The Mass General Crohn's and Colitis Center

Richard A. Hodin, MD, is chief for Academic Affairs in the Department of Surgery, surgical director of the Center for Inflammatory Bowel Disease, and chief of Endocrine Surgery at Massachusetts General Hospital; and a professor of surgery at Harvard Medical School. In this video, he discusses the advances his team at the Crohn's and Colitis Center has made in treatment for patients with inflammatory bowel disease.

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Transcript

The Massachusetts General Hospital Crohn's and Colitis Center is a special place. We have a group of gastroenterologists and a group of surgeons who work very closely together. There are other specialists who are also involved, like radiologists, pathologists, psychologists, nutritionists, social workers...there's a whole group of caretakers who help, but primarily IBD (inflammatory bowel disease) patients are taken care of by the gastroenterologists, and then by surgeons as needed.

We do have a great group of specialists here, and I have to say I really have been honored over many years to work with the gastroenterologists in the Crohn's and Colitis Center who are just so good at what they do. They are real experts, and I feel so confident when I tell patients that they are under the care of somebody who really knows everything about these diseases, all the medications, the latest trials—that they don't have to worry that they're not getting access to the best possible care.

[Inflammatory bowel diseases] are the kinds of diseases that require communication between providers and we, again, work very closely together. We have a weekly meeting every Friday, we call it the IBD Forum, where the surgeons and gastroenterologists get together and discuss patients primarily, sometimes other issues that come up. Directly talking about patients in this group is incredibly helpful.

Communication is so important and we can try to make sure that we're all understanding the situation and have full access to all of the kinds of data. Also, we're able to get opinions from other people, other surgeons, other gastroenterologists, reviewing various x-rays, scopes, pictures, pathology, and able to get other opinions which sometimes are really key to try to figure out the best approach. When we're thinking about the future of IBD care it's really exciting from a number of standpoints. I mean, I'm a surgeon and I don't deal as much directly with the medications, but the number of new medications that are being developed for IBD is just unbelievable. Almost every year or two there's a new medication that's either coming out on the market or about to come out and under trial, and they've really made a remarkable difference for patients. In fact, we think have saved a lot of patients' surgery, so that saves them from me, which in the long run is a good thing. So it's really unbelievable the way basic research in the research laboratory has been brought to the clinic. IBD is an amazing example of that, where new discoveries being made in cell culture, in animal models, are then brought to patient care, to clinical trials, and again have resulted in much better treatment for patients and more options for their diseases.

On the surgical side, there have been a lot of advances. Probably the most obvious one is the minimally invasive approaches that we now use, [such as] laparoscopic surgery [or] even robotic surgery. When I was training and doing this 30 years ago, basically every patient that needed surgery got the full "zipper" so to speak, from top to bottom had a big incision. That was just what we did, and people didn't really know better or think there was any other way, and at the time there wasn't. But now we are able to do these same operations, really better operations, through tiny little incisions or port sites makes a remarkable difference for patients. Recovery times are so much quicker.

Again, years ago we used to do surgery for patients with Crohn's or ulcerative colitis and they would be in the hospital seven to 10 days routinely after surgery and we'd say probably a six-week recovery at least, sometimes longer. Nowadays, we routinely send patients home after one or two nights in the hospital and talk about recoveries in a couple of weeks. It's a much different landscape and it's just getting better and better with the kind of techniques and various innovations [we have].

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