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Dr. Ryan Jacob Bachofer, MD is an alternative medicine practitioner in Missoula, MT specializing in complementary and alternative medicine and colon & rectal surgery. He graduated from University of Washington School of Medicine in 2019 and has 7 years of experience. Dr. Ryan Jacob Bachofer, MD is affiliated with Providence and Providence General and Specialty Surgery.
Colectomy (Colon Resection)
Colectomy is surgery to remove all or part of the colon, or the longest part of the large intestine. The colon may be affected by diseases such as cancer or inflammatory bowel disease. In a colectomy, all or part of the colon that is infected, blocked, or cancerous is removed.
A colectomy may be performed by laparoscopic or open surgery. A laparoscopic colectomy requires several small cuts on the abdomen, and uses a thin tube with a camera, called a laparoscope. Laparoscopic colectomies are less invasive than open procedures. For some individuals, a laparoscopic colectomy may not be possible, and instead an open colectomy is performed. In an open colectomy, a large incision is made on the abdomen. Open colectomies typically require longer recovery periods.
After the incisions are made, a portion of the colon is removed, and the remaining ends of the colon are attached to each other in a procedure called anastomosis. Waste can continue to travel through the body as normal. However, in some situations, it may be necessary for the end of the colon to be attached to an opening in the abdomen, called a stoma. This procedure is called an ostomy. Types of ostomies include:
An ostomy bag will be attached to the skin to collect waste. If the entire colon is removed, either an ileostomy is performed, or the small intestine is connected to the anus and waste may pass through as normal.
Stomas may be permanent or temporary. If the stoma is temporary, the ends of the colon will be rejoined in a later procedure. Temporary stomas are generally used to allow time for the colon to heal following surgery.
A colectomy may take between one and four hours. Following the procedure, patients will need to consume a liquid and low fiber diet before gradually returning to their normal diet. Patients will need to stay in the hospital for three to seven days for monitoring. Full recovery and return to normal activity may take anywhere from a few weeks to several months.
Proctectomy (Rectum Resection)
Proctectomy is the surgical removal of the rectum, which, along with the anus and colon, is part of the large intestine. Rectal resection (removal) is used in the treatment of cancers and inflammatory bowel disease (IBD). For rectal cancers that have not spread outside of the large intestine, proctectomy is the primary treatment option.
The type of proctectomy performed depends on the severity and location of the cancer. If the cancer is confined to the rectum, only the rectum will need to be removed. Surgery can be done transanally, without an incision on the stomach, if the cancer can be reached through the anus.
For cancers higher in the rectum (closer to the colon), a low anterior resection is done. Low anterior resection uses an incision on the abdomen to access the cancerous portions of the rectum. The remaining parts of the large intestine can be connected in a procedure called anastomosis, and waste can exit through the anus as usual. In some cases, surgeons may choose to perform a type of anastomosis called temporary ileostomy. This involves attaching the end of the small intestine (ileum) to an opening in the abdomen (stoma), through which waste will exit the body and be collected in a small pouch. This is done if patients have previously undergone other cancer treatments, such as chemotherapy, to give the remaining ends of the large intestine time to heal before waste passes through them again. The ends will be reconnected at a later date, typically within several weeks.
For rectal cancer that has spread to the anus, abdominoperineal resection is an option. Abdominoperineal resection removes the cancerous lower rectum along with part or all of the anus and, sometimes, part of the colon. Removing part of the anus can lead to waste leaking, so a permanent colostomy is always done during abdominoperineal resection. Colostomy is similar to ileostomy, but instead of the ileum, the end of the colon is attached to a stoma, through which waste will flow into a collection bag. Surgeons will make incisions in the abdomen and around the anus to perform this procedure.
For the treatment of inflammatory bowel disease, proctocolectomy is done. IBD causes infections and ulcers to occur in the colon, but it can spread to other parts of the large intestine as well, such as the rectum. If this is the case, removing the rectum along with the colon in a proctocolectomy can be used to treat IBD in the event that it has not responded to conservative approaches, such as medication.
After a proctectomy, patients will need to stay in the hospital for around one week, if they experience no complications. Patients may receive restrictions on diet and physical activity following the procedure, as well as medication to treat any pain. If patients have a stoma, they will also be given instructions on how to care for it. Full recovery may take up to six weeks.
Robotic Surgery
Robotic surgery is a type of minimally invasive surgery, using a tiny opening to get inside the body instead of making a large cut. It uses small tools attached to a thin robotic arm, which is controlled by the surgeon. Robotic surgery may be referred to by the specific kind of robot that is used. The most advanced robot currently in use is called the da Vinci, and surgery using it is sometimes called da Vinci surgery.
There are many benefits to robotic surgery, both for the patient and the surgeon. Robotic surgery allows for more precise movements and increased control during very delicate surgical procedures. This makes performing surgery accurately much easier for surgeons and reduces fatigue. The smaller 'hand' of the robot can enter the body via a much smaller opening, which reduces the risk of infection and scarring and leads to a faster recovery. The robotic hands also contain tiny moveable cameras among their tools, giving surgeons a much closer view of the procedure than would be possible with traditional surgery.
Dr. Ryan Jacob Bachofer, MD graduated from University of Washington School of Medicine in 2019. He completed residency at University of Arizona Phoenix. He is certified by the American Board of Surgery, Surgery (General Surgery) and has a state license in Montana.
Medical School: University of Washington School of Medicine (2019)
Residency: University of Arizona Phoenix (2024)
Board Certification: American Board of Surgery, Surgery (General Surgery)
Licensed In: Montana
Dr. Ryan Jacob Bachofer, MD appears to accept the following insurance providers: Humana PPO, Blue Cross Of Idaho Health Service Medicare Advantage-HMO, BCBS MT TRIWEST, BCBS MT Medicaid, United Behavioral Health PPO, First Health-Coventry PPO, Blue Cross Of Idaho Health Service, Missoula County Employee Benefits Plan PPO, BCBS MT HMO-PPO, BCBS MT PPO, Pacific Source Health PPO, BCBS MT, Mountain Health Co-Op, Allegiance PPO, First Choice PPO, BCBS MT HMO, Interwest Health PPO and Blue Cross of Idaho Health Service.
According to our sources, Dr. Ryan Jacob Bachofer, MD accepts the following insurance providers:
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Dr. Bachofer specializes in the treatment of colon and rectal cancer, including hereditary cancer syndromes, as well as rectal prolapse, inflammatory bowel disease, and a wide range of anal conditions such as hemorrhoids, fistulas, incontinence, and anal cancer. She also has expertise in minimally invasive and robotic abdominal surgery.
