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Another milestone for bowel cancer surgery

Mr Ralph Austin and Mr Greg Wynn

Caption: Mr Ralph Austin (left) and Mr Greg Wynn, consultant general surgeons.

25 June 2013

Surgeons at Colchester General Hospital have carried out what they believe is probably the first bowel cancer operation of its kind in the UK.

Mr Ralph Austin and Mr Greg Wynn, consultant surgeons based at the hospital, used a new technique of minimally invasive surgery to remove a rectal cancer from a female patient.

The woman, who is in her 70s and lives in the Colchester area, was discharged four days after last month's operation.

The procedure involved inserting a plastic channel or "port" into the back passage (anal canal) so that keyhole surgery instruments could be used to carry out an operation that until now could be performed only through the abdomen. The diseased section of bowel was then removed through this port.

Mr Wynn said this was another example of a type of surgery that involves operating through the body's natural orifices - or Natural Orifice Translumenal Endoscopic Surgery (NOTES) to give it its proper name.

This new technique reduces post-operative pain, meaning patients do not have to spend so long in hospital and can resume normal activities even sooner than after standard laparoscopic (keyhole) surgery.

Mr Wynn said: "Rectal cancer surgery is often difficult with a high complication rate and can involve making large cuts to access the pelvis.

"This novel approach will give surgeons better views of the anatomy and reduce operating times in addition to shortening hospital stays for patients.

"When the camera went in for the first time, there was a hush of expectation but when we saw inside, it was such an exciting revelation. We had never seen such good views of the important tissues surrounding the cancer."

The two surgeons intend to write up and publish information about the procedure. Like any new operation, minor modifications are likely to be needed but once more cases have been completed the operating time of three hours could be reduced significantly. Eventually, the intention is to train other surgeons in these techniques.

While Mr Wynn and Mr Austin know that this particular operation has already been carried out in just a handful of centres around the world such as in Spain, the Netherlands and Brazil, they believe the operation in Colchester was probably the first of its kind in the UK.

Last year, Mr Wynn performed another new type of surgery on a 67-year-old woman from the Chelmsford area. This involved extracting a cancerous section of bowel through the rectum and anal canal rather than through a cut in the abdominal wall. The patient was discharged from hospital in half the usual time.

In 2011, he visited Rio de Janeiro to learn more about operating through the body's natural orifices. He worked with surgeons who were pioneering innovative operations through the rectum, stomach and vagina which reduce pain.

Mr Austin has travelled to Spain and Holland to learn about this type of surgery and has been involved with experimental laboratory work that has been supported by Anglia Ruskin University and the European Association of Endoscopic Surgeons.

Colchester has an international reputation for excellence in laparoscopic surgery. These innovative techniques continue to build on the foundations laid by Professor Roger Motson, one of the pioneers of laparoscopic surgery in the UK.

Professor Motson had been a consultant surgeon in Colchester since 1984 before retiring from clinical practice last year. He is Director of The ICENI Centre, a state-of-the-art surgical education and research centre at Colchester General Hospital which is a joint venture between Colchester Hospital University NHS Foundation Trust and Anglia Ruskin University.

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