Colon Surgery: Robert Henderson
Like many people, Robert Henderson of Upton didn’t plan on surgery. But when a colonoscopy detected a tumor in his colon, planning had very little to do with it. “It all happened so quickly,” says Robert who thought his abdominal pain was due to diverticulitis. Seventeen days after the colonoscopy, Robert underwent a laparoscopic colectomy. “The tumor measured three to five inches,” he explains. “And while the tissue tested was benign, the tumor was pushing into the intestine’s wall, and was too big to be left in.”
With the recent addition of Milford Regional’s new Surgery Center in the fall of 2004, which houses eight of the nation’s most advanced operating rooms, the medical center also welcomed the addition of several highly regarded surgeons with expertise in advanced laparoscopic (minimally invasive) surgery. This advanced surgery utilizes a special camera and small surgical instruments that are threaded through several small holes in the abdomen. The camera, which is on the end of a scope, guides the surgery by allowing the surgeon to see inside the abdomen as it is projected onto a computer monitor. In fact, the view is often better than traditional or open surgery when a larger incision is made into the abdomen. Robert’s surgeon and a specialist in minimally invasive surgery, Patrick M. McEnaney, MD, explains, “When performing a laparoscopic procedure, the camera is closer to the tissue than your eyesight would be in an open procedure. So performing surgery laparoscopically actually allows you to visualize the surgery better.”
A laparoscopic colectomy uses this same technology to remove diseased parts of the colon. The most common reason for this surgery is to treat colon cancer. Fortunately, though colorectal cancer is one of the most common types of cancer, early detection through screenings such as colonoscopies means polyps can be removed before they become cancerous; thus avoiding surgery. Other reasons for a laparoscopic colectomy include severe ulcerative colitis, diverticulitis, rectal prolapse, Crohn’s disease, irritable bowel syndrome, and rare benign tumors.
And yet, laparoscopic procedures on the intestine were not always done routinely. “Gynecologists were the pioneers of laparoscopic surgery,” Dr. McEnaney states. “We owe them a lot in terms of initiation, and creativity in this field. Gynecologists began showing general surgeons how to use this technology, and it caught on. As the technology grew, the instruments became more diverse, and the tools were fine-tuned toward specific needs.” Gallbladder surgery was one of the first procedures to use laparoscopy, and it is now used for hernia repairs, colectomies, appendectomies, and anti-reflux surgery.
William E. Rockett, MD, of Surgical Associates of Milford, explains further, stating, “There were a lot of academic medical centers that didn’t pursue laparoscopic surgery. It was community hospitals that drove the process. Over time as more community surgeons offered the procedure, other surgeons began to realize that they can do the surgery without large incisions, and patients felt better more quickly”. In fact, the benefits to this less invasive surgery are many, including shorter hospital stays, a quicker recovery time, less pain, and a faster return to work.
While there was some debate over whether laparoscopic surgery was as good as open surgery for colon cancer, several studies including a recent trial published in the New England Journal of Medicine seem to have helped put the issue to rest. Dr. McEnaney says that the multi-center study compared open surgery to laparoscopic colectomy for the treatment of colon cancer. The final results showed that not only are laparoscopic colectomies a safe procedure for colon cancer patients but that they also benefit from shorter hospital stays, and the need for less pain medication.
Though the benefits of laparoscopic colectomy are many, not all patients may be good candidates for the procedure. According to Dr. Rockett, certain factors are evaluated when determining if a patient is appropriate for this type of surgery. A person’s overall health, their tolerance to prior surgeries and the position of the lesion in the colon all contribute to the decision. And while the majority of patients can be treated laparoscopically, Dr. Rockett states, “I don’t think laparoscopic surgery will ever completely replace open surgery, but in a large section of the population, it will be the procedure of choice.”
Robert, for one, is happy to have been able to take this less invasive route, saying, “My recovery time was much quicker than it would have been if I had conventional surgery. Within two weeks after surgery, I felt good and was back to work. In thirty days I felt a hundred percent back to normal.”
When asked what patients should understand about laparoscopic colectomies, Dr. McEnaney replies, “The most important thing is that laparoscopic colectomy is a safe surgery, and it doesn’t need to be performed at a tertiary center. We have the technology at Milford Regional Medical Center to perform this surgery and other laparoscopic procedures.” His patient agrees. “I had the opportunity to go to Boston, but chose Milford Regional,” Robert points out. “I discussed it with Dr. McEnaney who told me that the newly equipped operating rooms at Milford are among the best in New England. The whole experience was very professional – everything went smoothly- from pre-op to surgery.”