Selected Podcast

Innovative Surgical Techniques and Programs Offered at Keck/USC

Palmdale Regional Medical Center (PRMC) has formed an alliance with Keck Medicine of USC (University of Southern California) to develop specialty urological, colorectal and breast cancer services at the hospital.

The affiliation will initially focus on developing specialty cancer services supported by USC’s clinical and physician expertise.

These specialty cancer services include urology, breast and colorectal services.

Sang W. Lee, MD is here better explain that by working together with Keck Medicine of USC, we’ve expanded the depth and variety of our medical care for the Antelope Valley community.
Innovative Surgical Techniques and Programs Offered at Keck/USC
Featured Speaker:
Sang W. Lee, MD
Sang W. Lee, MD is one of the nation’s leading experts in laparoscopic colon and rectal surgery and endoluminal surgery. He has performed more than 1,200 laparoscopic colon and rectal surgeries. He has pioneered a non-invasive surgical technique called CELS (combined endolaparoscopic surgery), which removes large colon and rectal polyps not amenable for colonoscopic removal, while avoiding bowel resection. Sang W. Lee, MD is a member of the medical staff at Palmdale Regional Medical Center and at Keck Medicine of USC.

Learn more about Sang W. Lee, MD

Melanie Cole (Host): If you’re someone who has to have surgery for a particular condition, you want the techniques to give you the best outcome. My guest today is Dr. Sang Lee. He’s one of the nation’s leading experts in laparoscopic colorectal surgery and is a member of the medical staff at Palmdale Regional Medical Center as well as a member of the medical staff at Keck Medicine of USC. Welcome to the show, Dr. Lee. Tell us some of the most exciting advances in surgery in your field.

Dr. Sang Lee (Guest): One of the things that we have been working on over the last 10 years is that we’ve been trying to treat patients with the colon and rectal diseases using less invasive techniques such as laparoscopic surgery. Nowadays, we’re trying to combine the laparoscopy and endoscopy to even avoid removing a significant part of the colon to treat very large colon polyps and other benign conditions of the colon and rectal.

Melanie: Tell us about that combination surgery and how does that work for the patient?

Dr. Lee: For example, if a patient presents with a large colon polyp, and one that a gastroenterologist decides that it’s too large or too difficult to remove using colonoscopy, 50% of the population in this country will require an open colon resection. This means they make a large incision in the abdomen and they remove a significant part of the colon. If you’re pare of the lucky 50% of the population that live in an area close to a big academic institution, then you may be able to undergo laparoscopic colon resection. But still, even in that situation, morbidity associated with the procedure is significant. What combined endolaparoscopic surgery – for short it’s called CELS – what this technique does is we combine the advantage of a laparoscopy and endoscopy. So, we simultaneously perform a colonoscopy using carbon dioxide gas that doesn’t inflate the colon as much compared to the conventional air colonoscopy. Then, we also use the laparoscopic tools so that we can manipulate the colon from outside. What that allows us to do is to manipulate the polyp and the colon from outside of the colon so that we can, then, remove these benign polyps using colonoscopy. An advantage that we have over a gastroenterologist is that we can create a defect in the colon that we can immediate recognize and repair it. The bottom line is, by doing this procedure using this technique we are able to remove these difficult enlarged polyps. The difference in outcome is that the patients who have laparoscopic surgery, they stay in the hospital for about 3-5 days in comparison with this technique patients often go home on the same day. After laparoscopic colon resection, patients return to work in about 3-4 weeks, but with this technique patients can go back to work in three days. So, it’s a much less morbid procedure with a very, very good outcome.

Melanie: You mention benign colon polyps. Can this be used for cancerous polyps as well?

Dr. Lee: We have used it for select patients who are elderly and have a lot of other medical morbidities or who are just not very good candidates for laparoscopic or even open colon surgery. We have used this technique in select cases with very good outcome as well.

Melanie: Tell us what else you’re doing as innovative techniques that you really want patients to know about.

Dr. Lee: We not only treat very straightforward cases but also very complicated cases of patients who have been to other institutions and who were told that there is not really a lot that they can do. We use multidisciplinary approaches. We work together as a team from different specialties to tackle these problems. Oftentimes we are able to offer, for example, to patients who present with rectal cancers and who are told they need a permanent bag, by using multimodality therapies, we’re able to offer a good outcome with potential for cure while avoiding permanent colostomy or permanent ileostomy, for example. Having very specialized experts in different fields coming together and working together, I think, will allow us to provide a much better outcome and much less risk.

Melanie: As a laparoscopic colon and rectal surgeon, what do you see going on in the world of laparoscopic and minimally invasive surgery that patients should know about?

Dr. Lee: We just had a meeting in San Diego – Digestive Diseases Week – where all the gastroenterologists and surgeons come together for an annual meeting. What I’ve seen, and there is a lot of push towards, is to avoid performing a bowel resections. Traditionally, as surgeons, we offer essentially removing a piece of intestine and then joining it back together. That’s been our treatment for many, many, many years. Now, technique and technology has advanced to a point where we can do a lot of the procedures without going into the abdomen. We can actually go through the colon from inside. There are tools that allow us to take care of the disease processes. It’s called endoluminal surgery. You can see more and more of these types of procedures being offered for the patients. Although technology is not quite there yet, we will be able to offer a much less invasive treatment for benign, as well as cancerous conditions, using these latest techniques.

Melanie: What would you like patients to know about prevention of issues for their colon and for rectal issues that you tell patients when you’re done working with them?

Dr. Lee: Obviously, the chances for cure for colon cancer is greatest when the patients present with early stages. Colon cancer is one of those diseases where if you start to exhibit symptoms, oftentimes it’s too late. For colon cancer, also, we have a tool that can prevent patients from developing colon cancer which is colonoscopy. When somebody without any family history, without any symptoms turns 50, they should get a colonoscopy. Usually it takes about 10 years for benign polyps to turn into colon cancer. It’s very, very important that everyone get a screening for colon cancer by having a colonoscopy performed. I think that’s probably the best way to prevent patients from ever having colon cancer.

Melanie: In just the last few minutes, Dr. Lee, what should people with questions about some of these innovative techniques we’ve been discussing be thinking about when seeking care?

Dr. Lee: Obviously, it really depends on the surgeons experience and training. Although there are a lot of new, innovative procedures out there, if the surgeon is not experienced in performing these types of procedures, it doesn’t necessarily translate into a good outcome. I think the experience and training really matters.

Melanie: Why should they come to Palmdale Regional Medical Center for their care? Tell us about your team.

Dr. Lee: We have three internationally and nationally recognized leaders in the field of colon and rectal surgery, especially in the area of laparoscopic and minimally invasive colon and rectal surgery. We’re proud to bring the same expertise to the Palmdale area. Currently, a lot of the patients are traveling outside of the area to come to us and come to other institutions. We’re offering the same expertise and same techniques so that we can take care of the patients in their setting where patients don’t have to travel too far and they’re very close to their families after having a major surgery.

Melanie: Thank you so much. It’s absolutely fascinating information, Dr. Lee, and thank you for being with us today. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information please visit That’s Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.