Single incision colon surgery: ‘Absolutely amazing’

Not long ago, laparoscopic surgery was heralded as a big improvement over traditional “open” surgery. Now there’s an even simpler approach to laparoscopy. Single incision laparoscopic colectomy requires only one small incision, as opposed to four or five small incisions in standard laparoscopic surgery. To 66-year-old Paulette Reveiz of Des Moines, this is an “absolutely amazing” improvement. As a colon cancer patient  at The University of Iowa, Paulette was one of the first people in the entire Midwest to undergo the single incision laparoscopic approach. “There was practically no recovery time at all!” she says. “I took pain medication for a couple of days and then went home.” Better yet, Paulette was cancer-free at her last follow-up exam. Like many patients, Paulette originally felt fine and had no symptoms. She took good care of her herself, and had undergone a colonoscopy two years before. Why would she need a routine physical exam right now?

Paulette Reveiz
A colonoscopy revealed a large aggressive tumor in Paulette Reveiz’s colon.

Fortunately, two of Paulette’s daughters—Analisa Haberman of Mason City and Maria Filippone of Des Moines—knew better. Both are doctors. Between them, they helped convince Paulette to undergo a routine exam. After that, another family connection kicked in when Paulette’s son-in-law, radiologist Robert Filippone (Maria’s husband), insisted that Paulette get a CT scan. He actually performed and read the scan, which confirmed that something was wrong in Paulette’s right colon. A follow-up colonoscopy showed the presence of a large aggressive tumor in her colon.

Highly specialized cancer care was in order. “I have always gotten my care at University of Iowa Hospitals and Clinics,” Paulette says, “so I wasn’t going anywhere else.” Paulette’s initial diagnosis and care were directed by John Byrn, MD, a UI colorectal surgeon who specializes in minimally invasive procedures. Byrn removed the tumor, along with Paulette’s right colon, using the single incision laparoscopic technique. Byrn describes the technique as another big step in the evolution of minimally invasive surgery. “It maintains the advantages of laparoscopic surgery over open surgery, with a very rapid recovery,” he says.

In single incision colectomy:

  • One small incision is made around the navel
  • A small camera and instruments are introduced into the incision via a special port
  • Diseased tissue is removed from the abdominal cavity

Even if the entire colon and rectum need to be removed, single incision techniques can be employed and patients typically go home after three days. Paulette was amazed at how quickly she recovered, and how good she felt immediately afterwards. “There was practically no recovery time at all!” she says. “I took pain medication for a couple of days and then went home.” She is currently on a very aggressive (five drugs, six months) chemotherapy regimen. Best of all, she was cancer-free at her last follow-up exam.

Paulette’s decision to seek care at The University of Iowa had another benefit as well. Because her family has a strong history of colon and breast cancer, UI doctors in the Holden Comprehensive Cancer Center conducted genetic testing to see what else they could learn about the family’s vulnerability to cancer. “The results of that testing could significantly alter the lives of Paulette’s children—in a good way,” Byrn says. “It will increase the frequency of their colon cancer screenings as a way of preventing future colon cancers in the family.”

Colonoscopy: first line of defense

Colonoscopies provide the best available screening for colorectal cancer, says John Cromwell, MD, co-director of the UI Clifton Center for Digestive Diseases. “It’s the best test because it is the most accurate and polyps can be removed during the procedure,” he says. “It should be done as a screening exam in patients at risk before they develop symptoms.” For help scheduling a screening, call 800-237-1225 or visit the UI Colonoscopy Clinic.

Generally, colonoscopies are for:

  • Those with a family or personal history of colon polyps or colon cancer
  • Everyone age 50 or older
  • Anyone with suspicious symptoms

Signs and symptoms of colorectal cancer

  • Unexplained weight loss
  • Constant tiredness
  • Abdominal pains (gas pains, bloating, fullness)
  • Blood in the stool
  • Change in bowel habits

Risk factors

  • Lack of physical activity
  • Obesity
  • Smoking
  • Alcohol
  • Family history of colon polyps or cancer
  • Inflammatory bowel disease

UI part of Reveiz family history

Paulette Reveiz of Des Moines has received most of her health care over the years at The University of Iowa. She and her family have strong connections to the University:

  • Paulette herself was trained as an x-ray technician at UI, and worked for two years in radiation therapy at UI Hospitals and Clinics.
  • Husband Ed is a retired medical doctor who practiced 37 years in Webster City. He completed his general surgery residency at the UI Carver College of Medicine.
  • All five of the couple’s daughters (two of whom are doctors) completed their undergraduate degrees at UI.
  • One daughter and a son-in-law received their master’s degrees in physical therapy at UI.
  • One son-in-law received his JD at UI and two other sons-in-law have bachelor’s degrees from UI.