Diverticular disease
Recurrent inflammation, abscess, narrowing, fistula, perforation, or persistent symptoms may prompt surgical consultation.
General Surgery • Suffolk County, New York
Intestinal & Colon Surgery
Diseases of the small intestine and colon range from planned surgical problems to urgent emergencies. Michael Orloff, MD, FACS, provides individualized evaluation and treatment planning with attention to diagnosis, bowel function, and recovery.
Small Intestine & Colon
Different organs with connected functions
The small intestine performs most nutrient absorption. The colon absorbs water, stores stool, and moves waste toward the rectum. Disease may affect a short segment, several areas, or the bowel’s ability to move contents normally.
Surgery may remove a diseased segment, relieve a blockage, repair a perforation, control infection or bleeding, or treat a tumor. Whenever safely possible, healthy bowel ends are reconnected.
Planning is diagnosis-specific
The decision to operate—and how much bowel to remove—depends on the underlying disease, its location and severity, overall health, prior operations, and whether the situation is elective or urgent.
Conditions Evaluated
Benign, inflammatory, obstructive, and malignant disease
Not every condition listed below requires surgery. Treatment is based on symptoms, complications, response to medical therapy, and the risk of waiting.
Colon tumors & complex polyps
Biopsy-proven cancer or a polyp that cannot be removed safely by colonoscopy may require segmental colon resection.
Intestinal obstruction
Scar tissue, hernias, tumors, inflammation, or twisting can block the intestine. Some cases resolve without surgery; others are emergencies.
Inflammatory bowel disease
Selected complications of Crohn’s disease or ulcerative colitis may require surgery coordinated with gastroenterology and other specialists.
Stricture, fistula, or perforation
A narrowed segment, abnormal connection, or bowel leak may cause infection, obstruction, pain, or difficulty maintaining nutrition.
Ischemia or uncontrolled bleeding
Reduced blood flow or bleeding that cannot be controlled by other methods may require urgent or emergency intestinal surgery.
Evaluation & Diagnosis
Defining the disease before choosing treatment
The workup depends on whether symptoms are chronic, newly diagnosed, or urgent. Prior imaging, colonoscopy, pathology, and operative reports are valuable.
History & examination
Symptoms, bowel patterns, prior attacks, weight changes, family history, medicines, and abdominal findings are reviewed.
Imaging
CT and other imaging can show inflammation, obstruction, perforation, abscess, tumor location, or disease extent.
Endoscopy & pathology
Colonoscopy can inspect the lining and obtain tissue. Pathology establishes the diagnosis when cancer or another lesion is suspected.
Risk & staging
Blood tests, nutrition, heart and lung risk, cancer staging, and specialist input help create a safe treatment plan.
Treatment Decisions
Observation, planned surgery, or emergency care
The safest timing is determined by the diagnosis, symptom burden, complication risk, and overall condition of the patient.
Medical management
Selected inflammation, partial obstruction, or chronic conditions may be managed with bowel rest, fluids, medication, nutrition support, drainage, or specialist-directed therapy.
Planned operation
Scheduled surgery allows time to optimize health, review anatomy and pathology, coordinate cancer care, and discuss reconnection and ostomy possibilities.
Emergency surgery
Perforation, bowel death, complete obstruction, uncontrolled bleeding, severe infection, or clinical deterioration may require immediate hospital treatment.
A surgical consultation does not automatically mean an operation. It provides an opportunity to confirm the diagnosis, compare options, understand warning signs, and decide whether the benefit of surgery outweighs its risks.
Intestinal & Colon Operations
Surgery tailored to the diseased segment
Operative findings may require modification of the original plan. The priority is safe removal or repair of disease while preserving healthy bowel and function when possible.
Bowel resection
A diseased portion of small intestine or colon is removed. The extent depends on blood supply, disease location, inflammation, pathology, and healthy margins.
- Small bowel resection
- Partial or segmental colectomy
- Right or left colectomy
- Sigmoid colon resection
Anastomosis
When conditions are favorable, the healthy ends are joined to restore intestinal continuity. A leak at this connection is an important potential complication.
- Requires healthy, well-perfused tissue
- May not be safe with severe contamination or instability
- Can occasionally need protection with a temporary ostomy
Colostomy or ileostomy
An end or loop of intestine may be brought through the abdominal wall to form a stoma. It may be temporary or permanent depending on the disease and operation.
- Stool empties into a fitted pouch
- Preoperative marking may help placement
- Specialized ostomy teaching supports recovery
Minimally invasive or open approach
Selected operations can be performed laparoscopically or with robotic assistance. Open surgery may be preferred for certain complex, scarred, unstable, or emergency situations.
- Approach chosen for the individual case
- Conversion to open may be necessary for safety
- The internal operation remains the same objective
Colon Cancer Surgery
Coordinated treatment based on stage and location
Surgery is a central treatment for many colon cancers. The involved colon segment and its regional lymph nodes are typically removed for complete pathologic evaluation.
Some patients need chemotherapy or another treatment before or after surgery. Recommendations depend on final pathology, stage, tumor biology, overall health, and multidisciplinary review.
Information used for planning
- Colonoscopy and biopsy results
- CT or other staging imaging
- Tumor location and possible obstruction
- Blood testing, including tumor markers when appropriate
- Prior abdominal operations and baseline function
- Medical oncology and other specialist input
Preparing & Recovering
Supporting healing and return of bowel function
Instructions vary with the operation, diagnosis, and hospital pathway. Follow the surgical team’s specific plan rather than a generic timeline.
Prepare
Review medications, blood thinners, allergies, nutrition, diabetes, smoking, bowel preparation if prescribed, and home support.
Operate
The diseased bowel is treated through a minimally invasive or open approach, with reconnection or ostomy as clinically appropriate.
Recover in hospital
Pain control, early walking, blood-clot prevention, breathing exercises, fluids, and diet advancement support recovery.
Continue at home
Monitor hydration, nutrition, bowel or ostomy output, incision healing, activity, and follow-up appointments.
Diet and hydration
Diet advances as tolerated and directed. Appetite and bowel patterns may take time to settle, particularly after a larger resection.
Bowel function
Temporary constipation, loose stools, urgency, bloating, or irregularity can occur. The expected pattern depends on the section removed.
Activity and follow-up
Walking is usually encouraged. Driving, lifting, work, and exercise restrictions are individualized, and pathology review may guide further care.
Risks to discuss before surgery
Potential risks include bleeding, infection, blood clots, pneumonia, anesthesia complications, injury to nearby organs, prolonged bowel inactivity, obstruction, anastomotic leak, abscess, wound problems, incisional hernia, altered bowel function, ostomy complications, recurrent disease, and need for another procedure.
Contact the surgical team as instructed for worsening pain, fever, persistent vomiting, increasing abdominal swelling, inability to eat or drink, wound redness or drainage, lack of expected bowel or ostomy output, heavy bleeding, chest pain, shortness of breath, or leg swelling. Call 911 for life-threatening symptoms.
Patient Questions
Frequently asked questions
These general answers cannot replace recommendations based on your diagnosis, imaging, pathology, examination, and medical history.
What is a colectomy?
A colectomy removes all or part of the colon. A partial or segmental colectomy removes the diseased section and may reconnect the healthy ends. The exact operation is named for the segment removed.
Will I need a colostomy or ileostomy?
Not everyone needs an ostomy. It may be necessary when immediate reconnection is unsafe or when a connection needs temporary protection. The likelihood and whether it may be temporary or permanent should be discussed before surgery whenever possible.
Can colon surgery be performed robotically or laparoscopically?
Many selected operations can use minimally invasive techniques. Prior surgery, anatomy, inflammation, tumor size, urgency, and overall health influence the approach. Conversion to open surgery may be the safest decision.
Does diverticulitis always require surgery?
No. Many episodes are treated without surgery. Consultation may be appropriate for recurrent or persistent disease, abscess, fistula, narrowing, obstruction, perforation, or other complications.
How long will I stay in the hospital?
Hospital stay varies with the procedure, surgical approach, return of bowel function, pain control, mobility, diet tolerance, complications, and home support. Emergency and complex operations may require longer recovery.
How will bowel movements change after surgery?
Frequency and consistency may temporarily change after bowel resection. The long-term pattern depends on the amount and location of bowel removed, underlying disease, diet, medication, and individual healing.
What happens to tissue removed during surgery?
Resected tissue is generally sent to pathology for examination. For cancer surgery, the report helps establish features such as tumor type, depth, margins, and lymph-node findings that guide additional treatment and follow-up.
Medical review: Michael Orloff, MD, FACS
General surgeon • Suffolk Surgery PLLC • Last updated September 2026
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Discuss an abnormal test, recurring symptoms, diverticular disease, obstruction, a colon lesion, or a surgical opinion with Dr. Orloff. Offices serve patients in Commack, Lindenhurst, and communities throughout Suffolk County.
This page provides general educational information and does not establish a physician–patient relationship or replace individualized medical advice. For a medical emergency, call 911.