Colorectal surgery

We are a leading centre for the diagnosis and treatment of colorectal diseases. 

The colorectal department is staffed by three consultants surgeons, clinical nurse specialists as well as an experienced multidisciplinary team involved in surgical management of cancer, inflammatory bowel disease and pelvic floor dysfunction.  

The department is also staffed by three research fellows who in conjunction with Royal Marsden Hospital are undertaking innovative clinical research which has already helped improve our understanding of the staging and treatment of colorectal cancer. 

We perform most abdominal surgical operations using minimally invasive (keyhole) techniques. We see the majority of patients referred with suspected cancer within two weeks.  We also offer  a direct access rectal bleeding service for patients aged 40 or above, and who do not meet two week referral guidelines.  We also hold dedicated Colorectal outpatient clinics six times a week for patients with bowel symptoms that do not qualify for referral under the above guidance. 

You can find more information about the service below including the list of consultants and how to refer information


We treat

  • Colorectal (bowel) cancer
  • Ulcerative colitis
  • Crohn's disease
  • Diverticular disease
  • Rectal prolapse
  • Obstructed defecation syndrome
  • Haemorrhoids (piles)
  • Faecal incontinence
  • Anal fistulae and fissures
  • Perianal abscess and sepsis
  • Abdominal wall hernias, including Inguinal, Femoral, Epigastric, Umbilical and Incisional hernias.
  • Emergency bowel surgery such as bowel obstruction (blockage) and perforations

Diagnosis

We perform approximately 4,000 lower gastrointestinal (GI) endoscopies every year, and this continues to be our main tool for diagnosing colorectal disease.

In addition to diagnosis, endoscopy is used by our specialist team as a therapeutic tool to remove bowel polyps and to insert stents for large bowel obstruction, helping to avoid unnecessary surgical procedures in appropriate patients.

It is expected that the colorectal and endoscopy departments will introduce by the end of 2017 Bowel Scope screening which is part of the National Bowel Cancer Screening Programme. This will involve a one off flexible sigmoidoscopy for Croydon population once they reached the age of 55. 

The department has access to the latest imaging technologies including: US, MRI and CT scans as well as PET CT scans

Treatment

Our experienced surgeons provide all types of colorectal operations, ranging from minor to intermediate and major procedures. 

Bowel Cancer:

The colorectal department holds weekly multidisciplinary team meetings with Royal Marsden Hospital, which is a centre of excellence in the diagnosis, treatment and cancer research.  Here we will agree, with our combined clinical experts, the appropriate treatment plans for our cancer patients. 

Minimally invasive laparoscopic (keyhole) surgery is offered routinely for bowel cancer where appropriate.  

Surgical treatment is undertaken at Croydon University Hospital, with oncology treatment (chemotherapy and radiotherapy) undertaken at the Royal Marsden Hospital.  

Croydon University Hospital is also a tertiary referral centre for early rectal cancers diagnosed at other hospitals.  These are treated using an operation that avoids making a cut in the tummy and is undertaken using a camera introduced via the anal route, the Transanal Endoscopic Microsurgery (TEMS) and the Transanal Minimally Invasive Surgery (TAMIS) techniques.  We are one of few centres in the country recognised by NHS England for this treatment.  In 2017 we started performing major rectal operations via the anal route using the Transanal Total Mesorectal Wxcision (TaTME).  This operation allows the removal of a substantial part of the rectum in suitable patients with cancer or inflammatory bowel disease requiring pouch reconstruction.   

Inflammatory bowel disease

The department holds monthly multidisciplinary team meetings with the gastroenterology department and histopathology department at St George’s hospital.  Here we agree, with our combined clinical experts, the appropriate treatment plans for our patients with inflammatory bowel diseases.  Treatment ranges from medical to endoscopic and surgical treatments.  Croydon University Hospital is a recognised centre by NHS England for management of complex inflammatory bowel disease.

Pelvic Floor Dysfunction

The department holds monthly multidisciplinary team meetings with the urogynaecology department to agree management plans for patients with faecal and urinary incontinence, constipation as well as bowel and gynaecological prolapse. Treatment includes biofeedback, a recognised treatment which teaches and empowers patients on ways to achieve control of their bowel function.  Treatment also includes medical and the latest surgical techniques undertaken via the keyhole approach or the anal routes.  We are a recognised centre by NHS England for sacral nerve stimulation procedure which involves inserting an implantable electrode into the back to treat faecal incontinence. 

Miscellaneous anorectal conditions and hernias

We treat all anaorectal conditions using the latest recognised and accepted surgical and medical treatments.  Incisional abdominal hernias are treated either using the conventional open or the keyhole approach.


 

How to refer 

Email - ch-tr.generalsurgery@nhs.net

Tel - 020 8401 3679

Patients with the bowel related symptoms such as Rectal bleeding, Constipation, Diarrhoea,  Abdominal pain, Anal pain, Faecal incontinence, Anaemia and Abdominal Swellings can be referred for assessment via the following three routes:

Referrals for suspected bowel cancer  (Two week referrals)

Patients with symptoms that are suspicious for bowel cancer are referred under a 2 week rule system.  Although these symptoms do not necessarily mean that patients have cancer as a 2 week rule patients they will be seen within 2 week of the GP referral.  The majority of patients referred under the 2 week rule do not have cancer but if cancer is   found it will  be treated within 62 days.  Most patients referred to this service will receive a straight to test  examination as their first appointment.

Two week referrals are received by  e-referrals to our Cancer referral centre. 

All urgent suspected cancer (USC) referrals should be emailed to CH-TR.urgentreferraloffice@nhs.net.

If a patient shows possible signs and symptoms of any type of cancer it is important that GPs make an urgent referral directly to the Cancer Office. Patients will be seen within two weeks of the referral being received by the Cancer Office.

Tel: 0208 401 3986. 

All tumour site specific referral forms can be found using the link:

https://www.healthylondon.org/cancer/suspected-cancer-referrals/MS-word-referral-forms

More info on cancer referrals>>

Direct access proctology clinic

Patients aged 40 or above, and who do meet the two week referral guidelines, can be referred to our Direct access proctology clinic.  This clinic is for patients with rectal bleeding irrespective of the duration. 

These patients will undergo a flexible sigmoidoscopy at their first appointment.  If they are found to have haemorrhoids these will be treated at the same time and discharged back to primary care. Email CH-TR.DAproctology@nhs.net  for further referral information

Colorectal clinics

We run six colorectal clinics each week for patients with colorectal symptoms. These clinics are for patients who do not meet the two week referral guidelines, or the direct access proctology clinic criteria. 

In addition, the colorectal department runs the following specialised clinics which are designed to manage specific and complex conditions requiring multidisciplinary input or inout by specialist nurses although these are not open at present for direct referral from primary care except for the stoma care clinics.  

Specialised clinics

  • Joint Pelvic floor clinics (2 clinics per month) with uro-gynaecologists based at the Lancaster suite,
  • Joint IBD clinic (1 clinic a month) with gastroenterologists
  • Nurse led follow up clinics: Dedicated to the follow up of cancer patients. The clinic is run by an experienced advanced clinical nurse practitioner.
  • Bowel dysfunction clinic: dedicated to the treatment of patients with bowel dysfunction. This clinic is run by a clinical nurse specialist at the Lancaster Suite.
  • Stoma clinics: run by dedicated specialist nurses who also undertake community visits

 


 Consultants

Team

  • Ms Jo Turner-Banton, Advanced Nurse Practitioner (Cancer)
  • Ms Jan Harris, Clinical Nurse Specialist (Enhanced Recovery)
  • Ms Wendy Ness, Clinical Nurse Specialist (Pelvic Floor Dysfunction)
  • Ms Dee Braim, Clinical Nurse Specialist (Inflammatory Bowel Disease)
  • Ms Debbie Moody, Clinical Nurse Specialist (Stoma Care)
  • Ms Anna Wallace, Clinical Nurse Specialist (Stoma Care)
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