar in sensitivity and appearance to the mucous membrane that lines the inside of the mouth. It has no nerve endings so it does not hurt.
Mucocutaneous junction
This is the suture that joins the intestinal mucosa to the skin of the abdomen. The stitches are removed when the skin around the stoma has healed, which usually occurs between ten and fifteen days after surgery. Sometimes they fall off on their own, but there is no need to worry as long as the skin has healed.
Peristomal skin
This is the skin surrounding the stoma. Its care is essential to prevent leaks and ensure a good quality of life. It should maintain the same appearance as the skin on the rest of the abdomen.
Types of Ostomies
Colostomy
The portion of the intestine that opens onto the skin is the colon. It is necessary when the difficulty in passing is located in the rectum or final portion of the colon, and is generally caused by a tumor.
Because part of the colon is preserved, the contents of the bag will be similar to the normal formed stool before surgery.
The consistency will be more solid the further the intestinal contents travel through the colon.
Types and characteristics of feces
Ascending: on the right side of the abdomen. Uncommon, they are usually replaced by an ileostomy and the stools have characteristics similar to those of the ileostomy, that is, liquid.
Transverse: at the level of the transverse colon, towards the middle of the body. These are usually temporary colostomies. The stool is semi-liquid but continues to be irritating.
Sigmoid or descending : on the lower left side of the abdomen. Stools will be more similar to those passed through the anus, i.e. formed stools.
Appendicitis is an inflammation of the appendix, a small tube-shaped organ located in the right colon. Appendicitis is a medical emergency that requires immediate treatment, as it can lead to serious complications if not treated properly.
Symptoms of appendicitis can vary in intensity and presentation from person to person, but typically include:
What treatment do we offer?
Minimally Invasive Video Laparoscopic Appendectomy Appendectomy is performed to prevent serious complications, such as perforation of the appendix and spread of infection to the abdominal cavity, which can be life-threatening. Surgical removal of the inflamed appendix is the standard treatment for appendicitis and is considered a medical emergency, so it is important to seek immediate medical attention.
Very small incisions are made in the abdomen, through which a laparoscope, which is a thin, tubular medical instrument with a camera on the end, and other surgical instruments are inserted to remove the appendix without having to open the patient’s abdomen.
What are the advantages of a laparoscopic appendectomy?
Laparoscopic appendectomy, compared to traditional open surgery, offers several significant advantages, including:
Cholecystitis is an inflammation of the gallbladder. The gallbladder is a small, pear-shaped organ located on the right side of the abdomen, below the liver. The gallbladder contains a digestive fluid (bile), which is released into the small intestine.
In most cases, cholecystitis is caused by the presence of gallstones blocking the gallbladder’s exit route. The result is a buildup of bile that can lead to inflammation.
Other causes of cholecystitis include bile duct problems, tumors, serious illnesses, and certain infections.
Symptoms of cholecystitis include:
Cholecystitis occurs when the gallbladder becomes inflamed. Gallbladder inflammation can be caused by any of the following factors:
What treatment do we offer?
Video laparoscopic cholecystectomy, minimally invasive surgery
It is a minimally invasive procedure performed at the abdominal level to remove the gallbladder in the presence of pathologies such as gallstones. This technique, considered the gold standard for resolving this type of condition, requires only four minor incisions using a cannula and a tiny camera that guides the surgeon during the process.
Benefits:
What is a Hernia?
It is an opening or area of weakness in the abdominal wall through which abdominal contents can protrude.
What is an inguinal hernia?
An inguinal hernia is a protrusion of tissue, such as part of the intestine, through a weak area in the abdominal wall in the groin region. This protrusion may cause a visible bulge or swelling in the affected area.
Inguinal hernias can be congenital, meaning they are present from birth, or acquired, due to factors such as aging, excessive physical effort, obesity or muscle weakness.
Symptoms of an inguinal hernia can vary depending on the severity of the hernia and may include:
There are three types of inguinal hernias:
What treatment do we offer?
Inguinal Hernioplasty with Mesh
The surgery used to repair an inguinal hernia is called inguinal hernioplasty or groin hernia repair. There are several surgical techniques that can be used to repair an inguinal hernia, some of the common techniques include mesh hernioplasty, which can be performed under general anesthesia or local anesthesia and sedation. The surgeon makes an incision in the groin and pushes the bulging tissue back into the abdomen. The surgeon then sutures the weakened area and often reinforces it with synthetic mesh (hernioplasty). The opening is then closed with stitches, staples, or surgical glue.
It is an outward bulge in the navel area. It occurs when internal abdominal organs or abdominal lining protrude through the muscles near the navel.
The main causes of umbilical hernia in adults are related to:
What treatment do we offer?
The treatment of umbilical hernia in adults is surgical. Regarding the options for surgery on a hernia in the navel, we know that if the hernia orifice is less than 1.5-2 cm in diameter, it is preferred to suture it to close it (herniorrhaphy), and the use of mesh (in addition to suture) to reinforce the area when this orifice is larger than 2 cm (hernioplasty), which decreases the possibility of recurrence, that is, that the hernia reappears.
They are the result of inadequate healing after a previous surgical incision. There are many factors that cause a hernia to appear after surgery, including any pathology that causes increased intra-abdominal pressure.
An incisional hernia causes an increase in the volume of the abdomen, in the area where there is a previous scar (in the center or midline and especially near the navel, usually).
Sometimes it does not cause much pain, but it does cause discomfort when the patient performs physical activity, makes an effort, coughs, etc. At first the mass may disappear when the patient lies down and is more visible when standing up.
When a hernia cannot be reduced, it means that it has become trapped and then more pain, nausea, vomiting, etc. appear. In this case, you should see a specialist without delay.
What treatment do we offer?
We can mention 3 alternatives:
Simple aponeurotic suture.
Mesh prosthesis using open technique
Technique of separation of the parts, oriented for large midline hernias.
Simple aponeurotic suture
Prior to the introduction of polypropylene mesh in the early 1960s, most incisional hernias were repaired with direct suture primary closure techniques.
Mesh repair using open technique
Use of polypropylene mesh, due to its lower cost and because in current practice it produces very satisfactory results.
The polypropylene mesh can be placed either under the rectus abdominis muscles or in the preperitoneum; the important thing is that it does not come into contact with the intestinal loops.
Ideally, when using a mesh made of a non-absorbable material, it should be placed in the preperitoneal region, in contact with well-irrigated tissues such as the peritoneum and muscles, thus making its integration easier and reducing the risk of infection by being installed further away from the skin. Another fact of utmost importance is that the mesh should be installed without tension, since it is fixed with the patient under anesthesia and with muscles relaxed.
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