What's new in Colorectal Surgery
Aug 28, 2017
Dr Shahrir Kabir, Colorectal Surgeon, North Shore Private Hospital
Why did you choose to become a colorectal surgeon?
Colorectal surgery is a technically complex specialty, which requires great skill in a variety of modalities ranging from open, laparoscopic, endoscopic and trans-anal surgery. This makes it a challenging, and as a consequence, a rewarding discipline. The specialty is also very much focused on patient goals. By working together with patients it fosters good communication and collaboration and this results in a satisfying experience, both for my patients and myself.
What do you like most about your job?
One of the best aspects of my job is that I get to work with a large team of medical staff ranging from medical specialists, operating theatre staff, nursing staff and junior medical officers. Collaborating as a team to achieve our goals makes it an enjoyable experience.
Your special interest is minimally invasive surgery – what are the benefits to patients?
Over the last two decades since the introduction of laparoscopic or “key-hole” surgery, the benefits to patients have continued to improve as training and technology in this area has evolved. For example, most tumours in the colon and rectum (including low rectal cancers) can now be safely removed via a laparoscopic approach. This results in better post-operative outcomes with regards to pain, length of stay in hospital and earlier return to work. The benefits are not only limited to cancer surgery but are also applicable to surgery for inflammatory bowel disease, prolapse and hernias.
Are there any new advances in colorectal surgery?
It is currently an exciting time in the field of colorectal surgery as there have been many new developments in surgical technique in conjunction with technological advancement.
Firstly, laparoscopic surgery, which has traditionally been performed with 2D imaging since its origin, can now be performed with 3D imaging as a result of improvements in optical equipment. This allows for more visual information and depth perception, which leads to greater accuracy, efficiency, and safety in procedures, all of which benefit the patient.
Secondly, the recent the development of a transanal device has allowed the use of laparoscopic equipment to remove large polyps and selected tumours. This has meant that what originally required a full surgical resection and long-term recovery can now be done with just an overnight stay in hospital. This procedure has been aptly coined Transanal Minimally Invasive Surgery (TAMIS).
At present, one of the major topics of interest in colorectal surgery has been the advent of Transanal Total Mesorectal Excision (TaTME). This procedure is a simultaneous laparoscopic and endoscopic transanal technique for low rectal cancers. Prior to the development of this, low rectal cancers often meant that the only safe option was to remove the tumour along with the anal sphincter. This always left patients with a permanent colostomy. With this new technique sphincter preservation and bowel continuity is maintained.
Are these available to patients at North Shore Private?
We are fortunate to be able to offer all of the above mentioned procedures at North Shore Private. Over the past six months, the laparoscopic equipment has been upgraded to offer 3D technology and is now used regularly for our colorectal resections. Similarly, having fully trained and accredited in TAMIS and TaTME, we are able to offer this as an option for selected patients and have so in a number of cases already.
What are some of the resources available for colorectal patients at North Shore Private?
At North Shore Private, our patients have access to a wide range of facilities. There is a dedicated surgical ward for patients with excellent nursing and allied health support. Patients also have good access to a range of medical physicians for reviews when needed. North Shore Private also offers an excellent intensive care facility for complex surgical cases and/or patients with major comorbidities. Similarly, the radiology department is skilled in interventional radiology, which is extremely important in the management of complex colorectal surgical patients who may for example require percutaneous drainage procedures or angioembolisation for lower gastrointestinal bleeding.
To make an appointment or refer a patient to Dr Kabir, contact his via his North Shore Private Hospital profile.