The Colorectal team are a multi-disciplinary group of surgeons, doctors, nurses, dieticians and many more who treat conditions affecting your bowel. We work closely with other departments, including Gastroenterology, Gynaecology, Urology and Oncology.
We offer a wide of services including specialist surgeries such as robotic surgery and are a referral centre for the treatment of early rectal cancer and advanced colorectal cancer. Within our department we train future surgeons, medical students, allied professionals and are involved in a wide range of research and projects
Bowel conditions
We treat a wide range of common and complex conditions. We might need to perform a number of different tests to diagnose your condition in order to offer you the right treatment. The majority of our surgery takes place on a planned (elective) basis and occasionally as an emergency.
Endometriosis can be a painful chronic condition that affects women. It occurs when the cells that normally line the womb grow in other places outside the of the womb.
Internal pouch service
This specialised bowel surgery may be used in patients with ulcerative colitis, who have had a large section of large bowel removed and have been left with a stoma.
Pelvic exenteration
For patients who have more advanced cancer within the pelvis we may work with our gynaecology or urology colleagues to provide more complex surgery.
Transanal Endoscopic Microsurgery (TEMS)
Transanal Endoscopic Microsurgery (also called TEMS) is technique used to remove small early cancers or large benign polyps from the anus using a special endoscope (telescope).
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are special treatments for cancer that has involved the peritoneum (the lining of the organs inside the abdomen). This type of treatment involves surgical removal of the cancer and its deposits as well as heated chemotherapy given during the time of surgery.
Investigations and tests
Across our hospitals you may be sent for a wide number of tests to help the team in making a diagnosis and offering you the right treatment, which include:
We work closely with other hospitals across the region to provide our services. Occasionally you may be offered other specialised tests that may need to be done in different hospitals. The surgeon suggesting the investigation will explain this to you in more detail.
Patient resources: colorectal classroom
Types of Surgery
There are different ways we can perform your bowel surgery:
Open colectomy
The surgeon makes a large cut (incision) in your abdomen and removes a section of your colon.
Laparoscopic (keyhole) colectomy
The surgeon makes a number of small cuts in your abdomen and uses special instruments guided by a camera to remove a section of colon.
Robotic surgery
A type of keyhole surgery where the surgeon's instruments guide the robot, which removes the cancer.
A stoma (sometimes called an ‘ostomy’) is an opening on the abdomen that connects to your bowel or urinary system. It allows waste to be diverted away from the body and collected in a bag secured around the opening. Depending on your particular surgery, these stomas may be temporary and can be reversed at a later date, or may be permanent. There are different types of stomas:
ileostomy
colostomy
urostomy (sometimes called an ileal conduit).
Before Surgery: Getting ready for a Bowel Resection
Preassessment
Before your operation, you will be invited to a pre-admission clinic where we will ask you questions about your health and carry out routine tests. This will help to ensure that you are safe to have an anesthetic. In some cases, we may carry out additional tests to further assess the function of your heart and lungs.
We generally admit patients into hospital on the day of their surgery. However in some circumstances we will need you to come in the night before.
If you are undergoing surgery for cancer, it can be hugely beneficial for you to optimise your overall well-being before undergoing treatment. Prehabilitation is the process by which we can help to prepare you for your surgery by empowering you to enhance your physical and mental health.
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Recovery Package
If you have been diagnosed with colorectal cancer, you will have a detailed consultation with one of the colorectal nurse specialists. In addition to providing further information about surgery and recovery they will complete a needs assessment with you. This will let you highlight any physical, emotional, spiritual, and financial issues that you have and allow us to support you.
Pre-Rehabilitation
We know that patients see better outcomes from surgery when their heart, lungs and muscles are fitter and stronger beforehand. Engaging in positive health behaviors can also dramatically improve your quality of life whilst preparing to undergo surgery. This will vary for different individuals but may include quitting smoking, cutting down on alcohol, having good nutrition, exercising regularly and managing any other medical conditions as well as possible.
Enhanced Recovery After Surgery (ERAS)
ERAS is a scientific approach that helps patients recover quickly after colorectal surgery (particularly a bowel resection). It also helps reduce post-op complications, length of stay in hospital and improves the patient experience. Our enhanced recovery programme aims to empower our patients and starts from the time of diagnosis. It focuses on
Making sure our patients are as healthy as possible before surgery
Providing focused care during surgery
Delivering optimum care post-surgery
After Surgery
In-Patient Stay
After your operation you will be taken to the recovery area. The recovery nurse will make sure you have recovered from your anaesthetic and that your pain is under control. If you are undergoing day surgery, you can be discharged home from recovery or the day ward.
Recovering at home
When you first get home, it is natural to feel tired and not your usual self. This can be a result of the surgery, anaesthetic, pain killers and not being able to rest or eat properly whilst in hospital. It can also be part of coming to terms with your diagnosis and the events that have taken place. Please contact your specialist nurse if you have ongoing concerns.
Follow up and surveillance
After your operation we will ensure that you have recovered from the operation. Follow up may take the form of a telephone consultation and/or a face to face appointment in clinic. We will make sure that your wounds have healed, that you are eating and drinking well and managing with your stoma or change.
Other resources
There may be times where you and your friend and family require additional information and support. The following groups can provide a variety of psychological, physical and financial support. They are a reliable and comprehensive source of further information.
We support patients throughout their cancer journey. Our role includes co-ordinating care, giving specialist advice and supporting friends and family. We also take part in the multidisciplinary meetings and organise all aspects of follow-up, after your cancer treatment.
Diane Cook, Lylia Gill, Yvonne Melrose, Ana Baya.
Stoma, Internal Pouch and Urostomy Specialist Nurses
We look after all aspects of stoma, urostomy and pouch care. We will prepare you for your operation and will ensure that your stoma is formed in the best place for you. After the operation we will continue to support you to look after and monitor your stoma.
Nadine Humphreys, Lisa Murchison, Chris Robinson, Hayley Thomas, Hyacinth Thompson.
Colorectal Multi-Disciplinary Team and Two Week Wait Team
We co-ordinate the care of patients who have suspected or confirmed Colorectal cancer by organising a weekly specialist meeting. We check that patients on the 2ww pathway have their investigations performed and reviewed in a timely manner. We also monitor the 62- and 31-day targets.
