Surgical Endoscopy

Specializing in-

Colonoscopy

Colonoscopy is an endoscopic procedure that enables your surgeon at University Surgeons Associates, PC to evaluate the internal lining of the rectum and colon. It is performed in the GI Lab or the operating room.   After sedation, a long, flexible video-endoscope is gently inserted into the anus and advanced throughout the rectum and the colon.  Images of abnormalities can be taken.  Procedures such as biopsies and resections of polyps and tumors can be performed.

indications for colonoscopy

  • Routine screening for colon and rectal cancer
  • Screening in patients at high risk for colon cancer
  • Follow-up in patients with known polyps or previous polyp removal
  • Evaluation before or after colon surgery
  • Bleeding or a change in bowel habits
  • Crohn’s disease
  • Colitis
  • Diverticular disease

WHAT PREPARATION IS REQUIRED?

  • Preoperative preparation may include blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of colonoscopy, you will need to provide written consent for colonoscopy.
  • A bowel prep to clear the rectum and colon completely of stool is necessary to adequately visualize the inner lining of the colon.  Your surgeon or his staff will give you instructions regarding the cleansing routine to be used.
  • It is recommended that you shower the night before or morning of the procedure.
  • After midnight the night before the colonoscopy, you should not eat or drink anything except medications that your surgeon or anesthesiologist has told you are permissible to take with a sip of water the morning of colonoscopy.
  • Alert your surgeon if you require antibiotics prior to undergoing dental procedures, since you may also require antibiotics prior to colonoscopy.
  • Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and large doses of Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need to return home after the procedure.

HOW IS A COLONOSCOPY PERFORMED?

The procedure is usually done with you lying of your side or your back while the colonoscope is advanced throughout the colon.   Routinely you are sedated, but may have a feeling of pressure, gassiness, bloating or cramping during the procedure.  The lining of the colon is examined carefully while inserting and withdrawing the colonoscope. The procedure usually lasts for 15 to 60 minutes and you will be observed afterward in the recovery area until you are ready to go home.  Occasionally, the entire colon cannot be adequately visualized and you may require a barium enema at a later date.

WHAT IF COLONOSCOPY IS ABNORMAL?

A biopsy may be obtained of any abnormality that is seen.  This is submitted to a laboratory for analysis.  Polyps are generally completely removed if possible.  The majority of polyps are benign (non-cancerous), but your surgeon cannot always tell by the appearance alone.  They can be removed by burning (fulgurating) or by a wire loop (snare).  It may take your surgeon more than one sitting to do this if there are numerous polyps or they are very large.  Removal of a colonic polyp is an important means of preventing colorectal cancer from developing in that polyp.   Sites of bleeding can be identified and controlled by injecting certain medications or coagulating (burning) the bleeding vessels.  

WHAT SHOULD I EXPECT AFTER SURGERY?

Our goal is for your surgery and recovery to be as comfortable and convenient as possible.  You should be able to eat normally the same day and resume your normal activities after leaving the hospital.  Your surgeon will explain the results to you after your procedure or at your follow up visit. You may have some mild cramping or bloating from the air that was placed into the colon during the examination. This should quickly improve with the passage of the gas. Do not drive or operate machinery until the next day, as the sedatives given will impair your reflexes. You will need someone to drive you home after the procedure.  If polyps were found during your procedure, you will need to have a repeat colonoscopy. Your surgeon will decide on the frequency of your colonoscopy exams.

WHAT COMPLICATIONS CAN OCCUR?

Colonoscopy and biopsy are considered extremely safe when performed by surgeons who have had special training and are experienced in these endoscopic procedures such as the surgeons at University Surgeons Associates, PC. As with any operation, there is a risk of a complication. Complications during the operation may include:

  • A reaction to the sedatives can occur
  • Irritation to the vein at the IV site
  • Bleeding from the site of a biopsy or polypectomy
  • Occasionally blood transfusion is necessary
  • Rarely a tear or perforation of the bowel wall
  • Worsening of inflammation or infection

Surgery to repair a perforation or to control massive bleeding could be necessary but in most cases these rare complications can be managed conservatively.  Mild bleeding can occur for several days after a biopsy or polypectomy.

WHEN TO CALL YOUR DOCTOR

Be sure to call your physician or surgeon if you develop any of the following symptoms after surgery:

  • Worsening abdominal pain
  • Persistent fever over 101 degrees F (39 C)
  • Chills
  • Rectal bleeding of more than one-half cup
  • Pain that is not relieved by your medications
  • Persistent nausea or vomiting
  • You are unable to eat or drink liquids

IF YOU GO TO THE EMERGENCY ROOM

  • Call 911 and go to the nearest ER for life threatening emergencies
  • Go to the University of Tennessee ER if practical
  • Call University Surgeons Associates, PC (865) 305-9621 before you go
  • Your surgeon or the surgeon on call can make advance arrangements for you
  • This will expedite your evaluation and treatment
  • When you arrive, tell the triage nurse you are our patient and were instructed to have us called when you got to the ER

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