Apollo Hospitals, Guwahati was the first hospital in Guwahati to perform Minimally Invasive Cardiac Surgery on March 7, 2019. A team of experts headed by renowned Cardio Thoracic Surgeon Dr. J P Kalita performed the complex surgery and saved a patient’s life. The surgery was performed on a 45-year-old female patient who had a hole in her heart and leakage of a heart valve. Patient underwent a successful key hole surgery through chest wall rather than the conventional breast bone cutting open heart surgery. The main benefit of this surgery is minimal post-operative recovery time, less pain and minimal blood loss. Moreover, the chance of getting infected after the procedure is also comparatively very less. Any patient who undergoes minimally invasive cardiac surgery can resume their normal activities within two weeks. Patient recuperated well after the surgery and got discharged. The Cardiac surgery team at Apollo Hospitals Guwahati is headed by Dr. J P Kalita. Dr. Kalita is an expert in Minimally Invasive Cardiac Surgery for both Adult and Paediatrics. At the advent of this new Cardiothoracic unit in Apollo Hospitals Guwahati, people of Assam and neighbouring states will also be highly benefitted.

Mr. Desai, a 41-year-old male, met with a road accident that resulted in a traumatic brain injury and was promptly taken to Apollo Hospitals, Navi Mumbai on September 15, 2018. When bought in, he was unconscious, with evident CSF rhinorrhoea and otorrhoea from left ear, and herniating brain tissue from the left nostril. Once the patient was stabilized, he was taken for an urgent Craniotomy for evacuation of subdural Hematoma, intra-cerebral contusion, and repairing of the skull base. He was then moved to the ICU for recovery, which in view of the severe brain injury was slow. On October 29, 2018, he was finally discharged as his sensorium had improved. The patient’s brain was allowed to heal for several months before the planned Cranioplasty. The team of doctors at Apollo Hospitals, Navi Mumbai, had to ensure the best possible cosmesis without major intraoperative manipulation of the skull base repair. The defect also covered a large part of the forehead extending to the bridge of the nose and the left supraorbital ridge – all of which had cosmetic implications. Hence, 3D-printed titanium implant was opted because it would closely replicate the shape of the patient’s skull. On January 9, 2019, the patient underwent Cranioplasty with the implant, after which he made a swift recovery and was discharged three days later. 3D-printed implants are beneficial for multiple reasons like it fits the patient’s form, MRI compatible and lesser chances of getting infection. In this case, first a CT scan helped make an identical 3D model of the skull in its current form. Then a titanium mesh was created to perfectly fit the skull. Once it was ensured that the implant was a perfect match for the patients’ structure, the neurosurgeons went ahead with the Cranioplasty. Dr Sunil Kutty, Consultant, Neurosurgery, Apollo Hospitals, Navi Mumbai said, “It was a bad case of head injury and not many survive these kinds of injuries. His recovery was a team effort and we also had a challenge in the form of making his face and head look as normal as possible. After being admitted on September 15, 2018, Mr. Desai was in the hospital for about a month and half, before being discharged. After allowing the brain of patient to heal for several months, Cranioplasty (surgical repair of a defect or deformity of a skull) was undertaken. The team needed to ensure the best possible cosmesis without major manipulation of the skull base. A large part of the forehead extending to the bridge of the nose and part of the ridge was affected and had cosmetic implications. Therefore, we decided that a 3D printed titanium implant would be suitable to closely replicate the shape of the patient’s skull. On January 9, 2019, the patient was bought in for the Cranioplasty with the implant and was discharged three days later. 3D printed implants are MRI compatible, decrease the risk of infections and most importantly can be made to fit the patient’s form. Mr. Desai may take a couple of years for complete recovery, but he will soon get back to being a constructive part of the society.”

At the tender age of six months, Emmanuel Lila Kamank, a Kenyan national, underwent open-heart surgery for a rare cyanotic congenital heart defect known as Taussig-Bing anomaly at Indraprastha Apollo Hospitals. Just four days after his birth, Emmanuel was diagnosed with this heart defect and as his condition worsened, he was referred to Apollo Hospitals, Delhi for surgery. Dr. Muthu Jothi, Senior Consultant- Paediatric Cardiothoracic surgeon, Indraprastha Apollo Hospitals, New Delhi explains, “When Emmanuel came to Apollo, he was already cyanotic, which means that he had bluish discoloration of skin due to lack of oxygen in his blood. On examination, it was found that his respiratory rate was below normal at 20 breaths per minute. At the hospital, he suddenly underwent respiratory arrest. The attack was so severe that the child also had a cardiac arrest. His condition was pretty dire due to which he was put on ventilator and shifted to cardiac ICU.” Dr. Jothi further stressed on the criticality of the baby’s condition, “The child was already diagnosed with Taussig-Bing anomaly, which is a malformation of the heart in which there is transposition of aorta to the right ventricle, which in normal cases should originate from left ventricle. At the same time, his pulmonary artery was also wrongly positioned into the right ventricle. This is called double outlet right ventricle defect. Upon further investigation, we found out that there was also an interrupted aortic arch (block in the aorta). On top of that, the child had large subpulmonary ventricular septal defect (VSD), atrial septal defect (ASD), and Patent ductus arteriosus (PDA), wherein ductus arteriosus, the blood vessel that is open when the child is inside the mother’s womb does not close due to this defect. In addition to all this, he also had a single coronary origin giving rise to right and left coronary arteries. The right coronary had a part inside the wall of the aorta which we call as intramural coronary artery. This makes it very difficult technically to relocate the coronary arteries into the new aorta. Needless to say, it was very high risk case with limited chances of success even with surgery. We devised a treatment plan for the baby, but informed his family about the 50-60% surgical risk associated with it. The family consented to the high risk and we decided to go ahead with the procedure.” On 21st January 2019, the child underwent the surgery which was performed by Dr. Muthu Jothi and his team consisting of Dr. Manisha Chakrabarti, Senior Consultant Paediatric Cardiologist and Dr. Reetesh Gupta, Senior Consultant Paediatric intensivist. Explaining the complexity of the surgery, Dr. Muthu Jothi said, “The procedure was done under total circulatory arrest, which means that the entire blood in circulation in his body was drained into the heart lung machine. Before that we had to cool the child’s body to 16 degrees Celsius. This is near freezing for the human body. We even put ice on the surface of his brain. Without circulation, we can keep the patient in this state for maximum of 45 minutes. Beyond that, there’s the risk of injury to the brain, spinal cord, kidneys and other organs. The total time Emmanuel was on total circulatory arrest was 30 minutes. During this time, we repaired the aortic arch interruption by tying off and disconnecting the PDA blood vessel and connecting it to the aortic arch. After doing this, we put the child again on the heart-lung machine and did the switch operation to put the blood vessels in their correct position. The intramural coronary artery was a very difficult condition where we had to mobilise this blood vessel and re-implant it into the new aorta. During this process if there’s an error of even half a millimeter, if it doesn’t go exactly where it needs to go, the coronary artery’s blood supply will be reduced, which can cause a heart attack. This repair was followed by closure of ventricular septal defect (VSD) and atrial septal defect (ASD). It was a very long surgery lasting almost 9 hours.” The operation was successful and the baby was shifted to the ICU in a stable condition but with his chest still open, “The chest was kept open for 24 hours because there was a lot of swelling in the heart once we did the operation. Once the swelling came down and the child started passing urine post 12 hours after the operation, we closed the chest in the ICU. After this, child stayed for nearly a week on the ventilator,” Dr Muthu explained. Baby Emmanuel slowly recovered and was discharged on the 17th day from the hospital. The parents of the baby expressed their gratitude to the team at Apollo Hospitals who successfully operated on baby Emmanuel and treated him, “By the grace of God and the tireless efforts of Dr. Muthu Jothi and his team, Emmanuel is now well and has a long life ahead of him. Our prayers have been answered at Apollo Hospital and we cannot thank the doctors enough for their dedication. They kept us motivated throughout the treatment process.” Baby Emmanuel has now gone back to Kenya with his family and is doing well.  

The doctors at Apollo Hospitals, Hyderabad have successfully performed Liver Transplant on a four-month-old baby. It was a challenging case for doctors to perform transplant surgery on such a small baby. There are only few hospitals worldwide, having the capability to perform liver transplants among children, weighing less than 5 kgs and below 6 months of age. At Apollo Hospitals, Hyderabad, the Pediatric Liver Transplant team has tremendous experience and expertise along with the technology to perform critical and delicate liver transplant surgeries in infants, said Dr Manish C Varma, Head of the Liver Transplant Department at Apollo Hospitals, Jubilee Hills. In Vizag, the treating doctors performed a Porto-enterostomy surgery on the baby, to treat pediatric liver disease, where the bile ducts are abnormally narrow, blocked, or absent. The baby was only 2.5 months old when he underwent this surgery. However, even after the surgery, there was no sign of jaundice subsiding and the condition was further deteriorating. The doctors at Vizag recommended liver transplant and the baby was brought to Apollo Hospitals, Jubilee Hills. On March 14, Liver Transplant surgery was performed and Mrs. Sarojini, mother of the baby, was the donor. Post-operatively the baby recovered well and was discharged nine days after surgery on March 23. The donor was discharged on March 19. “There is a need for spreading awareness that however small and underweight the baby is, it can be treated with a liver transplant if it is needed,” said Mr. Y Subramanyam, CEO Apollo Hospitals. The complicated liver transplant was carried out by a multidisciplinary team consisting of Dr Ramesh Srinivasan, Pediatric Hepatologist, Dr L Sasidhar Reddy, Transplant Surgeon, Dr Manjunath and Dr Vijay, Anesthetists and Intensivists respectively and Dr Samiya Razvi, Pediatric Pulmonologist, at Apollo Hospitals, Hyderabad.  

Apollo Gleneagles Hospitals brings TARE (Trans Arterial Radio Embolization), the latest treatment for liver cancers for the first time in Kolkata. It is the only option and hope for a special set of patients, who are actually quite large in number. TARE is a procedure, where using special instruments and micro-catheters, the identified source of blood supply to the tumor in liver is accessed and intra-arterial radiotherapy is delivered using Yttrium-90 (Radiotherapy agent). This results in significant improvement and at times complete treatment of the tumor as well, giving new lease of life to these patients. The TARE procedure requires special permission for the hospital to perform it with multiple other considerations. Mr Rana Dasgupta, CEO Apollo Gleneagles Hospitals Kolkata, expressed “We at Apollo Gleneagles Hospital are happy to announce that honouring our commitment to deliver the best healthcare and innovative procedures for our patients; we have started performing TARE, which would benefit our patients substantially. With this, Apollo Gleneagles Hospital, Kolkata becomes the first corporate multispecialty hospital in the East to perform this procedure.” Present at the occasion, Dr Manash Saha, Senior Consultant, Vascular & Non-Vascular Intervention, Apollo Gleneagles Hospitals Kolkata expressed, “The first TARE procedure performed in Apollo Gleneagles Hospital was for a patient of multiple colorectal metastasis which was progressive in nature and was not responding despite two separate lines of chemotherapy.” He also mentioned, “Primary liver cancers, particularly hepatocellular carcinoma (HCC) and extensive metastasis or secondary deposits in the liver pose a great clinical challenge to treat, especially if they are progressive in nature despite all kinds of treatment. With a huge and increasing burden of Hepatitis B and C patients, the HCCs are in rise. Hepatocellular carcinoma, however, poses a completely different degree of challenge to treat . Usually they are detected when quite big in size and not possible to treat by any other means. Many a times they are detected with the tumor thrombus progression in the main blood supply to the liver that is the portal vein, which makes them inoperable or untreatable. Even small lesions in the liver peripherally can present with the malignant portal vein thrombosis rendering these patients untreatable even if they are completely preserved functionally in presentation. TARE procedure is considered as the pinnacle of intervention and with this, AGHL is now equipped with the full set of interventional radiology treatments to patients of liver cancer whenever required. The entire range of treatment is now available under one roof in AGHL, Kolkata starting from ablative therapies like radiofrequency and microwave ablation to TACE (transarterial chemoembolization) – both conventional as well as DEB (drug-eluting bead) TACE along with TARE. The TARE procedure is done in two sittings where in the first sitting, the tumor is identified by angiographic evaluation and any potential source of extrahepatic organs are embolized to reduce the chances of radiotherapeutic agents going to other organs. Following this, the dose is calculated and prepared usually in Canada or Singapore from where the dose is transported in a premeasured amount and delivered on specific dates using a special system in the Cath lab.  

‘No matter how hard life is, don’t lose hope’ – The saying stands true for 45-year-old Etika Kalra, a resident of Delhi, who underwent a third kidney transplant at Indraprastha Apollo Hospitals. This time, her husband donated his kidney to save her life. Even though they were ABO incompatible, which means that their blood groups did not match, due to the skilled expertise of Padma Shri awardee Dr. (Prof) Sandeep Guleria, Senior Consultant, General Surgery, GI Surgery and transplantation, Indraprastha Apollo Hospitals and his team, the highly complicated transplant was performed successfully. Dr. Guleria performed the earlier kidney transplants as well. In 1996, when she was 23 years old and recently married, Ms. Kalra found out, during a routine check-up, her kidneys were shrinking. She was diagnosed with Glomerulonephritis, a type of disease in which the part of kidney which filters blood (called glomeruli) becomes damaged. Since that time, Ms. Kalra has been constantly fighting a battle with this disease. Initially, she explored various Ayurvedic treatments to treat her condition, but there was no relief and the creatinine levels in her blood continued to rise. In December 2000, she had to start regular dialysis as her kidneys were no longer functioning properly. Ms. Kalra underwent her first kidney transplant in 2001 where her elder sister Anshoo Walia donated her kidney. For more than a decade the donated kidney served Ms. Kalra well, but the life of a donated organ is limited. By 2014, she again started facing kidney problems. “By the time we found out that her first kidney was failing, it was too late to start her on dialysis. Her health was deteriorating fast and so we opted for a pre-emptive transplant. This time, her other sister, Ritu Pahwa, donated a kidney,” Dr. Guleria said, explaining the procedure and the unexpected complications which arose after. “A few days after her second transplant, while Ms. Kalra was still in ICU, she started complaining of severe stomach pain. It was found that she had gangrene of intestine for which we had to do an immediate major abdominal surgery to save her life. This was while she was still recovering from her second kidney transplant and it made her quite weak.” Unfortunately, the second kidney was functional only for about 4 years after which it started failing. “It was a case of acute antibody rejection of the transplanted organ, in which Ms. Kalra’s own immune system started attacking the kidney. There were only two viable options for her at that time – either live on dialysis for the rest of her life or undergo another kidney transplant. Ms. Kalra chose the latter and this time her husband, Tarun came forward to donate his kidney. We counselled the family about the various risks involved with this surgery, after which they gave us consent to go ahead. Their blood groups did not match so to overcome the ABO incompatibility; we did numerous plasma exchanges. The first two transplants took about three hours but the third transplant took five and a half hours since the third operation was technically more difficult. However, we successfully overcame that barrier and transplanted the third kidney.” In regards to Ms. Kalra’s incredible story, Dr. Guleria said, “Etika’s body is responding well to the new kidney and we hope that this time it will last for the rest of her life. Surviving three kidney transplants takes an incredible amount of strength, endurance and faith. She did not lose hope and her strong will to live pushed her to not give up at any point. Her family support was unwavering throughout.” Ms. Kalra is now doing well and wants that her story motivates others to not give up in the face of adversity, “When the option of kidney transplant for the third time was presented to us, it came as a surprise. For a layman, two kidney transplants are rare. But Dr. Guleria explained that kidney transplant is possible even for the third time and one can lead a normal life after that. He apprised us of all the possible complications. But since he had already performed the kidney transplants twice on me before, I had full faith in him and knew that my life was in the hands of an experienced and trusted doctor. After all these years, Dr. Guleria is like family to us now, and his guidance and support has been invaluable. My children are the source of my inspiration who keep me going,” said Ms. Kalra. “Even after the third transplant, the precautions I have to take are the same as before. The food I eat has to be hygienic and freshly prepared. Eating outside should be avoided, and it is essential to have medicine on time,” Ms. Kalra said.  

Global Innovation & Technology Alliance (GITA) on behalf of Department of Science & Technology, Government of India and Israel Innovation Authority (IIA), on behalf of Government of Israel, granted HealthNet Global, a part of the Apollo Hospitals Group, India and Zebra Medical Vision, Israel funding to validate, co-develop and deploy medical imaging Artificial Intelligence (AI) across India and to increase Tuberculosis (TB) screening capabilities in the rural areas. HealthNet Global (HNG), a part of the Apollo Hospitals Group, India and Zebra Medical Vision (Zebra-Med), one of the global leaders in AI Imaging software, Israel announced a new collaboration that will focus on validating and deploying AI based tools at scale across India. The companies shall jointly receive support from India-Israel Industrial R&D and Technological Innovation Fund (I4F) for their $4.9 Million project to co-develop and to provide clinical validation, and evidence of the efficacy of radiology Al based tools in India as per I4F norms. The final developed project will be able to assist as a primary screening method for major diseases in large scale screenings. For example, World Health Organization (WHO) estimates that 3.6 million people with TB are missed by health systems every year and do not receive adequate care. This is primarily because patients with TB may present with mild or no symptoms, particularly early on. Many affected people arrive at clinics too late with advanced disease or multi-drug resistant TB (MDR-TB), which is difficult to treat and more likely to cause death. One of the key strategies to tackling TB is early diagnosis. Unfortunately, sputum testing is only 50% accurate and frequently misses the disease in its early stages. Both companies will focus on development of AI-based Chest X-ray interpretation tool for TB which can help address the gap. Speaking of the initiative, Sangita Reddy, Joint Managing Director, Apollo Hospitals said “When it comes to health, the promise of AI to provide access and improve outcomes in very intriguing. There is a critical need to provide good healthcare access in remote and rural communities, and we believe this initiative will allow us the opportunity to make significant advances in this area. Apollo’s clinical and scientific depth and Zebra-Med’s expertise in AI complement each other perfectly. This project is part of our continuing endeavour to design new tools to improve healthcare access and deliver best outcomes to patients at lower cost.” In addition to leveraging clinical depth and breadth of the Apollo Hospitals network, HNG will work in close collaboration with Apollo Radiology International, a distinguished part of Apollo Hospitals, to bring in leadership, experience and technology in Radiology reporting to the project. The partnership will capitalize on the advancements already achieved by Zebra-med in developing dozens of AI tools. The arsenal of algorithms will include deep learning algorithms for the detection of acute conditions such as brain bleeds in head CTs and Pneumothorax in chest X-ray, detection of breast cancer in mammograms, Osteoporosis in CT scans and 40 other conditions. “We are excited to partner with the leading healthcare services provider in India and to help bring AI to India at such a scale,” noted Eyal Gura, Co-founder and CEO of Zebra-Med. “When we met the Indian team for the first time few years ago we found common ground and similar dream of scaling healthcare from millions to billions of patients. We are honored that the two governments have placed their trust in us and we are committed to utilize this opportunity to impact millions of lives.” The grant will aid the partners to focus on development of India specific algorithms tool which would be of immense benefit to patients across India and other emerging nations. The project will also modify existing algorithms to make them suitable for the Indian population. The final product will assist provide high quality radiology access to remote locations by alerting the presence of critical findings immediately. This will help provide timely, cost-effective, quality care to patients in remote and rural locations. “This is an exciting time for AI in medicine,” said Vikram Thaploo, CEO of HNG. “As these systems increase in accuracy, so will the viability of using AI to extend the reach of Chest X-Ray interpretation, improve reporting efficiency and save lives. We believe in the impact that technology can have in helping provide timely, cost-effective, quality care to patients in remote locations and our partnership with Zebra-Med is a step in this journey.” “We believe that this project will be a very important milestone in the introduction of AI in Indian healthcare. We are excited to provide clinical leadership and expertise to this initiative”, said Dr. Sreenivasa Raju Kalidindi, CEO and Medical Director of Apollo Radiology International.  

The Apollo Hospital Group announced the formal release of a postal stamp on Preventive Healthcare by Shri Banwarilal Purohit, Hon’ble Governor of Tamil Nadu. The commemorative stamp honours and acknowledges the Chairman of Apollo Hospitals; Dr. Prathap C Reddy’s pioneering efforts in encouraging preventive healthcare in India. Shri R Anand, Postmaster General, Chennai City, Ms. Preetha Reddy, Vice Chairperson Apollo Hospitals and Ms. Suneeta Reddy, Managing Director, Apollo Hospitals attended the special occasion at the Raj Bhavan, Chennai Over thirty-five years ago, in 1983, Dr. Prathap C Reddy had established Apollo Hospitals, India’s first corporate hospital to make advanced medical care accessible to all in the nation. Since then, Apollo Hospitals’ pioneered innumerable initiatives in healthcare management and amongst them, one was the launch of the ‘Master Health Check’, which introduced a culture of preventive healthcare into India. Cognizant of the intrinsic value of good health, Dr. Reddy has been empowering and encouraging fellow Indians to live healthy and screen regularly to diagnose disease early, particularly vital to conquer cancer. Speaking on the occasion, the Hon’ble Governor of Tamil Nadu, Shri Banwarilal Purohit said, “Dr. Reddy and Apollo are synonymous with Healthcare excellence in the world. They excel in end to end healthcare of consumers from 140 plus countries and have many firsts including the recent launch of South East Asia’s first ever Proton Cancer Care Therapy centre. Preventive Care was first pioneered in India by Dr Prathap Reddy and today I am happy to commend his dedication to Disease Prevention through this special stamp.” Ms. Preetha Reddy, Vice Chairperson of Apollo Hospitals said “Our Chairman, Dr. Prathap C Reddy’s dream is to do all that is needed to ensure that everyone has good health and happiness. His life’s objective has been to not just make advanced medical care accessible to patients, but also, to prevent the onset of disease. Apollo’s Preventive Healthcare initiatives have been working tirelessly for almost four decades to ensure that his dream is realised. We take pride in having touched 20 million lives through our preventive healthcare endeavours. It is a very significant moment for the entire Apollo family, as a special preventive healthcare commemorative stamp is being released, in recognition of our efforts”. Shri Alok Ojha, Senior Superintendent of Post Offices, congratulated Dr. Prathap C Reddy, Founder and Chairman, Apollo Hospitals Group & his team for successful completion of 20 million health checks & delivering excellence in health services for past 36 years. Such commendable services have set a world record in Preventive Health Checks.

On February 15, 2019, Apollo Hospitals Group has offered free treatment to the injured troopers of the Central Reserve Police Force (CRPF), who survived the terror blast in Pulwama district’s Awantipora town, Kashmir on February 14, 2019. “We offer to treat the CRPF troopers injured in the terror attack till recovery and rehabilitation at any of our hospitals across the country,” said Dr. Prathap C. Reddy, Founder and Chairman, Apollo Hospitals Group. Grieving the loss of 45 brave troopers, Dr. Prathap C. Reddy hailed the martyrs who laid their lives for the country and offered condolence to their bereaved families. “We salute the families of the victims who gave the country such brave sons of the soil and for their supreme sacrifice,” added Dr. Prathap C. Reddy.

A team of experts at Indraprastha Apollo Hospitals, New Delhi successfully blessed Mrs. Jane Gumbo, aged 42 with a new lease of life. Mrs. Gumbo is from Tanzania and duly serves the nation as a Police officer. She weighed 123 kgs and was suffering from deep vein thrombosis, clot in heart and pulmonary embolism. She had a big ball like clot in her heart which was in the ventricle almost at the verge of blocking the pulmonary artery (the main artery which goes from heart to the lung) and lungs were studded with blood clots. Considering her critical condition and very poor chances of survival, surgeons turned her down for surgery as it was very high risk for open heart surgery. But a team comprising of Dr. (Prof.) N N Khanna- Senior Consultant, Interventional Cardiologist &Endovascular Specialist, Dr Suranjit Chatterjee- Senior Consultant, Internal Medicine and Dr. Nalin Nag- Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals successfully saved her through a novel technique and an incision free procedure. Explaining about the disease the patient was suffering from Dr. (Prof.) N N Khanna said, “When the patient came to our hospital, she had severe breathlessness and was in cardiogenic shock and had very low oxygen concentration in the blood. Post investigation, we found that she had large blood clots in both legs, a big clot in the right ventricle and both lungs. Considering the criticality of her situation, surgeons refused to operate on her as the mortality rate is high during surgery.” Talking about the procedure performed Dr. Khanna said, “Firstly, the Femoral Vein was punctured to implant the filter in Inferior Vena cava for preventing the movement of clots from legs to heart and lungs. Later, clot-busting drug called Tissue Plasminogen Activator (TPA) was given by catheters placed directly on the clots to open the blocked lung arteries and to carefully dissolve the clot in the heart under supervision. The procedure continued for 96 hours patiently and meticulously with continuous monitoring of the status of lysis of the clots by imaging and measuring serum fibrinogen levels of the blood to avoid the risk of major bleeding. Eventually, the clots in the heart and lungs got dissolved.” “This was a highly critical and potentially dangerous procedure. The clot in the heart was of the size of a table tennis ball and if it had moved towards the pulmonary artery it would have blocked the outflow of the heart like a ball valve suddenly and completely and she would have died in less than a minute. Despite being a critical procedure, the patient was not given even a single incision and the entire procedure was through a key hole endovascular technique and post procedure, she recovered in less than 24 hours. She is doing fine now and requires no further treatment except for oral medicines,” Dr. Khanna said further. Mrs. Jane Gumbo, the patient after the surgery said, “I am really thankful to Dr. Khanna and his team here at Indraprastha Apollo Hospitals. It is only because of them that today I am living a new life. I was in a very bad situation. I was not even able to breathe properly but doctors here treated me even when others surgeons had refused to operate on me. Dr. Khanna explained me all the risks associated with the procedure. Seeing his confidence and belief, I underwent the procedure. For me, he is no less than a god who has given me a new life.”

Apollo Gleneagles Hospitals, Kolkata has launched a dedicated Department of Comprehensive Hernia surgery. The department will address treatment of all kinds of hernias from the simple to the extreme, complex ones through the most modern surgical techniques. Hernia is basically a gap in the muscles and fascia of the abdominal wall through which the inner contents, small and/or large intestine, stomach, bladder etc, may protrude out from the abdomen, below the skin. Apollo Gleneagles Hospitals, Kolkata is the first ever hospital in India to have a dedicated department for comprehensive hernia treatment. The pioneering concept ensures a more specialized approach towards treating hernias. State-of-the-art facilities and advanced equipments assist the team of expert surgeons to tackle the most critical hernias. There are several types of hernias broadly divided into internal and external hernias. Internal hernias are not apparent on the outside and can be dangerous while external ones are the more common ones and are of several types. Following are the external hernias – Inguinal hernia, Femoral hernia, Incisional hernia, Umbilical hernia, Epigastric hernia, Lumbar hernia, Spigelian hernia, Paraesophageal and Diaphragmatic hernia, Parastomal hernias and Diastasis of recti. Common symptoms of hernia: Swelling in the groin or abdominal wall which increases on prolonged standing, coughing, sneezing or even a good laugh! Pinching or dull aching pain in the swelling. Constant pulling sensation inside the abdomen. Constipation. Backache due to poor posture. Hernias may lead to obesity and the reverse is also true. Surgery is the only way out to treat a hernia. In current times, laparo-endoscopic approaches have mitigated the fear involved with open surgery such as long cuts, prolonged and severe pain, delayed recovery, loss of work and wages. Using mesh is the gold standard followed worldwide to reduce the chances of recurrence. Many patients have difficult hernias that defy conventional surgical solutions. The department would serve as a tertiary referral centre for all such cases. At Apollo Gleneagles Hospitals, the latest hernia surgeries include minimal hospital stay and low pain scores. The patients are generally able to walk and eat within 4 hours of surgery and go home the next morning. Speaking on the occasion, Dr B Ramana, Senior Consultant Laparoscopic and Hernia Surgeon, Apollo Gleneagles Hospitals Kolkata, said, “We try to ensure speedy recovery of the patient so much so that s/he can get back to normal life almost immediately after the surgery. These modern laparoscopic surgery techniques lead to reduced post-operative pain, minimal blood loss and single day hospital stays in most cases. The department would offer the entire gamut of modern AWR procedures comprising of open, minimally invasive and robotic approaches. The most advanced surgery techniques include eTEP, TAR, SCOLA, BOTOX, PPP etc.” Incisional hernias occur to 20-30% patients who undergo any kind of open abdominal surgery. This is specially seen in women after pregnancy and C section. These hernias are typically difficult to cure using traditional surgeries and with more number of attempts to cure the hernia the complications increase along with increased failure rate. Hence the need for specialized hernia treatment using new techniques comes in picture. Women after pregnancy even have flabby abdomen due to the abdominal muscle losing its tenacity while giving space for the growth of the uterus. This goes mostly unaddressed till the belly becomes very saggy, or the patient feels low back pain. Using the modern SCOLA method, the shape and tone of the abdominal muscles may be regained, with the scars being barely visible. The modern hernia treatments at the Department of Comprehensive Hernia Surgery would include: e-TEP : the most advanced surgical approach for inguinal, incisional, umbilical, epigastric and lumbar hernias in the world. One can walk and eat within 4 hours of surgery and go home the next morning. TAR – complex hernias, hernias with loss of domain and multiply recurrent hernias may need this complex surgery known as Transversus abdominis release. This may be an open or endoscopic approach depending upon individual case. SCOLA – subcutaneous onlay laparoscopic approach is a minimally invasive approach for small umbilical hernia or epigastric hernia with diastasis of recti or diastasis of recti alone. BOTOX – Hernia with loss of domain may need temporary paralysis of abdominal muscles for complete reduction of hernia contents. PPP – Preoperative progressive pneumoperitoneum is also an adjunct used in modern day hernia surgery in cases of loss of domain hernia. Groin pain – pain in the groin could be related to problems of hips, spine, muscle and most importantly an occult/hidden hernia. Mesh related complications.

It’s never an easy task to walk again on your own when you have a fall at the age of 98 and fractured your hip. The lower body is immobile and the patient needs to be cared for long. Doctors say that the chance of success for patients undergoing surgery like Hip Replacement at that age is minimal. When no alternatives are available and pain relief is to be provided immediately, Hip Replacement surgery is the best alternative, to relieve a painful hip joint. Mrs. Lakshmamma, a nonagenarian, who had a fall resulting in hip fracture, underwent a successful Hip Replacement surgery and has been walking on her own now. Dr. Vasudev Prabhu, Senior Orthopedic Surgeon, and his team of doctors from Apollo Hospital, Sheshadripuram at Bangalore have accomplished a Hip Replacement for Lakshmamma who has recovered well post-surgery. A resident of Sira Taluk, Tumkur District, Lakshmamma fell at her home and sustained injury to her left hip in March 2018. When asked about the need and the procedure required, Dr Prabhu informed that the patient had already undergone a Hip Surgery on the right hip earlier, 10 years back. The fall in March 2018 had resulted in the left Hip, needing a replacement instead of the plate and screw, due to age related problems. The patient was immobile and had difficulty even to get a bedpan. Necessary precautions were taken, Doctors at the Apollo Hospitals headed by Dr. Vasudev Prabhu and team suggested patient to undergo the surgery for which the family agreed in full confidence. What made this surgery challenging was the risks involved. At that age risk factors included osteoporotic bones, Sub optimal lungs and cardiac status and high chances of pulmonary embolism due to immobilization. All the efforts paid off when the patient starting to walk the next day of surgery with the help of support staff. Dr. Anitha, granddaughter of Lakshmamma, informed that within eight hours after consultation with the Dr. Vasudev Prabhu, the patient was ready for the surgery the next day. The patient was anemic and blood had to be transfused to perform the aforesaid procedure. The confidence instilled in the patient, the will to stand on her own legs did it for the patient , and a day after, she was able to walk with the support of medical staff at Apollo Hospitals, Sheshadripuram at Bangalore. Availability of specialists like Cardiologists, Pulmonologists, Geriatric care team within the hospital and necessary equipment and availability of ICU facilities was the key to the success quotes Dr. Anitha. Within 12 days, the patient was mobilized to Tumkur where she now lives a healthy life. Dr. Anita and the patient’s family is full of raise and respect for the team of Doctors especially to Dr. Vasudev Prabhu and team, the medical care team that provided excellent post-operative care. The patient is walking towards completing her 100 years and the team of doctors wish her a healthy long life.