Lower Digestive

Depending on their severity, the following conditions may need surgical treatment:

• Ulcerative colitis: chronic inflammation of the lining of the colon and rectum.
• Crohn’s disease: a chronic inflammatory bowel disease, most often affecting the terminal ileum or the large intestine.
• Diverticulitis: inflammation of the diverticula, small pouches on the wall of the colon.
• Rectal prolapse: the rectum falls down to the anus; about 80-90% of cases involve women.
• Anal fistula: an abnormal channel between the intestine and the skin around the anus.
• Small intestine diseases: such as adhesive ileus, Meckel’s diverticulum, fistulas and tumors.

Symptoms vary with the condition and may include abdominal pain or cramps, diarrhea or constipation, bleeding from the rectum, a feeling of incomplete emptying, and loss of weight and appetite. An anal fistula causes pain, redness and swelling around the anus. In rectal prolapse, part of the rectum may stick out as a reddish mass, and heavy bleeding or a rectum that cannot be pushed back into the body needs immediate medical attention.

Diagnosis starts with a medical history and a physical examination and continues, depending on the condition, with blood and stool tests, colonoscopy or other endoscopic examinations. Small bowel diseases may also call for CT, MRI or capsule endoscopy, while in an acute diverticulitis attack the examination of choice is a CT scan.

Bowel surgery is needed when patients do not respond to medication and the damage to the intestine is extensive, or when complications appear, such as stenosis, fistulas, obstruction or perforation. Depending on the condition, the procedure may be a colectomy, enterectomy, adhesiolysis for adhesive ileus, rectopexy or sigmoidectomy, while anal fistulas are treated with techniques such as FiLaC, LIFT and VAAFT.

Dr. Konstantinidis and his surgical team use minimally invasive techniques, laparoscopic and robotic, with the da Vinci Xi system at Athens Medical Center. After a laparoscopic or robotic colectomy, patients walk the very next day and are ready to return to their daily activities in about ten days.