For the first time in the Mid-South, an innovative integrated surgical approach to the minimally invasive removal of colon polyps is being performed at Methodist University Hospital.

Mohammad Ismail, M.D., A.G.A.F., chief of gastroenterology at Methodist University Hospital (MUH), approached John Cromwell, M.D., medical director of colorectal surgery at MUH, and chief of colon and rectal surgery at the University of Tennessee Health Science Center, about working together to perform a minimally invasive endoscopic and laparoscopic procedure to help Charles Brooks. Brooks is one of Dr. Ismail’s patients who needed to avoid a major colon resection and through the use of combining both physicians’ skills they were able to remove a difficult to reach polyp in the colon.

“At first, Dr. Ismail felt like my only alternative was the colon resection and for him to take the time and investigate other alternatives is really amazing and demonstrates what an exceptional physician he is,” said Brooks.

Brooks was diagnosed in 1978 with ulcerative colitis, which puts him in a high risk group for developing colon cancer. He has a colonoscopy every two years to check for any polyps. During Brooks’ last colonoscopy, Dr. Ismail found a large flat polyp tucked in a fold in the colon that he could not reach during regular colonoscopy so he approached Dr. Cromwell about teaming up.

“Using endoscopy and laparoscopy together to remove a large colon polyp is really optimal for a university hospital setting like Methodist University Hospital where we teach the value of integrated approaches to health care to our residents and medical students,” explained Dr. Cromwell. “The use of unique integrated approaches illustrates how we are improving health care for patients of Tennessee and the Mid-South by exposing our new doctors to these techniques.”

Colon polyps, an uncontrolled overgrowth of tissue in the lining of the colon, are extremely common in middle-aged and older adults. These growths are often benign, but they can become cancerous, so it is important that they are removed to help prevent patients from developing colon cancer.

“Most colon polyps are removed during a routine colonoscopy, said Dr. Ismail. “However, the colon is about six feet long and sometimes large polyps can hide behind a fold in the colon making it impossible to access and remove during a traditional colonoscopy. With the help of laparoscopy, the colon can be manipulated, giving endoscopist a clear access to the polyp for endoscopic removal.”

Several tiny incisions less than half an inch long are made in the abdomen through which small instruments are placed. Surgeons like Dr. Cromwell then use those instruments to
position the colon in a way so that a gastroenterologist such as Dr. Ismail can reach the polyp and remove it.

Advantages to an endoscopic laparoscopic team approach include:
• Going home the same day
• Back to normal activities within a few days

In comparison, having to do a colon resection in which a segment of the colon containing the polyp is removed and the colon is sewn back together, patients often experience:
• 5 to 10 day hospital stay
• 3 week recovery period

“It’s wonderful to have this procedure behind me,” said Brooks. “If I had to have had a colon resection, the rest of the year could have been impacted by that surgery. I’m back at the gym. I’m playing golf. I’m feeling great.”

To see surgical highlights from this amazing procedure and to learn more about teaming endoscopy and laparoscopy together to remove large colon polyps, a procedure only performed at Methodist University Hospital, visit methodisthealth.org/MIS.

Methodist University Hospital is the principal adult private teaching hospital in the Shelby County area for the University of Tennessee Health Science Center.