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Article Type: Blog

How to Choose a Colon & Rectal Surgeon

When you or a loved one need a surgeon for a colon or rectal condition, how do you go about finding one? Or, perhaps more to the point, what qualities should you look for in a colon and rectal surgeon to make sure you will receive excellent care?

“Colon and rectal surgeons perform a very wide variety of procedures,” says Haane Massarotti, MD, FACS, FASCRS, Colon and Rectal Surgeon at the AdventHealth Digestive Institute Tampa. Colon and rectal surgeons not only provide outpatient procedures to treat conditions such as hemorrhoids and anal fissures but also offer complex surgery for cancer, diverticulitis and Crohn’s disease. 

The expertise of understanding the anatomy of the pelvis differentiates colon and rectal surgeons from other surgeons.

“Pelvic operations are very complex,” continues Dr. Massarotti. “The rectum is located near urinary and reproductive organs, and there are important nerves and major blood vessels in that area,” she says.

Given these surgeons must be adept at handling many different complex procedures, Dr. Massarotti shares some advice about what questions people should ask when looking for a colon and rectal surgeon.

What kind of training did they receive and are they board-certified?

Dr. Massarotti explains that all colon and rectal surgeons start off as general surgeons, and there are multiple ways to receive enough training to call oneself a colon and rectal (sometimes shortened as “colorectal”) surgeon. 

All such surgeons start off as general surgeons who went through four years of medical school before a five- to seven-year accredited residency in the United States in general surgery. They then have to study and sit for boards to become certified by the American Board of Surgery as general surgeons. 

At this point, some surgeons gain training in this area by being mentored by a colon and rectal surgeon. However, Dr. Massarotti says that if a surgeon wants to become a board-certified colon and rectal surgeon, there is only one path: by completing a one-year accredited fellowship. After this fellowship, the surgeon sits for another round of boards with the American Board of Colon and Rectal Surgery before becoming board-certified. Becoming double-board certified in both general surgery and colon and rectal surgery is a rigorous process. It ensures the surgeon has extensive training.

Do they have experience in minimally invasive surgery?

Today, the standard of care for colon and rectal surgery is a minimally invasive procedure. Instead of performing an open surgery that involves a large incision, the surgeon uses instruments inserted through a few small incisions. One of these instruments contains a camera with a light allowing the surgeon to see inside the patient’s body. This approach is also linked with less pain and a faster and easier recovery.

Some surgeons may not be  familiar with these minimally invasive methods, although many have learned them from other surgeons or during their residencies and fellowships. Robotic surgery – another minimally invasive approach – is currently gaining popularity amongst surgeons; many are learning this technique from their colleagues or through extra training.

At the Digestive Institute, Dr. Massarotti and Colon and Rectal Surgeon Allen Chudzinski, MD, FACS, FASCRS, use both robotic and laparoscopic surgery to accomplish their procedures. With robotics, the surgeon sits at a console in the operating suite that translates his or her hand motions directly to the minimally invasive instruments attached to the surgical robot. This method allows for very small movements to be made at the site of the operation. 

“As long as the surgeon is able to offer some sort of minimally invasive surgery – laparoscopic or robotic – you will be receiving the latest approach to care,” says Dr. Massarotti. She adds that the surgical outcomes from either laparoscopic or robotic surgery are very similar.

How many surgical procedures have they done?

The more times we do something, the better we get at it. This also holds true for surgeons. Those who have more experience in performing the same procedure many times tend to provide better outcomes with fewer complications and shorter hospital lengths of stay. Studies bear this out. Being treated by a “high-volume” colon and rectal surgeon provides an extra layer of security that you will likely receive good results. 

While some operations are more common than others and there is no standard definition for what makes a high-volume colon and rectal surgeon, you can do your research to find out if a surgeon has a lot of experience in the procedure that you need them for. The Digestive Institute is considered a high-volume center in the greater Tampa area for colon and rectal procedures, and Dr. Massarotti and her colleague Dr. Chudzinski each perform hundreds of these operations each year.

Are they supported by the right team?

Dr. Massarotti says that people should consider if the surgeon is alone in their clinic or if they have partners. If the operation you need is especially complex, your colon and rectal surgeon might need to draw upon the experience and advice of specialty nurses, physician extenders and other subspecialty surgeons – after all, two heads are better than one.

“Colon and rectal surgery takes a team of nurses, PAs [physician assistants] and fellows,” says Dr. Massarotti. “There should be other knowledgeable caregivers who can respond when a patient calls with an immediate concern while the surgeon is in the operating room with another patient.”

Is the surgeon someone you like?

It is important that you trust and have a good rapport with your surgeon. “Surgeons are not just technicians,” says Dr. Massarotti. You want to find someone who sees you as a whole person and takes your lifestyle and concerns into account when proposing a surgical solution. You want to have a surgeon with whom you feel comfortable discussing all of your surgical concerns.

“We spend a lot of time in the clinic with patients,” she says. Your surgeon should be open to having discussions with you and explaining your operation at the level of detail you desire. He or she should genuinely care about making your life better. Even if you ultimately do not end up having surgery, your colon and rectal surgeon may be the one leading your care team (as in cases of cancer), and you want to have mutual respect with that person.

The Colon and Rectal Surgeons at AdventHealth Digestive Institute Tampa have the advanced training and experience to provide their patients with outstanding surgical outcomes. For an initial consultation, call Call813-615-7557.