Surprised that doctors do not recommend SILS; as a patient, I can clearly feel the magic of SILS

I am 46-year-old businessperson from Lucknow and have been maintaining a very balanced, exercised and disciplined lifestyle. Gallstone problem came to me as a surprise on Mar 17, 2014 when I suffered the first attack – intense pain in stomach travelling to my back with no relief from any acidity or pain relief medicines or injections. The next day, my ultrasound report confirmed that I had gallstones and I was advised removal of the gallbladder. As a habit and training, I do a lot of Internet research on any topic concerning my business or life and that led me to single incision laparoscopic surgery (SILS). It seemed like such a common sense to opt for SILS – if someone is offering to make only one small cut instead of four and as such, I always believe that technology is improving fast and early adoption of technology is looked by too many with skepticism. Unfortunately, this proved true even for SILS. I spoke to many doctors and wrote to famous international hospitals even in Singapore. However, most of the people told me various factions of their views – someone said “As a doctor, I would never convince myself about the advantages of SILS over normal 4 cut laparoscopic surgery”. Most of the doctors and hospitals said that they did not perform SILS and conventional 4-hole surgery was safer and quicker.

However, I could easily make out (what is actually quite true in my business as well) that in a fast-moving and crowded life in India, everyone wants to run in a safe and conventional way, instead of opting for innovation. There was resistance in my family also to go for SILS as in most of the places we did not hear much high recommendation for SILS. But I listened to my mind and conscience. If I was advocating use of innovation and technology in my own business (non-medical), why should that conviction not apply to my own treatment? I went ahead with 100% confidence on the process and Dr. Deepraj Bhandarkar, who is such an experienced doctor in SILS. Honestly, I saw him as someone who believed and devoted himself to innovation like SILS which is a boon for patients instead of a trial. My SILS surgery was done on April 10, 2014 around 4.30 p.m. and I gained full consciousness by 7 p.m. No dizziness, no nausea, no uneasiness – nothing. I went to use the washroom on my own some 5 hours after my surgery.

Next morning, I had usual light breakfast and the walking had improved to almost 90% of normal level. Second day after surgery, I took a flight back to Lucknow and in fact, conducted a client meeting at the airport before flying!. Within 3-4 days I was quite normal. SILS made me feel this surgery as a pleasant experience with no side effects. I would recommend SILS to anyone who may have doubts against this process rather than conventional 4-cut surgery as the advantages are numerous. It is our body and if someone can do the same thing with one cut instead of four, common sense should prevail. I am writing all this also because I had expected sufficient reviews and experiences about SILS on Internet when I researched the subject but found very little from Indian patients. I am quite sure that awareness needs to be spread in favour of SILS, instead of reservations.

Vinay Agarwal
Lucknow

Having a single incision laparoscopic cholecystectomy

Two words describe this procedure the best – “pleasant surprise”. How else can one describe it in a layman’s words? Options for me: to undergo an open surgery (cut along the stomach), regular laparoscopy or single incision laparoscopic surgery(SILS). I opted to undergo SILS.

I was asked to undergo blood tests, CT scan, x-ray and an ECG a week prior to the surgery. Upon finding all the reports normal, I was asked to admit myself a night prior to surgery. On the day of surgery I was taken into the OT around 12noon. I was administered general aeeasthesia after which the surgery commenced. The surgery lasted about 60-75 minutes, post which I spent about 1.5 hours in the recovery room.

After the surgery within a few hours of returning to the room, I could actually walk in the room. The next day I felt much better and had a decent appetite was put on solid foods. The second day post surgery, I was discharged and returned home – to return to normal home food and a normal life. I was however told to stay away from lifting heavy weights and driving for a few weeks.

The pleasant surprise came on the day of the dressing change (7 days post surgery). I was pleased to notice only one small incision right below my naval (where as the other procedures would have left me with either a huge scar or 4 incisions). My initial thoughts on the gallbladder surgery was one of apprehension about getting the surgery done as I was skeptical about the surgery process, the scars and the post surgery life /restrictions. Ten days after my surgery and I feel absolutely back to normal.

Regards

Raveena Thadani
Mumbai

My experience of laparoscopic splenectomy

The very word ” SURGERY ” triggers fear and creates phobia within us. To top it up, mine was indeed a rare case. I was diagnosed with a tuberculous abscess (pus) in my spleen. As per most of the surgeons, such cases are one in a thousand.

As they rightly say, half the battle is won if we find the right doctor at the right time. After consulting various surgeons for a month, I was suggested to undergo open surgery, which was not fruitful in my case. But Dr. Jacky Lalmalani – a reputed Urologist and a family friend referred me to undergo laparoscopic surgery to you, which was less painful as compared to open surgery. I had lost all hopes of survival, as there was pus in the spleen and some parts of stomach and pancreas. It was indeed a miracle that I survived after going through such a grave situation as Dr. Bhandarkar removed the entire spleen and some portion of stomach. The whole surgery lasted for about 4 -5 hours, which was indeed a difficult one. But thanks to Dr. Bhandarkar, he made it possible.

I would like to thank you from the bottom of my heart as you gave me second life since I had completely lost all hopes of survival. With the grace of God, I took the right decision to opt for laparoscopic surgery instead of open surgery and I was operated on 19th November 2007. Today nearly five years after the surgery I am leading a healthy and a normal life without any feeling that I was once diagnosed with such a fateful disease.

Thanks a billion.

Regards,

Meenal Kodwani

Laparoscopic surgery for bowel obstruction

Dear Dr. Deepraj Bhandarkar,
I thank you doctor for looking after my father Dr. N. S. Sundaram who is 85 years of age from the time of admission till the time of discharge and postoperative care.

He developed abdominal discomfort on the night of Sunday March 25th. On Monday he felt better and did not do anything. In the night he felt slight pain and vomited. I thought it was because of new addition in his diet and he had taken some brown bread and flax seeds for nutrition. We discussed about his treatment and arranged for an ultrasound as per our doctor’s advice. On 26th march Tuesday afternoon at 12:30pm we finished the ultrasound. The doctor performing the ultrasound advised us to visit a surgeon immediately. So my brother called a doctor colleague, who suggested us to come to you at Hinduja Hospital.

After you saw him soon after admission and put in the Ryle’s tube he was greatly relieved from his hiccups. You suggested a CT scan on Wednesday, the result of which proved that he had partial intestinal obstruction. You then advised him to have a laparoscopic operation. Surgery was fixed for Friday 30th March at 8:00am. The operation was successfully performed with great support from the Anesthetist Dr. Bapat. I especially thank the surgical team and the anaesthetic team at Hinduja Hospital who took special care of him. Although he is a cardiac patient you made him comfortable during the surgical session. He never felt that he was operated and spoke to us within few minutes after coming back to the room. We had a pleasant stay except his 5 postoperative days during which time he had dryness of tongue and mouth. I was very happy with his blood sugar levels, which were very well controlled by Dr. Manoj Chadha and his heart was also taken care of very well by Dr. Navneet Kumar.

I would like to thank you all for giving us our father back safely . Wish you a great success in the field of laparoscopic surgery.

Yours sincerely,

Swarna S.
Daughter of Dr. N. S. Sundaram

Surgery for umbilical hernia that recurred after open operation

I had previously undergone an operation to repair my umbilical hernia in Jakarta, Indonesia, but due to certain complications the surgery was a failure. The hernia recurred and I suffered from discomfort and pain, which is when my family and I decided to go to India to get the hernia repaired. Since we’ve not lived in India for around 20 years, we resorted to looking up hospitals on the Internet, which is when we came across Dr Deepraj Bhandarkar from the Hinduja Hospital. Within a few hours of sending him a query via email, I received a prompt reply where he provided his contact details and very soon I called him up to discuss my case. Dr Bhandarkar was very courteous and helpful, and on sending him my reports and other vitals, he advised me to undergo a non-invasive laparoscopic surgery. On reaching India, Dr Bhandarkar was of a great help to us, and despite having an extremely busy schedule helped us in booking the operating theatre, rooms and other things that were not possible for us to do.

Postoperatively I was able to consume liquids on the very same day and eat a normal diet within 24 hours. I was also able to move around and walk a bit on the day of surgery, which was very convenient. Not much pain. After this surgery, I experienced a lot more relief and comfort as compared to my previous surgery. The laparoscopic surgery barely left any scars and was a better choice as it reduced the risk of haemorrhage, reduced my hospital stay and also allowed me to travel back to Jakarta, Indonesia within a short period of time as my husband and I were unable to get too many days off from our work. All this wouldn’t have been possible if I had undergone a normal surgery to repair the hernia. All this wouldn’t have been possible without Dr Bhandarkar’s treatment, support and advice.

Till date, if I need any medical advice of any form, I know I can drop an email to Dr Bhandarkar who would be happy to help me out in any way that he can. Dr Bhandarkar is a true professional and a genuine human being, and I am truly grateful and blessed to have come across a person like him.

Dr Anita Coutinho
Jakarta, Indonesia

Laparoscopic surgery for my paraumbilical hernia

I was first recommended a surgery for my condition called paraumbilical hernia in the year 2008. I was quite disturbed by the news which meant that I had to stop a lot of activities I liked doing but most of all it was not possible for me to pick up my 2 year old son which struck me especially hard. After going through all the possible options I was referred to Dr. Deepraj Bhandarkar for the surgery. He explained that due to my obesity the pressure on my abdomen had ruptured the muscles thus leading to the hernia. He explained that in the condition the best course of action would be to perform a surgery through which he would place mesh over the weakness and fix it to the abdominal walls thus repairing the hernia. He further explained that he would achieve the same using a surgical technique called “laparoscopic surgery” also called minimally invasive surgery, which would involve a few small incisions on my abdominal area. What made the surgery attractive to me were the advantages it offered which have stood true after and during the surgery.

Reduced hemorrhaging, which reduced the chance of my needing a blood transfusion.
Smaller incisions, which reduced the pain and shortened the recovery time. In fact, post surgery I was on my within the first 48 hours
Less post-operative scarring.
Less pain, leading to less pain medication.
Hospital stay was less.
Reduced risk of acquiring infections due to reduced exposure of internal organs.

This surgery was absolutely tension free because it took care of all the mishaps, pains and the trauma associated with a surgical procedure. After the surgery I have managed to get back to my favorite activities namely running. And yes I can hold my son over my head now without any pain or care. I have managed to reduce my weight by more then 10 kilos and am gunning for another 10kg. All of this due to the almost perfect surgery. I would like to thank Dr. Deepraj Bhandarkar and his wonderful team for their unbelievable care and absolute professionalism.

Regards,

Rahul Agasti

My hernia surgery

Dear Dr. Bhandarkar,

First of all I am very much thankful to you for my successful, painless laparoscopic surgery for my hernia.
Sir, my hernia was detected during my annual health check in one of the well known hospitals in Vashi, Navi Mumbai and their surgeon advised me to undergo surgery. That time I was scared for surgery, as I had never undergone any surgery -small or big – in 46 years of my life. Due to fear I became sleepless and I consulted four well-known doctors in Mumbai and Navi Mumbai. Some of them advised me to have open surgery and others advised laparoscopic surgery. I became more confused was unable to take a decision. Meanwhile, I started to get more information regarding both type of surgery through various sources including internet .
Finally I came to know about you as a well known laparoscopic surgeon and I consulted you at Hinduja Hospital. Our meeting was very satisfactory and I decided to go for laparoscopic surgery with you. You operated me at Hinduja hospital and I had a pleasant experience due to following reasons

My operation was very smooth as being minimal body cut.
No pain at all after surgery.
I started walking around in the hospital after a few hours and started taking full meal the day after the operation.
I was discharged on the 3rd day.
I joined my office on the 8th day and started working normally.
Beauty is that I become completely fit within 7 days and had no pain observed after the operation.

Once again I am very thankful to you sir for serving society with right technology. God bless you.

Thanks & Regards

Divyesh P. Panchal
Kharghar, Navi Mumbai

Having a laparoscopic surgery for a recurrent hernia

Dear Dr. Deepraj,

I want to share with you my experience of laparoscopic surgery under you and your able two assistant doctors. As I said on the day of discharge, and I repeat, you folks are a great team.

I was not new to hernia surgery having got both sides operated by open surgery in 2003 (right hernia in Japan) and 2005 (left hernia in India). In both cases I was given a spinal anesthesia and had to stay in hospital for 3 nights post-surgery. Thus, when the right inguinal hernia recurred I just tried to postpone its treatment for almost 6 months. I was just delaying the inevitable. The bulge was becoming bigger day by day and finally my family (read wife) decided that we needed to act. Of course, I knew it would be an open surgery again with those dreadful spinal injections and just the thought of pain in getting up from the bed for as long as 2 weeks post-operation gave me sleepless nights. My sister-in-law (Dr. V. Herekar, MD Anesthesia) knew of my fears and introduced me to the world of “laparoscopic surgery” through you. I consider myself as well read and did know about this procedure but never thought it would work in my case especially since mine was a recurrent hernia. In addition, I did not know what the Japanese doctors had done to my right hernial gap and was worried about it too. I was certain it would not work in my case but decided to go ahead and meet you along with Dr. V. Herekar. I carried all my necessary reports (blood/ 2D echo/ x-ray) as are necessary for any surgery. All my fears were unfounded in our first meeting and within 30 minutes of my meeting you – to my amazement – we had penciled in the day, the date and the time for surgery!!! I must admit that GA vs. spinal anesthesia helped quicken the decision-making. I put all my faith in your hands and I can now say that laparoscopic surgery was the right decision for me. You did advise me to read all about the procedure before coming to hospital, but let me share a secret: as it is I am afraid of any cuts even if it is 1 mm and I would rather get it executed without worrying about how and where!!! That’s what you experts are for…….

Today, I am perfectly normal and I still “fondly” recount our first meeting as the turning point that led me to this “happy” state. Yes, I am very satisfied (many thanks to my sister-in law who introduced me to you) that I came to you and got the hernia repaired — just to put it in perspective — within 20 hours after I returned to my room after the surgery I had left the hospital and on 10th day post-surgery I was on a flight to Japan and back to normal life albeit – no heavy weight lifting for 3 months. You did tell me that operation was a bit complex due to the Japanese technique of fixing the hernia and I was told that due to laparoscopic surgery you could even check my left hernia at the same time so that I do not have to worry about it in coming months. This, obviously, would not have been possible in open surgery – unless of course I was cut on both sides!!!. I have not had any medicines except those given in the first 20 hours, that was a great miracle for me.

Finally, the biggest compliment that I received (which is all yours) – I had met my relatives just a day before the operation and did visit them on the 4th day after the surgery – everyone commented that it did not look like that I had been in the hospital for a hernia surgery just few days back. I think I may have planted more seeds of laparoscopic surgery in few more minds.

Thanks you once again and am glad that I met you.

Regards

Gurunath Nayak
Kobe, Japan

Gastroesophageal Reflux Disease – A patient’s Experience

GERD crept in very slowly on me. At first the heartburn and heaviness was a nuisance, a discomfort, which, with a busy schedule, I tried to ignore. As it increased, it became very convenient to pop antacids into my mouth and forget the whole thing for a while. The real problem would hit me at night, when I just could not lie flat without experiencing severe pressure in the chest, nausea and the terrible sensation that food would regurgitate anytime. Since extra pillows didn’t really help, I ended up purchasing a wedge which lifted me waist upwards, and helped a little. Meanwhile I continued to ingest antacids at an alarming rate, till I finally saw a gastroenterologist and got a new set of medicines, namely proton pump inhibitors. I took these for about three years, without thinking of the side effects that some of them have. I had become dependent on these medicines, which brought some relief during the day. Nights were unpredictable. The proverbial last straws were the choking episodes which would come on suddenly in deep sleep, and shock me into bolting upright. Every episode caused my husband to panic and pound me on the back till the stomach contents went back in or came out, and opened the airway. Of course, every time I felt sure that I had already breathed my last, and no more breaths would come! Good advice of doctor relatives led me to Dr. Deepraj Bhandarkar at Hinduja Hospital, Mumbai. What gave me a lot of confidence was the fact that he actually listened to me, and asked questions about my symptoms before looking at endoscopy test results etc. Especially in today’s situation when only tests and more tests seem to clarify things, never mind what the patient goes through. I also realized after some internet research that the procedure I would have to go through, a Nissen fundoplication, is a tricky one. It’s success depends on the skill and precision with which it is done. Many people tried to discourage me from going through this surgery, but I felt I had to take this chance to improve the quality of my life, trust the surgeon completely, and leave years of severe discomfort behind me. Minimal invasive surgery has many benefits. Recovery is much faster and the patient is reasonably independent. However, in this particular surgery, a lot of work takes place within the system, and one cannot expect to suddenly rise and shine immediately after. The first 24 hours are difficult, but not terrible. After that, each day becomes better than the previous one. I had to strictly follow the discipline of eating only pureed, blenderized food for nearly six weeks. Initially I did not have any desire for food. I used to stare at the soup, pureed fruit/vegetable and custard that was served. I found it difficult to swallow—even a teaspoonful does not go down the esophagus very easily. I had to be patient with myself. After about 4 weeks I felt I was ready to eat soft, semi solid foods. It is important to be very cautious at this stage, and go very slowly with changing food textures. At the end of two months I was back to normal food. In fact, I travelled to the US before 2 months were done, and even managed to eat some portions of fairly awful airline food! Dr. Bhandarkar’s advice of eating small portions more frequently has been very helpful. Thanks to the doctor’s skill, my recovery was smooth and uneventful. There is some amount of tiredness for a few weeks, but that is normal and natural. Hinduja Hospital provides excellent service, a meticulously clean and hygienic environment, and has an extremely pleasant and efficient staff Today, after nearly three years, I feel fit and fine (I am 64), and am into a lot of productive work. I have not even touched an antacid. I do not take any medicines whatsoever and have no side effects to worry about. Thanks to Dr. Bhandarkar, GERD is history for me.

Mangala Deshmukh
USA

A doctor’s tryst with an infected gallbladder

One Monday morning I woke up feeling out of sorts. As Mondays are busy days, I decided to pull myself together and get to work. I conducted a full OPD and went for my coffee break with friends. There I became conscious of a nagging pain in the upper abdomen and nausea. I skipped the coffee, came home and skipped lunch too. I drank about two spoonful of buttermilk, which I promptly threw up. The pain became worse until I could not even tolerate the pressure of my clothing. My doctor husband gave me some tablets and advised me to go to bed saying that the pain would disappear soon. At 4pm I told him to request a gastroenterologist colleague to come home and see me as the pain had become excruciating and was accompanied by 3-4 vomits. The likelihood of a perforated ulcer, pancreatitis or perhaps even a myocardial infarct raced through my mind. The gastroenterologist Dr Sunil Shah came home promptly, ordered a sonography and called in a laparoscopic surgeon – Dr Deepraj Bhandarkar. They admitted me to the hospital with a diagnosis of acute cholecystitis – an infection in my gallbladder. I was treated with antibiotics. Results of my tests showed that in addition to the infection in the gallbladder I had passed a stone in the bile duct. An ERCP (endoscopy) was done the next day and the stone from the bile duct was removed.

The day following the ERCP was the day of my surgery for removal of the gallbladder. The preparations were brief but meticulous. Dr Bhandarkar performed the laparoscopic cholecystectomy in about 30 – 40 minutes and removed the swollen gallbladder with lots of stones and some mud (sludge). I had had a prior abdominal operation for another condition many years ago. The postoperative pain and discomfort I experienced after the laparoscopic surgery were minimal as compared to the previous open operation. I was standing up within a few hours of my surgery and was able to pace the corridor outside my room the next morning. I was sent home on the third day and was allowed full activity. Some abdominal discomfort and bloating were present for about 3-4 days after coming home. After removal of the stitches around a week later there was nothing to remind me of my ordeal. I was delighted. Practically no scars, back home after only 5 days in the hospital (considering that I had a stone in my bile duct as well as an infected gallbladder) and resumption of work a week later! God forbid that anyone should have cholecystitis. But, if one does, then a laparoscopic cholecystectomy is the definitely the solution.

Dr. Sudha K. Shah
Mumbai