| BANGALORE, KARNATAKA, INDIA | 08-09-2011 06:08 PM |
.JPG) The team of Surgeons from the Institute of Surgical Gastroenterology and Minimal Access Surgery lead by Dr. G. Srikanth at BGS Global Hospitals, Bangalore, part of the Global Hospitals Group performed a major liver surgery for metastatic cancer through the keyhole surgery procedure. The right lobe of the liver of the patient was completely removed by totally avoiding a major open resection of liver. The case 69 year old Lingappa (name changed) was distraught when he was diagnosed to have recurrence of cancer in the liver. He went through the ordeal of surgery for rectal cancer and post-operative chemotherapy just one year before. Now his follow-up scans clearly indicated that he had a metastatic liver cancer in the right lobe. His whole body PET scan showed no evidence of disease elsewhere. Surgical removal of the right lobe of liver would give him an opportunity for cure. But he was distressed to learn about the need for a second surgery for his current problem. Minimally invasive (key-hole) major liver surgery performed Dr. G. Srikanth, Director of Gastroentrology Services, BGS Global Hospitals said, ?The surgical removal of the right lobe of the liver afflicted with cancer was performed laparoscopically. In fact we are possibly the only other centre in the country performing such a major liver resection by minimal invasive surgery and this is the first of its kind in Karnataka. The surgery was performed through five small incisions of 0.5 inch each and the right lobe of liver of size 15 cms x 12 cms was removed through a 2.5 inch incision. Blood transfusion was not required during or after surgery.? .bmp) The patient could walk comfortably the day after surgery. He made quick recovery and was fit for discharge in 6 days after surgery. This procedure enables the patient to enjoy many benefits as detailed below: Patient benefits: -- Smaller incision -- Aesthetically better with less scarring which fade with time -- Less post-operative pain -- Fewer wound related complications. -- Early recovery -- Lesser chance of infections -- The need for pain killers is significantly less -- Early mobilization, patient can walk the day after surgery -- Short stay at the hospital Surgery extremely challenging Laparoscopic surgery of the liver is extremely challenging and considered the ?holy grail? of laparoscopic surgery. It requires a dedicated team of Surgeons, Anesthetists and Intensivists with requisite support facilities, operation theatres, ICU and infrastructure. Minimally invasive surgery an encouraging option for metastatic liver cancer Dr. Srikanth added, ?It is important to highlight that there is a misconception that 'when metastasis to liver occurs in colo-rectal cancer it is incurable?. The fact is that in selected patients cure is still possible. Since many of the patients presenting with metastasis in the liver from colon and rectal cancer have previously undergone a surgery for removal of the primary cancer, when metastasis are detected at follow-up as in the patient highlighted, a minimally invasive liver surgery is a very encouraging option for these patients who need to undergo reoperation.? What happens in an open surgery which is normally performed? An open surgery usually performed entails a very large abdominal wound. An incision of 12 to 15 inches ?mercedes benz? incision is required. (It is so called because of its resemblance to the logo of Mercedes benz). This leaves behind a very big scar. The wound is larger hence more risk of wound related complications and a higher chance of infection. A big incision limits breathing making it shallow and hence the patient is more prone to chest infections. The duration of hospital stay is around 10 to 12 days, and the patient can walk only after 4 days. About Department of Surgical Gastroenterology, Minimal Access Surgery and Bariatric Surgery The team of dedicated specialists has extensive experience in laparoscopic liver, biliary, pancreatic surgery and advanced laparoscopy. The hospital boasts of infrastructure, operating room facilities with latest equipment and liver intensive care unit which is the largest in the state. About BGS Global Hospitals BGS Global Hospitals is a multi-speciality tertiary care hospital focused on Neurosciences, Hepatology and Multiorgan Transplantation, Cardiac Sciences, Urology and Nephrology, Gasteroenterology, Minimally invasive and Bariatric Surgery, Orthopaedics, Oncology, Critical Care and Trauma. The Hospitals advanced infrastructure includes 14 major speciality operating rooms, more than 120 intensive care beds and a comprehensive emergency care and trauma unit. It?s Liver and Transplant ICU is the largest available across the state of Karnataka. | |
Monday, September 19, 2011
BGS Global Hospitals performs very rare Minimal Invasive (Key Hole) Liver Surgery for Metastatic Cancer
Sunday, September 18, 2011
Breastfeed to save lives
The importance and benefits of breastfeeding is increasingly lost on mothers in Sarawak, who rank second to last in a nationwide poll on breastfeeding mothers in Malaysia.
The Star Online
ACCORDING to the United Nations Children’s Fund (Unicef) fact sheet, breastfeeding has been proven to be the most effective way of reducing the mortality rate of children under five years old and it saves more than 3,500 children lives everyday.
“With so much at stake, we need to do more to reach women with a simple, powerful message: ‘Breastfeeding can save your baby’s life’,” said Unicef executive director, Anthony Lake, at the recent World Breastfeeding Week.
Mothers in Sarawak seem to have a lot of catching up to do in terms of breastfeeding. A nationwide poll on exclusive breastfeeding by mothers during the first six months after childbirth puts Sarawak second last with 6.1%.
The fact was made known by Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin last July when she spoke at a food basket presentation at Bekenu. She also noted that Sarawak needed to do something about the worrying statistics.
Research has shown that artificially-fed babies are at greater risk of gastro-intestinal, respiratory and urinary tract infections. They are also more prone to allergic diseases as well as Type 1 and Type 2 diabetes and childhood leukaemia.
It is a known fact that mothers who breastfeed have lower risk of getting breast cancer, ovarian cancer and hip fractures.
Some recent studies even claimed that breastfeeding lessened the risk of having rheumatoid arthritis and postnatal depression. But these claims need to be substantiated with further research.
Breastfeeding is most economical. Breast milk substitutes that are nutritionally adequate are expensive.
A tin of nutritionally comparable infant formula could go up to RM70 or more per tin. One baby would consume about 40kg of formula over a year, this is equivalent to 80 tins.
Breast milk is best but many mothers take it for granted by falsely thinking that formula is just as good or even better. Some even believe that using formula milk depicts a better quality of life while breastfeeding is a thing of the past from the villages.
The good news is more people are becoming aware of what is good for them by going back to nature and opting an all-natural solution as a lifestyle. With this we also see breastfeeding making a comeback.
Breastfeeding isn’t easy. Mothers who go to Klinik Kesihatan Ibu dan Anak are always asked whether they are still breastfeeding, and who gives them support? This is done each time they come in for an appointment.
Without support, breastfeeding usually fails as the formula is an ever-ready, easy way out. And once formula is used to substitute a feed, it will further decrease the milk supply. It acts almost like a trap.
“Most mothers give up on breastfeeding as soon as they resume work. Some just can’t be bothered to make that extra effort of breast pads and breast pumps during office hours. I only managed to breastfeed for six months,” said Nurhaiza-wati Samsimon, who has a three-year-old son.
Another mother claims that she has struggled to make it happen but gave up in the end because of the unsupportive environment at the workplace and public places.
“I use a nursing poncho in public but still get stares as if I’m doing something wrong and there aren’t many baby-friendly places around in Kuching,” says another mother, who has a four-month-old daughter.
Then there are those who give up at the first obstacle encountered as they have preconceptions and false expectations of breastfeeding.
Mastura Ishak, a mother of four, used to believe that she didn’t have enough milk. She also used to complain of painful breastfeeding sessions. It wasn’t until she met with a lactation consultant that she realised she wasn’t doing it right.
Her wrong techniques and positioning was what made it painful during feeding and to her surprise, she actually had more than enough milk for her youngest son.
It was announced last May that nurseries will soon become a permanent feature at Sabah state government department offices. The announcement was made by the Community Development and Consumer Affairs Minister Datuk Azizah Mohd Dun.
Hopes are that this move will be followed by Sarawak’s state government as well. So far, nurseries are being built at some chosen government departments in Kuching. This move would be greatly appreciated by breastfeeding mothers in Sarawak as they could easily drop by at the nursery to breastfeed their babies.
“A nursery within the office would be a great contribution to all working mothers. It would definitely ease the mother’s burden and worry as the child is in the same building and there won’t be any need for a breast pump,” said Farah, a mother of six who works as a radio presenter in Kuching.
Basically, mothers want a supportive environment at work and public places. It doesn’t seem much to ask but there is still hesitation and ignorance that hinders further support.
There are only a few public places that are equipped with a nursing room and even less work places with a nursing facility. Even public places such as airports and shopping malls don’t have nursing rooms.
Many mothers have had to do breastfeeding in a car or public toilet. Those who are brave enough will nurse in public without escaping glares and stares of some closed-minded individuals. Some skeptics argue the obscenity of nursing in public even when the mothers are properly dressed for nursing.
Last August, a breastfeeding flash mob was organised at KLCC. It was a protest against the management that hasn’t been supportive of mothers who choose to nurse in public. Around 150 people joined in including fathers, grandparents and even some young unmarried women.
“Breastfeeding should be simple. Your baby can’t wait for you to run from fourth floor to the concourse level in KLCC for you to breastfeed,” says Ayuni Zainudin who organised the flash mob.
The full-time mother also firmly suggested that the government should give women six months’ maternity leave instead if they are serious about promoting exclusive breastfeeding for the first six months. The government has been promoting breastfeeding since the early seventies.
A National Breastfeeding Campaign was initiated by the Ministry of Health in 1976. Three years later, the Code of Ethics for Marketing and Distribution of Infant Formula Products was formulated.
In 1997, all Ministry of Health’s hospitals were declared Baby Friendly Hospitals. Approved Baby Friendly Hospitals must comply with ten specific criteria such as helping mothers to initiate breastfeeding within one and half hours of birth, practise rooming in and foster the establishment of breastfeeding support groups.
The Malaysian Breastfeeding Peer Counsellors (MBfPC) is an effort to have more trained peer counsellors to support breastfeeding mothers. It puts forward peer support as an im-portant tool in ensuring prolonged breastfeeding as well as exclusive breastfeeding for the first six months.
The project is carried out by susuibu.com, an online breastfeeding support centre. It is supported by World Alliance for Breastfeeding Action and is partly funded by Unicef.
MbfPC started by training 19 individuals as programme administrators in January last year. In 2010 alone these individuals then trained 158 individuals as peer counsellors.
So far there are peer counsellors all over Malaysia except for Sarawak. Thus, the group hopes to conduct its first training in Kuching this November and any interested individuals are advised to get in touch with them through their website.
HM4HB Malaysia is a chapter of the global milk-sharing network, HM4HB Global Network. HM4HB Global network aims at promoting nourishment of babies and children around the world with human milk.
It has over 130 chapters in over 50 countries. The chapter basically serves as a platform for milk sharing. It brings together local families that choose to share breast milk.
By accessing their Facebook page, mothers can share their milk in a safe and ethical manner. This enables families to make informed choices.
The HM4HB Malaysia has had many heartwarming success stories.
Breastfeeding is the best way to nurture and nourish a child. Even formula makers admit that their formula can’t quite match breast milk’s nutient and vitamin content.
The best way to promote breastfeeding is not just to create awareness of the issue but also create a supportive environment that extends beyond the baby-friendly hospitals.
The government could only do so much without the private sector’s support.
It’s about time both parties as well as businesses show that they care about saving lives.
Monday, September 12, 2011
SUCCESSFUL SIMULTANEOUS SWAP LIVER TRANSPLANATION SURGERY ON TWO ADULTS.
Two Sri Lankan Donors’ livers swapped to save lives of their respective Liver transplant patients in the family.
- Simultaneously four surgeries performed on two donors & two recipients
- Innovative surgical procedure to significantly address acute shortage of organs and pave way to save more lives.
7-6-2011, Chennai:
The Liver Transplantation Team at Global Hospitals, which is acknowledged as the world’s most comprehensive centre for Liver & Pancreas diseases and transplantation, performed the Country’s first Living Donor simultaneous Liver "SWAP" Transplantation surgery on two adults. In this unique procedure, two families with donors whose organs were incompatible for the patients in their respective families have exchanged their organs for transplantation under a “Paired Donation Program”. This surgical procedure is by far the most complex and comprehensive exercise where simultaneously four surgeries were performed, on two liver donors and two liver recipients. Prof. Mohamed Rela, world’s foremost liver transplant surgeon and Director HPB & Liver Transplantation at Global Hospitals Group along with a team over 50 members comprising of Surgeons, Hepatologists, Intensivists, skilled technicians & support staff performed this over 16 hour non-stop surgical marathon successfully. The complex procedures were performed simultaneously in four different operation theatres supported with three Surgeons per theatre, Physicians, anaesthesiologists, technicians, support staff along with blood bank and other support systems functioning in complete synchrony.
The successful SWAP Liver Transplantation procedure performed on two adults addresses the acute shortage of organs and helps in optimising the small pool of living donors who want to donate a part of their liver to a family member but cannot do so due to issues such as incompatible blood types and other medical suitability issues.
Mr. Mohamad Nazeem, 50 year old male from Kandy, Srilanka was diagnosed to have cirrhosis of liver due to an unknown cause (Cryptogenic) few months ago and was referred to Global Hospitals & Health city, Chennai for liver transplantation. His family members were willing to donate part of their liver but unfortunately they were either medically not suitable or their blood group did not match that of the patient. His wife was medically suitable but had an incompatible blood group.
At the same time Mr. Mohamed Nazir, 48yrs old from Kandy, Srilanka too was diagnosed to have chronic liver disease and was advised to go to Global Hospitals & Healthcity, Chennai for further treatment. After a complete evaluation, the Hepatologists at Global Hospitals & Health city diagnosed him as a case of end stage liver disease, secondary to hepatitis C and advised him to undergo liver transplantation.
Mr. Nazir’s son came forward to donate a part of his liver to his father, but blood groups were not matching.
Mr. Nazir’s son came forward to donate a part of his liver to his father, but blood groups were not matching.
Both families were at an “end of the road” situation, not able find suitable living related donors. This unfortunate situation of the families triggered the innovative thinking of the Liver Transplantation Team, headed by Prof. Mohamed Rela. The Team gave a ray of hope to the families by suggesting a SWAP Liver Transplantation option to them. Interestingly the organ suitability between these families’ donors and recipients was found to be appropriate if organs were to be swapped.
SWAP liver transplantation / Paired liver transplantation is a procedure in which a family member of a liver transplant patient who is not compatible as a donor exchanges organs with another incompatible pair. The liver transplantation team suggested this option to these families and explained in detail to both the donors and recipients involved on the implications, outcomes and complications of the procedure. The open minded families understood the concept well and immediately opted for this procedure.
Having made the decision, the Liver Transplantation Team at Global Hospitals & Healthcity, was faced with the most important task in SWAP transplantation – EXECUTION. The unique aspect of swap transplant is, to perform the transplants simultaneously. The planning of logistics, availability of infrastructure and expertise of the transplant team is vital to the successful execution of 2 simultaneous Living donor Liver transplantations, in effect 4 surgeries.
The Liver transplant of Mr.Nazeer from Mr.Nazim’s wife as donor and that of Mr.Nazim, with Mr.Nazeer’s son as donor was performed in 16 hours with almost 55% - 60% of the liver taken from the donors and successfully transplanted into the recipients. The donors and recipients recovered quickly, the donors were discharged in about a week and the recipients in 2 to 3 weeks. They are currently one month post Liver transplant and are doing well.
The vast experience of Prof. Mohamed Rela, world renowned liver transplant surgeon and his team of 5 dedicated transplant surgeons, anaesthetists, support staffs and world class infrastructure of the hospital have made this SWAP liver Transplantation a successful one.
Speaking on this occasion Prof. Mohamed Rela said, “The burden of liver disease in the country and ofpatients needing liver transplantation is very high; on the other hand, there is a huge shortage of organs. The option of cadaveric transplantation, which is available in western countries, is also limited in India. In such situations, it becomes important to think of innovative ways to optimise the scarce resource of living donors”.
Dr. K. Ravindranath, Chairman & Managing Director, Global Hospitals Group said, “At Global Hospitals, we are completely committed to delivering medical services of the highest quality. This complex surgical exercise is a testimony for highly skilled consultants, technical staff and technology working perfectly with enormous dedication and team work. Through cutting edge clinical solutions, research, extraordinary patient care and infrastructure of world class standards, we are certain, concerns around human suffering on complex and end-stage diseases will be significantly addressed. Every step of ours has always been on this direction.”
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