Colorectal surgery

What is colorectal surgery?

Colorectal surgery is used to treat problems affecting the large intestine (colon), rectum and anus. It can help manage a wide range of conditions, including bowel cancer, ulcerative colitis and Crohn’s disease. 

At Guy’s and St Thomas’ Specialist Care, our colorectal surgeons care for both adults and children, offering a full range of procedures to remove or repair damaged areas of the bowel, relieve symptoms and help you return to normal daily activities. 

Colorectal surgery takes place at Guy’s and St Thomas’ hospitals for adults and Evelina London Children’s Hospital for children. Our hospitals are recognised for their expertise in gastrointestinal care, with teams of surgeons, gastroenterologists and specialist nurses working together to provide safe, effective treatment. 

Our colorectal surgeons are specialists in both routine and complex procedures. These include removing damaged areas of the bowel, creating or reversing a stoma (an opening in the abdomen that allows waste to leave the body), and complex bowel reconstruction (for patients with severe, complex conditions). We use the latest minimally invasive and robotic techniques, where possible, to help reduce recovery time and improve comfort after surgery. 

Our gastroenterology teams work closely with our surgeons to provide expert assessment and care before and after surgery. Their diagnostic expertise helps us understand your condition in detail and plan the most effective treatment for you. This may include tests such as a colonoscopy to assess your bowel health and guide your care.

Who might need colorectal surgery? 

You may need colorectal surgery if you have a condition affecting your large intestine, rectum or anus that does not improve with other treatments. This can include bowel cancer, Crohn’s disease, ulcerative colitis, diverticular disease or severe bowel obstruction. Some people may also need surgery to repair damage after previous procedures or to create or reverse a stoma. 

If you have ongoing digestive symptoms or you are worried about your risk of a bowel condition, our specialists can help with diagnosis. Contact our team to arrange an appointment.

What are the different types of colorectal surgery?

There are different types of colorectal surgery depending on your condition and its severity. Our team offers a wide range of procedures to treat bowel and digestive problems.

Bowel resection surgery 

Bowel resection is a common procedure used to remove a section of the large intestine that is damaged or diseased. It can be used to treat bowel cancer, ulcerative colitis, Crohn’s disease and other inflammatory conditions. 

Once the affected section of bowel is removed, the healthy ends are rejoined. This can be done using open, laparoscopic (keyhole) or robotic-assisted techniques. Bowel resection helps relieve symptoms, prevent complications and restore bowel function.

Stoma surgery 

Stoma surgery involves creating a small opening in the abdomen to allow waste to leave the body when the bowel cannot function normally. It may be temporary or permanent, depending on your condition and recovery. 

Our surgeons also perform stoma reversal surgery and complex para-stomal hernia repair. Specialist stoma nurses will support you before and after your procedure, helping you adjust and manage your stoma with confidence.

Complex bowel reconstruction surgery 

Complex bowel reconstruction is often needed after previous surgery, trauma or long-term disease. Our surgeons specialise in rebuilding and reconnecting the bowel to improve function and quality of life. 

These procedures may involve repairing scar tissue, reattaching the bowel or reconnecting the intestine after stoma reversal. 

As well as resection, reconstruction and stomas, we also offer adult colorectal surgeries, such as:

• anal fissure and fistula surgery 
• gastrointestinal cancer surgery and resection 
• haemorrhoid surgery (haemorrhoidectomy) 
• hernia repair, including inguinal, umbilical, epigastric and incisional 
• pelvic floor surgery for bowel incontinence, bowel dysfunction and rectal prolapse 
• pilonidal sinus surgery 
• ulcerative colitis and Crohn’s disease surgery

For children, we offer:

• anorectal malformation surgery 
• hernia repair, including inguinal and umbilical hernia surgery 
• Hirschsprung disease treatment 
• pilonidal sinus surgery 
• surgery for constipation 
• surgery for inflammatory bowel disease (IBD) 

If you would like to speak to one of our colorectal specialists about the most suitable treatment for your condition, please contact our team to arrange a consultation. 

How is colorectal surgery performed? 

Colorectal surgery can be carried out using open surgery (where a large incision is made), laparoscopic (keyhole surgery) or robotic-assisted techniques. The type of surgery depends on your condition and overall health. 

In keyhole and robotic surgery, small cuts are made in the abdomen so that surgical instruments and a camera can be inserted. These methods allow surgeons to operate with precision and usually mean smaller scars, less pain and a quicker recovery. In some complex cases, an open procedure may still be the safest option. 

Our surgeons work closely with anaesthetists, specialist nurses and gastroenterologists to make sure you receive the safest and most effective treatment.

Preparing for colorectal surgery 

Before your operation, you will have a pre-assessment to check your general health and make sure you’re fit for surgery. You may also need blood tests, imaging scans or a colonoscopy to confirm your diagnosis and plan your treatment. 

We will give you clear instructions on how to prepare. This might include fasting before your operation, adjusting your medication or using a bowel preparation to empty your intestines. You’ll also have the opportunity to discuss any questions or concerns with your care team.

For children, our teams at Evelina London Children’s Hospital help families prepare in a calm, supportive environment.

How long does colorectal surgery take? 

The length of surgery depends on the type of procedure and your individual needs. Most colorectal operations take between 1 and 4 hours. Complex reconstructive surgery or procedures involving more than one area of the bowel may take longer. 

Your surgeon will explain how long your operation is expected to last and what to expect afterwards.

What is the recovery time for colorectal surgery?

Recovery times vary depending on the type of surgery and whether it was performed using open or minimally invasive techniques. Most people stay in hospital for a few days after their operation while we monitor their recovery and manage any pain. 

Starting to move and eat as soon as you can helps recovery. Once home, most people feel ready to return to light activities after 2 to 4 weeks, although it can take longer to recover fully. 

Our team will give clear guidance on caring for your wounds, managing your diet and gradually returning to normal activities. You’ll also have follow-up appointments to check your recovery and discuss any ongoing care needs. 

Contact our customer care team to learn more about how our team can help with the preparation and recovery associated with colorectal surgery. 

Benefits of colorectal surgery 

Colorectal surgery can significantly improve your quality of life, especially when other treatments have not worked.  

Surgery can: 

• relieve pain, bleeding or other distressing symptoms 
• remove diseased or cancerous parts of the bowel 
• restore normal bowel function 
• prevent complications such as blockages or perforations (a hole or tear) 
• reduce flare-ups in conditions like Crohn’s disease and ulcerative colitis 
• improve continence and control in pelvic floor disorders

Many procedures can now be performed using minimally invasive or robotic techniques, which can mean smaller scars, less pain and faster recovery.

Risks of colorectal surgery

All surgery carries some risk, though our teams take every step to keep you safe. Specific risks depend on the type of surgery you have and your general health.  

Possible risks include: 

• a temporary or permanent stoma 
• anaesthetic complications, which are rare 
• blood clots (deep vein thrombosis) 
• infection or bleeding 
• injury to nearby organs or nerves 
• leakage from where the bowel is joined together 

Our specialists will discuss any risks with you before your operation so you can make an informed decision about your care.