What We Do Now
Live broadcast operation from Brazil
Multidisciplinary rectal cancer care
Our team of experts has worked together for more than 10 years to create and deliver individualized programs of care for people with rectal cancer, still achieving unsurpassed cancer outcomes and the highest quality of life for our patients. Every rectal cancer patient’s condition and course of treatment is discussed by the team in twice-monthly Rectal Cancer Management conferences.
Minimally Invasive Surgery (MIS) for colorectal cancer and noncancer conditions
Our MIS skill set is broad and always expanding as we work to continuously improve surgical care for patients. Some of the techniques in our tool kit are
Single-Port (SP) and Multi-Port Robot Surgery
Single-Port and Multi-Port Laparoscopic Surgery
Transanal Endoscopic Microsurgery
Specifically for rectal cancer (some rectal polyps)
taTME (Transanal Total Mesorectal Excision) This minimizes the need for abdominal incisions by working through the anus to remove the rectum while still preserving the anal sphincter mechanism, now done using the SP robot
TATA (Transanal Transabdominal) Proctosigmoidectomy. With this precursor to the taTME, the rectal mobilization is performed through small (laparoscopic) abdominal incisions.
taTAMIS (Transabdominal Transanal Minimally Invasive Surgery). We now use the SP robot for this procedure which, like Transanal Endoscopic Microsurgery, works through the anus to excise large polyps and select tumors, often avoiding removal of the rectum or a larger operation.
No Immediate Surgery (Watch and Wait) for highly selected rectal cancers
Working closely with our colleagues Dr. Angelita Habr-Gama and Dr. Rodrigo O. Perez in Brazil who first reported and helped define the parameters for nonoperative management of rectal cancer, we have one of the most mature US experiences with this protocol.
The full spectrum of colorectal surgical care
This list highlights some of the operations we developed or help develop and that are signatures of our program. We also offer colonoscopy and are well-versed in the diagnosis and treatment of all colorectal conditions.
The transanal part of a TATA procedure
Our OR Team and the Single-Port Robot
Dr. Marks, Dr. Schoonyoung, and our colleagues and good friends Dr. Angelita Habr-Gama and Dr. Rodrigo O. Perez at our 2019 Multidisciplinary International Rectal Cancer Society Rectal Cancer Symposium hosted at Lankenau Medical Center.
Hot off the press! A labor of love and a moment of real joy.
Our Beginnings
Marks Colorectal Surgical Associates was formed when Dr. John Marks joined his father, Dr. Gerald Marks, in practice 3 decades ago.
In a remarkably fruitful collaboration begun 20 years earlier, colorectal surgeon Dr. Gerald Marks and radiation oncologist Dr. Mohammed Mohiuddin developed a revolutionary treatment strategy to improve the outcomes for patients with rectal cancer. This involved delivering radiation before surgery and performing an innovative surgical approach to preserve the anal sphincter even when a patient’s tumor was large or very low in the rectum, near the sphincter. In the era when their work began, surgeons were leery of operating on irradiated tissue, fearing that it would be difficult to handle and not heal properly. Using a novel approach and meticulous technique, this proved untrue. The Marks-Mohhiuddin regimen not only achieved dramatic improvements in rectal cancer outcomes, but their system also helped the vast majority of patients avoid a permanent colostomy bag.
Dr. Gerald Marks was an early adopter of flexible endoscopy. His appreciation of the importance of including this skill in the surgeon’s repertoire led him to help create SAGES (Society of American Gastroinstestinal and Endoscopic Surgeons) and to be elected the founding president of the organization.
Dr. John Marks’s mission was to take the patient experience to the next level by mastering and becoming an innovator of minimally invasive surgical techniques. He has performed over 2,000 laparoscopic colorectal operations, has one of the broadest experiences in the world with transanal management of tumors and polyps, and is conducting the first clinical trial studying the use of the latest generation, single-port robot for colorectal conditions.
Dr. John Marks in the operating room. Minimally Invasive Surgery is also image-based surgery that requires intense concentration and refinement of coordination to visual cues that take the place (especially in robotic cases) of touch sense or haptic feedback.