Issue link: https://tmcpulse.uberflip.com/i/990281
14 T M C » P U L S E | J U N E 2 0 1 8 "This was God telling me that it's time to have the surgery. We had been fighting for so long and left no stone unturned," Tomsu said. "I knew it was going to happen at some point in my life when- ever some medication would stop working, but I never got any relief from medication. Surgery is the first relief I've felt in four or five years." Rerouting the plumbing Haas performed "J pouch" surgery using the da Vinci Xi surgical robot to reconstruct Tomsu's intestines. During the first stage, performed in January 2018, Haas removed Tomsu's entire colon and rectum through a tiny 1.5-inch incision in the belly button. The surgeon created a J-shaped pouch using the last few inches of the small intes- tine and attached that to the top of the anal canal. This effectively "reroutes the plumbing" without committing Tomsu to the lifelong use of an ileos- tomy bag, Haas said. During the second leg of the surgery in April 2018, Haas reattached both ends of the bowel. "Traditionally, you'd cut the patient wide open, remove everything first and then do all the reconstruction," Haas said. "But with modern medicine and innovations, we do it all minimally invasively. ... The robotic technology helps us overcome a lot of barriers and has become our preferred approach to remove the colon … and reconstruct the colon so that [patients] can have normal function." Colon reconstruction and J pouch surgery have been around for years, but the robot- assisted, minimally-invasive approach using the da Vinci Xi only recently emerged as an option. This approach boasts many advantages over traditional methods, including increased safety, a decreased chance of needing a transfusion and a lower risk of surgical site infection. Most impor- tantly, patients experience significantly less pain and, as a result, require fewer painkillers. Considering the opioid epidemic sweeping the nation, Haas added, the ability to treat a patient's post-surgical pain using non-opioid medications is a major benefit. "After colon surgery, you're in pain. We've noticed an amazing reduction in the need of opioids after surgery," he said. "In fact, most times we send patients home with just Tylenol or Advil. We don't even take the risk of getting them hooked on opioids." After he has healed from surgery, Tomsu will have his ileostomy bag and stitches removed— finally ending his long battle with UC. "Once you're done with surgery, you don't need to be treated any more medically," Haas said. "It cures the disease." After the surgery, bowel movements are reduced to four to six times a day. "[It] may seem like a lot, but to the patients, it's amazing because you can eat, have one or two movements, and be done until your next meal," Haas said. "It's a tremendous difference and the lifestyle is a 180-degree turn." Haas handles the controls of the da Vinci Xi surgical robot to remotely reconstruct Tomsu's colon.