Traditional Hemorrhoidectomy: Is It Still Relevant?

Who Needs The Traditional Hemorrhoidectomy? Prior to the advent of newer operative procedures for the treatment of hemorrhoids, the only tool in the armamentarium of the proctologist, also known as a colon and rectal surgeon, was a surgical hemorrhoidectomy.  The surgeon simply cut out the hemorrhoids.  With the advent of PPH (procedure For Prolapse And

Lipomas: Non-Cancerous Tumor

What Is A Lipoma? Lipomas are fairly common, and in fact are the most common non-cancerous tumor diagnosed. The growth is a pocket of fat cells just under the skin. While these tumors are most common on the skin of the chest, back and shoulders, they may also grow in the gastrointestinal tract. The colon

When Can I Exercise After A Hemorrhoidectomy?

A hemorrhoidectomy can keep you from your normal routine for several weeks, and getting back to the gym may not go as smoothly as you’d hoped. Still, this procedure offers the best results paired with the lowest chance at a recurrence of hemorrhoids. By starting slowly and listening to your body, you can return to

Can Hemorrhoids Burst?

Hemorrhoidal tissue is a normal part of everyone’s anatomy; everyone has these veins. In some people, though, they become enlarged. This leads to pain, irritation and sometimes bleeding. Reports indicate that about 40 percent of adults in the United States suffer from this condition. Many people fear not only the pain and itching associated with

What is Pilonidal Cyst?

Pilonidal cysts are a fairly common diagnosis, especially in young men. These cysts typically occur at the top of the intergluteal cleft, near the tailbone. They are often found in the cleft itself, between the two sides of the buttocks. Unfortunately, these cysts have a tendency to become painfully infected. If diagnosed early, your proctologist,

Anal Fissures and Stress: How Are They Related

Why Do I Hurt?  What Is An Anal Fissure? “I have pain.”  “My rear end hurts!”  “It’s killing me!!!”   These are common complaints heard by every proctologist (also known as a colon and rectal surgeon or coloproctologist), every day in big cities. Big cities, stress and anal fissures.  Los Angeles.  Fissures.  All day, all week.

Tem. Tamis. Same Local Excision, Different Acronyms.

Get the PDF version of this article. Alphabet Soup What is TEM? What is TAMIS? Transanal Endoscopic Microsurgery (TEM), or Transanal Minimally Invasive Surgery (TAMIS) are two acronyms for the same operative procedure, in which a rectal mass or lesion is removed using a minimally invasive approach through the anal opening.   TEM was developed to

Ruptured Hemorrhoid Symptoms

Blood In Your Stool.   Hemorrhoids? Noticing blood in your stool can be a frightening experience.  If this is the first time that you have seen the blood, the feelings and thoughts can go beyond frightening.  However, a quick trip to the proctologist, also known as a colon and rectal surgeon, is usually reassuring. There’s Blood

Cedars-Sinai Proctologists

Los Angeles Colon and Rectal Surgical Associates No one wants to hear the news…you have cancer. But many people will develop colorectal cancer.   Even more people will face benign problems that affect the colon and rectum. But with the right treatment from the experienced physicians and surgeons of Los Angeles Colon Rectal Surgical Associates,

New Laser Treatment for Rectal Fistulas

The Anorectal Fistula.  What Is It? The anal area is a complex anatomical location.  The anal canal is designed to store stool until such time as it can be discharged.  As such, the anus is endowed with nerves (to sense the arrival of stool) and muscles (to hold the stool and then help to discharge

What is a Colon and Rectal Surgeon

Becoming A Surgeon.  Extensive Training A colon and rectal surgeon is a physician with a university degree and a medical degree (M.D.).  Medical school is a four year education during which time the medical student studies all aspects of the human body and then participates in caring for patients.  Following graduation from medical school, the

Prevention and Management of Nonhealing Perineal Wounds

Get the PDF version of this article The Perineal Wound The  perineal wound  resulting  from  an abdominoperineal resection  (APR) has always   been  considered  troublesome. Miles’  original description  of the treatment of the  perineal incision  involved leaving  it open  to heal by secondary intention, a  strategy resulting in  a  long-term chronic  wound.6 Modern use  of  chemotherapy

The Rhomboid Flap for Pilonidal Disease

Get the PDF version of this article What is a Rhomboid Anyway? THE BASICS. Pilonidal disease represents several forms of a single abnormality. Pilonidal disease may consist of nothing more than asymptomatic midline skin pits overlying the sacrococcygeal area. At the other extreme, the disease may be a large complex abscess associated with sepsis. In

Exercising Safely After Hemorrhoid Surgery

Because regular exercise can help you maintain a healthy weight, regulate your digestion and prevent the rectal pressure of long hours spent sitting, it is considered an important part of preventing hemorrhoids in Hollywood and Beverly Hills. However, if you’ve recently had a hemorrhoidectomy, transanal hemorrhoidal dearterialization (THD) or PPH procedure, you will need to approach your exercise routine carefully to ensure that you do not aggravate the surgical site.

THD: A New Approach?

A relatively new, tested and improving technology is making steady gains in the realm of operative interventions. It is transanal hemorrhoidal dearterialization (THD). It is considered to be a part of the “minimally invasive” family of surgical interventions.

Anal & Transanal Surgical Techniques

It is axiomatic that a happy rectum and a happy mind (and body) go hand in hand. So, how do colorectal surgeons remove abnormal tissue from the 20 cm long rectum while not disturbing its happy functioning? By using transanal surgical techniques, the surgeon may be able to avoid having to perform a complex abdominal proctectomy, thus sparing the rectum.

Colonic Volvulus

Adding to life’s twists and turns, is an entity known as colonic volvulus. The word volvulus is derived from the Latin term meaning torsion or twisting. Although the linguistic anatomy may be obscure, the intestinal anatomy is clear. The colon and its mesentery twist, leading to a closed loop colonic obstruction, a more proximal intestinal obstruction, and an abdominal crisis.

Exercise Tips for Post Colon Cancer Surgery

Though regular exercise is an important part of any healthy lifestyle, finding an appropriate workout routine after undergoing colon surgery or treatment for colon cancer in Los Angeles can be tricky. Patients generally benefit from regular exercise while recovering, but it is important to engage in light activities that reduce your chances of straining tender abdominal tissues. As a general rule, consult your colorectal surgeon before engaging in any kind of post-surgery activity, but here are some tips on working out after colon surgery and why it can be a significant help in staying healthy and cancer-free.

Colorectal Surgeon vs. Gastroenterologist

Many patients often do not know if they need to see a Colon and Rectal Surgeon or a Gastroenterologist for their symptoms or condition. Moreover, even more are confused as to the difference between a Colon and Rectal Surgeon and a Gastroenterologist. The differences between the two specialties can be quite large. Because we treat

Rectal Foreign Bodies

Get the PDF version of this article HOW TO REMOVE A RECTAL FOREIGN BODY IN ONE EASY STEP (RARE IS THE PATIENT WHO EXPERIENCES THIS PROBLEM TWICE) THE END For those with a short attention span and a desire for immediate answers, here is the conclusion of this article: CONCLUSION: From a safety standpoint, the

GI Associated Hemangiomas & Vascular Malformations

First documented in 1839, hemangiomas and vascular malformations of the GI tract are an infrequently encountered entity. Having the potential to occur anywhere along the intestinal system, the small bowel is the most frequent site with hemangiomas and malformations accounting for only 10% of all small bowel tumors.

Anal Cancer – Part 4. Unusual Anal Cancers.

Squamous cell cancer of the anal canal is rare and adenocarcinoma is rarer still, accounting for 10% of all anal cancers. , The three types of anal adenocarcinoma are those arising in the anorectum, those arising in anal glands, and those arising in an anorectal fistula.

Anal Cancer – Part 1. Malignant Precursors.

Anal neoplasms are a rare, diverse group of lesions. Each manifests a different behavior. With the recent publicity surrounding anal cancer, attention has focused on screening, early diagnosis and treatment.

PPH: To Staple or Not to Staple: That is the Question

Get the PDF version of this article INTRODUCTION Symptomatic internal and external hemorrhoids present with some of the most vexing problems known to mankind and to surgeons. Each year, over 525,000 patients are treated for symptoms associated with hemorrhoids. (1) Of these, 10-20% ultimately require surgical treatment. Watch this brief video of Hemorrhoid Treatment Options

Anal Cancer – Rare Malignant Tumors of The Anus

Get the PDF version of this article The Good News? These are Rare Lesions. PERIANAL TUMORS: “Most of these rare anal tumors are aggressive tumors and are difficult to treat. The best that can be said of them is that they are rare.” pdf only Paget’s Disease Perianal Paget’s disease is thought to be a

Procedure for Prolapse & Hemorrhoids (PPH)

A 15- to 35- minute minimally invasive procedure is the new gold standard for hemorrhoidectomy, according to American and European experts in the field. The procedure, known as PPH (procedure for prolapse and hemorrhoids) stapled hemorrhoidectomy, combines hemorrhoidal devascularization and repositioning to return the veins to the anal canal. “This year, this is the revolutionary new procedure in the United States,” Gary Hoffman, MD, clinical faculty member in general and colorectal surgery, Cedars-Sinai Medical Center, Los Angeles, told General Surgery News after moderating a live PPH telesurgery at the 2003 annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons. “PPH stapled hemorrhoidectomy will supplant the traditional open operations in patients with symptomatic grades 3 and 4 hemorrhoids, because it results in a tremendous reduction in postoperative pain, and in a rapid return to work and to activities of daily living.”

Anal Abscess & Perirectal Fistula

With the development of a new material and a relatively painless technique to close a perianal or perirectal fistula, it is useful to review the pathophysiology and treatment options for anal abscesses and anorectal fistulae. The new material, Surgisis®, is composed of po­­­rcine small intestinal submucosa ­rolled into a conical shape and inserted into an existing fistula (figure 1). This allows for tissue ingrowth and fistula closure.

Anal Fissure

Anal fissures are a common problem, bringing many patients to the colorectal surgeons’ office with complaints of anal pain. Most patients report feeling a tear, or a splitting sensation at the anus after a normal bowel movement, a bout of diarrhea, or after a particularly hard or large stool.

Anal Cancer – Squamous Cell Carcinoma

Squamous cell carcinoma of the anus is the most well known member of an uncommon group of GI neoplasms. The incidence of this tumor has been increasing slowly, with 3,500 cases reported in the United States in 2001, and 5,260 cases reported in 2009.