It was Austrian neurologist Sigmund Freud who stated that it is best to,“Do as much as possible for the patient and as little as possible to the patient.” Putting this comprehensive concept into medical practice, Dr O’Rane Thomas, a consultant general surgeon at the May Pen Hospital (MPH), has helped to revolutionise treatment at the hospital, leading the team which performed the parish’s first laparoscopic colon surgery.
“I know it was something special, groundbreaking and historic to perform this surgery. But at the time, I could not allow myself to be overwhelmed by the moment. I am actually from May Pen. I was born at May Pen Hospital. And I’ve always been passionate about improving the standard of health care at this hospital. So what better way to do it than by introducing laparoscopic surgery,” Dr Thomas told The Sunday Gleaner.
The surgical procedure, he explained, had recently made its way to the green shores of Jamaica, but it was only available at institutions such as the University Hospital of the West Indies (UWHI) and Kingston Public Hospital (KPH). Having performed the surgery several times at the UHWI, he was excited to bring this practice to the rural community.
“This was the first laparoscopic colon surgery to be done in May Pen Hospital, and it was a major case. [It is] usually performed as a standard procedure in first countries. In Jamaica, it is mainly done at UHWI or KPH, so for May Pen to be offering this kind of care is significant and speaks to the advancement in terms of patient care throughout the region. We’ve also done the first laparoscopic appendix surgery and laparoscopic hernia surgeries and diagnostic laparoscopic procedures,” he shared.
Also called the keyhole surgery, the laparoscopic colon surgery, he explains, involves using small cuts on the abdomen to do the procedure. “This procedure avoids making large incisions and spares the patient pain and long recovery thereafter. Patients are able to get back to their normal physical activity in a shorter time and return to work so that they can increase productivity,” the doctor revealed. In addition, the surgery results in a better cosmetic outcome.
According to Dr Thomas, colon cancer is the third most common cancer in both men and women and it often goes undetected, noting that at different stages, no symptoms are presented. He is particularly passionate about this field because he has identified several cases and incidents where people have succumbed to the disease due to late detection.
“When it becomes more advanced, you start to have bleeding from the bottom or bleeding with the passage of [your] stool. Other common symptoms include abdominal pain, as well as constipation or bowel obstruction. This is why screening early for colon cancer and management are so important. We prefer to have screening and see small growths called polyps,” he said. You can do a stool test, colonoscopy or a CT scan to detect early polyps.
A recent case saw the early management resulting in a good patient outcome, “We performed this procedure on a female patient recently. Her early management saw her getting [a] smaller incision surgery. She was discharged by day three post procedure, which was pretty good. And she made a great recovery.”
Partnering with AA Laquis, based in Kingston, he shared the company was instrumental in providing much-needed equipment, including energy devices, staplers and other specialised sutures required for the surgery. This added to what was already available. “We’ve had the basic laparoscopic tower, the basic equipment needed for this kind of surgery since 2017,” he added.
For patient preparation, she had to undergo a colonoscopy prior to the surgery, in order to, “... localise the tumour, to see exactly where it is. And she had to do bowel preparations, meaning [a] bowel washout beforehand to decrease the amount of contamination during the surgery.”
It is important to note that surgery was completely laparoscopic. And by that, the doctor means a part of the colon was removed with the tumour, rejoining the bowels in a laparoscopic fashion. “We didn’t have to open up the patient in order to join back the bowels. And there was no need for a stoma bag or faeces bag.”
Dr Thomas’ journey has taken him full circle and now he is able to improve the lives of those patients in and around Clarendon, without them having to make that commute to Kingston. Always open to sharing the risks of laparoscopic surgery, Dr Thomas is looking forward to improving even more lives by performing these procedures in the near future.