Advances in Chrons Disease Surgeries

This week, leading Chrons Disease experts at the York-Presbyterian Hospital, in the US have said that today people who suffer from chrons disease, the chronic inflammatory bowel condition are living longer healthier lives and this is mainly down to innovative new surgery.

There are an estimated half a million people in the USA alone who suffer from Chrons disease, which starts off inflammation along the gastrointestinal tract and is most often found in the lower bowel. Today there are certain drugs can help ease symptoms of chrons disease, but to date there is no cure for crohn's. There are often complications related to Crohn's disease and these often include fistulas which are abnormal, obstructive connections between tissues in the body, strictures which is basically the narrowing of the bowel, abscesses, perforations, haemorrhage and even cancers. Because of these complications chrons disease sufferers will often require some sort of surgery.

Dr Fabrizio Michelassi who is an author as well as a professor and chairman in the Department of Surgery at Weill Cornell Medical College he is also the surgeon in chief at New York-Presbyterian Hospital/Weill Cornell Medical Center said that out of five patients with chrons disease, four of them will need some kind of surgery during some point of their lives. The new,advanced and minimally invasive techniques however are sparing the patients precious bowel tissue and at the same time improving quality of life.

Dr. Sharon Stein who is the assistant professor of surgery at Weill Cornell Medical College and colorectal surgeon at New York-Presbyterian Hospital/Weill Cornell Medical Centre said that "In the past, this was limited to complex, invasive surgeries that required the removal of whole sections of the affected bowel. But over the past two decades, advances in surgery have changed that paradigm,"

Innovations in Chrons Disease Surgery

Fistula Plugs:

For anyone who has had a fistula, and I will know they are often painful as well as being dangerous as they can cause the contents of your intestines to diverge from the anal canal. This can often progress to anal incontinence, abscesses and in the most serious cases systemic infection. There are now certain surgical procedures that can drain the fistula tract but for more difficult lesions there is a new new surgical anal plug which is made from grafted porcine tissue and is then placed over the fistula. This fistula plug then is the catalyst for the growth of fibrotic tissue in the area that will then close off the fistula passage. According to Dr Stein, recent studies have shown this method to be successful in up to half of Chrons patients.


Laparoscopic surgery:

Another new innovation in surgery for people with Chrons disease is known as Laparoscopic surgery which are minimally invasive techniques requiring only a small incision and leaves very little external scarring. Laparoscopic surgery can take longer to perform than conventional surgery techniques, but lead to shorter stays in hospital, which not only saves money, but because chrons disease patients often spend long periods in hospitals can be very important to them.


Strictureplasty:

The technique of Strictureplasty has completely changed bowel surgery as the technique alows the surgeon to leave the disease affected length of bowel in place but widen it, it is "much like letting out the seams on a pant-leg," explains Dr Michelassi, who is a world renowned pioneer in the technique of Strictureplasty. This saves bowel tissue while "restructuring" it, so that intestinal contents can safely pass through. before Strictureplasty, surgeons would have to cut out whole sections of bowel affected with Chrons disease, shortening the organ which leads to the limiting of the gastrointestinal tract.

(Source: New advances in surgical treatment of Crohn's disease. Practical Gastroenterology: November 2008)

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