~64 year old lady undergoes minimally invasive surgery for Colorectal cancer at Fortis Hospitals Mulund~

Fortis Hospitals Mulund recently treated a complicated case of colorectal cancer through minimally invasive surgery. At the time of the surgery, the patient had reached a critical phase where surgery was compulsorily needed to be performed.

According to Dr. Anil Heroor, Consultant Onco Surgeon Fortis Hospitals said “minimally invasive surgery is the best possible way to treat cancers in general and specifically to ones that affect the uterus and intestines”.

Case Highlights-

-    Patient suffering from severe rectal bleeding underwent treatment for piles in another city hospital which later was diagnosed as colorectal cancer at Fortis Hospitals

-    Minimally invasive surgery, safe way to treat cancers of intestines and liver

Although minimally invasive surgeries (MIS) have become common today for many illnesses, MIS is not performed on a large scale in an area like cancer.

“Right expertise is needed to treat cancer through minimally invasive approach as many oncologists are not trained for minimally invasive surgery or minimally invasive surgeons are not oncologists. Today there are very few hospitals and surgeons with the right expertise to operate cancer through a minimally invasive way. Minimally invasive surgery is safer compared to open surgery as pain is less, hospital stay is shorter and there is quicker recovery,” said Dr. Heroor.

Mrs Anuprita, 64, started experiencing PR bleeding (rectal bleeding) with severe pain. She visited her family doctor who recommended few medicines which cured the bleeding and pain following which she visited Malaysia with her family. While at Malaysia, she again experienced PR bleeding and had to come back to India to see the doctor. Family doctor recommended her to a surgeon who wrongly diagnosed it to be a case of piles and suggested surgery. She underwent surgery in October 2010.

Post surgery within two months she again experienced PR bleeding. Heavily dissatisfied from her previous experience, she started to look for the right and permanent answer to her problem. She was referred to Dr Anil Heroor at Fortis Hospital. Dr Heroor prescribed few tests to the patient that confirmed colorectal cancer.

“Anuprita was really lucky as the detection took place really on time. Had we delayed further, anything could have happened,” said Dr. Heroor.

Dr. Heroor suggested to her minimally invasive approach as the cancer was in its initial stage. Post surgery the cancer was completely removed and as a minimally invasive approach was adopted the patient was discharged within 6 days.

I am thankful to Dr Heroor who cured the cancer and ensured an easy and early recovery. The pain has stopped completely and I am confident that I’ll be able to get back to normal course of life within few weeks after the surgery. Today, technology and medical science has advanced so much and it’s amazing that a disease like colorectal cancer could be cured through minimally invasive surgery.

The  Indian Super  Bug ” NDM” New Delhi Metallo -1 has failed to scare medical tourists coming to India for Treatments. According to Sarita Rai of Global Post.

The Big , bad superbug resistant to even the most powerful antibiotics, and it’s allegedly making the rounds of medical establishments in India, and even in the developed world, causing all sorts of problems and scaring the dickens out of everyone.  Everyone, that is, except the thousands of Westerners who are still flocking to India to get their world-class, extremely affordable medical care. “India is a great option. I spent only half of what I would have back home,” said Meece, who hails from Memphis.”

NDM-1 makes bacteria highly resistant to almost all antibiotics, including the most powerful class called carbapenems, and experts say there are no new drugs on the horizon to tackle it. A garden variety bacteria that invades the intestine, causing diarrhea, or the bladder, causing a urinary tract infection, has now acquired a gene (NDM-1) that renders it resistant to almost all antibiotics.

In a study published in The Lancet Infectious Diseases journal on Wednesday, Walsh’s team found that NDM-1 is becoming more common in Bangladesh, India, and Pakistan and is also being imported back to Britain in patients returning after treatment.

Rodney Schaubroeck, 48, a San Francisco nativ is one such patient who  arrived in Fortis Hospitals,Bangalore ,in the middle of August for heart surgery, just as news of the superbug began to break. Schaubroeck, fully covered by an insurance provider in Indianapolis, Ind., was offered a choice by his insurer: return home to San Francisco to get his mitral valve repaired or come to India with his wife, all expenses paid for three weeks, and take home a part of his insurer’s savings..

Rodney is happy that he choose India..

A team of cardiac specialists led by Dr. Mohammad Rehan Sayeed, Sr. Consultant Cardiovascular & Thoracic Surgeon at Fortis Hospitals Cunningham Road performed a complicated coronary artery bypass surgery through minimally invasive technique on a 78 year old lady.

Mrs. Sarawasti a resident of Indiranagar, Bangalore was diagnosed of coronary artery disease and underwent stenting three months back. However she complained of chest pain post stenting and was brought for a repeat angiogram and reports revealed that her main artery Left Anterior Descending (LAD) had significant obstruction. She was also suffering from Rheumatoid Arthritis for the past 20 years and was on steroids and pain killers for many years. She also developed significant osteoporosis of bones due to long term steroid effect.

“Due to the location of the block in the artery another stenting was not possible so we decided to a bypass surgery to correct the blockage. However due to her severe arthritis and osteoporotic bones which made her bones very brittle traditional open heart surgery could prove difficult as it would have prolonged the recovery of the sternum wound and the patient will experience a lot of pain. Hence keeping her condition in mind and the complications associated we decided to perform the minimally invasive cardiac bypass surgery so that her sternum cut was minimized and post op could be faster” said Dr. Rehan Sayeed.

“Technical advances have benefited medical science phenomenally bringing in newer surgical process for better patient care. Today we are able to perform heart surgeries better and more safely through smaller incisions than ever before giving patients a better post op life,” says Dr. Rehan Sayeed.

“The mini-bypass procedure offers huge advantages like patient experiences less pain, less bleeding, undergoes faster recovery and healing process, shorter hospital stay. It is of great advantageous in high risk cardiac patients as well. In this case it was the most viable option as the patient’s bones were weak and big incision on the sternum would have taken a lot more time to heal. We made a partial division of the bone with an incision of 6 cms which reduces the infection rate to 0% and also makes the faster recovery. There was no blood transfusion required during the surgery.” said Dr. Rehan Sayeed.

Minimally invasive cardiac surgery is done through a minimal access technique where the incision is phenomenally reduced and it causes least trauma to the patients’ body. The incisions are smaller about 6–8 cms whereas in the traditional open heart surgery the incision size is about 20-25 cms. In mini-bypass the sternum cut is minimum making the recovery process and bone healing faster. The bypass is done on a beating heart maintaining the body’s normal processes. It is done to reduce the trauma of surgery on the body and heart, less pain, better cosmesis, 0% infection rate and almost bloodless surgery. The same incision and approach can also be used for Valve replacement or repair surgery and most congenital heart surgery.

All patients with moderately well functioning hearts qualify for this approach. It gets the patient back to life faster with better recovery and less pain. In this approach there is no usual sternal precautions one needs to take post surgery as the size of the incision is very minimum and the patient can get back home in just about 4 days post surgery, to a desk job in 2 weeks time and to driving in just 6 weeks time.

Dr. Rehan who has joined Fortis Hospitals Cunningham Road has performed about 25 mini cardiac bypass surgeries. Prior to this he has performed about 150 cardiac bypass and 300 + for the entire range of minimal access cardiac surgeries.

One need to undergo an extensive training to perform mini bypass surgery on the whole and also need to do a large volume to do multi vessel bypass. Most minimal access approach is mainly done for single vessel or two vessels. Dr. Rehan does it for quadruple and more bypasses on a beating heart.

Fortis Hospitals ( Former Wockhardt Hospitals,) Cunnigham Road now makes Single Incision Laparoscopic Surgery (SILS) a routine

Fortis Hospitals , Cunningham Road Bangalore  has consistently begun to use an advanced surgical technique in the field of laparoscopic surgery called ‘Single Incision Laparoscopic Surgery’ (SILS). The team led by Dr. Aashish Shah, Consultant Gastrointestinal and Laparoscopic Surgeon, Wockhardt Hospitals, has performed 10 Single Incision Laparoscopic Surgeries which includes Cholecystectomies (removal of the gallbladder) and Appendicectomies (removal of the appendix).

Globally, Single Incision Laparoscopic Surgery has only gained popularity over the last one to two years and this surgical technique is mainly offered at major laparoscopic centers. In India, the procedure is relatively new as most hospitals lack the expertise and equipment required for the procedure.

SILS is an advanced minimally invasive surgical procedure in which the surgery is done through a single entry point i.e. the navel. A 20mm incision at the umbilicus is all that is required for the surgery. A scope is inserted that can be moved around in the body and return images form various angles giving the surgeons a larger field of vision for the surgery and the instruments used to perform the surgery are flexible thereby enabling extra reach and maneuverability.

“SILS involves the use of flexible instruments and a higher level of laparoscopic expertise. Currently we have been using this technique for uncomplicated Gallstone Disease and Appendicitis. All of our ten patients have been discharged in 24 hours after surgery and have been ambulant within 3 to 6 hours of the surgery. In fact, in one of our patients’ both the gallbladder and appendix were removed using SILS and she was discharged within 24 hours and was back to routine activity in three days post surgery, thus highlighting the advantages of SILS” said Dr. Aashish Shah Consultant Gastrointestinal and Laparoscopic Surgeon, Wockhardt Hospitals.

Earlier, patients had limited choices when it came to surgery i.e. conventional open surgery or laparoscopic with multiple incisions, laparoscopic surgery being the preferred choice. However now with the introduction of Single Incision Laparoscopic Surgery, patients can undergo surgical procedures with just a single incision (approx half an inch) in the belly button and that too with a number of benefits over conventional procedures such as less pain, quicker recovery, less blood loss, less complications and minimal scarring and helping patients getting back to work faster.

“SILS is the next big step in laparoscopic surgery worldwide. It offers a huge cosmetic advantage and also enables much quicker recovery for the patient compared to conventional lap surgery. For the patient it is extremely appealing to be offered surgery through a single small cut, than through multiple incisions” Dr. Aashish Shah adds.

SILS is an excellent option for all patients who need laparoscopic surgery more so for uncomplicated Gallstones, Appendicitis and Hernia operations. At Wockhardt Hospital, Cunningham Road, as a routine, SILS is being offered to all suitable patients.