Collier Edition

Understanding Gastroenterology

Publications such as Health & Wellness have a goal: to educate. In this case, the education is focused on making the patient public better consumers of medical products and services. If people are willing to spend hours online researching the best price for the latest and greatest flat-
screen TV, it stands to reason that the same amount of time should be given to the understanding of—and caring for—the most complex “machine” of all: the human body.

For example, if asked, how many would understand the difference between a “gastroenterologist” and a “colorectal surgeon?” At one time or another, chances are good that the vast majority of the population will have to interact with one of these professionals; however, few can likely explain what, how or why they do what they do.

Medical professionals specializing in gastroenterology diagnose and treat conditions of the digestive tract affecting the stomach, gallbladder, pancreas, liver, small intestines, colon (large intestines), rectum and the ducts between all these organs. Gastroenterologists—a.k.a. GI doctors—are trained in general internal medicine; however, they also receive additional training in gastroenterology, or disorders of the gastrointestinal (GI) tract.

A colon and rectal surgeon (formerly known as a Proctologist) is a physician with training in the surgical treatment of diseases of the colon, rectum and anus. The primary difference between a colorectal surgeon and a gastroenterologist is quite literally in the name: Colorectal surgeons typically provide surgical treatments.

And the reason that most will interact with one of these professionals? The dreaded-though-it-should-not-be-dreaded colonoscopy.

Everyone should be educated on the various types of colorectal screenings recommended based on age and various risk factors. The reason is simple: a colonoscopy is a vitally important procedure that can save your life. Please see Sidebar.

Though the online world is full of medical information, the patient population must strictly rely on trusted sources. Just because you “read” it, doesn’t make it fact. As is the case with any medical procedure, if you have questions on the various colorectal screenings as they apply to you, please consult your physician.

Next: think ahead. Just because you may not currently need a specific treatment or procedure doesn’t lessen the need to understand it is available to you or a loved one.

As most physicians view the doctor/patient relationship as a “partnership,” by keeping yourself informed on advancements in medical technology, you literally empower yourself to be a better patient. When you’re sick you want answers, so why not flip the model and get some of those answers in advance?

Dr. Anthony Vernava of Physicians Regional Healthcare System, falls into the “colorectal surgeon” category. He is a board-certified surgeon with over 20 years of experience. And like any reputable surgeon, Dr. Vernava prefers to avoid surgical intervention unless it is absolutely necessary. However, there are those times when an actual surgical procedure cannot be avoided.

Perhaps the most fascinating advancement is the recent release of the latest and greatest in surgical technology, the da Vinci Xi robot. The da Vinci Surgical System enables surgeons to perform operations through a few small incisions. It features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far beyond the abilities of the human hand.

The da Vinci Xi robot enables a surgeon to operate with enhanced vision, precision and control; nevertheless, the surgeon is 100% in control of the da Vinci System at all times throughout the procedure.

Dr. Vernava has been using the various iterations of the da Vinci robot for close to 10 years. Though the system has provided exceptional benefits to physicians and patients, Dr. Vernava also warns that the learning curve for operating the system can be a long one. Just because a facility has a da Vinci robot does not mean they have the experienced staff necessary to maximize the benefit to the patient.

“You have to have a well-trained team that is used to setting up and using the robot in order to help the surgeon be successful,” says Dr. Vernava. “This is certainly the case at Physicians Regional.”

Physicians Regional Healthcare System was the first medical facility in Southwest Florida to offer surgery using the da Vinci Xi. In fact, the da Vinci Xi robot can be used to perform colorectal, cardiac, gynecologic, head & neck, thoracic and urologic surgery.

Dr. Vernava describes the benefits of robotic surgery as “less invasive with less blood loss. The physician sees more and the patient goes home sooner.” In the case of traditional surgery, the average length of stay is 8 – 10 days; however, with the da Vinci Xi robot, the length of hospital stays are drastically reduced.

When asked about role that the da Vinci Xi will play in the future of surgical medicine, Dr. Vernava wisely stated: “I think this is the future — but the future is now.”

The future cannot—and should not—be avoided either. Read, learn, hope for the best, prepare for the worst, and understand that nothing will ever beat a trusted medical ally: a skilled and knowledgeable physician.

American Cancer Society recommendations for colorectal cancer early detection

People at average risk:
The American Cancer Society believes that preventing colorectal cancer (and not just finding it early) should be a major reason for getting tested. Having polyps found and removed keeps some people from getting colorectal cancer. Tests that have the best chance of finding both polyps and cancer are preferred if these tests are available to you and you are willing to have them.
Starting at age 50, men and women at average risk for developing colorectal cancer should use one of the screening tests below:

Tests that find polyps and cancer
. Flexible sigmoidoscopy every 5 years*
. Colonoscopy every 10 years
. Double-contrast barium enema every 5 years*
. CT colonography (virtual colonoscopy) every 5 years*
Tests that mainly find cancer
. Guaiac-based fecal occult blood test (gFOBT) every year*,**
. Fecal immunochemical test (FIT) every year*,**
. Stool DNA test every 3 years*

*Colonoscopy should be done if test results are positive.

** Highly sensitive versions of these tests should be used with the take-home multiple sample method. A gFOBT or FIT done during a digital rectal exam in the doctor’s office is not enough for screening.

People at increased or high risk:
If you are at an increased or high risk of colorectal cancer, you might need to start colorectal cancer screening before age 50 and/or be screened more often. The following conditions make your risk higher than average:

. A personal history of colorectal cancer or adenomatous polyps
. A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
. A strong family history of colorectal cancer or polyps
. A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)

For more information or to schedule an appointment with a gastroenterologist, call Physicians Regional Healthcare System at 239-348-4221.

For more information on the da Vinci Surgical System or to schedule an appointment with a gastroenterologist or colorectal surgeon, please call Physicians Regional Healthcare System at 239-348-4221.

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