Tuesday, October 12, 2010
GASTROENTEROLOGY
GASTROENTEROLOGY: "Diseases of stomach , small intestine , colon , anorectum , Liver, Biliary tree, Pancrease and spleen all under one roof Ulcer, Acidity, Gastritis, Varices,G..."
Friday, June 4, 2010
Metamorphosis!
A year ago Mrs. Kate was brought to Dr. Maran with morbid obesity. The scales tipped at about 420 pounds! Her legs refused to bear the weight of her body. She couldn’t stand, let alone walk!She had a lot of co existing problems too along with her obesity. She was a diabetic, hypertensive and had severe sickle cell anemia with a sickle cell crisis every two months! This induced unbearable bone pain so much so that even a gentle touch during a medical examination made her cry out aloud in pain. She also had an umbilical hernia and a hiatus hernia. Almost all her problems were the direct result of her obesity and high Body Mass Index.
The picture below was taken at the
Contrast the picture above with that of the one below. Today, a year after a Laparoscopic Gastric Bypass with Roux-en-Y, she is the picture of a lissome beautiful young woman brimming with confidence. She is a business tycoon now, great dancer...no diabetes, no hypertension and no more of those deadly sickle cell crises. She is due for her review next month and the smile on her face says it all and that’s the surgeon's pride.
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Thursday, March 11, 2010
Tuesday, March 9, 2010
Asia-Pacific Region's FIRST SILS Right Adrenalectomy
Yeah, Dr. Maran is at it again. I say this with a big dollop of pride for yet again my good friend and colleague has raised the bar and scaled newer peaks. Earlier it was the SILS sleeve gastrectomy along with a hysterectomy and now it is Asia Pacific region's first Single Port Trans-peritoneal Approach Right Adrenalectomy.
Single Access Retroperitoneoscopic Adrenalectomy aka SARA is a common procedure but a trans-peritoneal approach and that too on the right side is a Herculean task considering the fact that vital gut organs have to be mobilized carefully without causing any inadvertent injuries.
The path breaking surgery was performed on a 29 year old mother of two who was diagnosed with a 6cm tumor mass over her right supra renal region which was an incidental finding detected on a CT/MRI scan while evaluating her for chronic abdominal pains. Through a 1cm single hole over the umbilicus (belly button) the Right adrenal gland was approached which is located in the back near the 12th thoracic vertebra. The Adrenal gland which secretes essential steroids and adrenaline was removed without any blood loss. Earlier these types of tumors have been surgically removed by making a 25 – 30 cm incision over the abdomen by conventional laparotomy techniques.
The First-ever Laparoscopic Adrenalectomy was done in Year 1992 in the United States. These Second generation surgeries were done through 3 – 4 ports each measuring 12 mms. The current advancement is the Third generation technology otherwise known as Single Incision Laparoscopic Surgery which requires great expertise, good dexterity of the surgical hands as well fly by wire surgical instruments sophisticated enough to delicately handle the instruments through a 1cm single hole made via the Belly button).
This particular case is now Asia-Pacific regions First-ever Single Incision Laparoscopic Surgery for Right Adrenalectomy. Congrats Dr. Maran, and may you keep attempting the seemingly impossible!
Benefits:
Advantages of this ‘Belly button’ surgery:
a) Blood loss is minimal.
b) Because of a single key-hole, the patient feels absolutely no pain!
c) Hospital stay is reduced minimizing on hospitalization bills.
d) Patient can take liquid diet on the very evening of such a major surgery!
d) Newer technology doesn’t necessarily mean higher cost! In fact the treatment costs are reduced by at least a third.
f) Though this is the first of a kind here in India, this emerging technique doesn’t require a corporate hospital set up and can be done at your neighbourhood hospitals.
g) Hitherto, one had to travel abroad for sophisticated surgery, but with the advent of rapid technology transfer along with globalization we can have it done conveniently at home reducing on the travel cost and hassles of traveling.
e) Last but not the least, cosmetically there is absolutely no scar!
Scope and Future of SILS:
Henceforth the spectrum of gastro-intestinal surgeries will be categorically looked at from a SILS point of view, next comes Conventional Laparoscopic methods and only when both the methods fail, will open surgical procedures will be considered.
Single Access Retroperitoneoscopic Adrenalectomy aka SARA is a common procedure but a trans-peritoneal approach and that too on the right side is a Herculean task considering the fact that vital gut organs have to be mobilized carefully without causing any inadvertent injuries.
The path breaking surgery was performed on a 29 year old mother of two who was diagnosed with a 6cm tumor mass over her right supra renal region which was an incidental finding detected on a CT/MRI scan while evaluating her for chronic abdominal pains. Through a 1cm single hole over the umbilicus (belly button) the Right adrenal gland was approached which is located in the back near the 12th thoracic vertebra. The Adrenal gland which secretes essential steroids and adrenaline was removed without any blood loss. Earlier these types of tumors have been surgically removed by making a 25 – 30 cm incision over the abdomen by conventional laparotomy techniques.
The First-ever Laparoscopic Adrenalectomy was done in Year 1992 in the United States. These Second generation surgeries were done through 3 – 4 ports each measuring 12 mms. The current advancement is the Third generation technology otherwise known as Single Incision Laparoscopic Surgery which requires great expertise, good dexterity of the surgical hands as well fly by wire surgical instruments sophisticated enough to delicately handle the instruments through a 1cm single hole made via the Belly button).
This particular case is now Asia-Pacific regions First-ever Single Incision Laparoscopic Surgery for Right Adrenalectomy. Congrats Dr. Maran, and may you keep attempting the seemingly impossible!
Benefits:
Advantages of this ‘Belly button’ surgery:
a) Blood loss is minimal.
b) Because of a single key-hole, the patient feels absolutely no pain!
c) Hospital stay is reduced minimizing on hospitalization bills.
d) Patient can take liquid diet on the very evening of such a major surgery!
d) Newer technology doesn’t necessarily mean higher cost! In fact the treatment costs are reduced by at least a third.
f) Though this is the first of a kind here in India, this emerging technique doesn’t require a corporate hospital set up and can be done at your neighbourhood hospitals.
g) Hitherto, one had to travel abroad for sophisticated surgery, but with the advent of rapid technology transfer along with globalization we can have it done conveniently at home reducing on the travel cost and hassles of traveling.
e) Last but not the least, cosmetically there is absolutely no scar!
Scope and Future of SILS:
Henceforth the spectrum of gastro-intestinal surgeries will be categorically looked at from a SILS point of view, next comes Conventional Laparoscopic methods and only when both the methods fail, will open surgical procedures will be considered.
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