Dr. Domingo E. Galliano Jr.,
MD, FACS, FASCRS

MASTER SURGEON

Dr. Galliano is the most experienced Board Certified Colorectal Surgeon with Da Vinci Robotic Surgery in Lee, Charlotte, Sarasota, and De Soto Counties. He has performed over 1600 DaVinci Robotic procedures!

General Surgery

Board Certified by
the American Board of Surgery

Colon and Rectal Surgery

Board Certified by the The American Board of Colon and Renal Surgery (ABCRS)

Surgical Critical Care

Board Certified by The American Board of Surgery

HOSPITALS

Bayfront Health

Dr. Galliano is Medical Director of Bayfront Health's Colorectal Center of Excellence.

Why is it important you choose a Board Certified Surgeon?

A surgeon certified in general surgery by the American Board of Surgery has training, knowledge and experience related to the diagnosis and comprehensive management of surgical conditions.

3D Anal Ultrasound Testing

An examination using high-frequency sound waves to create 3D images of tissue layer beneath the surface of the rectum. A probe is put into the rectum through the anal opening. A small amount of fluid is put into the tip of the probe so that the surface of the probe is touching the inside of the rectum. This allows for better visualization of the tissue. It is a safe painless procedure and no radiation is used.

3D Anal ultrasound is extremely useful in the evaluation of fecal incontinence in men. Unlike women, the majority of men do not have a sphincter defect by anal ultrasound, and conservative management is usually successful in these patients. In contrast, in men with anal sphincter damage, almost all of these defects resulted from previous anal surgery. Conservative management rarely is successful in these cases, and surgical repair of the anal sphincter may be indicated. Therefore, because the presence or absence of sphincter damage on anal ultrasound usually predicts the response to nonoperative treatment, anal ultrasound should be used to guide the initial management of men with fecal incontinence.

IIntractable constipation is a major colon motility disorder. This prolonged constipation does not resolve with dietary changes or other simple therapeutic measures. Causes vary, but intractable constipation may be caused by several factors:

Abnormal colon contractions
Anal sphincter spasm leading to a functional obstruction
Dysfunctional innervation of colonic, anal sphincter, or pelvic floor muscles. These abnormalities can lead to an uncoordination among the colon, anal sphincter, and pelvic floor.
Normal defecation involves coordination between colonic contractions and relaxation of three muscles—the puborectalis, the internal anal sphincter, and the external anal sphincter—allowing stool to pass. Some patients with intractable constipation are unable to relax these usually contracted muscles to defecate successfully.

Fecal incontinence may be due to postpartum anal sphincter injuries or neurological damage even in the absence of obvious perineal trauma. Anal physiologic testing with transrectal ultrasound, manometry, and pudendal nerve terminal latency studies help to identify those patients with anal sphincter injuries who might benefit from anal sphincter repair.

Although two-dimensional endosonography is very valuable, it has some shortcomings. Images are normally produced only in the transaxial scanning plane with the anterior of the patient at the 12 o’clock position. The only way to extend a scanning in the proximal-distal direction is to move the probe farther in or out of the anal canal or rectum. Precise positioning of the probe is crucial to the examination. 3D anorectal endosonography extends the usefulness of anal endosonography.

The data from a series of closely-spaced two-dimensional images is combined to create a 3D image that can be freely rotated and sliced to allow the operator to get the most information out of the data – while not under the time pressure of the examination itself. In some situations, if it is difficult to pass the area occupied by a rectal tumor, only one acquisition of images may be possible. The data stored in a file originating from an acquisition can then be reviewed at any time

More information ABOUT 3D Anal Ultrasound Testing HERE.

SmartPill Capsule-Based GI Testing

This is a crucial test in evaluating patients with gastrointestinal symptoms such as irritable bowel syndrome (IBS), bloating, nausea, abdominal pain, constipation, and fullness.

It is pain-free and less invasive than most other GI procedures. Once the capsule is ingested, this device collects important information such as pressure, PH and temperature and transmits this data to a receiver the patient wears on a belt for a period of four days.

The physician then downloads the input to his computer and reviews the test results with the patient. This greatly facilitates the patient’s diagnosis and treatment plan without any discomfort or disruption of normal activities for the patient.