Colon and Rectal Surgery

Colon and Rectal Surgery

Welcome to the colon and rectal surgery division at Care New England. Our team of colorectal surgeons and advanced practice clinicians provide comprehensive colorectal care for patients in a safe, caring, and personalized environment.

We care for clinical disorders of the colon, rectum, small bowel, and anus. Our colorectal surgeons specialize in advanced surgical techniques including laparoscopy, robotics, and transanal minimally invasive surgery. We also offer colonoscopies, office-based procedures, surgery, and endoscopy at both Kent Hospital and Women and Infants Hospital.

Our colorectal team is committed to providing the highest quality of cancer care for patients by utilizing a multidisciplinary approach and collaborating with our colleagues in gastroenterology, medical oncology, radiation oncology, pathology, radiology, and genetics to care for our patients.

Colon and Rectal Surgery

building-1455 Toll Gate Road
Warwick, RI 02886

building-1101 Pain Street, 4th Floor
Providence, RI 02903

P: (401) 738-6611

F: (401) 921-6952

Contact Form

Based on your insurance, you may need a referral from your PCP. Please contact your PCP to request your referral. Contact our office to make an appointment or if you have any questions.

Our Services

Colon Cancer Screening
  • Colonoscopy
  • Cologuard Testing
  • Virtual colonoscopy
  • Genetic Testing for patients at high-risk for colorectal cancer
Inflammatory Bowel Disease
  • Crohn’s Disease
  • Ulcerative Colitis
Treatment of Anorectal Conditions
  • Anal fissures
  • Anal condyloma (anal warts)
  • Constipation
  • Fecal incontinence
  • Fistula-in-ano
  • Hemorrhoids
  • Hypertrophied anal papillae
  • Pilonidal cyst
  • Perirectal abscess
Patient-Centered Multidisciplinary Colorectal Cancer Care
  • Colon Cancer
  • Rectal Cancer
  • Anal Cancer
Treatment for Benign Colorectal Conditions
  • Diverticulitis
  • Rectal prolapse
  • Motility Disorders
  • Colorectal Polyps
  • Recto-vaginal fistulas
  • Bowel Incontinence
Multidisciplinary Support Services
  • Medical Oncology
  • Radiation Oncology
  • Pelvic Floor Testing
  • Pelvic Physical Therapy
  • Wound Care
  • CNE VNA Services
  • Wound Ostomy Care Nurse Support Services

Procedures Offered

Colectomy

A surgical procedure to remove all (total abdominal colectomy) or part (partial colectomy) of the colon. This is done for many reasons, including large polyps, cancers, inflammatory bowel disease, or diverticular disease. Surgery is typically done through minimally invasive techniques including laparoscopic or robotic surgery.

Proctectomy

A surgical procedure to remove all or part of the rectum. Often this procedure involves a temporary or permanent stoma (an opening on the skin where fecal material flows out of the body). Surgery is typically done through minimally invasive techniques including laparoscopic or robotic surgery.

Abdominal Perineal Resection (APR)

A surgical procedure that involves performing a proctectomy and removal of the anal sphincter resulting in a permanent stoma (an opening on the abdomen where fecal material flows out of the body).

Small Bowel Resection or Stricturoplasty

A surgical procedure to remove a segment of the small intestine or to open a narrowed portion of the small intestine.

Transanal Minimally Invasive Surgery (TAMIS)

A minimally invasive approach in which we perform laparoscopic surgery through the anus to remove rectal polyps or early cancers without abdominal incisions.

Rectal Prolapse Surgery

We offer two approaches for rectal prolapse; the perineal approach (through the anus) called a perineal rectosigmoidectomy, as well an abdominal approach laparoscopic or robotic rectopexy. Your surgeon will discuss with you which approach is best for you.

Anal Fistula Repair

Anal fistulas may be complex and frustrating for patients. We offer multiple techniques to repair anal fistulas including seton drains, traditional fistulotomy, fistula plugs, endoanal advancement flaps, or ligation of inter-sphincteric fistula tract (LIFT procedure).

Hemorrhoid Surgery

A surgical procedure to remove inflamed/bothersome hemorrhoids.

Anal Fissure Surgery

For patients who do not respond to conservative treatment to repair anal fissures, we offer both chemical sphincterotomy (Botox Injection) as well as traditional open or closed lateral internal sphincterotomy.

Interstim Placement/Sacral Nerve Stimulator

A surgical procedure in which we implant a sacral nerve stimulator to aid patients with bowel incontinence.

Colon Cancer Screenings Saves Lives

Colorectal cancer is the second leading cause of cancer death in men and women in the United States. Regular screening can detect colorectal cancer early when it is small and has not spread. If found at an early stage, the 5-year survival for colon cancer can be as high as 90%. Screening may prevent colorectal cancer by identifying polyps prior to them turning into cancer.

The American Cancer Society recommends screening for colorectal cancer to begin at age 45 if you are at average risk. If you have a family history of colon cancer or polyps or symptoms you may need to be screened earlier than age 45. Please talk to your doctor about getting screened.

What is Colorectal Cancer?

Colorectal cancer starts in the colon or the rectum. It is most commonly seen in older adults but it can happen at any age. It usually begins as small cells in the body begin to grow into small clumps called polyps. The polyps grow over time and may transition and develop into either colon or rectal cancer. Once the cells have turned into cancer cells they can spread locally or travel through the blood and lymphatic system to other areas in the body.

What are Common Symptoms of Colon Cancer?

Signs and symptoms of colorectal cancer may include:

  • Change in bowel habits or change in the consistency of your stool
  • Rectal bleeding or blood in your stool
  • Persistent abdominal pain/discomfort
  • Sense of rectal pressure or that you cannot empty completely
  • Weakness or fatigue
  • Unexplained weight loss

Many patients with colorectal cancer have NO symptoms which is why it is important to follow screening guidelines.

Risk Factors of Colorectal Cancer

There are several factors that can increase your risk of colorectal cancer.

  • Older Age: Colon cancer may be diagnosed at any age but the majority of patients with colorectal cancer are greater than age 50. With screening, the rate of patients diagnosed with colon cancer in patients over age 50 is decreasing. Recent trends demonstrate an increase in colorectal cancer in patients less than age 50 but the underlying reason is unknown. It is critical to get your colonoscopy by age 45 if you are at routine risk or earlier if you have any additional risk factors.
  • African American Race: African Americans are diagnosed with colorectal cancer at a higher rate than other races and have worse outcomes after diagnosis and treatment. It is very important that African Americans are screened by age 45 to decrease the racial disparity in colorectal cancer outcomes.
  • Personal History of Colorectal Cancer or Adenomatous Colon Polyps: If you have already had colorectal cancer or precancerous polyps (adenomatous) you are at increased risk of colorectal cancer and need to follow colon cancer surveillance guidelines.
  • Inflammatory Bowel Disease (IBD): Patients with known IBD, either Crohn’s Disease or Ulcerative Colitis, may be at increased risk of colorectal cancer and must follow the recommended screening guidelines.
  • Inherited Genetic Syndromes: There are some gene mutations that may be passed on by family members that increase your risk of colon cancer. These include Familial Adenomatous Polyposis (FAP) and Hereditary Non-Polyposis Colon Cancer (HNPCC) also known as Lynch syndrome.
  • Family History of Colon Cancer: You have an increased risk of developing colorectal cancer if you have a blood relative that developed colon cancer.
  • Lifestyle Factors: Obesity, alcohol use, smoking, and a sedentary lifestyle have all been linked to an increased risk of colorectal cancer
Colorectal Patient Resources

American Society of Colon and Rectal Surgeons Patient Information: https://www.fascrs.org/patients 

American Cancer Society: Colon and Rectal Surgery: https://www.cancer.org/cancer/colon-rectal-cancer.html 

Colon and Rectal Cancer: What to Expect

Staging Process for Colon Cancer

If you are diagnosed with colorectal cancer, your surgeon will then assess if the cancer has spread either locally or to other areas in your body. They will routinely order “staging” tests which may include abdominal, pelvic, and chest CT scans. For rectal cancer, they may order a rectal MRI or endorectal ultrasound.

Treatment for Colon and Rectal Cancer

Your surgeon will discuss treatment options once the staging of the colorectal cancer has been completed. Treatment may include Surgery, Chemotherapy, and Radiation. Patients with colorectal cancer are discussed at the system-wide gastrointestinal tumor board to discuss the best treatment strategy. The patient’s goals and wishes are taken into account when developing a treatment plan. Our surgeons specialize in minimally invasive techniques for cancer surgery.

Enhanced Recovery After Surgery

Our colorectal surgeons follow Enhanced Recovery After Surgery (ERAS) for all major colon and rectal surgeries. This is part of a “colon bundle” process that has been demonstrated to improve patient outcomes. ERAS allows patients to be active participants in their recovery process. The benefits of ERAS include reduced surgical complications, decreased wound infection, and decreased hospital length of stay. Your colorectal surgeon will provide you with ERAS instructions at your preoperative visit.

Click here to download our ERAS process>>

Colon Cancer Surveillance

Following treatment for colorectal cancer, your surgeon will follow national guidelines to assess for recurrence or development of new primary cancer.

Patient Story

 

da Vinci Xi Robot System

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Our colon and rectal surgeons perform surgery using the daVinci Xi robot for a minimally invasive approach to colon and rectal surgery.

The Xi Robot allows the surgeon to perform surgery using state-of-the-art technology to see in 3-D while in high-definition.The surgeon can see better and be even more precise in their surgery, especially when working deep in the pelvis.

Robotic surgeries being performed by the colorectal team include colectomy, proctectomy, rectopexy, and abdominoperineal resection.

Our Recent Posts

Learn from the experts about the various topics related to all things colon and rectal health and wellness.

Melissa M. Murphy, MD, Executive Chief of Surgery, Care New England Health System; Chief of Surgery, Kent Hospital

The question, "why should I get a colonoscopy" is a question I am frequently asked as a colon and rectal surgeon, says Melissa M. Murphy, MD, Executive Chief of Surgery, Care New England Health System...

Melissa M. Murphy, MD, Executive Chief of Surgery, Care New England Health System; Chief of Surgery, Kent Hospital

What are the numbers specific to colorectal cancer affecting the African American population in the United States? In 2019, it was estimated nearly 20,000 African Americans were diagnosed with colorec...

Melissa M. Murphy, MD, Executive Chief of Surgery, Care New England Health System; Chief of Surgery, Kent Hospital

Doctors recommend screening tests to see if you have colon cancer. Several screening tests exist but the gold standard remains a colonoscopy which is both diagnostic and cab be therapeutic. There are ...

Meet the Team

Melissa M. Murphy, MD, MPH, FACS
Executive Chief of Surgery, CNE Chief of Surgery, Kent Hospital Board Certified Colon and Rectal Surgeon

Affiliations: Kent Hospital, Women and Infants Hospital, Brigham and Women’s Hospital/Mass General Brigham

Melissa received her medical degree from George Washington University School of Medicine. Prior to enrolling in medical school, she received her Master of Public Health and Master of Medical Science degrees from Boston University. Dr. Murphy completed a research fellowship and general surgery residency at the University of Massachusetts Medical School and completed her fellowship in Colon and Rectal surgery at Brigham and Women’s Hospital and Harvard Medical School. Dr. Murphy is an Assistant Clinical Professor of Medical Science at The Warren Alpert Medical School of Brown University and an Instructor in Surgery at Harvard Medical School.

Lindsay M. Fink, PA-C, MPAS

Colon and Rectal Surgery, CNE

Affiliations: Kent Hospital, Women and Infants Hospital

Lindsay is an experienced advanced practice clinician in the CNE division of Colon and Rectal Surgery. She completed her Bachelor of Science from the University of New England in 2010 followed by her Master of Physician Assistant Studies from the Massachusetts College of Pharmacy and Health Sciences in 2012. Ms. Fink joined Care New England in 2018 and has played an integral part in developing our colorectal program. Her role includes evaluating and treating patients in the clinic setting, first assisting in surgery, and providing inpatient hospital care. Ms. Fink also has prior clinical experience working as a PA in both orthopedic surgery and emergency medicine.

FAQ's

When should I get a colonoscopy?
  • If you are 45 years old or older
  • If you have a family history of colon and rectal cancer you may require a colonoscopy at an earlier age, please discuss this with your primary care physician
  • If you have any concerning symptoms (rectal bleeding, change in bowel pattern, persistent abdominal pain) 
I have had rectal bleeding intermittently for years. I have always assumed that it was related to hemorrhoids, however, I have never been examined before. I’m embarrassed to be seen by a doctor for this.

Patients may often feel “embarrassed” to seek a colorectal surgery evaluation and can be scared to have a colonoscopy. We reassure our patients and make sure they feel comfortable and safe. We normalize and acknowledge their concerns. We also provide anesthesia with our colonoscopies to ensure patients have a comfortable experience.

What should I expect from my first office visit?
  • Coming into the office, our colorectal (CRS) team will start by taking a thorough history. This includes your symptoms, bowel pattern, family history, and medical history including any surgeries you have had or medications you currently take.
  • We strive to make our patients feel as comfortable as possible during an examination. We understand anorectal examinations may be uncomfortable and invasive and we are careful to communicate with you throughout the procedure. If we are unable to perform an exam in the office, we may offer to perform a rectal exam under anesthesia (in the operating room) at a later date.
I am having my hemorrhoids surgically removed. It has been explained that this is an outpatient surgery and I will go home the same day. What is my expected recovery?

Anorectal surgery can be quite painful due to its location. We typically tell patients that the surgical site may be acutely painful for up to 1 week. In preparation, we provide patients with a nerve block during surgery and inject a long-acting numbing medication surrounding the surgical site. If patients are able to take Tylenol and NSAIDs, we recommend alternating between Tylenol and Ibuprofen (Motrin, Advil) over the counter. If additional pain medication is needed, you will be provided additional medication for the immediate post-operative period. Conservative measures such as warm compresses, soaks in a bathtub, or sitz baths are also encouraged for additional relief.

I am scheduled for colon surgery. What should I expect during my hospital stay?
  • Patients typically stay in the hospital between 2-4 days. Every patient’s hospital stay can vary due to multiple factors (i.e. nutrition status, history of prior abdominal surgeries).
  • We follow a checklist that patients complete prior to being discharged:
    return of bowel function (passing gas), tolerating a regular diet after the return of bowel function, surgical pain is controlled (with medication), and no fever or sign of post-operative infection
  • CNE VNA services are available to patients that require additional needs. For example, patients may require a visiting nurse if they have a new stoma, abdominal drain in place, complex wound dressing, or a PICC line. VNA services are arranged by our Case Management department while you are in the hospital.