How minimally invasive surgery is having a maximum impact on patients

Gastrointestinal and inflammatory bowel diseases like Crohn’s disease and ulcerative colitis can be distressing diagnoses. At times, the debilitating symptoms can sideline a person’s day-to-day life, but the treatments can also take a physical and emotional toll. When patients go under the knife for invasive procedures, they can be left with large visible scars, or in some cases - a stoma: an external bag that collects human waste.

Sinai Health’s Dr. Anthony de Buck sees firsthand the impact this can have on patients’ mental wellbeing, especially since so many of them are between the ages of 20 and 40 - in the prime of their young lives. Luckily, there’s nothing typical about the way Dr. de Buck treats his patients. In fact, the way he approaches patient care is changing colorectal surgery as we know it.

Dr. de Buck’s journey to Sinai Health was years in the making. Training with some of the best colorectal surgeons in his native Belgium, he knew he wanted to join one of the world’s leaders in the treatment of digestive diseases. In 2013, Dr. de Buck joined Sinai Health’s Zane Cohen Centre for Digestive Diseases for a six-month fellowship, learning how to care for some of the most complex cases alongside Dr. Cohen himself. It was immediately clear to Dr. de Buck that this is where he belonged.

“Historically, Sinai Health has been a focal point for IBD. Countless people have been treated here over the decades,” he explains. “There’s a huge amount of expertise here. We have the best wound care, the best stoma care, the best social help. We have so many world-renowned experts all together in the same building.”

Four short years after his fellowship, Dr. de Buck returned full time to Sinai Health, bringing the skills he learned on both sides of the Atlantic to this already-world renowned institute. His first order of business? Minimizing the invasiveness of surgeries.

“What we do inside hasn’t changed, but how we access the abdominal cavity has changed dramatically,” says Dr. de Buck. “We’re doing a lot of complex and extensive surgery just by going through the belly button, which cleverly hides scars, or the anus rather than cutting open a patient’s stomach. I developed the trans-anal technique in Belgium in 2015 and initiated that here as soon as we had all the necessary equipment.”

The results are nearly instantaneous. Not long ago, recovery took upwards of a week. Now, patients are going home just two days after surgery. But Dr. de Buck and his team are doing much more than hiding visible scars and getting patients home sooner. A major priority is improving quality of life.

For the young women Dr. de Buck sees, this means preserving their fertility. The invasive surgeries associated with IBD can often damage a woman’s reproductive system. The minimally invasive surgery techniques Dr. de Buck is spearheading means women can get the help they need without having to abandon their dreams of one day starting a family.

When a patient requires a temporary stoma, the external bag that collects human waste, Dr. De Buck is taking the initiative to improve stoma care, and in turn, a patient’s quality of life.

“There’s another technique we’ve started at Sinai Health that helps heal leaks in patients undergoing pouch surgery, which improves outcomes for patients,” says Dr. de Buck.

The greatest challenge, however, has been the COVID-19 pandemic.

“I’ve seen the most dramatic cases ever. Patients are extremely malnourished because of their condition, and surgeries are far behind. We’ve never had to prioritize patients until now. It’s having a huge impact on their life,” says Dr. de Buck. “Because what we do is so specialized, they need to be here at Sinai Health. Sending patients to other centres simply isn’t an option.”

Despite the pandemic backlog, Dr. de Buck is on the forefront of his field and offers the needed expertise and hope for people facing a life-altering diagnosis.

“Things are moving all the time. There are new drugs and surgical techniques keep evolving,” assures Dr. de Buck. “Sinai Health is a great place to be, and you have an entire team of experts here to take care of you. It really is a game changer.”