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October 2006 Issue

Bradley Davis, MD, and his team perform about 100 laparoscopic colon and rectal procedures annually.
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Small-Incision Rectal Cancer Procedure Results in Less Pain, Minimal Scarring

By Amanda Harper
Published October 2006

UC colorectal surgeons are now performing an advanced, minimally invasive (laparoscopic) procedure for difficult-to-treat cancers that develop very low in the rectum.

“Treatment options are very limited for people with advanced, lowlying rectal and anal cancers,” says Bradley Davis, MD, assistant professor of surgery at UC. “By doing the procedure laparoscopically, we can minimize the patient’s postsurgery pain, expedite recovery and improve their cosmetic outcomes.”

Known as laparoscopic abdominoperineal resection (APR), the affected tissue is removed from an incision between the legs, thus eliminating the need for a major incision into the abdomen. It’s used in special cases to treat advanced rectal cancers that affect the anal sphincter muscles, which control the release of bodily waste.

Davis and his colleagues are the only physicians in the Greater Cincinnati region specifically trained to perform this laparoscopic procedure.

Instead of accessing the cancer via a large incision in the abdomen, the surgeon makes a one-third inch cut near the belly button and inserts the laparoscope, a flexible instrument equipped with a light source and camera at its tip that displays a
clear image of the operative area on a monitor near the operating table.

Other specialized surgical tools are inserted into the abdomen through four more tiny incisions (less than one centimeter each).

During the procedure, surgeons remove about 15 inches of the lower large intestine—including the sigmoid colon, rectum and anus—from a small incision between the patient’s legs.

Because the surgery requires removing both the rectum and the anal sphincter muscles, the patient must wear a permanent colostomy bag. This “pouch” is connected to the bowel and worn outside the body to collect waste that would normally pass through the digestive system.

“Although we can’t eliminate the need for a permanent colostomy in patients with this type of advanced rectal cancer, we can offer them the best chance for eradicating the disease,” says Davis. “APR is very effective in curing this type of cancer, if detected early.

The important thing is to perform a safe and effective procedure, but to do so using smaller incisions.”

Davis and his colleagues are trained to research, diagnose and treat diseases of the colon and rectum.

Together, they perform more than 100 laparoscopic colon and rectal procedures annually.

The team sees patients at Christ Hospital and the University Pointe Medical Campus in West Chester. To schedule an appointment or receive more information, call (513) 929-0104.

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