Revolutionized Procedures for Colon/Rectal Patients

Advancements in colon and rectal surgery can alleviate the disease with far less disruption to the individual’s quality of life than in previous decades. Colon and rectal surgery includes removal of cancer and treatment for benign diseases.

"In both areas, surgeons are more conservative in the amount of bowel removed during surgery," says Robert Orringer, M.D., attending colon and rectal surgeon for Saint Barnabas. "Patients have smaller incisions and fewer require ostomies than in the past. Our goal is restoration of function as close to normal as possible."

TREATMENT FOR BENIGN CONDITIONS

Ulcerative colitis, a disease that causes inflammation and ulcers in the lining of the large intestine, was previously treated by removing the entire section of colon. Surgeons performed an ileostomy to attach the bottom of the small intestine to a new opening in the abdomen. The stool was directed into a bag attached to the opening.

"Today that type of procedure is very rare as a treatment for ulcerative colitis," says Dr. Orringer. "Instead, the surgeon reconstructs a new rectum made out of small intestine. The operation cures the colitis and the patient does not need a permanent ostomy. This new method has revolutionized the treatment of these patients."

Surgery for Crohn’s Disease, a chronic condition that causes inflammation in the large and small intestine, also requires the surgeon to take out less intestine than before. Surgeons use newer techniques and, with a better understanding of the disease process, can now conserve as much bowel as possible.

Treatment for diverticulities has also taken a revolutionary turn in the past decade. When small pouches in the colon become infected or inflamed, the condition is called diverticulities. Past treatment, says Dr. Orringer, required up to three operations and a week-long hospital stay each time. Today, one operation is performed laparoscopically with a small incision and patients return home in 2-3 days.

CHANGES IN COLON/RECTAL CANCER SURGERY

Although surgeons in the United States have generally not treated colon or rectal cancer laparoscopically, many surgeons in this country and in Europe are experimenting with new procedures. "The big advantage of laparoscopic surgery is a reduction in the amount of post operative discomfort as well as shortening the hospital stay and overall convalescence," says Dr. Orringer.

Advancements in the diagnosis of those with rectal cancer have meant that surgeons can more accurately stage the progress of the disease. The latest rectal ultrasound probes gauge the depth of the cancer more accurately than ever before.

Those with more advanced rectal cancer can begin chemotherapy and radiation treatment preoperatively. The advantage is less damage to adjacent structures by having chemotherapy and radiation preoperatively, and a higher likelihood of cure.

Those with colon cancer who suffer from blockages are now treated with temporary stents instead of the colostomies of the past. The stent is taken out at the same time the tumor is surgically removed.

"Surgeons are performing a fraction of the number of colostomies for cancer compared to what they used to do," says Dr. Orringer. "The point is to get rid of the disease with minimal impact on the general health and lifestyle of the patient."

Saint Barnabas First in the State to use New Technology for Operating Rooms

Saint Barnabas Medical Center is the first hospital in New Jersey to use state-of-the art operating technology in two newly designed operating rooms. The new rooms provide surgeons with the latest modalities for performing a broad range of minimally invasive surgical procedures laparoscopic living related donor nephrectomy (organ transplant), laparoscopic colon resection, hernia repair, appendectomy and gall bladder removal.

The highlight of the new rooms is a sophisticated overhead electronic guidance system including touch-control, flat screen computers and centralized control of overhead mounting systems, lights, tables, endoscopic equipment, and camera and video systems.

"Previously, the staff was required to bring a variety of mobile equipment to the operating rooms, which was very labor intensive and required a good deal of space," says Nancy Slaughter, R.N., Director of Perioperative Services. "Now, all the endoscopic equipment is built into a system that is suspended from the ceiling. This amazing cordless environment has made the environment safer for the staff and saves time, which benefits patient care. The satisfaction of the surgical team is just

For a referral to a Saint Barnabas colon/rectal surgeon, please call 1-888-SBMC-DOC.