Our colorectal service has a ‘target referral’ system and fast-tracks investigations for the management of all suspected colorectal cancer. It also provides specialist surgical treatment for some patients within the North Central London Sector diagnosed with bowel cancer under the NHS bowel cancer screening programme based at UCLH. In addition to conventional surgery, the service also offers minimal access or keyhole surgery for many patients requiring an operation. The state-of-the-art Gastro-intestinal (GI) Physiology Unit also deals with investigation and management of constipation, incontinence, irritable bowel syndrome (IBS) and upper GI functional disorders.
We are also the base for the nutrition service to UCLH, which is integral to tertiary work in intestinal failure and provides the medical input to the Trust’s nutrition support team. A full range of nutritional investigations (including bioelectrical impedance and indirect calorimetry) is offered, together with a comprehensive programme of nutritional support, including Home Parenteral Nutrition.
A specialist adolescent Inflammatory Bowel Disease (IBD) service exists, with close links to the paediatric services within UCLH and at Great Ormond Street NHS Hospital.
The Colorectal service is linked to floors 9 and 13 of the UCLH Tower.
There are regular multi-disciplinary clinical team meetings which are integrated with the services and together make decisions regarding recommended treatment of patients.
The unit has a well-established ‘Target Referral’ system and fast track investigations for the management of all suspected colorectal cancer. In addition to conventional open surgery we are now able to offer minimal access or keyhole surgery for many patients requiring operation for their cancer.
Inflammatory bowel disease
Allied to the department of gastroenterology the unit now offers a specialist IBD service. We are able to offer multidisciplinary management of patients from their initial presentation of Crohn’s or colitis through to complex surgery such as ileoanal pouch. In addition, we offer a national referral service for the management of complex problems such as nutritional support, intestinal failure and enterocutaneous fistula.
With an increase in consultant staff, the unit is now able to offer rapid assessment of all routine proctological problems.
Complex pelvic surgery & pelvic floor dysfunction
Disorders of the pelvic floor are complex and require a multidisciplinary approach. A collaborative service currently exists between the colorectal department, the department of GI physiology and with specialists within the Trust gynaecology service for the diagnosis and treatment of these complex problems.
This service was initially developed to support men with anorectal disease – particularly HIV positive patients, where serious complications can present. Through the development of this service the department have also employed new screening and therapeutic techniques (in collaboration with the Department of laser therapy) for Anal Intra-epithelial Neoplasia (AIN).
Laparoscopic colorectal surgery
The unit offers laparoscopic colorectal surgery utilising state-of-the-art facilities to treat inflammatory bowel disease, diverticular disease, colorectal cancer and other benign pelvic floor disorders. The future focus of the unit is to establish a specialist centre for the training and teaching of advanced laparoscopic colorectal surgery and welcome referrals related to this area of surgery.
- Target referrals are around two weeks for cancer
- Routine referrals are around six weeks
- Surgery takes place within approximately six weeks
Patient support services
Support for patients is provided by the consultants' team and a clinical nurse specialist throughout their treatment programme.
Patient aftercare will be shared between the hospital and GP. Regular follow-up will be arranged even prior to discharge.