Why is it important?
Patients are more likely to have better outcomes if their IBD surgery is undertaken by a colorectal surgeon with relevant expertise and experience and supported by an experienced clinical team.
The surgeon should be able to make informed decisions about the timing and need for surgery in collaboration with the patient.
They should have a substantial amount of their working time devoted to IBD, be a core member of the IBD multidisciplinary team, and work in a unit where IBD surgery is performed regularly. The clinical team’s expertise and experience will help ensure surgery is undertaken at the right time – as well as the quality of clinical care before, during and after surgery.
If this expertise isn’t available locally, patients who need either elective or urgent surgery should be referred to a specialist unit in a timely way. Referral to a unit with specialist expertise should be considered for paediatric or adult IBD patients with complex or recurrent disease, including revision and excision pouch surgery, rectovaginal fistula, and Kock pouch. Emergency procedures may sometimes be performed by a surgeon with the appropriate skills and experience, but less specialist experience. However, every effort should be made to avoid this unless absolutely necessary.
Children and young people need particular attention. It’s important for operations to be carried out by surgeons with specific experience of children and young people with IBD. This should always follow discussion with a dedicated paediatric gastroenterologist.
Where local paediatric surgeons lack experience of the relevant procedure, it may be necessary to either perform surgery jointly with a colorectal surgeon or refer to a paediatric surgeon with the necessary experience.