Colorectal Surgery

If you're experiencing severe rectal pain due to an anal fissure, hemorrhoids or other discomfort, we're here to help, offering next-day appointments for acute conditions. Schedule a next-day appointment now.

The AdventHealth Digestive Health Institute and the AdventHealth Medical Group Colorectal Surgery team now offer comprehensive services for patients with peritoneal surface malignancy. Our program provides specialized care for various advanced colorectal conditions, including peritoneal metastases.

Our program team is led by Christopher Aquina, MD, MPH, who is fellowship-trained in surgical oncology and colorectal surgery. Dr. Aquina is highly skilled in treating metastatic cancers originating from the appendix, colon, rectum, small bowel and peritoneal surface. He uses advanced treatment methods, such as cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

We take a multidisciplinary approach to peritoneal surface malignancy and colorectal cancer by including experts from colorectal surgery, hepatobiliary surgery, medical oncology and radiation oncology. We offer a wide range of services, including:

• Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS and HIPEC): these treat peritoneal surface malignancy, targeting peritoneal metastases of appendiceal, colorectal and ovarian origin, as well as peritoneal mesothelioma
• Multivisceral resection: a surgical procedure for locally advanced or recurrent colon cancer that involves removing multiple affected organs
• Pelvic exenteration: a surgical option for locally advanced or recurrent rectal cancer to remove the pelvic organs affected by the disease
• Liver resection and ablation: for colorectal cancer liver metastases, this addresses the spread of cancer to the liver through surgical removal or destruction of the affected tissue

Liver-directed therapies: hepatic artery infusion chemotherapy, transarterial chemoembolization/embolization (TACE/TAE), Y90 selective internal radiation therapy (SIRT) and stereotactic body radiation therapy (SBRT) are offered for unresectable colorectal cancer liver metastases

Anal and anorectal disorders and diseases can affect the anus or where the anal canal and rectum meet. Our team is trained in diagnosing, treating and managing many of these conditions, including:

• Anal fistula
• Anal sexually transmitted infections (STIs) or diseases (STDs)
• Anal skin tags
• Anal trauma
• Anal ulcer
• Melanoma of the anus
• Paget’s disease of the anus
• Pilonidal disease, cyst or abscess
• Pruritis ani
• Radiation proctitis
• Retrorectal cyst

If you're experiencing severe pain due to any of the above, schedule a next-day appointment for acute conditions today.

Anal dysplasia is a precancerous condition that’s typically caused by human papillomavirus (HPV). Diagnosing, treating and monitoring this condition is important to help prevent anal cancer from developing.

The AdventHealth Digestive Health Institute offers an Anal Dysplasia Clinic — the first of its kind in Central Florida — to ensure you get the care you need, when you need it. Our specialties include:

• Anal pap smear
• Anal warts and condyloma
• Colonoscopy
• HIV-related anorectal conditions
• High-resolution anoscopy (HRA)
• Non-invasive surgery

Our team is here to help you on your journey to whole health. If you’ve been diagnosed with anal dysplasia or are at risk, our providers can help keep you healthy and well.

An anal fissure is a small tear in the tissue that lines the anus that’s typically caused by large or hard bowel movements over time. Individuals with an anal fissure may experience pain or bleeding during bowel movements.

We offer comprehensive care for diagnosing, treating and preventing anal fissures, especially if you experience recurring fissures or have difficulty treating it at home.

We’ll work with you to create a plan that gets you back to whole health. Your treatment may include:

• Blood pressure medicine to relax the anal sphincter
• BOTOX® injections (chemical sphincterotomy BOTOX®) to relax spasms
• RECTIV® prescription medicine (an externally applied nitroglycerin) to encourage healing
• Topical pain relief

Surgery may be recommended if you have a severe or recurring anal fissure. Our surgeons routinely perform sphincterotomy. During this procedure, your doctor will cut a small portion of the anal sphincter muscle. This helps reduce spasms and pain and encourages healing.

Anal warts are caused by human papillomavirus (HPV). Some common signs and symptoms may include:

• Bleeding or discharge from the anus
• Itching around the anus
• Lump in the anal area
• Warts on other body parts, including genital warts or in the mouth or throat

The Anal Dysplasia Clinic at the AdventHealth Digestive Health Institute offers comprehensive care for diagnosing, treating and preventing anal warts. Our clinic is a one-stop-shop for patients who are at risk of or who have precancerous or cancerous cells.

Your treatment may include:

• Cryotherapy
• Electrocautery
• Laser treatments
• Surgery
• Topical medications

Our team will work to understand which treatment options best meet your needs to start healing.

A colon polyp is a small clump of cells that grows along the lining of the colon. Most of the time, polyps are benign, which means they aren’t cancerous. However, some polyps can turn into colon cancer.

A colonoscopy is the most effective screening tool for identifying, diagnosing and removing a colon polyp before it causes symptoms or grows into cancer.

Some people may also be at a higher risk because of genetic mutations that cause colon polyps. Those include:

• Familial adenomatous polyposis (FAP)
• Hereditary nonpolyposis colon carcinoma (HNPCC)
• MYH-associated polyposis

Polyps are typically discovered and removed during routine screening colonoscopies and diagnostic colonoscopies, so it’s essential to get these screenings. If you’re over age 50, have a personal or family history of colon polyps or cancer and have not had a colorectal screening, talk to your health care provider about a colorectal screening.

If you have a colon polyp, your surgeon will most likely recommend a procedure to remove the growth. This may include a polypectomy or minimally invasive surgery.

People with a genetic mutation may need a total proctocolectomy, a surgery to remove the colon and rectum.

Hemorrhoids are nothing to be embarrassed about. In fact, it’s estimated that 50% of people over the age of 50 experience them.

Left untreated, they can cause pain and discomfort. Fortunately, most hemorrhoids respond to conservative treatment at home, such as topical creams, eating a diet high in fiber, drinking plenty of water or taking over-the-counter medication.

However, if you have persistent, recurrent or large hemorrhoids, you may need more specialized care.

We offer many different treatment options, from conservative therapies to minimally invasive procedures and surgical care for hemorrhoids. Our treatments include:

• Hemorrhoid banding
• Hemorrhoidectomy
• Transanal hemorrhoidal dearterialization

Pelvic floor dysfunction refers to the inability to properly relax the pelvic floor muscles to have a bowel movement. It can also refer to loosening or weakening muscles that have allowed organs in the pelvis (including the uterus, bladder and rectum) to shift out of place.

Our team is here to help you get your life back. We offer comprehensive diagnostic tools to get a better idea of what’s causing your symptoms. We treat many different conditions related to pelvic floor dysfunction, including:

• Anal stenosis
• Anismus
• Fecal incontinence
• Rectal prolapse
• Rectocele

Once we have a clear diagnosis, we’ll work together to create a treatment plan that’s right for you. Today, you have more options than ever before, from prescription medications to injections that help relax or tighten muscles, and from minimally invasive procedures to innovative therapies.

Your physician will discuss which treatment is best to get you back to whole health. That may include:

• Pelvic floor disorder therapy
• Rectopexy
• Sacral nerve stimulator

Learn more about pelvic floor disorders.

It can be alarming to experience rectal bleeding. But often, it’s nothing to be worried about. Bleeding can happen from constipation or straining too hard during a bowel movement. If you’re concerned about the amount of blood you see and the frequency you experience it, you should talk to your doctor to rule out other, more serious conditions.

At the AdventHealth Digestive Health Institute, we diagnose and treat many different conditions that can cause rectal bleeding, including:

• Anal fissures
• Cancer
• Crohn’s disease
• Constipation
• Diarrhea
• Diverticulosis and diverticulitis
• Inflammatory bowel disease (IBD)
• Hemorrhoids
• Proctitis
• Solitary rectal ulcer syndrome

Together, we’ll get to the root of your condition and create a treatment plan that helps you get back to what’s most important — enjoying and living your life.

Advances in surgical care offer exciting new procedures for our patients. Today, you have more options than ever before to treat a wide range of colorectal conditions with minimally invasive procedures. These approaches often lead to less pain and a shorter recovery time, so you can get back to what matters most.

Your colorectal specialist will discuss if you’re a candidate for minimally invasive procedures. Some traditional procedures can now be performed with a minimally invasive approach, such as:

• Laparoscopic surgery
• Robotic surgery
• Transanal minimally invasive surgery (TAMIS)
• Transanal total mesorectal excision (taTME)
• Transanal endoscopic microsurgery (TEMS)

Sometimes, surgery is required to treat colorectal or gastrointestinal disorders. If your provider recommends surgery, you can rest assured that you’re in good hands.

Our team has experience performing many different surgeries that will help you improve your quality of life, relieve symptoms and reduce pain.

Colorectal surgery available at the AdventHealth Digestive Health Institute includes (but is not limited to):

• Colostomy
• Colostomy reversal
• Ileostomy
• Ileostomy reversal
• Ostomy
• Ostomy reversal
• Stoma prolapse and reversal
• Pouch surgery and re-do pouch surgery

For people who’ve had ostomy procedures — sometimes as part of their IBD treatment — our specialized nurses offer enterostomal therapy to care for stomas before and after surgery.

Learn more about enterostomal therapy as a part of IBD treatment.

Colorectal conditions often call for a treatment approach with many different therapies to help heal your body, mind and spirit.

We work with providers, specialists and therapists across different disciplines to ensure you get the care you need, when you need it. Your care team will work closely with you to discuss different therapies that may be right for you. Often, we recommend these treatment paths alongside or before surgical intervention:

• Behavioral health support
• Exercise planning
• Pain management
• Pelvic floor disorder therapy
• Managing chronic health conditions
• Nutrition counseling
• Weight management