Every year millions of Americans are affected by a broad range of colorectal and anorectal diseases ranging from benign conditions such as hemorrhoids, to life-threatening cancer or colitis. These conditions can cause significant suffering and often require complex evaluation for definitive management. With state-of-the-art resources and a team of highly skilled specialists, the Colon and Rectal Surgery program at Montefiore is dedicated to providing exceptional care in surgical and nonsurgical treatment for the full spectrum of diseases that affect the colon, rectum, and anus.
At the Montefiore Einstein Center for Cancer Care, our colorectal surgeons collaborate with the nation's leading physicians in medical and radiation oncology, radiology, pathology, and gastroenterology to offer the latest treatments available for colon and rectal cancer, and develop innovative strategies for the detection and management of this extremely prevalent malignancy. With our comprehensive, multidisciplinary approach, our patients receive cutting edge therapies for colon and rectal cancer which allow for a substantial rate of sphincter-saving procedures, as well as enhanced outcomes in highly advanced disease. Using cutting edge technology such as TEMS (Transanal Endoscopic Microsurgery) and TAMIS (TransAnal Minimally Invasive Surgery), we can offer patients sphincter-sparing transanal procedures, which in appropriate cases, helps avoid unnecessary abdominal surgery.
While colorectal cancer is one of the most common malignancies in the world, it is also one of the most preventable. Together with our colleagues in gastroenterology, the colon and rectal surgery program employs state-of-the-art endoscopic technologies for colon cancer screening and removal of precancerous polyps. In addition, a dedicated team of pathologists and genetic counselors can be called upon to identify high risk patients or families who may need more intensive surveillance, genetic testing, or prophylactic interventions.
Anorectal Disease includes a diverse and frequently debilitating set of disorders. At Montefiore, we treat the full gamut of anorectal disease including hemorrhoids, fissures, abscesses, fistulas, sphincter injuries and anal cancer. We have experience treating everything from the straightforward to the complex, including patients with recurrent disease. We provide both operative and nonoperative treatment tailored to each specific patient. Some of the newer treatment modalities we offer include the Transanal Hemorrhoidal De-arterialization (THD), the Procedure for Prolapse and Hemorrhoids (PPH) or stapled hemorrhoidopexy, the application of prosthetic plugs for complex fistulas, Botox® for Anal fissures that fail medical therapy, and high resolution anoscopy for the screening and prevention of anal cancer.
Pelvic Floor Disorders
Pelvic floor problems are often physically and mentally debilitating for patients; our surgeons evaluate and treat the whole spectrum of the disease. From diagnosis and workup, to bowel management and surgical interventions, we are here to properly evaluate and treat many pelvic floor disorders. We offer treatment for chronic constipation, fecal incontinence, and other pelvic floor disorders. With the only free-standing physiology lab in the Bronx, we have the ability to effectively diagnose complex disorders of the pelvic floor and deliver the best in minimally invasive and interventional therapies. Some advanced procedures we offer include laparoscopic ventral mesh rectopexy for rectal prolapse and sacral nerve stimulation for management of fecal incontinence.
Ulcerative colitis and Crohn's disease are inflammatory conditions which affect the gastrointestinal tract causing severe illness, which can have devastating symptoms and complications. As colorectal surgeons, we have specific expertise in addressing all aspects in which these diseases present. Our priority is to work with the gastroenterologists to optimize medical therapy and develop carefully-timed surgical interventions that will maximize quality of life and yield the best overall outcomes for our patients. For ulcerative colitis, our specialized training in laparoscopic reconstructive pouch procedures (J-pouch) allows us to create a neo-rectum and provide curative surgery without the need for a permanent stoma. While Crohn's disease is not curable, the combination of aggressive medical management and bowel-sparing surgery offers patients the best chance for prolonged remission with minimal morbidity.
The estimated risk of developing diverticular disease is as high as 80% by age 80. While not everyone who has diverticular disease develops divertuiculitis, if they do it can be very painful. Complications of diverticulitis such as abscess, perforation, and fistula can also cause patient suffering. We are experienced in evaluating and treating acute and chronic, as well as complicated and uncomplicated cases. We can help manage diverticulitis, and when indicated, perform minimally invasive surgery to remove the problematic area of the colon (usually the sigmoid colon), with fast recovery and excellent cosmesis.
Laparoscopic Colorectal Surgery
Minimally invasive, or "laparoscopic", surgery offers patients many advantages over the traditional open approach to colon resection, including decreased pain, shorter hospital stay, faster recovery, and less scarring. The same operation is done internally, and instead of making one large incision to enter the abdomen, specialized surgical instruments and a fiber optic camera are inserted through several tiny (5-12mm) incisions. This approach is routinely performed by the colorectal surgeons at Montefiore for management of most colorectal conditions, including diverticulitis, inflammatory bowel disease, cancer or polyps, motility disorders, and rectal prolapse.
An ostomy is a surgically created opening connecting an internal organ, such as the intestine or bladder, to the surface of the body. Nearly a million people in North America have ostomies and thousands are created each year. The Colon & Rectal Surgery program at Montefiore recognizes that patients who require ostomies, either permanently or temporarily, benefit from specialized support and education. Our highly trained and devoted team of Enterostomal Therapy (ET) nurses play a vital role in the perioperative management of our patients. They offer counseling prior to surgery, including advice on what to expect and proper stoma care, as well as preoperative "siting" which helps determine the best anatomic location for surgeons to place the stoma. After the surgery, they are available both in the hospital and in the office for follow-up to provide further education, assess healing, and troubleshoot any problems that may arise. A monthly "ostomate" group offers patients the additional opportunity to connect with their peers, further easing the transition and providing an invaluable source for long-term moral support.
Below is a list of conditions we treat:
|Diseases of the Colon and Rectum
||Anal and Rectal Diseases