New type of surgery means 'zippo pain'

William Lam owes his life to his daughter's hunch.

Last fall, the 76-year-old security guard was feeling poorly. A diabetic, he had a lot of tests done, but his daughter suggested that he have just one more: a colonoscopy.

The colonoscopy revealed bad news: a cancerous tumor "about the size of a half-dollar," he said.

The good news was that the cancer was still in the early stage. And even better news awaited him. A new surgical technique meant he could have the tumor removed in an outpatient surgery and he could be back at work in a little over a week.

So Lam told his surgeon, Dr. Gregory FitzHarris, "Let's go for it."

The technique has the admittedly unfriendly name of Transanal Endoscopic Microsurgery (TEM) and involves the removal of rectal polyps or early-stage cancers through the natural opening of the anus, rather than cutting through the abdomen and colon. That means much quicker recovery and "zippo pain," Fitz-Harris said.

TEM is part of a growing trend toward what's called natural orifice surgeries, which include techniques that allow some brain tumors to be removed through the nose and gall bladder operations done through the mouth.

The surgery Lam went through became possible after the development of high-tech equipment that allows for better visibility and reach of surgical instruments, FitzHarris said.

"You can see the tumor in 3-D, which is cool," FitzHarris said. "You can see the edges, the borders and really get a good idea as to where" to cut. When it comes to the actual removal of the polyp, it's like "peeling off a stamp."

The alternatives for patients like Lam are traditional or laparoscopic surgeries, both of which require a colon resection, FitzHarris said. Even with the less-invasive laparoscopic option, several days in the hospital and a few weeks of recovery time are needed.

The difference for the patient: "It's like removing a wart as opposed to cutting your hand off," FitzHarris said.

There are limitations. The equipment will allow the surgery to be done only about eight to 10 inches up into the rectum rather than further up the colon, and it's not used for later-stage cancers.

But usually, the surgery can be done on an outpatient basis.

Lam said he went to Sentara CarePlex Hospital in Hampton for his February surgery about 5:30 a.m. He was operated on under general anesthetic and discharged shortly after noon.

By the end of the week, he felt fully recovered and was happily back at work shortly thereafter.

"I didn't need any pain medication," Lam said. "It was no problem at all."

In the middle of March he got more good news from FitzHarris: Everything was clear and he didn't need radiation or chemotherapy.

Lam knows that the key was catching the cancer early - and that was done during a far more common procedure: the colonoscopy. He's grateful to his daughter for thinking of it.

"I tell her all the time, 'You saved my life.' "

Nancy Young, (757) 446-2947, nancy.young@pilotonline.com.