This book provides clear surgical options when the cases are not "routine".  It follows both a "how to" manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. In each chapter, international experts address how to avoid being in tough surgical situations through preoperative planning, how to better deal with commonly encountered intra-operative findings, how to deal with difficult laparoscopic, open, endoscopic, and anorectal cases, and how to avoid medico-legal issues.

Colorectal Surgery Consultation is simple and succinct and provides pragmatic advice and reproducible techniques that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems through endoscopic and endoluminal approaches that may make the difference in patient outcomes.

How to Avoid Getting into Difficult Operative Situations

Principles in Approaching Difficult Operative Situations
Extensive Intraabdominal Adhesions
Intraoperative Injury to Small or Large bowel
Injury to the Rectum During Pelvic Surgery
Appendectomy Pathology Report Returns Adenocarcinoma, Carcinoid or Appendiceal Mucinous Neoplasm
Unexpected Findings: Normal Appendix During Appendectomy
During Sigmoid Resection for Diverticulitis the Patient is Found to have Diffuse Diverticulosis
Intraoperatively the Patient is Found Incidentally to have Colon or Small Bowel Inflammation
Unexpected Findings:  Intraoperatively Suspected Colon Cancer Turns Out to be Rectal Cancer
Unexpected Findings: Can't Find the Colon Lesion
Unexpected Findings: The "Malignant Polyp"
Unexpected Findings: Positive Air Leak
Unexpected Findings: Anastomotic "Donut" Problems: Incomplete or Missing Donuts with a Negative Leak Test
Unexpected Findings: Locally Advanced Colon Cancer
Difficult to Close Abdomen
Difficult Splenic Flexure Take Down
Hartmann Takedown: Managing the Hard to Reach or Devascularized Left Colon
Cannot Find the Rectal Stump During Hartmann Reversal
Perforated the Rectal Stump while Passing an EEA Stapler
Inability to Pass EEA Stapler
The J Pouch Does Not Reach
Intraperative Management of Bleeding at Stapled Side-to-Side Anastomosis
Postoperative End-to-End Anastomotic Bleeding
Postoperative Anastomotic Leak After Low Anterior Resection
Colon Does Not Reach for a Coloanal Anastomosis
Cannot Find Internal Opening of Fistula-in-Ano
How to Deal with Crohn's Friable and Fragile Mesentery
Ulcerative Colitis with Severe Inflammation and Friable Tissues.  How to Avoid Intra-operative Perforation and Manage the Colorectal Stump
Patient Develops Anastomotic Stricture After Low Anastomosis with Diverting Ileostomy
Presacral Bleeding
Cannot Extract the Circular Stapler
General Technical Recommendations for Difficult Laparoscopic Cases
Dislodged Laparoscopic Cannulas
How to Keep the Small Bowel from Getting in the Way of a Laparoscopic Operation
Laparoscopic Suturing
Re-look After Laparoscopic Resection
Retraction of a "Floppy Uterus" Encountered During Minimally Invasive Rectal Resection
Bleeding During Colectomy
Cannot Find the Ureter
Ileum Becomes Ischemic Due to Torsion During J Pouch Creation
Difficult Laparoscopic Rectal Dissection
Techniques for Laparoscopic Distal Rectal Stapled Transection
How to Avoid "Twisting" an Ileocolic or Ileorectal Anastomosis
How to Deal with Splenic Injury During Laparoscopic Flexure Mobilization
Entering the Reoperative Hostile Abdomen Laparoscopically
Manage Inferior Epigastric Bleeding
Hard to Reach Colostomy/Ileostomy
Stoma Prolapse
Ileostomy Retracts Below the Skin
Difficulties with the stapled hemorrhoidectomy procedure
Symptomatic Long Residual Rectal Cuff Status Post J Pouch
Difficult Anterior Perineal Dissection During Abdominoperineal Resection
Anastomotic Sinus After Low Anterior Resection and Diverting Loop Ileostomy
Cannot Pass the Scope Into the Cecum
Difficult to Remove Polyp
Bleeding After Colonoscopic Polypectomy
The Thin Colon After Endoscopic Mucosal Resection
Cannot Remove the Snare During Colonoscopy
How to Address a Polyp Involving the Appendiceal Orifice
Medico-legal Issues in Minimally Invasive Colon and Rectal Surgery: A Primer.