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Minimally Invasive

Minimally Invasive treatments for colorectal procedures

When people think of colorectal surgical treatments, their first thought often goes to invasive surgery. These days, vast advancements have been made in minimally-invasive procedures that can be used to treat a variety of colorectal conditions and help patients return to more normal lives much sooner than they would have with older traditional treatments.

At Huntington Colorectal Surgeons, we are a leading colorectal and gastrointestinal treatment facility in Pasadena, California. In 2008, Dr. Howard Kaufman was the first surgeon in California to remove part of the colon through a single incision in the belly button. Since that time, we have been early adopters in minimally invasive robotic techniques for colon and rectal surgery and treat all of our patients using Enhanced Recovery Pathways, that are associated with less pain and need for opiates, earlier return to eating, earlier discharge from hospital, faster recovery at home, and faster return to normal activities.

Our staff of leading colorectal surgeons like Dr. Howard Kaufman, Dr, Gabriel Akopian, and Dr. Juliane Golan, have developed novel treatment techniques that utilize small incisions, minimize your discomfort, and facilitate faster healing. Our priority is to ensure that no unnecessary diagnostic and surgical tools, technology, and chemicals are introduced into your body and that you benefit from premium-quality care.

Visit us to see our world-class treatment facilities.

When do minimally-invasive colorectal
treatments become useful?

Invasive treatments that involve larger incisions are rarely the best option for treating colorectal disease. You should consider minimally-invasive treatments when:

  • You want a quicker recovery with less pain and scarring.
  • You have recently had another surgery, whose results could be impacted with invasive treatment.
  • You have a medical condition that can affect the healing process of an invasive procedure.
  • You are on anticoagulants or antiplatelet drugs.
  • You don’t want the large scars that come with invasive procedures.
  • You can’t devote long downtime for healing.
  • You don’t want to take too many medications post-surgery.

In experienced hands, minimally-invasive treatments are safer on the body because they don’t involve larger incisions that have higher chances of infections and hernia formation. Surgical stress to the body and organ systems is minimized resulting in fewer complications and shorter hospital stays. There are smaller scars that are present after the treatment.

How are minimally-invasive
procedures performed?

Adjacent to our office is a full service line of advanced imaging equipment and state-of-the-art surgical suites. We may use the the following to more accurately plan and complete surgery:

  • CT or MRI scanning for diagnosis and treatment planning.
  • Laparoscopy for diagnosis and biopsies.
  • Da Vinci robotic systems for surgical treatments.
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Enhanced recovery pathways

If you had surgery more than 10 years ago, your experience might be markedly different. You might end up with a large incision, wake up with a tube in your nose that drained your stomach, be kept in bed for several days, had food withheld, and had the main component of your pain management include opiates alone, which has many adverse effects on the body.

Over the past decade, the surgeons at Huntington Colorectal Surgeons in collaboration with Huntington Hospital teams have pioneered and led advanced surgical recovery using techniques such as prehabilitation (getting the body ready for the main event of surgery ahead of time), specialized nutritional drinks that boost the immune system, avoiding starvation prior to surgery, specific preoperative bowel preparation, and minimally invasive surgery.

In the operating room, we work closely with our anesthesia colleagues to help minimize opiate needs by having nerve blocks performed with long-acting local anesthetics, limiting fluid overload, and carefully monitoring organ system function. Postoperatively, we continue with opiate sparing techniques using multimodal analgesia (multiple pain medications that block pain receptors at multiple pathways) and allow patients to be out of bed early and start on a diet often the first night of surgery. Many of our patients have very limited pain, tolerate their diets, and go home in 1 to 3 days after a surgery that would have kept them in the hospital for at least 7 days just 10 years ago.

Our practitioners are fully trained in using these state-of-the-art technologies, and you can trust us for premium care.

Minimally-invasive treatments we offer for anorectal disorders

At Huntington Colorectal Surgeons, our board-certified specialists can diagnose and treat the following anorectal conditions through minimally-invasive procedures:


Hemorrhoids are swollen veins and cushions of tissue located in the low rectum and anus. Hemorrhoids can bleed, prolapse (descend out of the anal area), cause itching, and make hygiene difficult. We offer office-based therapy with the rubber band ligation procedure. This procedure is performed during a short office visit with minimal preparation and very limited pain. Hemorrhoids are essentially choked off by a tight rubber band placed above areas that sense pain. Most patients experience no discomfort at all, but some experience a dull ache in the area for 24 hours. Complications are rare.

Other treatment options are available including hemorrhoid energy therapy (HET), where the blood flow is reduced to hemorrhoids by using a device that imparts energy to the hemorrhoidal blood vessels and seals them off. That procedure is typically done in the endoscopy suite under sedation. For more advanced hemorrhoids, we are able to operate with less pain using advanced technologies such as Total Hemorrhoidal Dearterialization (THD) or even traditional surgical hemorrhoidectomy utilizing long-acting local anesthetics and multimodal pain medications. Hemorrhoid surgery does not need to be as painful as it had been in past years!

Injection Therapy to bulk the upper part of the anal canal

Solesta for Fecal Incontinence: Solesta is a biocompatible material that is injected into the upper part of the anal canal. Four 1cc injections are performed at right angles to each other in order to bulk the tissue to prevent passive leakage of stool. An additional four injections may be necessary. Contact us to see if this treatment is appropriate for you.

Other Anorectal Disorders

Other anorectal disorders like anal abscesses, fissures, fistulae, and warts, are also treated surgically utilizing long-acting local anesthetics and multimodal analgesia to reduce pain and opiate requirements. We minimize incisions and preserve tissue as much as possible.

Sacral Nerve Stimulation Therapy to treat fecal incontinence

Our colorectal specialists use the state-of-the-art Sacral Nerve Stimulation Therapy in Pasadena to treat fecal incontinence.

The sacral nerves control the movement of the pelvis and the lower limbs. They are responsible for the functioning of the pelvic floor and the opening/closing of the rectum. If the sacral nerve is damaged, then the pelvic floor starts to dysfunction, leading to fecal incontinence.

In Sacral Nerve Stimulation Therapy, electrical pulses are directed at the sacral nerves. These pulses control the contraction and expansion of the pelvic floor and anal sphincters, preventing fecal leakage.

How is Sacral Nerve Stimulation Therapy performed?

The procedure starts with local anesthesia to numb the lower part of the body. The first stage of the procedure starts with the insertion of a thin lead wire near the sacral foramen. Vibrations are sent through the wire and you are asked to confirm where you experience the slight pulling sensations. Based on your inputs, the position of the wire is adjusted so that the vibrations are felt in the anorectal region.

The lead wire is then moved deeper into the right or left buttock (this depends on your unique requirements) and brought out through the skin, where it will be connected to an external stimulation device. The vibrations from this device correct the erroneous neural impulses that cause your pelvic floor or anorectal muscles to malfunction. After the procedure, the settings of the device are adjusted to suit your needs and comfort.

This device is a temporary solution that will be used for about 2-3 weeks, to verify whether you benefit from sacral nerve therapy. After the trial period, you will be asked to return to our Pasadena colorectal surgical facility for a check-up. Your fecal incontinence symptoms should have decreased in frequency by at least 50% for you to be eligible for stage two of the treatment.

In stage two, the temporary device is removed and the permanent neurostimulator is implanted. Using minimally-invasive robotic surgery, we make a small pocket just below the surface of the skin. The neurostimulator is implanted in this pocket and a small lead is connected to this device.
The neurostimulator we use is the Axonics System, a cutting-edge technology designed specifically for sacral nerve therapy. The titanium-ceramic construction protects it from damage inside the body, keeping you safe. The coin-size device is inconspicuous and has a functional life of 15 years.

The neurostimulator comes with a discreet patient control programmer, that is easy to use and can be tucked away in your pocket. With this, you can control the strength of the electrical impulses, customizing your therapy as you heal. The wireless charging system makes the device easy-to-use and you only need to charge it once a month.

Once the procedure is complete, our doctors teach you how to use the remote control and adjust the settings as necessary. You will be asked to come in for post-op checks to ensure the therapy is producing the desired results.

The neurostimulator, when switched on, is completely pain-free and you feel only gentle vibrations near the anorectal region. You will notice an immediate difference in your ability to control your bowels and you’ll be able to return to your normal routine in no time.
If you have any questions about the procedure or require advice on lifestyle changes to prevent fecal incontinence, feel free to speak to our surgeons. You can also visit our facility for more information about Sacral Nerve Stimulation in Pasadena, California.

Contact Us Today!

Our number one priority is helping you regain your colorectal health and, with it, your quality of life. Contact us today to schedule a consultation with our team.


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Contact Us (626) 397-5896