Specialty Description
Colon and rectal surgery is the specialty that focuses on the medical, surgical, endoscopic and perioperative management of disorders involving the colon, rectum and anus, and related problems of the abdomen, pelvis and perineum (1).
How to become a colon and rectal surgeon?
A board-certified colon and rectal surgeon has successfully completed at least a five-year training program in general surgery and one additional year in an ACGME-accredited colon and rectal surgery residency. The individual has then passed both the written (qualifying) and oral (certifying) examinations given by the American Board of Colon and Rectal Surgery. Certification by the American Board of Surgery is required for all candidates prior to taking the ABCRS Certification (Part II) Examination.
In addition to having proficiency in the field of general surgery, colon and rectal surgeons have acquired particular skills and knowledge with regard to the medical and surgical management of diseases of the intestinal tract, colon and rectum, anal canal, and perianal area. Colon and rectal surgical specialists also have special skills in the performance of endoscopic procedures of the rectum and colon and evaluation of the anal sphincter and pelvic floor using anorectal physiology techniques. Colon and rectal surgical residency programs also provide training in minimally invasive abdominal surgery involving the colon and rectum, including robotic surgery.
A colon and rectal surgeon has been trained to deal with conditions such as, but not limited to, colon and rectal cancer, polyps, inflammatory bowel disease, diverticulitis, pelvic floor abnormalities, as well as anal conditions such as hemorrhoids, fissures, abscesses and fistulae. Training in colon and rectal surgery also provides the specialist with in-depth knowledge of intestinal and anorectal physiology required for the treatment of problems such as constipation and incontinence. Board-certified colon and rectal surgeons are committed to the highest standards of care for patients having diseases affecting the intestinal system.
A colon and rectal surgeon diagnoses and treats various diseases of the small intestine, colon, rectum, anal canal and perianal area, including the organs and tissues related with primary intestinal diseases (liver, urinary and female reproductive system). They treat conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum). They also diagnose and treat problems of the intestine and colon such as cancer, polyps (precancerous growths) and inflammatory conditions.
What is a colon and rectal surgeon?
Colon and rectal surgeons are experts in both surgical and nonsurgical treatment of colon and rectal problems. They have completed advanced training in the treatment of colon and rectal problems in addition to full training in general surgery. Colon and rectal surgeons treat benign and malignant conditions of the large and small intestine and anorectal region, perform routine screening examinations, and surgically treat problems when necessary.
Colon and rectal surgery is limited enough in scope to allow a surgeon to be a specialist, yet broad enough to keep one stimulated with its variety of procedures and patients. It encompasses a wide range of interventions ranging from major abdominal operations through open or minimally invasive approaches to outpatient anorectal surgeries and endoscopy. It also offers an excellent lifestyle, with opportunities in both the academic and private practice realms. Colon and rectal surgeons deal with relatively few emergency problems and perform most of their work on an elective basis during daylight hours.
What does a colon and rectal surgeon do?
Following specialized training, colon and rectal surgeons have demonstrated expertise in the following areas:
Colon and rectal cancers, especially sphincter sparing surgery including total mesorectal excision, Transanal Endoscopic Microsurgery (TEM), laparoscopic and robotic resections
Inflammatory bowel diseases, particularly ulcerative colitis with ileoanal pouches and the surgical management of Crohn’s disease
Diagnosis and treatment of complex anorectal problems
Diagnosis and treatment of pelvic floor disorders such as rectoceles and obstructive defecation
Surgical treatment of complicated diverticular disease
Surgical treatments for rectal prolapse
Office and surgical treatments of common anorectal disorders
Specialized procedures for incontinence, such as sphincter repairs, the artificial bowel sphincter and Sacral Nerve Stimulation
Reoperative abdominal and pelvic surgery
Laparoscopic and other minimally invasive surgery for most of the conditions listed above
To complement their office- and operating room–based practice, colon and rectal surgeons receive additional training in colonoscopy, sigmoidoscopy, anoscopy and endorectal ultrasound. This combination of intra-abdominal cases, anorectal cases and endoscopy leads to a well-balanced practice and lifestyle.