Fall 2006
The Rusty Pipe
 

Michael, Kathy, Glen, Gabrielle, Alden and Kathleen Snajder. Missing: Amanda.

A 42-year-old Monroe father of five learnsthat having colon surgery isn’t as bad as it sounds—when it’s done as a minimally invasive procedure at Bridgeport Hospital.

S omething wasn’t right.

It wasn’t the flu and it wasn’t his appendix (he’d had that out years ago). But the fever, the horrible chills, the abdominal pain (“It sometimes knocked me to the floor!”), the loss of appetite, the exhaustion in a normally healthy man—no, something definitely wasn’t right.

So 42–year-old Glen Snajder went to Bridgeport Hospital’s Emergency Department. A series of tests showed that he had diverticulitis—an infection in his colon. (The colon is the major portion of the large intestine.) Intravenous antibiotics and four days in the hospital brought the fever down, and Glen went home thinking, “Well, I’ll watch my diet, eat more fiber, and that will be that.”

During his initial stay at Bridgeport Hospital, Glen was treated by Gregory Soloway, MD, a gastroenterologist (specialist in diseases of the digestive tract). In a follow-up procedure a few months later, Dr. Soloway performed a colonoscopy (a procedure that involves sliding a slim tube with a camera up into the colon so the doctor can see what’s going on inside).

“I could see that his lower colon was quite thickened and abnormal-looking,” says Dr. Soloway, “but he seemed to be progressing well.” A round of antibiotics helped.

However, diverticulitis in a man as young as Glen is cause for watchful concern. It’s usually a disease of people over age 50. When found in younger people, it’s a much more aggressive condition. And Glen’s condition was aggressive. After his third attack of diverticulitis, and third round of antibiotics, in a four-month period, Dr. Soloway determined that the diverticulitis had become chronic. He recommended that Glen consider having the diseased section of his colon removed—and that he have it done before his disease progressed to the point where emergency surgery was required.

So Glen went to colorectal surgeon Scott Thornton, MD, for consultation.

Dr. Thornton had the proverbial bad news and good news. Glen really did need to have about a foot of diseased colon removed — but there was a way to do it without having to open up his abdomen. Instead of a long abdominal scar, minimally invasive surgery would involve only three small incisions.

Glen’s point of view: “If you can have the minimally invasive procedure done by an expert, with smaller scars, less pain, a shorter hospital stay and a quicker recovery— well, why wouldn’t you?”

Glen came to Bridgeport Hospital on June 26, 2006, for surgery. While expert anesthesiologist Amarjit Lamba, MD, monitored Glen’s breathing and oxygen levels, Dr. Thornton made two incisions in Glen’s lower abdomen, plus a third in Glen’s navel through which he inserted a miniature camera.

“Because the camera presents a magnified view, I can see even better than with the naked eye,” he explains.

As is true for all surgeries, surgeons and anesthesiologists work in close partnership during minimally invasive laparoscopic surgery.

A man and his mulch: Two months after his surgery, Glen is digging in his garden!

Dr. Lamba continually observed and made fine adjustments to ventilation, fluids and anesthesia drugs as Glen’s abdomen was inflated and his body frequently repositioned to help Dr. Thornton achieve the best possible views of the area.

Using miniature instruments inserted through the abdominal incisions, Dr. Thornton cut out the diseased portion of intestine, “like removing a section of damaged, rusty pipe,” he says. He next positioned a special tubular stapling device through the rectum up to the area of removed colon. “Then,” he explains, “I pulled the two ends of the pipe together, and used the stapler to simultaneously staple all around the circumference of the pipe to hold the ends together.” The diseased segment of colon was withdrawn through the navel.

The operation was a complete success. Glen began eating solid foods the day following surgery and went home the next day. Within three weeks he was back at work on a reduced schedule as a bank supervisor. Two weeks later, he was back to work on his regular schedule. His diet is now normal— with an emphasis on plenty of fiber “to keep things moving,” he says with a grin.

Glen’s advice to anyone with symptomatic diverticulitis: “You’re not going to get any healthier! Ask your doctor about minimally invasive surgery and take advantage of this newer, easier procedure.”

Diverticu-what?

OK, time for a discussion of all the diverticular things you may have heard about. Bridgeport Hospital–affiliated gastroenterologist Darlene Negbenebor, MD, explains:

Diverticula (singular: diverticulum) are little pouches that form on the inside of the digestive tract. Lots of people have diverticula, “and 90 percent of the people who have them don’t even know it,” says Dr. Negbenebor.

Diverticular disease is a catchall term for conditions that involve diverticula.

Diverticulosis is a condition in which you have lots of diverticula. (Osis = abnormal increase.) Again, if you have no symptoms, there is no problem. The problem comes when you progress to…

Diverticulitis. That’s when the diverticula become inflamed (swollen) and infected. (Itis = inflammation.) “At this point you are pretty sure to be having symptoms. If you have not seen your d