Georgia Colon & Rectal Surgical Associates, P.C.

A Colon & Rectal Surgery Educational Program

TRAINING & RESEARCH FOR DISEASES OF COLON AND RECTUM

"One of the most complex challenges a modern-day colon and rectal surgeon faces is a patient suffering from either cancer of the colon or rectum or inflammatory bowel diseases," according to
Guy Orangio, M.D. "Knowing how to deal with these problems requires extensive and specific sub-specialty training."

It is estimated that as many as one million Americans suffer from inflammatory bowel disease (IBD). Ulcerative colitis and Crohn's disease are the most common types of IBD and include symptoms of chronic diarrhea, abdominal pain, fever, weight loss and at times rectal bleeding. Surgical therapy is part of the continuum of care for patients with IBD. Two-thirds to three-quarters of patients with IBD will require surgical therapy as an adjunct to medical therapy at some point of their lives. These patients suffer complications of their disease that require surgical intervention for example failure to thrive, failure of medical therapy, complications of medical therapy fistula, chronic infection or hemorrhage to name a few. The ultimate goal for the colon and rectal surgeon and the gastroenterologist is to return the individual with IBD to the best quality of life.

In the United States, cancers of the colon and rectum combined (colorectal) are the third most common site of new cancer cases in both men and women. The American Cancer Society estimated 148,300 new cases from the disease in 2002. Once colorectal cancer is detected, surgery is the primary treatment and results in the cure of 45-50 percent of all patients.

"The amount of experience the fellow gains in this program is outstanding. This fellowship provides the surgeon with the volume and diversity of cases necessary to become an expert in the field of colon and rectal surgery," says Edward Stringer, MD, 2003 colorectal fellow.

WHY IS TRAINING ESSENTIAL?
Studies show that patients who are treated by colorectal surgeons who have the additional year of training through a fellowship show the following improved outcomes:

Higher patient survival rates after cancer surgery.
Fewer complications following surgery
Faster recovery.
Avoidance of colostomy in most cases.

Source: Foundation for Colorectal Surgical Education

A REGIONAL VOID IN SUBSPECIALTY TRAINING
A fellowship in colon and rectal surgery is offered to general surgeons who have finished an approved five-year residency and are board eligible in general surgery. This sixth year of training is in the subspecialty of diseases of the colon and rectum. This intense year includes anorectal, endoscopic (colonoscopy) and major abdominal surgery on the small bowel (jejunum and ileum) and large bowel (colon).

Until recently, no such training opportunity existed in the southeastern United States for American surgical graduates. In 1999, The Georgia Colon & Rectal Surgical Clinic established a training fellowship program to teach advanced techniques in colorectal surgery including miniminally invasive techniques (Laparoscopic Bowel Surgery) and most recently advanced telesurgery (Robotic Bowel Surgery), for interested physicians to learn and improve upon. For the training surgeons involved, this was an opportunity to give back" something that they had been privileged to learn in such institutes as the Mayo Clinic (Rochester, MN), Cleveland Clinic (Cleveland, OH), Oschner Clinic (New Orleans, LA) and The University of Texas (Houston, TX).

This program was the first of its kind in the Southeast. The Georgia Colon & Rectal Surgical Clinic in Atlanta, GA, has filled a void, to provide new opportunities for surgical graduates/fellows to develop advanced skills, and to propagate their knowledge and know-how throughout the United States.

"Although many general surgeons are capable of performing colon and rectal procedures, they do not have the same level of training and expertise as colorectal surgeons. To compound this issue, the choice to see a specialist is not always available because of the lack of training programs across the nation, says Richard Billingham, MD, past president, American Society of Colon & Rectal Surgeons.

"As the primary teaching facility for the Colon & Rectal Surgery Fellowship, Saint Joseph's Hospital continues to put forth initiatives that improve the outcomes and satisfaction of our patients," says Bonnie Phipps, president & CEO, Saint Joseph's Health System.

Saint Joseph's Hospital has partnered with the practice to facilitate continued growth in the fellowship program. Eventually, Saint Joseph's hopes to expand the availability of fellowships into other specialties. This initiative supports Saint Joseph's vision to build partnerships with physicians to improve patient outcomes, as well as to build loyalty and invest in future successes.

TEACHING FELLOWSHIP CONTINUES TO GROW
Since its inception in 1999, the fellowship program has attracted the best and brightest surgical minds throughout the United States. As the only free-standing program and one of only 34 accredited colorectal training programs in the United States, potential candidates apply from within the general surgical programs at established universities and hospitals across the nation. Twenty-five applicants, on average, are interviewed each year for a maximum of two accredited fellowship positions. Successful graduates continue to serve in communities across America. Professors visit annually to deliver lectures and seminars from such prestigious institutes as the Mayo Clinic, MN, Cleveland Clinic, OH, and Lahey Clinic, MA.

INNOVATIONS IN RESEACH
As the only free-standing program in the United States, The Georgia Colon & Rectal Surgical Clinic program has been at the forefront of research and new methods in treating colorectal disease. In the four years since its inception, the faculty and fellows have presented at the annual meetings of The American Society of Colon and Rectal Surgeons and The Society of Laparoendoscopic Surgeons. Research projects and innovations developed by Georgia colon & Rectal Surgical Clinic have received the accolades of nationally-recognized organizations, such as "Best Research Project" from The New Jersey Colorectal Society, and have developed new technologies from international corporations such as Ethicon Endosurgery and Wilson Cook Medical.

CURRENT RESEARCH PROJECTS

Laparosopic colectomy for pediatric inflammatory bowel disease
Remote colectomy using Telesurgery robotic technology
Fistuloscopy for fistula-in-ano: A new technique.
Topical metronidazole for intractable anorectal Crohn's disease
Multiple synchronous hemorrhoidal ligation: In-office "mini-hemorrhoidectomy."

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