Treatment for Colorectal Cancer and Polyps
Using robotic, laparoscopic, and open surgical approaches, the highly experienced colorectal surgeons at NewYork-Presbyterian Westchester are often able to maintain or restore bowel continence. Robotic-assisted laparoscopic surgery provides the surgeon with 3D views of the intestine and a stable viewing platform. This enables the surgeon to use instruments narrower than a centimeter to safely remove the tumor and reconnect the remaining ends of the intestine.
We also perform advanced procedures such as:
- Transanal minimally invasive surgery (TAMIS) to remove large polyps and some cancers in the rectum and lower colon. By operating through the anus, patients are spared external incisions and have a quicker return to normal bowel function.
- Combined endoscopic-laparoscopic surgery (CELS) to remove large, complex, or hard-to-reach polyps.
Inflammatory Bowel Disease (IBD) Surgery
Our colorectal surgeons use minimally invasive robotic surgery or laparoscopy, whenever possible, to treat people with Crohn’s disease and ulcerative colitis. Surgical approaches include:
- Reconstructive J-pouch surgery for some patients who need to have the colon and rectum removed for ulcerative colitis. Our surgeons can also select patients with Crohn’s disease who may benefit from J-pouch surgery. The surgeon creates an internal pouch from part of the small intestine to provide a storage place for stool, avoiding the need for a permanent ostomy bag.
- Resection to remove diseased tissue in the intestine.
- Intestine-preserving strictureplasty to treat short areas of Crohn’s disease and narrowing caused by scar tissue. The surgeon opens one or more areas of narrowing to restore the flow of contents through the intestine.
- Ileostomy to create a temporary or permanent opening, or stoma, on the surface of your abdomen, through which waste is emptied into a bag.
Diverticulitis Surgery
Diverticulitis is very common and can often lead to chronic abdominal pain or emergency surgery. Our surgeons are able to use the robotic platform to perform minimally invasive surgery for sigmoid diverticulitis, often resulting in just a few tiny incisions. This minimizes pain after surgery and allows for a faster recovery.
For patients with a colostomy bag after emergency surgery, our surgeons are specialized in reversing the colostomy to allow the patient to live without a stoma.
Care for Anal Fistulas and Fissures
We have extensive experience treating anorectal fistulas — small channels or connections that form between the rectum and skin near the anus — and fissures (a tear in the lining of the anus), using:
- Fistulotomy to surgically open and flush out an anal fistula to promote healing.
- Seton placement, where a thin silastic tube (seton) is placed in a fistula to help drain infection.
- Advancement rectal flap to cover the internal opening of the fistula. This is useful for fistulas that significantly affect the anal control muscles.
- LIFT procedure for complex fistulas. The surgeon accesses the fistula between the sphincter muscles and inserts a seton, widening it over time. A few weeks later, the surgeon disconnects the seton and closes the fistula opening.
- Sphincterotomy involves cutting a portion of the internal anal sphincter to reduce pressure in the area and allow an anal fissure to heal. This treatment can help people with anal fissures that cannot be managed with other approaches.