Da Vinci Surgery

If you suffer from a colorectal disease, you may find that symptoms can disrupt your daily life and prevent you from living a higher quality of life. At Farouk Tootla, we can help you find relief with the minimally invasive Da Vinci robotic surgery.

What is the Da Vinci surgery?

Da Vinci is a form of robotic-assisted surgery that allows our doctors to operate within the abdomen in a less invasive way by the use of laparoscopic surgery. With robotic-assisted surgery, procedures are performed with robotic arms equipped with surgical tools and a computer console that produces a three-dimensional view of the operation to assist in the surgery. These mechanics are under the doctor's control at all times.

During the procedure, three small incisions are made in the abdomen, allowing a camera and robotic arms to enter the body with greater precision than that of a human hand.

Benefits of the Da Vinci Surgery

As stated above, the Da Vinci surgery is a form of laparoscopic surgery. Laparoscopic surgeries use a slim surgical tool known as a laparoscope that has a small light and telescope attached to the end of it.

With laparoscopic surgeries, a small incision is made, and the laparoscope is inserted into the surgical site. The light and telescope on the end of the laparoscope enable your doctor to use smaller surgical instruments to complete the surgery without leaving a large scar.

The Da Vinci procedure has the benefits of both robotic-assisted procedures and laparoscopic surgeries. These benefits include the following:

  • Faster recovery time
  • Improved precision and accuracy of the procedure
  • Lower risk of complications
  • Minimal scarring
  • Reduced pain and discomfort during the procedure
  • Shortened time spent in the hospital

Following the procedure, some discomfort, soreness, and swelling may be present during the recovery period but should subside within several days.

For more information on robotic-assisted surgeries or to schedule a consultation, please contact our office at (248) 334-3197.

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Anal Abscesses

An anal abscess is an infected mass filled with pus near the anus or rectum. These can be extremely painful and uncomfortable. An abscess typically develops when an internal anal gland becomes clogged, the gland then becomes inflamed and infected due to bacteria or fecal matter.

If the abscess is near the anus, it is known as a perianal abscess. If the infection and abscess are around the rectum, then it is called a perirectal abscess.

Causes

  • An anal abscess can have a variety of causes, including the following:
  • Blocked anal gland
  • Diabetes
  • Infection of an anal fissure
  • Inflammatory bowel diseases such as Crohn’s, Diverticulitis, or Ulcerative colitis
  • Pelvic inflammatory disease
  • Poor immune system

Symptoms

  • Common symptoms of anal abscess are not limited to but may include:
  • An area of redness or warmth to the touch beside the anus
  • Constant pain or pressure in the anal area
  • Drainage of pus
  • Feeling ill
  • Fever or chills

Treatment
An abscess is treated by draining the pus from the infected cavity by making an opening on the abscess to relieve pressure. This is often performed in a doctor’s office with the use of local anesthesia for added patient comfort.

For those with pre-existing conditions such as Crohn’s or diabetes or if the abscess is large or deeper in the cavity, hospitalization may be required. Different anesthesia will be used during the procedure to open the abscess.

After opening and draining the abscess, you may have an open wound that will need to heal naturally. Closing the skin over the infection may result in complications. Follow your doctor’s recommended post-surgical care instructions. If properly healed, the abscess should not return.

For more information on anal abscesses or to schedule an appointment, please contact our office today at (248) 334-3197.

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Anal Fistula

An anal fistula is almost always the result of a previous anal abscess. A fistula is a small tunnel that forms under the skin and connects a previously infected anal gland to the skin on the buttocks outside of the anus. It can be present with or without an anal abscess.

Causes

  • Anal fistulas can have a variety of causes, including:
  • Abscess
  • Colon cancer
  • Intestinal inflammatory disease
  • Sexually transmitted infections
  • Trauma
  • Tuberculosis
  • Tumors

A physical examination of the rectum and additional testing will be able to confirm a diagnosis and help our doctors to determine the underlying cause of the fistula to ensure you receive treatment that works best for you.

Symptoms

  • Some common symptoms of anal fistulas include the following:
  • Constant pain that may worsen while sitting or during bowel movements
  • Constipation
  • Discharge of pus or blood
  • Fever
  • Redness, swelling, or tenderness around the anus

Treatment
Surgery is necessary to treat an anal fistula and usually involves opening up the fistula tunnel. This procedure is often performed under anesthesia for added patient comfort. During the procedure, the anal sphincter muscle will be cut to join the external and internal opening to convert the tunnel into a groove, this will allow the fistula to heal.

It may take several weeks to heal, but you will be able to return to normal activities shortly after the procedure. Pain medication may be prescribed to help you throughout recovery, and in some cases, antibiotics may also be prescribed to prevent infection. Stool softeners may be recommended to help alleviate discomfort during bowel movements.

Please follow your doctor’s recommended course of post-surgical care including changing the wound dressing periodically as this will help to prevent infection and promote a healthy recovery.

Will my anal fistula return?

The goal of treatment is to permanently remove the anal fistula, however certain diseases and conditions may put you at an increased risk of developing anal fistulas.

For more information on anal fistulas or to schedule an appointment, please contact our office at (248) 334-3197.

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Rectal Bleeding

There can be a variety of causes for rectal bleeding or blood found in your stool, some of which are more concerning than others. Common causes can include hemorrhoids, anal fissures, colon diseases, polyps, colon cancer, and gastrointestinal conditions.

There are two categories of rectal bleeding, external and internal.

External bleeding occurs outside of the rectum, from the anal skin or cavity. This type of rectal bleeding will appear bright red both on the toilet paper or in the toilet bowl. It is not associated with bloody stools or diarrhea and does not contain blood clots.

Internal rectal bleeding occurs within the rectum or even from within the small intestine or stomach. This type of rectal bleeding is associated with blood clots, bloody diarrhea, and blood mixed with stools. The blood may appear purple or cause black stools.

It is important to mention any type of rectal bleeding to your doctor as it can be a sign of a more serious underlying condition that may be life-threatening.

For more information on rectal bleeding or to schedule an appointment, please contact our office today at (248) 334-3197.

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Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a broad term that refers to chronic swelling or inflammation within the intestines and can represent a group of intestinal disorders including Crohn’s disease and ulcerative colitis.

It is important to note that this condition is often confused with the non-inflammatory condition of Irritable Bowel Syndrome (IBS) and although they may share symptoms, there are key differences.

Causes
The exact cause of inflammatory bowel disease is unknown however certain factors are associated with this condition. These factors include your genetic makeup, the health of your immune system, lifestyle choices, and family history.

Symptoms

  • The symptoms of inflammatory bowel disease will vary depending on the location and severity of the inflammation, but common symptoms include:
  • Bleeding ulcers
  • Diarrhea
  • Stomach pain, cramping and bloating
  • Weight loss

In some cases, it may be associated with problems outside of the digestive system, such as eye inflammation, skin disorders, and liver disorders.

Our doctors will conduct a thorough physical examination and additional testing such as X-rays and stool samples to confirm a diagnosis and determine the best treatment option for you.

Treatment
Common treatment options for inflammatory bowel disease include dietary and lifestyle adjustments, medication, and surgery. Drinking plenty of fluids, avoiding dairy products, and adding supplements to your diet can help avoid nutritional deficiencies.

Surgery may be recommended for more severe cases of inflammatory bowel disease and can include the removal of fistulas, removal of affected areas, or widening a narrowed bowel.

While these treatment options offer temporary relief, this condition can persist.

For more information for inflammatory bowel disease or to schedule an appointment, please contact our office at (248) 334-3197.

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Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common intestinal condition that is separate from inflammatory bowel disease (IBD) and is not related to other bowel conditions. Irritable bowel syndrome consists of several intestinal symptoms that generally occur together and can vary in severity and duration for each patient.

Causes
The symptoms of irritable bowel syndrome often occur as a result of abnormal functioning between the nervous system and the muscles of the bowel. This abnormal regulation can cause irritation or sensitivity.

Symptoms
Those with irritable bowel syndrome may experience the following symptoms:

  • A feeling of incomplete bowel movements or urgency
  • Abdominal pain and cramping
  • Bloating and gas
  • Changes in bowel movements including diarrhea and constipation
  • Nausea
  • Passage of mucous

It is not uncommon for patients to experience both constipation and diarrhea. Some patients do have continuous symptoms while others may seem less persistent.

Women may experience more severe symptoms around or during menstruation and while pregnant.

Treatment
There is no specific test for irritable bowel syndrome, however after conducting a thorough physical examination, discussing your symptoms, and running additional testing a diagnosis can be confirmed.

Mild to moderate cases of irritable bowel syndrome can often be managed through dietary changes. Your doctor may recommend avoiding meals that are high in fatty or fried foods, reducing your intake of caffeine, alcohol, and gas-producing foods. Eating more fiber from fruits and certain vegetables or taking fiber pills can help to relieve symptoms as well.

For those with more moderate to severe cases, medication can be prescribed to help manage symptoms of irritable bowel syndrome but do not cure the condition.

For more information on irritable bowel syndrome or to schedule a consultation, please contact our office at (248) 334-3197.

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Hemorrhoids

Hemorrhoids, also known as piles, occur when the veins in the anus and lower rectum swell. These swollen veins are similar to varicose veins and are quite common. There are two types of hemorrhoids: internal and external.

Symptoms
The symptoms experienced while having a hemorrhoid are largely dependent upon the type, or location, of the hemorrhoid.

Internal hemorrhoids, or those located inside the rectum, typically don’t cause any discomfort and are not visible. However, straining during bowel movements can cause bleeding. In some cases the hemorrhoid can push through the anal opening, also known as a prolapsed or protruding hemorrhoid. In this case, the hemorrhoid may cause irritation and become painful.

External hemorrhoids, or those located under the skin around the anus, are usually accompanied by discomfort or pain, bleeding, irritation or swelling around the anus, and itching around the anal area. If a clot forms in an external hemorrhoid, also known as a thrombosed hemorrhoid, a hard lump may form near your anus and you may experience intense pain, inflammation, and swelling in the area.

Causes

  • Hemorrhoids develop when intense pressure is applied to the lower rectum. This increased pressure can be the result of a variety of causes such as:
  • Pregnancy
  • Strained bowel movements
  • Heavy lifting
  • Obesity
  • Sitting on the toilet for long periods of time
  • Chronic constipation or diarrhea
  • After anal intercourse

Older individuals and pregnant women are at increased risk for developing hemorrhoids as the tissues which support the anus and rectum stretch during pregnancy and over time as you age. Though rare, there are a few complications that can accompany hemorrhoids such as anemia, blood clots, and strangulated hemorrhoids.

If you experience bleeding during a bowel movement, it is important to seek a consultation with your doctor. While you may be experiencing a hemorrhoid, rectal bleeding can also be indicative of more serious issues such as colorectal or anal cancer.

Treatment and Prevention
Our recommended treatment for your condition will depend on the type and severity of your hemorrhoid. In some cases home remedies and/or medication will suffice, while others may require surgery or a minimally invasive procedure.

The best prevention for hemorrhoids is to soften the stool so you can better avoid straining when using the restroom. A few steps you can take to help soften stool include:

  • Consuming a diet high in fiber
  • Taking fiber supplements
  • Drinking plenty of water
  • Getting plenty of exercise
  • Going to the restroom as soon as you have the urge
  • Taking breaks from sitting for long periods of time

If you believe you are experiencing a hemorrhoid or for more information about our services, contact us today at (248) 334-3197.

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Diverticular Disease

Diverticular disease, or diverticulitis, occurs when diverticula, or small bulging pouches, form in the colon wall under pressure and become inflamed. Symptoms of diverticular disease include:

  • Constant pain that continues for several days
  • Fever
  • Nausea and/or vomiting
  • Tenderness around the abdomen on one or both sides
  • Constipation or diarrhea
If you experience any of these symptoms accompanied by abdominal pain that persists for more than a few days, contact your doctor for a consultation.

Risk Factors
There are a few risk factors that may make you more susceptible to diverticular disease such as:

  • Obesity
  • Smoking
  • Old age
  • A sedentary lifestyle
  • Medication such as steroids, opioids, and anti-inflammatory drugs
  • Consumption of a diet high in animal fat but low in fiber

Treatment and Prevention
Our prescribed treatment will depend on the severity of your symptoms and your overall health. Most conditions should be able to be treated at home. In cases where underlying conditions or complications are present, hospitalization and/or surgery may be necessary. In some cases it may be recommended to have a colonoscopy 6 weeks after a successful treatment to rule out colorectal cancer. If you have had multiple cases of diverticulitis, we may recommend having surgery to prevent future episodes. We will discuss your options at your follow up appointment so you can make an informed decision.

We strongly recommend incorporating the following steps into your lifestyle to best prevent diverticular disease:

  • Get plenty of exercise. This helps promote healthy bowel function and pressure within the colon.
  • Consume a diet rich in fiber. This helps to soften stool so it can pass easier through the colon. Foods rich in fiber include whole grains and fresh fruits and vegetables.
  • Drink plenty of water. As you increase your fiber intake, you also want to replenish your body with plenty of water.
  • Quit smoking. Smoking puts you at a greater risk of developing diverticular disease.

For more information about our services or to schedule a consultation, contact us today at (248) 334-3197.

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Colon Cancer Treatment

Colon cancer can be a dangerous, scary diagnosis. That is why our team here at Farouk Tootla is here to help you through every step of your diagnosis, treatment, and follow up care. Colon cancer typically begins in the large intestine as small clumps of cells called polyps. Over time, these polyps can become cancerous. For this reason, it is recommended to take the proper preventative steps such as routine colonoscopies and polyp screenings to encourage early detection and best reduce the risk of developing cancer.

Surgical removal of colon cancer in most instances cures the disease, especially if it is early. Other modalities include radiation treatment of rectal cancer, and chemotherapy if the cancer has spread beyond the colon or rectum There are various treatment options available such as radiation therapy, chemotherapy, targeted therapy, immunotherapy, drug treatments, and/or surgery.

For more information about our treatment options or to schedule a consultation, contact us today at (248) 334-3197.

Colonoscopy

We are proud to offer colonoscopy services to our patients. A colonoscopy is typically performed to identify any changes in the colon and rectum such as the presence of polyps or other intestinal abnormalities and/or to screen for colon cancer. Healthy individuals typically need a colonoscopy screening once every 10 years.

There are a few preparations you should make before your procedure which we will discuss with you when you make your appointment. If you have questions regarding your preparation, be sure to ask them at this time. Be prepared to modify your diet in the days leading up to your procedure, and clear your schedule the night before your appointment. You will also need to arrange for someone to take you to and from the Endoscopy Center the day of the procedure.

During the procedure we will insert a camera attached to a long, flexible tube into the rectum. This gives your doctor a visualization of your colon to best identify any inflammation, polyps, or the presence of cancer. If needed, biopsies can be taken during the procedure.

For more information about our services or to schedule an appointment, contact us today at (248) 334-3197.

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Polyps

During a colonoscopy, your doctor will examine your colon for the presence of polyps, or small clumps of cells that form on the colon lining. Though they are typically harmless, it is important to have routine colonoscopies as polyps can develop into cancerous tissue over time.

Fortunately, polyps generally do not cause any symptoms and those which are caught early can typically be removed completely, preventing the development of cancer. It is important to talk with your doctor about polyp screenings, especially if you are over the age of 50, obese, have a history or family history of colon cancer or polyps, or if you are a smoker, as these factors can increase your risk.

For more information about our services or to schedule an appointment for polyp screenings, contact us today at (248) 334-3197.

Rectal Prolapse

At Farouk Tootla we provide services to help those patients struggling with rectal prolapse. This condition occurs when the rectum slips outside of the anus causing fecal incontinence, or the inability to control bowel movements. Rectal prolapse is most common in women over the age of 50, though it is possible for men and children to be diagnosed as well. Rectal prolapse requires surgical treatment.

We understand that rectal prolapse can be an inconvenient, embarrassing condition, and it is our goal to help you experience a better quality of life through one of our treatment options. For more information or to schedule an appointment, contact us today at (248) 334-3197.