The past 15 years have witnessed a revolution in surgical procedures for treatment of conditions such as colon cancer, ulcerative colitis and diverticulItis.
Operations such as colectomy — compete or partial removal of the colon — that used to require lengthy, open incisions can now be performed using just a three-inch incision, plus tiny openings for a camera and instruments. Hartford hospital surgeons have led this transformation.
In the late 1990s, Hartford Hospital surgeons — all members of the Colorectal Division of Connecticut Surgical Group — pioneered the hand-assisted laparoscopic colectomy now used by physicians around the world. Now they teach the procedure to other surgeons at professional conferences and through live webcasts. They’ve made numerous presentations and published widely on the subject, and patients from all over the Northeast come to them for treatment.
Several factors contributed to Hartford Hospital’s leadership in this field, including the hospital’s purchase of specialized equipment, the synergy among Hartford Hospital surgeons from a variety of disciplines and the volume of surgical cases performed at Hartford Hospital. Today, these colorectal surgeons perform approximately 225 laparoscopic colectomies annually.
“The most many other hospitals may do is 50 a year,” says colorectal surgeon Jeffrey Cohen, MD, “and some may do only 10 or 20. We are second or third in the country in terms of volume and far and away the largest in New England. Colorectal surgeon William Sardella, MD, notes that experience builds expertise. “You have to do 30 to 50 fairly straightforward cases before you’ve mastered the learning curve for average procedures,” he says.
While aggressive in developing minimally invasive techniques, the colorectal surgeons have been careful to ensure quality of care. “When we first started doing this surgery, we offered it only as treatment for benign disease, not in cases of colorectal cancer,” says Paul Vignati, MD. “We wanted to gain more experience and be sure its results equaled those of open surgery. Only after we’d done hundreds of cases and seen evidence from research that it was equally effective did we start offering it to patients with colorectal cancer.”
Dr. Vignati notes that one of the unique strengths of his group is that they have the expertise to perform procedures either laparoscopically or as open surgery. “A major benefit to patients who come to us is that we have all the tools in our tool bag,” he says. “Since we do a lot of laparoscopic surgery and a lot of open surgery, the patient benefits from having an experienced surgeon recommend the procedure that is best for that patient’s particular condition.”
Hartford Hospital is one of very few places in the country with experience performing laparoscopically a complex operation called an ileoanal pouch procedure. A reconstructive procedure for patients with ulcerative colitis, the operation, sometimes called a “J-pouch” procedure, bypasses the colon, but without necessitating a permanent colostomy. As of January, 2009, approximately 100 such procedures have been performed at Hartford Hospital. Mastering complex procedures is part of the culture of this team of surgeons.
“It’s our group’s philosophy to be the very best,” says Dr. Cohen. “We are fellowship-trained surgeons—specialists who can take care of patients other surgeons or hospitals can’t handle. It’s very rewarding to be at the forefront of providing the highest quality of care.”
Kristina Johnson, MD, notes that her group’s quality of care is enhanced by the full range of outstanding subspecialty surgeons who practice at Hartford Hospital. “Colorectal disorders often involve other abdominal and pelvic organs, as well,” Dr. Johnson points out. “Being at Hartford Hospital, we can readily collaborate with experts in urology, gynecology and other fields to provide truly outstanding care to our patients.”
Photo Above (Left to Right): Dr. Vignati, Dr. Cohen, Dr. Johnson, and Dr. Sardella.