Call Us Today 248-334-3197
5220 Highland Road, Suite 200
Waterford, MI 48327

Surgery, Surgeon, Surgical Mask.
Dr. Tootla Robotics provides colonoscopy related services, including the procedure itself, colon prep, and post-op care. Preparing for this procedure begins several days before the appointment and continues until 10pm the night before the procedure. The procedure itself takes an hour or so, and you’ll need someone to drive you to and from the appointment. After your procedure, Dr. Tootla will advise you of possible side effects and recovery times. He will also review the results of the colonoscopy, scheduling any follow up care if needed.


What Is Colorectal Cancer Screening?

A screening test is used to look for a disease when a person is not showing any symptoms.

Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early, when treatment works best.

Screening Guidelines

Regular screening, beginning at age 50, is the key to preventing colorectal cancer. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 years and continuing until age 75 years.

When Should I Begin to Get Screened?

You should begin screening for colorectal cancer soon after turning 50, and then continue getting screened at regular intervals. However, you may need to be tested earlier than 50 or more often than other people if:

  • You or a close relative have had colorectal polyps or colorectal cancer.

  • You have inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.

  • You have genetic syndrome such as familial adenomatous polyposis (FAP) hereditary non-polyposis colorectal cancer (Lynch syndrome).

You can call to schedule an appointment at our office to speak with Dr. Tootla about when you should begin screening and how often you should be tested.
Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports, which allow access to the inside of the patient.

The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.

What are the advantages to Laparoscopic Surgery?

  • Less post operative discomfort since the incisions are much smaller

  • Quicker recovery times

  • Shorter hospital stays

  • Earlier return to full activities

  • Much smaller scars

  • There may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.

Robot Assisted Surgery

Da Vinci™ is a computer-assisted robotic system that expands a surgeon's capability to operate within the abdomen in a less invasive way during laparoscopic surgery. Da Vinci™ system allows greater precision and better visualization compared to standard laparoscopic surgery.

The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is remote from the patient, working a few feet from the operating table while seated at a computer console with a three-dimensional view of the operating field.

The physician operates two masters (similar to joysticks) that control the two mechanical arms on the robot. The mechanical arms are armed with specialized instruments with hand-like movements, which carry out the surgery through tiny holes in the patient’s abdomen. Three small incisions (approximately one half inch) are made in the abdomen, through which a video camera and the robotic arms with the highly-specialized instruments are introduced. The video camera provides high-resolution, high magnification and depth perception.

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Miralax Bowel Prep

Several days before your scheduled procedure:
Purchase over the counter: two 32 ounce bottles of Gatorade, (any flavor but NOT red or purple), 7 Dulcolax tablets and one 255 gram bottle of Miralax (prescription).

Five days prior to colonoscopy:
STOP taking any blood thinners (Plavix, Coumadin, Aspirin).

Two days prior to colonoscopy:

Take 3 Dulcolax tablets at bed time. Day before colonoscopy:
Follow a clear liquid diet, NO SOLID FOODS!! You may have liquids such as apple juice, jello (no fruit added and no red), bouillon, broth, black coffee or tea (no cream or milk), water, white grape juice, ginger ale, 7-Up, Vernors, Coke. NO RED OR PURPLE LIQUIDS AND NO DAIRY PRODUCTS!!

2 PM:

1. Take 4 Dulcolax tablets with water and continue taking clear liquids.
2. Mix 1/2 of the Miralax in each 32 ounce bottle of Gatorade until dissolved.
5 PM:

Drink the first bottle of the Miralax and Gatorade mixture, 8 ounces every 20 minutes until finished.

10 PM:

Drink the second bottle of the Miralax and Gatorade mixture until it's gone.


  • You may apply a petroleum based product or diaper rash ointment to the rectal area if you experience discomfort from frequent stools.

  • You MAY take your blood pressure medications with a sip of water the morning of your procedure.

  • **You MUST have a driver with you, who must remain in the waiting room during your procedure.**

  • If you have any questions or concerns, please call the office at 248-334-3197.

What is a Colonoscopy?

A colonoscopy is a long tube with a fiber optic light source and the act of examining your colon with this tube is called a colonoscopy. We examine the entire colon which starts at the lower left side of your abdomen, travels up and arches across the upper abdomen to the left side of your chest, then downwards towards the pelvis and ends in the rectum or more accurately at the anus. Since the colon is 6 to 7 feet long, the colonoscope is approximately the same length.

Why do I need this test?

There are many reasons for doing a colonoscopy and you may have one or more of the following:

1. Bleeding which cannot be explained by examining the lower end of the colon or rectum.
2. Your lower G.I. or colon x-ray, also called a barium enema, showed a growth or a possibility of a growth such as a polyp or a lesion.
3. You have had a history of colon polyps or colon cancer.
4. You have a first degree family history of colon cancer or polyps such as your mother, father, brother or sister.
5. You have had a stool test which showed evidence of blood which could not be seen with the naked eye.
6. You have unexplained anemia or unexplained weight loss.
7. You have recently noted a change in bowel habits.
8. You have or have a history of colitis.
9. You have abdominal pains which your own doctor or we cannot explain by doing all other exams.
Do I continue taking my medications which preparing for this test?

  • ***Aspirin and Blood thinners such as Plavix and Coumadin must be stopped at least 3 days prior to the exam.***

  • You are to take all your other medications at the regular time unless you are instructed not to do so.

  • If you are a diabetic, please do not take your diabetic medication on the day of your procedure.

  • You will be instructed if certain medications should not be taken and you may be given certain medications to take at home, such as antibiotics if you have an artificial heart valve or other heart conditions.

  • You must let the doctor know all the medications you are taking and if you are allergic to certain medications.

  • If you have any questions regarding which medications you should stop taking, please contact the office.

Will I be asleep for this test?

Yes. Anestheia is administered by an Anesthesiologist. You must not eat or drink anything after midnight prior to your procedure in order for anesthesia to be given to you.

Do I need to bring someone with me on the day of my procedure?

Yes. You MUST bring a member of your family or a friend with you to drive you home. You will not be allowed to drive all day because of the anesthesia. Your procedure will not be performed unless you have a driver with you.

What are the complications of this test?

As with any procedure, there is some risk to colonoscopy. This includes bleeding, perforation and other complications associated with any procedure. However, these risks are minimal.

How soon will I get a report on my exam?

Most patients are too drowsy at the end of the exam for Dr. Tootla to talk to them. So at the end of the procedure we will come out to the waiting area and explain to your family member or friend what we found and what was done. If you prefer that Dr. Tootla not talk with your family or friend, please let him know in advance. When we remove a growth or do a biopsy we send the specimen to the laboratory for analysis. For the pathologist to prepare and analyze the tissue it takes anywhere from 4 to 6 days. We prefer you to call the office within 24 hours to make a follow-up appointment so we have the opportunity to discuss the findings with you and any type of follow-up that you may require in the future.

Questions or Concerns

If you have any questions or concerns about this procedure after you have read this information please feel free to call us so that we can explain anything you don't understand. We always feel that we should take care of our patients in the same manner and respect that we would want to be taken care of. You give us the privilege to take care of your body and we will do the best we know how.
Post-operative Instructions

Excision of thrombosed hemorrhoid

A thrombosed hemorrhoid is a hemorrhoid that has a blood clot in it. This is usually an external hemorrhoid. The symptoms include pain and swelling on the outside. On occasion it may rupture and bleeding will occur. The treatment of this condition is to remove the blood clot, which provides relief from the pain. This is done under local anesthesia.

After the procedure is completed a pressure dressing is applied. This dressing is left in place until the next day. The dressing is then removed and warm sitz baths are taken about three to four times a day for about 15 minutes. You will also asked to come to the office for a follow up within a week to examine the operative area. If there is excessive bleeding please call the office so that you can be seen on an emergency basis. Please remember this is very slow healing area and it may take over a month for this area to heal.

Rubber band Ligation of hemorrhoids

Hemorrhoids are very common. Hemorrhoids are varicose veins filled with liquid blood. With the passage of time, these veins get larger and start to protrude and cause different kinds of problems. They can cause irritation, discomfort, and soilage which makes it difficult to keep the area clean. They may bleed and the bleeding is usually bright red with or without bowel movements. After a detailed history is taken, Dr. Tootla will examine you. A small rubber band is placed over the hemorrhoid, cutting off its blood supply.

The hemorrhoid and band will fall of in a few days and the wound usually heals in a week or two. At the time of your treatment you may feel some discomfort or pain, which usually lasts 24-48 hours. Mild to moderate pain medication may be necessary and soaking in a warm tub or sitz bath for about 15 minutes will be helpful. Usually only one hemorrhoid will be banded at a time to prevent excess pain and swelling. Typically the banding treatment can be completed on the third visit. After your treatment you may resume your normal activity.

We recommend that you do not strain or get constipated. You may notice mild bleeding 3-5 days later, but if the bleeding is severe, call us immediately. One out of 200 patients may experience with type of bleeding. Allow 2-3 weeks after your last visit for the area to heal up. There is no special diet necessary but avoid constipation or diarrhea. A fiber supplement, such as Metamucil, may be recommended.

Ano-rectal surgery, including rectal abscess, anal fistula, anal fissures and both internal and external hemorrhoidectomy (for an explanation of these procedures follow the link to the American Society of Colon and Rectal Surgeons.

The procedure will be explained to you before you are scheduled for surgery. These procedures are done as an outpatient. At the time of completion of surgery, a local anesthetic will be injected into the operative site so that no pain will be felt for at least 4-6 hours. A prescription for oral pain medication will be given to you at discharge. If enough relief is not achieved ice packs may be applied to the operative area. Dressings are to be removed the next day and warm sitz baths are started 4-6 times a day for about 15 minutes.
5220 Highland Road, Suite 200 Waterford, MI 48327