One-cut solution for abdominal surgeries

MUMBAI: The days of making a 15-cm cut to perform abdominal surgeries are long gone. While laparoscopic surgeries with three-four incisions have been in practice for a while now, some city doctors have taken the concept of a minimally invasive surgery a step further.
The current trend is to introduce the instruments through a laparoscopic port in the navel and another small incision alongside it.Though the advantages of this single incision technique are many, it is not every surgeon's cup of tea as it is quite complicated to perform, say experts.
"As compared to the earlier laparoscopic surgery, wherein three to four cuts (between 5 mm to 10 mm) were required to insert the equipment for the surgery, the single-incision-laparoscopy requires only one cut. This cut (between one to two cms) within the navel is enough to push in a laparascope and another instrument. So the laparascope is left there through the surgery and we push in other instruments as and when required," said Dr Deepraj Bhandarkar, gastrointestinal surgeon with P D Hinduja Hospital.
From the removal of the gall bladder to a hysterectomy-single-incision surgeries are being done for a host of problems. Ketki Sarang (33) (name changed), for example, had a stone in her gall bladder for a year. Visits to various doctors revealed that her gall bladder needed to be removed since the stone could not be removed.
"Every doctor I consulted told me that I would have to undergo an open surgery, which would require them to make a cut of around seven inches. I didn't want that big a scar on my stomach. When I heard about single incision laparoscopy, I was not sure if a whole gall bladder could be removed with it. But the surgery was done successfully and my scar doesn't even show," said Sarang, who underwent the surgery last year. "I could walk the day after the surgery," she added.
Dr Pritesh Naik, who works at Purnima Hospital in Borivli (E) and specializes in single-port hysterectomy, has come up with a technique that involves only a 10 mm cut next to the navel. "The surgeries are technically difficult, slightly expensive and need expertise. On the other hand, there is less bleeding and a smaller scar which doesn't show and the patient recovers faster," he said.
Dr Rasik Shah, consultant paediatric surgeon at Bhatia Hospital, says that one of the main advantages of this surgery is that a child does not have to face the trauma of having a big surgical scar all their life.it is good for the psychology of a child. "We have been doing this surgery for the removal of appendix, hernia, cysts, diseased intestines and kidneys. The good thing is that a child does not have to go through the trauma of having a big scar all their life after a surgery," he said.
The single incision surgeries, are being done for a host of problems. 33-year-old Ketki Sarang (name changed), for example, had a stone in her gall bladder for a year. Multiple visits to various doctors revealed that her gall bladder needed to be removed since the stone could not be removed. "Every doctor I consulted, told me that I would have to undergo an open surgery which would require them to make a cut of around seven inches. I didn't want that big a scar on my tummy. When I heard about single incision laparoscopy, I was not sure if a whole gall bladder could be removed with it. But the surgery was successfully done and my scar doesn't even show," said Ketki, who underwent the surgery last year. "The incision was within my naval. I could walk the next day," she adds.
The days of opening the abdomen with a 15-cm cut for a surgery are long gone. While laparoscopic surgeries with three-four incisions have been in practice for quite sometime, many doctors have taken the concept of minimally invasive surgery a step further.
The current trend is to introduce laparoscopic equipments through a laparoscopic port in the naval and another small incision alongside it. Though there are many advantages of the single incision technique, it is quite complicated to perform and not every surgeon's cup of tea, say experts.
"As compared to the earlier laparoscopic surgery, wherein three to four cuts (between 5 mm to 10 mm) were required to insert the equipments to carry out a surgery, the single incision laparoscopy requires only one cut. This cut (between one to two cms) within the naval is enough to push in a telescope and another instrument. So the telescope is there throughout the surgery and we push in other instruments as and when required," said Dr Deepraj Bhandarkar, gastrointestinal surgeon with P D Hinduja Hospital.
From removal of gall bladder to intestine to a hysterectomy-- the single incision surgeries, are being done for a host of problems. 33-year-old Ketki Sarang (name changed), for example, had a stone in her gall bladder for a year. Multiple visits to various doctors revealed that her gall bladder needed to be removed since the stone could not be removed. "Every doctor I consulted, told me that I would have to undergo an open surgery which would require them to make a cut of around seven inches. I didn't want that big a scar on my tummy. When I heard about single incision laparoscopy, I was not sure if a whole gall bladder could be removed with it. But the surgery was successfully done and my scar doesn't even show," said Ketki, who underwent the surgery last year. "The incision was within my naval. I could walk the next day," she adds.
Dr Pritesh Naik, who specializes in single port hysterectomy, has come up with a technique which involves only a 10 mm cut alongside the umbilicus. "The surgeries are technically difficult, slightly expensive and needs expertise. But on the other hand, there is less bleeding, a smaller scar which doesn't show and the patient recovers faster," he said.
Dr Rasik Shah, consultant pediatric surgeon at Bhatia Hospital says that one of the main advantages of this surgery is that it is good for the psychology of a child. "We have been doing this surgery for removal of appendix, hernia, cysts, diseased intestines and kidneys. The good thing is that a child does not have to go through the psychosis of having a big scar all through their life after a surgery," he said.