This is a special technique whereby the surgeon uses an operating camera inserted through your bottom (anus) to reach inside the rectum. It is used to excise significant polyps in the rectum which are too big to remove by conventional means, using the flexible camera (colonoscope). It always involves a general anaesthetic. It is very important in planning the procedure that the surgeon has accurate knowledge of the position and height of the polyp to be removed. The surgeon performing the procedure will usually want to perform at least a sigmoidoscopy themselves beforehand to ascertain this information. This is used to plan your surgery as once you are asleep, you are positioned either on your back, your side or your front, in order that the polyp is at the correct orientation for the camera to work. Once you are asleep and in position, the surgeon then inserts the camera through the anus to find the polyp. The camera is wide enough to allow fine instruments to pass down the middle of it together with a telescopic view which allows the surgeon accurate vision whilst he is operating. The polyp is then excised complete with a full thickness disc of the normal bowel wall around it to enable complete removal. The procedure can take a couple of hours to complete, but may be quicker. A special instrument is used to cut and seal the blood vessels as they are divided and usually there is minimal or no bleeding afterwards. At the end of the procedure the surgeon may then close the area in the bowel using some sutures, again using the camera with the suture material passed through the middle of it. Alternatively, some of these defects can be left open quite safely and the bowel will heal normally. In the immediate aftermath, because of the nature of the surgery through the bottom, without involving any cuts of the surface, people are usually quite comfortable. You may feel a bit uncomfortable from where the camera has been inserted but this is usually short lived. People can eat and drink normally immediately afterwards and often go home the following day if they are well.

As with all surgery there are some specific risks that are associated with this procedure. Rarely, you may get a degree of bleeding afterwards but this is not usually too serious. You will be given antibiotics at the time of surgery but although the risk of infection is present, it is not a big problem and most people heal very well without any ill effect. The area should be surveyed regularly in the future by camera surveillance as there is always a chance that significant polyps may grow back. It is fairly common to get a low grade temperature after the procedure. Whilst you remain well this is just observed and we normally don’t allow you to leave the hospital until this has resolved. Occasionally this may mean observing you for an extra day. Usually the polyp would have been biopsied beforehand so we know what type of growth it is. Occasionally, there can be a surprise when the whole of the polyp is analysed; we always warn people there is a chance that there may be cancer found within the final specimen at excision. If this is the case, your surgeon will talk to you about whether any further treatment would be necessary. Lastly, the camera is of a certain size to allow the surgeon to get the instruments in to operate. This means that your sphincter muscles do get a gentle stretch during the procedure and occasionally this can lead to problems with urgency and occasionally seepage afterwards. All tests suggest however, that people regain their normal muscle strength after 4 months, so even if you experience these side effects, they are usually only temporary. This is a specialist procedure which can be done as a private patient at Basingstoke and North Hampshire Hospital. By using a “private status” you will be afforded all the usual privileges such as a side room and Consultant care during your time in hospital.