Dr. Raphael Micah Byrne, MD

Patients may be asked to drink only liquids in the days before a colonoscopy, or they may be given an enema to remove residual fecal matter. Before the exam, patients are given medication to help them relax, and then lay on their side on a table. The scope is inserted into the anus and gently moved all the way through the large intestine. Air may be pumped into the intestine to improve the view for the physician. Any polyps that are found will be removed. Then the colonoscope will be withdrawn. A colonoscopy is not usually painful, but patients may feel some bloating or have some cramps right afterward. If patients have polyps removed, they might experience a small amount of bleeding. Any side effects should go away within a few hours.

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.

SNS surgery has two parts. The first part is an evaluation phase, during which it is determined if neurostimulation is effective treatment option for patients. Patients lie on their stomachs while a temporary electrode lead, through which electrical signals will travel, is inserted into their lower back. A permanent lead may also be used, and it would remain in place should the trial period prove successful. The lead is connected to an external neurostimulator. The procedure takes approximately one hour and may be performed in a doctor's office, hospital, or surgical center. After the procedure, patients are required to keep a log of their toilet habits over approximately two weeks, and they may need to limit their activities during this time. If patients' symptoms do not improve after the trial, they may repeat the test phase or discuss other treatment options with their doctors.

If the trial stimulator is effective, patients will undergo the second phase of SNS surgery, which is permanent implantation. In the second stage of surgery, the temporary lead (if used) will be replaced with a permanent lead. Then the sacral nerve stimulator will be implanted subcutaneously (under the skin) in the upper buttock. Patients should be able to return home the day of their procedure.

If patients are sore after surgery, their doctors may give them medication. The sacral nerve stimulator will be programmed after the procedure, and when it is turned on, patients should feel a sensation similar to pulling, tapping, tingling, or pulsing. Patients will need to work with their doctors during follow-up appointments to determine the most effective settings for the stimulator. Patients will be given instructions on how to adjust it themselves at home. The stimulator is powered by a battery that will last approximately five years, after which it can be replaced.