Colon and Rectal Surgeons
of Kansas City

Shawnee Mission Medical Center

SMMC First in Region
with Minimally Invasive J-Pouch Procedure

With an outstanding laparoscopic team and dedicated nurses, SMMC has been aggressive in bringing laparoscopic procedures to the hospital. Graham has been performing various colon surgeries for years, and has smoothly transitioned to the laparoscopic approach.

Shawnee Mission Medical Center (SMMC) continues to open the door to new, minimally invasive procedures in the Kansas City area. Bruce Graham, MD. is the only physician in the city, and one of a select few in the country to perform a minimally invasive ileo anal J-Pouch procedure.

Prior to this advancement, the procedure was done through a 15-inch incision. Now, minimally invasive technology available at SMMC allows the procedure to be done with three small incisions, leading to a faster, less painful recovery and minimal scarring.

The J-Pouch procedure is used after removal of the colon and rectum for patients suffering from ulcerative colitis or familial polyposis.  Ulcerative colitis is a disease that affects the lining of the colon and rectum, creating severe inflammation and ulceration.  “It usually attacks younger individuals, even in the pediatric group,” said Graham.  “But it can occur in any age.”

Familial polyposis is a genetically transmitted disease where people begin forming hundreds of polyps that will turn to cancer at a fairly young age.

Patients who undergo the minimally invasive J-Pouch procedure can get back to normal physical activities faster than with the traditional surgery, and they experience very little pain.  "In many it’s almost like they had not had surgery’” said Graham. “They’re not as sick overall, and they’re eating the first day after surgery.”

While there are certain foods they can’t eat, Graham said patients greatly value their ability to lead a normal life again following the procedure. “They are probably some of the most grateful patients that we have,” he said. “We hear frequently from these people. It really has changed their lives.”

While the minimally invasive method is new, the J-Pouch procedure has been around for 20 years. Prior to that time, after removal of the colon and rectum, the only option for patients with ulcerative colitis or familia prolyposis was the use of a permanent ileostomy, a plastic pouch that adheres externally to the skin. In the early 1980’s the J-Pouch became a viable option. The procedure has been modified over the past 10 years and is now the standard.

During his career, Graham has seen the life of the J-Pouch and its evolution. He said he never envisioned the surgery becoming as popular as it has. But, he said the advancements have provided tremendous relief for patient.

Most people are candidates for the minimally invasive approach. But, for those who have had numerous abdominal surgeries and have a lot of scar tissue, the surgery becomes more difficult.  The procedure is not done in emergency situation.  Graham said obesity makes the surgery more difficult, as well.

For patients who are candidates, Graham said the minimally invasive approach will quickly become the standard of care.  “If the patient is a candidate, it is really well worth doing,” he said.

Graham stresses the experience of the surgeon is instrumental in successful outcomes for both the traditional and minimally invasive J-Pouch procedure. Not only is he the first surgeon in Kansas City to perform the minimally invasive procedure, he has performed more traditional procedures than any other area physician.

With an outstanding laparoscopic team and dedicated nurses, SMMC has been aggressive in bringing laparoscopic procedures to the hospital.  Graham has been performing various colon surgeries for years, and has smoothly transitioned to the laparoscopic approach “in the last year we’ve done over 100 laparoscopic colon surgeries. This is just a natural extension of what we’ve been doing.”

Fro more information regarding this or other laparoscopic procedures at SMMC, contact the ASK-A-NURSE Resource Center at 913-676-7777 or visit ShawneeMission.org.