February 5, 2013
Health care providers at the Michael E. DeBakey VA Medical Center (MEDVAMC) have refined and pushed the limits of a new approach to Transanal Endoscopic Microsurgery (TEM) to successfully treat a 75-year-old Veteran at risk for colon cancer.
Retired Navy Veteran Felix Piña discovered he had a large rectal polyp very high in his upper rectum after a routine colonoscopy procedure. After several unsuccessful attempts to remove it using conventional colonoscopy, Piña was referred to Avo Artinyan, M.D., M.S., Operative Care Line staff surgeon, for a second opinion. Artinyan offered him this alternate procedure.
“This new technique is similar to the conventional TEM operation where a small portion of the rectum is removed endoscopically; however, we used a newer platform that makes the surgery easier for patients,” said Artinyan, who is also an assistant professor of Surgery/Surgical Oncology at Baylor College of Medicine. “Mr. Piña’s case pushed the limits of this procedure, but we were willing to perform it because I believed this course of action might spare him unnecessary treatment.”
TEM has revolutionized the treatment of colon cancer. Performed through the rectum with specially designed microsurgical instruments, TEM has made it possible to excise lesions high inside the rectum that otherwise would be accessible only by major abdominal surgery.
“While not appropriate for every patient, the benefits of TEM for patients with early cancers or pre-cancers can be dramatic compared to radical rectal resection,” said Artinyan. “No abdominal surgery, no large incision or scar, no intra-abdominal infections, no risk of hernia, no temporary or permanent colostomy, no leaks, almost no discomfort, faster recovery, and a shorter hospital stay.”
Piña underwent the surgery to remove the polyp and left the hospital after only a few days. Post-operative tests confirmed he was cancer-free.
“It was truly a blessing. It would have been a horrible experience to deal with cancer,” said Piña. “I sure do thank Dr. Artinyan and the VA staff. I feel great!”
The American Cancer Society reports colorectal cancer, defined as cancer that starts in the large intestine or the rectum, affects more than 103,000 Americans each year. Colorectal cancer is currently the second leading cause of cancer-related deaths in the U.S., according to the Centers for Disease Control and Prevention. While more adults are being screened, one in three adults still ignore the disease.
“I am so proud of my husband,” said Piña’s wife, Marilyn. “He has not had any problems at all and he has been very active. We owe it all to the Houston VA.”
MEDVAMC is one of the few hospitals nationwide offering minimally invasive alternatives to radical abdominal surgery for the excision of certain rectal polyps and early stage rectal tumors.
“It is immensely gratifying we are able to save the lives of our Nation’s heroes like Mr. Piña,” said Samir S. Awad, M.D., Operative Care Line executive and Associate Professor of Surgery at Baylor College of Medicine. “We are proud the Michael E. DeBakey VA Medical Center has some of the best doctors and nurses in the country and offers the latest, minimally invasive alternatives for our Veterans.”