INDIA: Less PAIN, more GAIN

BANGALORE (The Times of India), August 17, 2008: By Nirmala M. Nagaraj, Times News Network Fifty-five-year-old Oyebamiji Mojisola Ester from Nigeria underwent a hip replacement surgery at the HOSMAT Arthritis and Joint Replacement Centre. Ester, who belongs to the Jehovah Witness Faith, refused to take blood from others. With help of a computer navigation system with minimally invasive approach wherein the blood loss is significantly low, she successfully underwent hip replacement without blood transfusion. "Many patients from the US and Africa of the Jehovah Witness faith, who turn down blood transfusion, come here for treatment. With minimal invasive surgery, recovery is faster: within 24 hours of hip replacement, the patient can start walking,'' says Dr Thomas Chandy, chief of orthopaedics and managing director of HOSMAT Hospital. Recently, a team of cardiothoaracic surgeons along with the minimal-access surgeon at Wockhardt Hospital conducted a live video-assisted surgery on two patients suffering from tumour in the chest and hyperhydrosis (excessive sweating disorder). In the traditional surgical approach, the thoracic cavity has a single large incision placed between the patient's ribs. The ribs are then spread apart, allowing the surgeon to look directly into the patient's chest cavity. These incisions are very painful and require the patient to stay in hospital longer. In video-assisted surgery, a small camera is introduced into the patient's chest via an incision. Through the camera , the surgeon views the chest cavity . This reduces chest wall trauma, deformity and postoperative pain. It comes handy during macro neurosurgeries too. In brain surgeries, surrounding tissues of the operated area get affected because of which patients might suffer from disability. Incision minimizes such a threat. "Earlier, some neurosurgeries used to take up to 20 hours per surgery, because of which neurosurgeons were known to work by the calendar! With the advances made in technology, we are getting used to hours and minutes. We used to cut open one-fourth or half of the skull for some surgeries. In these minimally invasive surgeries, morbidity is less, recovery faster. Now, not all head surgeries need to have the head shaved, which has reduced the psychological press,'' says Dr Venkataramana, neurosurgeon and vice-president of BGS Global Hospital. The minimal invasive surgery has also made a breakthrough in cancer treatment. "The role of laparoscopic surgery in the removal of rectum compared to the traditional method is tremendous, as the postoperative complications are less. The minimally invasive approach has been beneficial in treating all types of cancer: rectum, colon, stomach, liver pancreas, lung. But conversions are common. Sometimes , after conducting the minimally invasive surgery, we may have to do the same surgery traditionally with bigger incision,'' says Dr Kodaganur S Gopinath, director, Bangalore Institute of Oncology. "We are still in the infancy when it comes to minimal invasive surgeries. Generally, these surgeries are recommended for low-risk patients; for high-risk cardiac patients, we follow the regular procedure. These fancy techniques are cosmetically beneficial , leaving fewer scars,'' says Dr Devi Shetty, chairman, Narayana Health City. Most city hospitals are upgrading their technology to be on a par with international standards. These technically empowered hospitals have adopted minimal invasive approach. BENEFITS * Fast recovery * Hospitalisation period reduced * Less bleeding, less pain * Reduced risk of infection by blood transfusion * Reduced pain-killer dosage * Post-operative risk reduced * Fewer post-operative scars Copyright © 2008 Bennett Coleman & Co. Ltd.