Division of colorectal surgery, Department of Surgery, Taipei Veterans General Hospital

Major event

1. 1959: Establishment of division of rectal surgery, at the very beginning of Taipei Veterans General Hospital. We were among the earliest of subspecialty in Taiwan.

2. 1959: The first time to place patient in lithotomy position to perform abdominoperineal resection in one position, rather than two position before.

3. 1964: Change of name of "Division of Rectal Surgery" to " Division of colorectal surgery" to meet the actual clinical practice.

4. 1964: Using phenol in olive oil, instead of sodium mofourate, for hemorrhoids injection to avoid the side effects.

5. 1965:  Using prone Jack-Knife position and local anesthesia for hemorrhoids surgery. It was adopted till now.

6. 1967: Starting with Duhamel operation for congenital megacolon patients.

7. 1969: Confirming that the origin of anorectal abscess and fistula in ano originated from cryptitis. One stage operation could be performed in stead of two stage operation, that is, incision and drainage for abscess, followed by definite fistulotomy or fistulectomy.

8. 1971: using partial internal sphincterotomy to treat anal fissure.

9. 1972: Performing total pelvic exenteration to treat locally far advanced rectal cancer.

10. 1972: Establishment of rectoscopy room and rectoscopy was included in routine examination.

11. 1973: complete closure of hemorrhoidectomy wound to reduce pain and hospital stay.

12. 1973: application of total anoplasty to treat advance rosette type hemorrhoids.

13. 1973: using "The no-touch technique ", advocated by Turnbull, to perform colorectal cancer surgery to reduce cancer cells spreading.

14. 1973: application of partial closure of horseshoe type anal fistula to reduce anal deformity.

15. 1977: application of “Koch pouch” to treat patient receiving total proctocolectomy.

16. 1978: starting colonoscopy examination. In addition to checking colorectal lesions, we could performed biopsy and polypectomy. Currently, more than ten thousands examinations were performed a year.

17. 1982: using ileal J pouch or S pouch with anal anastomosis to preserve anorectal function.

18. 1983: using GIA with end to end anastomosis in low anterior resection for sphincter saving. The incidence of APR reduced from 50% to 15~20%.

19. 1984: starting anorectal manometry examination and establish anorectal functional examination laboratory for the diagnosis of function of anorectal disease. It is the pioneer in Taiwan.

20. 1987: using “Defecography " to evaluate patient with constipation, incontinence, rectal prolapse, intussusception, rectal prolapse, pelvic floor descending. It is in the first place in Taiwan.

21. 1989: application of double S rotation flap for reconstruction of skin loss after advanced resection of perineal skin, such as Paget's disease and Bowen's disease.

22. 1992: using trans-rectal ultrasound to evaluate invasion depth of rectal tumor.

23. 1992: we performed the first laparoscopic colon resection in Taiwan. Initially, it was used in benign disease and recently, it could be applied in colorectal cancer surgery.

24. 1993/9: using laser knife in hemorrhoid surgery.

25. 1996: using colon pouch-anal anastomosis in LAR to improve the anorectal function.

26. 1999/11: using TEM surgery (Trans-anal Endoscopic Microsurgery) to treat middle to upper rectal lesion, avoiding trans-abdominal operation.

27. 2000/3: using trans-colonoscopy ultrasound to evaluate the invasion depth of colon cancer.

28. since 2001: a comprehensive database including colorectal surgical specimens and clinical data, in order to provide resource for further translational research.

29. since 2001: starting basic study for colorectal cancer, such as standardization of report form, analysis of prognostic and predictive factors.

30. 2005: establishment of prognostic classification of colorectal cancers using oncogene, mutation and variation.

31. 2005: establishment multidisciplinary team to treat colorectal cancer.

32. 2007: registry of FAP and gene mutation study of FAP patients.