The entire intestine has a length of about six meters and fills most of the abdominal cavity. It begins with the duodenum, which connects to the stomach, and ends with the rectum. The intestine is divided into two main sections: the small intestine and the large intestine. In the small intestine, the food is broken down and nutrients are absorbed. In the one-meter-long large intestine, water is extracted from the food pulp and the rest is then stored in the rectum or anus until defecation.
Diseases in this area manifest themselves, for example, through symptoms such as a feeling of pressure or pain in the upper abdomen.
Today, surgeries on the large intestine and rectum should routinely be performed using "keyhole technique" and, if available, robotic assistance.
Polyps in the intestine are benign growths that appear either mushroom-shaped or turf-like inside the intestine. They can be precursors to colon cancer and must therefore be completely removed. The good news: These precursors remain benign for a long time – sometimes up to 10 years – so that with regular colonoscopies, there is almost no risk.
Therapy: In most cases, polyps can be removed during a colonoscopy. Only rarely are there reasons that make surgical removal necessary. However, this is almost always possible with the very gentle minimally invasive technique.
Diverticula are sacs of the intestinal wall that protrude outward and occur throughout the colon, most commonly in the sigmoid colon, the so-called sigma. They are not inherently dangerous and occur in many people over the course of their lives. If these diverticula become inflamed by stool, seeds, or similar, it is called diverticulitis.
Therapy: This inflammation can usually be treated conservatively with diet or antibiotics. However, if there are repeated inflammations, a narrowing in the area of the inflammation, or even a rupture of the diverticulum, surgery should be performed. Rarely, bleeding can also occur from a diverticulum – in such cases, surgery is often necessary. The operation is a domain of minimally invasive surgery and is now standard. It is performed either conventionally using keyhole technique or with the assistance of an operative robot.
Crohn's disease is part of the group of chronic inflammatory bowel diseases (IBD) and can occur throughout the gastrointestinal tract - from the oral cavity to the anus. The end of the small intestine (terminal ileum) or the large intestine (colon) is often affected. Involvement of the esophagus, stomach or duodenum is very rare. Several sections of the intestine may be inflamed at the same time, separated by healthy sections.
In Crohn's disease, the inflammation affects not only the mucous membrane but also all layers of the intestinal wall. Consequently, the intestinal wall thickens and loses elasticity. The result: Narrowing in the intestine that promotes the growth of inflammatory cells. Young adults between the ages of 15 and 35 are most frequently affected, but Crohn's disease can also develop in people over the age of 60. Both women and men are equally affected by this bowel disease.
Therapy: The therapy for Crohn's disease is ideally coordinated by an interdisciplinary team of surgeons and gastroenterologists and almost always begins conservatively. Various medications are used - particularly modern antibodies and immunomodulators. Surgery also plays an important role and is a decisive factor in coordinating the different disciplines. If surgery becomes necessary, it should be performed minimally invasively or with robotic assistance.
Ulcerative colitis is one of the chronic inflammatory bowel diseases and almost exclusively affects the colon. The inflammation spreads continuously throughout the colon (colon), starting from the rectum, and can occasionally extend to the lower section of the small intestine (ileum) (backwash ileitis). Ulcerative colitis mainly attacks the mucous membrane of the colon, while the deeper layers of the wall are not involved in the inflammatory process. The diagnosis is most often made between the ages of 20 and 35, only occasionally in childhood. Women and men are equally affected by this bowel disease.
Therapy: The therapy is almost always conservative medical at first. Various classes of substances are used, especially modern antibodies. If the medications do not work or the symptoms are uncontrollable, the disease can be cured with surgery. In this case, the entire colon, including the rectum, is removed, preserving the sphincter muscle. Reconstruction is carried out by means of a so-called pouch, which imitates the rectum and can thus offer a very good quality of life. These operations are performed minimally invasively or robot-assisted at specialized centers and require a high level of expertise from the entire treatment team (surgery, gastroenterology, physiotherapy, experiential medicine, psychology).
Colon cancer is the second most common type of cancer in men and women. In the vast majority of cases, it develops from benign precursors, so-called polyps or adenomas. Often, hereditary factors also play a significant role. Thanks to preventive examinations in Germany, the number of colon cancer cases is decreasing overall. Unfortunately, however, we are seeing a dramatic increase in young people between the ages of 30 and 50. The reasons for this are not yet fully understood, but should lead to the definition of risk groups in the future. These should then go for a colonoscopy as early as the age of 30 or 40.
Therapy: The gold standard is surgical therapy, which is usually performed minimally invasively or robot-assisted. In the early stages, the chances of cure are excellent. Even in advanced stages, colorectal cancer can be curable through differentiated, individually tailored multimodal therapy concepts.
Colon cancer is the second most common type of tumor in both new cases and cancer-related deaths in Germany – 45% of these are attributed to rectal carcinoma. However, thanks to increasing and consistent prevention, the mortality rate decreases year by year. Symptoms include diarrhea or constipation, blood in the stool, a dark discoloration of the stool, cramping abdominal pain, or nausea. Since these symptoms can also occur with other bowel diseases, they should be medically clarified.
Therapy: In the treatment of rectal cancer, so-called multimodal therapy concepts are successfully used. This means that after appropriate diagnostics, a combination of radiation and Chemotherapy is performed to shrink the tumor in the rectum. The second step involves surgery. Often, additional chemotherapy is recommended after the surgery.
The aim of treatment should be not only to cure but also to preserve the sphincter and its function. Rectal surgeries require a very high level of surgical experience and should therefore be handled by renowned surgeons/centers. This procedure can also be performed minimally invasively in specialized units, achieving excellent functional and tumor-specific results. Here, the surgical robot is also used, which significantly improves precision and safety for the patient.