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Bruce E. Freedman, M.D., F.A.C.S.
Breast Surgery
Bowel Surgery
Cancer Surgery
Endocrine Surgery
Laparoscopic Surgery
Reflux Surgery
Hernia Surgery

Bowel surgery has to do with the removal of both benign and cancerous lesions of the small and large intestines.  Small bowel surgery usually deals with malignant tumors, but occasionally benign tumors may grow enough to cause obstruction, bleeding, or even perforation.

More commonly are the lesions of the large intestines or colon.  Most non-cancerous lesions of the large intestines or colon are related to diverticular disease.  Diverticula are out-pouchings of the colon. They occur most frequently in weak areas where blood vessels enter.  Patients with diverticula are said to have diverticulosis.  Diverticulosis may be the cause of significant lower gastrointestinal bleeding. If the diverticula get inflamed and infected, this is then called diverticulitis.  There is significant pain primarily in the left lower abdomen caused by diverticulitis. Patients with severe complications (recurrent episodes, perforations, and those non responsive to medical treatment) are deemed to be surgical candidates.  Patients with severe, unrelenting bleeding from diverticulosis are also considered surgical candidates.

Polyps are common growths of the large intestines (colon).  Most of these can be removed by colonoscopy.  Some polyps may be too large or too sessile (flat) to remove.  These may require surgical intervention to remove the polyp and the portion of the colon involved.

The type of surgery for disorders of the colon depends upon the situation.  For acute perforations or obstructions, either from malignant or benign causes, a temporary colostomy and removal of the offending portion of the colon is required. The colostomy, in most situations, can be reversed after a few months.  In most situations that are not acute, colon resection with reanastomosis (reconnecting the colon back together) is feasible.  Prior to surgery a bowel prep is indicated to try and decrease  the bacteria count to make surgery safer.

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