About Dr. Paul Sitzler

Melbourne Colon Surgery

Melbourne Colon Surgery represents the practice of colon and rectal surgery based at Epworth Richmond Hospital. Paul Sitzler has been practicing at this site for over 30 years. This site is the only site that has the facility to perform robotic colon and rectal surgery and abdominal wall surgery. The hospital has an emergency department ans a ICU, making it well-equipment for major colon and rectal surgery. Colonoscopy is performed routinely in this hospital. The well-appointed rooms on the 9th floor is where consulting is performed. Minor procedures can be performed during consulting. Paul works at Box Hill Hospital where public patients can be taken. Paul also has begun work at Kew Endoscopy which is another facility that endoscopy can be performed for patients in the eastern suburbs of Melbourne..The aim is to provide up-to-date quality service in the field of colorectal surgery. Through initial assessment, diagnosis, investigation, surgical treatment, and follow-up, the focus remains on efficient, state-of-the-art management.

Dr Paul Sitzler has an associated rooms and practice in bayside Melbourne, called the Bayside Colorectal Group where patients from bayside Melbourne are treated.

Robotic Surgery

Robotic surgery in colorectal conditions is established in many centres and accepted as a mode in minimally invasive surgery by most world authorities. Studies are ongoing, in particular when applied to colon and rectal cancer but there have been no significant negative factors found for this technique in cancer surgery to date. In fact the positive of clearer view and stable platform that the robot offers can make this technique a better alternative to open and even laparoscopic surgery in some cases.

We perform robotic colorectal surgery currently for colorectal conditions at Epworth Hospital Richmond where the robot is located in the hospitals we practice at. Currently robotic surgery is recommended for some cases of distal colon and rectal conditions requiring high and low anterior resections. These pathologies can be cancer or benign such as surgery for diverticular disease.

The other condition that can be performed robotically is surgery for rectal prolapse including ventral rectopexy.

Abdominal wall surgery has also been an area where robotics is effective. Mr Sitzler will advise if he thinks your condition is suitable for robotic surgery, and you the patient can select this technique if you are comforatable with this approach

LOWER ENDOSCOPY

Colonoscopy

This procedure is for evaluation of symptoms and diseases of the colon. Altered bowel habit, rectal bleeding and unexplained abdominal pain are common indications. Follow up colonoscopy is often done if you have a history of polyps in the bowel, a history of bowel cancer in the past, or a family history of bowel cancer.

The preparation is more involved than gastroscopy. The colon needs to be cleansed with a bowel preparation prior to the procedure. If the bowel preparation is unsatisfactory then the procedure is generally unsatisfactory and must be repeated.

The preparation must be taken in advance of the procedure. Once the preparation is started, NO SOLID FOOD must be eaten UNTIL AFTER THE PROCEDURE.

Once the preparation is begun, as well as the preparation, you are allowed, MODERATE AMOUNTS OF CLEAR FLUIDS until you fast for your procedure.

Again certain diabetic tablets and anti-coagulants must be ceased prior to your procedure, so please check with the booking staff or myself. You will be given detailed instructions on your bowel preparation as part of the booking process.

Colonoscopy has 2 main risks associated with it. Bleeding can occur after a polyp has been removed. Immediate or primary heamorrhage is uncommon and can usually be controlled with diathermy[electrocautery] or clipping at the time.

Bleeding is more likely to occur in a delayed fashion at about 5 days after polyp removal. If you experience moderate or large volume bleeding at this time you must immediately go to a large hospital emergency centre for treatment. Treatment is often resuscitation only treatment, where once you are stabilized, no further bleeding occurs. Very rarely re-colonoscope and clipping or even surgery can be required to stop the bleeding. This complication can occur at a rate of approximately 1:500 if there is a polyp taken.

The other complication is colon perforation. This thankfully rare but very serious. If you experience significant pain after colonoscopy then this complication needs to be ruled out.

You must let medical staff know if you have any pain when you wake up after the procedure. If after assessment there is a possibility that a bowel puncture has occurred treatment with antibiotics and investigation with X-Rays and scanning will often take place. If your condition worsens/fails to improve/or you deteriorate in your nursing observations, urgent surgery is required to close the puncture. This could be done simply but in some cases a stoma-bag is placed is part of your surgery.

The risk of this complication is varied in the literature but most experienced endoscopists will see this only 1:3000.

Booking your procedure:

• • Monday to Friday
• • 9.00am - 5.00pm
• • (03) 9428 8064 or (03) 9521 8484

Please remember to bring:

• Your referring doctors letter
• A list of your current medications if not provided by your doctor
• Your pension card, medicare card, veterans card
• Your private health insurance card or details
• Relevant pathology results or X-Rays/Scans