The Division of Colorectal Surgery at Mount Sinai Beth Israel offers a full range of the latest surgical techniques, working in close collaboration with gastroenterologists, gynecologists, urologists, plastic surgery and cancer specialists to ensure that surgery is a successful component of a comprehensive approach to care that may involve medications, radiation and other treatments.

Procedures include:

da Vinci Endowrist
Robotic Surgery
Robotic assisted surgical techniques have been a breakthrough in minimally invasive surgery. The division’s surgeons have kept abreast of these pioneering changes and have vast experience in this technique. Using robotics for colorectal surgery is a very new approach to treatment that only a few institutions in the New York tri-state area offer. For more on robotic surgery, click here.
Laparoscopic Surgery
Laparoscopic surgery (including colectomy, lower anterior resection or LAR, abdominoperineal resection or APR, total proctocolectomy with J-pouch) is a minimally invasive approach that is performed through small incisions rather than the large incision used in standard, open surgery. Laparoscopic surgery uses long, thin instruments that may attach to tiny cameras, lights, scissors, scalpels and other tools. Often the surgeon is guided by the camera’s images displayed on a screen. The benefits of laparoscopic surgery include shorter recovery times and less post-operative pain and scarring. Laparoscopic surgery is frequently used to treat irritable bowel disease, diverticulitis and cancer.

Transanal Excision
Transanal excision is a technique used for rectal polyps and cancer to remove rectal tumors and small amounts of surrounding tissue that spares the anus and leaves the sphincter muscle intact. This procedure makes it possible for the patient to retain bowel function and eliminates the need for a permanent colostomy bag.

Transanal Minimally Invasive Surgery (TAMIS)
TAMIS combines the benefits of transanal excision with minimally invasive surgery for the removal of both malignant and benign lesions of the rectum.

Stapled Hemorrhoidopexy
The division also offers a newer approach called stapled hemorrhoidopexy. A surgeon inserts a stapler through the anus, cuts out a portion of the hemorrhoid tissue, pushes back remaining tissue and tacks it back into the anal canal. This approach offers the advantages of hemorrhoidectomy, but eliminates the considerable pain associated with the more traditional surgery.

Fissure Interventions

  • Anal dilation, when the anus is enlarged.
  • Sphincterotomy, when surgeons cut through the outer areas of the opening to the rectum to stretch and relax tight internal muscles that lead to fissures.
  • Botox injection: This new approach injects Botox directly into the anal sphincter and relaxes the tight muscles. When the Botox wears off after several months, often the tear has resolved itself.

Fecal Incontinence Interventions
Solesta gel is injected into a layer of tissue beneath the anus lining and helps build tissue in that area, tightening the anus and allowing for better muscle control.

Fistula Interventions

  • Fistulotomy is the surgical removal of the fistula.
  • Seton is when a thread-like material is inserted in the fistula to provide drainage.
  • Advancement flap is a procedure in which a flap of tissue is cut around the opening of a fistula. The fistula is then cleaned and sewn. The end of the flap is pulled down over the sewn internal opening and stitched in place.
  • Biodegradable fibrin glue is used to close a fistula.
  • A fistula plug is made from small intestinal tissue. The fistula plug is sutured into the inside of the anus, stimulating the body to close the fistula.

Anal Dysplasia Interventions

  • Anal pap smears are similar to cervical pap smears and are now being considered for groups at risk for anal cancer (men who have sex with men, patients who are HIV positive, women who have had cervical abnormalities, anyone with a history of genital or anal warts).
  • High-resolution anoscopy: If an anal pap smear shows abnormalities, this procedure allows surgeons to view the anal canal for microscopic evidence of precancerous changes. Depending on the degree of the abnormality, patients may be watched carefully for more changes or the abnormal tissue may be destroyed using electric current. Patients with staged anal cancer will be referred to the Continuum Cancer Centers of New York where they can be treated with a full range of chemotherapy and radiation options.
  • Fulguration is a procedure to destroy abnormal anal tissue using an electric current.

Patients suffering from gastrointestinal problems may need to undergo a colonoscopy. A colonoscopy is a test that allows a physician to examine the large intestine (rectum and colon). During the procedure, a flexible video endoscope is passed through the anus and guided through the rectum and colon to provide a diagnostic view of the lining of the colon and access for treatment. At the time of the procedure, tissue samples can be collected (this is called a biopsy) and abnormal growths (like polyps) can be taken out. Colonoscopy is frequently used as a screening test to check for cancer or precancerous growths in the colon or rectum (polyps).

For more information or to make an appointment with a colorectal surgeon at Mount Sinai Beth Israel, please call 212.420.3960.

For Appointment Call
T: 212-420-3960
F: 212-420-2846