Doctor proud of colon surgery results
Bermuda could become a centre for specialist colon removal surgery, a surgeon at the Bermuda Hospitals Board has said.
Fitzroy Hamilton said results in Bermuda were better than those of top European clinics that use single-incision laparoscopic surgery for colon removal.
Dr Hamilton said: “What we have seen from reviewing 186 cases we have done is that we have the outcome to show that we are very much on par with the guys in Europe and even better.”
He added: “We are leading in our outcome and I think we should explore making Bermuda the destination for patients for Sils colon surgery not only for medical tourism, but also the possibility to train surgeons in the diaspora. We should try to make Bermuda a centre of excellence for Sils colon surgery.”
Dr Hamilton said Bermuda is already a leading centre for the procedure on this side of the world.
Dr Hamilton explained that the procedure involves the use of a single point to get into the abdomen and remove the diseased part of the large intestine.
He said the method shortens the amount of time patients have to spend in hospital and “significantly” reduces the risk of complications.
Dr Hamilton said: “It is widely expected that you are going to have complication rates roughly up to 13 to 14 per cent in any population that does this procedure.
He added: “Our complication rate was 11 per cent.”
Dr Hamilton said operating times were also faster, at an average of about 130 minutes, “which is the bottom of normal”.
He added: “Everyone knows the procedure now, so it flows, so your operating time is less, the patient stays on the table less, there is less anaesthesia, less operating time, less risk.”
Dr Hamilton explained that male patients and those who are overweight or obese are at greater risk of complications.
He added: “In Bermuda, we are dealing with two out of three people with a body mass index over 25 so we have a third obese, a third overweight.
“So off the bat, we are expecting worse outcomes. Not so based on our findings.”
He explained that patients can be rejected for the surgery in other parts of the world if they are too sick or overweight.
Dr Hamilton said: “We don't have that luxury. We are in the middle of the Atlantic. There is no second or third-choice hospital.”
“For the patients, who for the most part we think are fit enough for surgery, we do the procedure with excellent outcomes.”
Dr Hamilton said the results showed that this surgery “can be done in patients who are sick, who are advanced in age, who are a little heavier than normal, with great outcomes”.
He put Bermuda's success down to skilled surgeons performing the procedure on-island and experienced operating-room staff.
Dr Hamilton added: “Safety comes first. We have a safe procedure, great outcomes and very capable surgeons so nobody needs to go overseas for colon surgery.”
He said Sils surgery, widely used in Europe but less so in the United States, had become the mainstay for colon removal in Bermuda since it was introduced on a large scale in 2012.
“Dr Boris Vestweber, who is world renowned in this procedure, was integral in getting the procedure accepted here.
“Now there are five surgeons in the hospital and they all do the procedure in varying degrees. Four of them learnt the procedure here on-island.”
Dr Hamilton said the team are now looking to publish their results.
He added: “This procedure has never been studied in any population this size, in such a remote setting with such a small population.
“But this population is rich for this procedure because of the diseases we find, because of the age of the patients, because of the size of the patients.
“The main focus of this and what we want everybody to see is that this can be done anywhere once you have surgeons who can be trained in the use of the port.”