UofL Physicians – Colon & Rectal Surgery and UofL Physicians - Colon & Rectal Surgery Associates understand that our patients deserve equal doses of expertise and compassion, and our board-certified colon and rectal surgeons recognize how colorectal disease uniquely affects each patient’s life. That’s why we consider our patient’s individual lifestyles and needs when we explore treatment options. As partners in their healthcare, we work with our patients to achieve the best medical and surgical results so they can enjoy what is most important to them: family, work, school and play.
Our practices specialize in the diagnosis, evaluation and treatment of disorders of the colon, rectum, small intestine and anus, including colorectal cancer, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), diverticulitis, colonoscopy, advanced colon surgery, simple anal conditions such as hemorrhoids, fistulas, fecal incontinence, pelvic floor problems and more. Our expertise in robotic and other forms of minimally invasive surgery reduces pain and speeds recovery for a wide variety of patients.
We strive to provide patients with the best medical care available and to improve the quality of life for patients and future generations at risk of developing a disease by making it preventable, more manageable or curable. Our regionally and nationally recognized surgeons take care of patients with the most complicated and difficult problems imaginable. University of Louisville’s record of excellence in colon and rectal surgery began in the last century when it was the site of the first university department devoted to caring for colorectal disease. Later, it was among the first in the country to pioneer colonoscopy.
UofL Physicians – Colon & Rectal Surgery was the first in the region to use the da Vinci robot to treat patients with colorectal conditions. The robot provides the surgeons with exceptional vision, precision, skill and improved access to the treatment area. As a result, patients experience less pain and quicker recovery.
UofL Physicians – Colon & Rectal Surgery was the first in the state to provide surgery to avoid permanent stomas (colostomy, ileostomy) for a wide group of patients (rectal cancer, ulcerative colitis, familial adenomatous polyposis, and certain cases of Crohn’s disease), as well as surgery for continent stomas. A wide range of treatment options is available for fecal incontinence, ranging from medical management to sacral nerve root stimulation, sphincteroplasty and artificial neosphincter.
One of the unique aspects of our practice is that it is connected to a university setting, which means many of our surgeons are training the next generation of physicians and surgeons. In fact, our clinical and research training programs attract candidates from across America and from around the world. This assures that you are receiving the best and most up-to-date treatment options and more attentive care than other institutions can offer.
Diseases and conditions
Our highly skilled surgical team treats all varieties of colon and rectal disease including:
- Colon cancer
- Rectal cancer
- Anal cancer
- Hereditary colon cancer
- Familial adenomatous polyposis
- Attenuated polyposis
- Inflammatory bowel disease
- Crohn’s disease
- Ulcerative colitis
- Indeterminate colitis
- Benign colon disorders
- Diverticulitis
- Colon polyps
- Rectal polyps
- Pelvic floor problems
- Rectal prolapse
- Fecal incontinence
- Bowel incontinence
- Chronic constipation
- Rectocele
- Anorectal disorders
- Anal fistula
- Anal fissure
- Rectovagin*l fistula
- Hemorrhoids
- Radiation proctitis
- Bowel obstruction
Treatments and services
Colorectal cancer treatment
Colon or rectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Most cases of colon cancer begin as small, non-cancerous clusters of cells called adenomatous polyps. Over time, some of these polyps may become cancers. Polyps may be small and produce few if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying polyps before they become colon cancer and removing them. Our surgeons are skilled endoscopists who perform both screening colonoscopy, as well as advanced polypectomy. UofL Physicians – Colon & Rectal Surgery is highly experienced in the diagnosis and treatment of colon and rectal cancer, including rare genetic forms, such as Familial adenomatous polyposis and Hereditary Non-polyposis colorectal cancer.
UofL Physicians – Colon & Rectal Surgery is an integral part of the UofL Health – Brown Cancer Center’s Colon & Rectal Cancer Multidisciplinary Program. This program brings together senior colorectal surgeons, surgical oncologists, medical oncologists, radiation oncologists and others in one place to provide comprehensive care for our colorectal and anal cancer patients.
Treatments include:
- Surgical resection (removal) of primary and recurrent colon cancer
- Colonoscopic stent placement
- Treatment of primary and recurrent rectal cancer, including procedures such as:
- Colo-pouch anal anastomosis: A small pouch is made by doubling back a short segment of the colon. This small area of the colon then functions as a storage space for fecal matter like the rectum did before surgery.
- Coloplasty: Enlarging a segment of the colon to make a small pouch. This small area of the colon then functions as a storage space for fecal matter like the rectum did before surgery.
- Intra-operative radiation: An intensive radiation treatment that’s administered during surgery. Intra-operative radiation is used to treat cancers that are difficult to remove during surgery, particularly when there is a concern that a microscopic amount of cancer may remain behind.
- Transanal excision of rectal cancer and rectal polyps: Traditionally, rectal cancer is treated by removing the anus and anal muscle along with the tumor in the rectum. In certain patients, UofL Physicians – Colon & Rectal Surgery providers can perform surgery through the anus, removing only the rectal tumor and small amounts of surrounding tissue while leaving the anus and anal muscle intact.
- Endorectal ultrasound: This is used to determine the rectal cancer stage (depth of penetration through the rectal wall and if it has spread to lymph glands) before treatment to select the best treatment for a tumor. Endoanal ultrasound can be used in cases of fecal incontinence to determine how much of the anal muscle has been injured (often during childbirth) and in cases of anal fistula (an abnormal passage between the rectum and peri-anal skin or vagin* associated with drainage).
- Colonoscopic polypectomy: Surgery to remove colorectal polyps
- Endoscopic mucosal resection: A procedure to remove cancerous or other abnormal tissues (lesions) from the digestive tract.
* Minimally Invasive Options Available
Inflammatory bowel disease
Inflammatory bowel disease (IBD) is a collective term for Crohn’s disease and ulcerative colitis — two chronic, intestinal illnesses with similar symptoms and complications. IBD affects an estimated 1.4 million Americans. Management of IBD begins with an accurate diagnosis, which includes a careful history, thorough physical examination, lab tests and appropriate diagnostics. UofL Physicians highly skilled colon and rectal surgeons offer state-of-the-art diagnosis and treatment for all forms of the disease including Crohn’s disease, ulcerative colitis and indeterminate colitis.
Treatment options include:
- Strictureplasty and resection for Crohn’s disease. These surgical procedures are performed for scar tissue that has built up in the intestinal wall from IBD. The scar tissue accumulates as a result of repeated damage and healing, with the scarring causing a narrowing of part of the bowel. The narrowing can force bowel contents into fissures (cracks) and ulcers at the site, causing additional damage and narrowing. The surgery restores free to flow through the bowel by surgically widening it without resection of any bowel.
- Ileal pouch-anal anastomosis for ulcerative colitis and familial adenomatous polyposis. During the ileal pouch-anal anastomosis procedure, a pouch is created from the end of a patient’s small intestine and attached to the anus. This restores continuity and control of stool passage for patients who have had their large intestines removed.
- Use of colonoscopy to monitor ulcerative colitis and Crohn’s disease
* Minimally Invasive Options Available
Benign colonic disorders
There are many diseases and conditions affecting the small bowel, colon and rectum. Treatment options include:
- Surgery for diverticulitis
- Surgery for bowel obstruction (colonic Volvulus)
- Colectomy (surgery) for severe constipation
- Colon Resection for large polyps
*Minimally Invasive Options Available
Anorectal disorders
Anorectal disorders such as hemorrhoids, fecal incontinence, fistulas or fissures can be a source of symptoms ranging from embarrassment to great discomfort and pain. With appropriate treatment and lifestyle changes, many of these conditions can be treated on an outpatient basis. Treatment options include:
- Office treatment of hemorrhoids (rubber band ligation)
- Surgery for hemorrhoids (Hemorrhoidectomy)
- Procedure for Prolapsed Hemorrhoids (PPH)
- Treatment of pelvic floor problems
- Fistulotomy: The surgical opening of a fistula, which is an abnormal passage
- LIFT procedure, which is based on secure closure of the internal opening and removal of infected cryptoglandular tissue (located in the anal canal) through the intersphincteric approach.
- Sphincterotomy: A surgical procedure to cut the lower part of the inside anal muscle that is in spasm in patients with anal fissure
- Botox injection for anal fissure
- Injection therapy, sacral nerve root stimulation, sphincteroplasty and implantation of artificial bowel sphincter for fecal incontinence
- Endoanal ultrasound, anorectal manometry and EMG
- Endorectal ultrasound
- Abdominal and perineal procedures for rectal prolapse, occur when the tissue that lines the rectum falls down into or sticks through the anal opening.
- Rectocele repair, which involves repairing the hernia of the bowels into the vagin*.
*Minimally Invasive Options Available
Colonoscopy
We also perform routine colorectal cancer screening, as well as colonoscopic polypectomy. Screening tests for colorectal cancer can save 30,000 lives each year. These tests not only detect colorectal cancer early but can prevent colorectal cancer. In one test, non-cancerous polyps are removed before they become cancer.
