Thirty eight-year-old Sejal Sanjay Kamat, a teacher at a playschool in Lokhandwala, who underwent a single incision laparoscopy surgery for hysterectomy — the first in Mumbai — can’t believe it’s already over. “I didn’t feel any pain before and after the surgery and I don’t feel like I have been operated on at all. There’s no fatigue either,” says Kamat who has started walking around the corridors of Kokilaben Dhirubhai Ambani Hospital, where she was operated, barely 20 hours after the surgery.
The hospital says this is the first time a single-incision surgery has been conducted in Mumbai and insists that it’s here to stay. A traditional surgery leaves behind a 12 cm scar, while in a laparoscopic surgery there are 3-4 half centimetre scars. The single-incision laparoscopy is a scar-free surgery. A single opening in the belly button, enough to conduct the surgery, isn’t visible later.
“Women who wear saris and don’t want scars will be particularly keen on the single-incision laparoscopy,” says Dr Anshumala Shukla Kulkarni, who conducted the surgery, “Only a tiny bandage is required to close the navel,” she explains. This form of operation doesn’t take away from the benefits of a laparoscopic surgery — there’s no haemorrhaging (bleeding), surgeons can see inside the body more clearly as there is more magnification, there is less chance of infection, and other benefits too.
“The surgery becomes less painful. Skin incision causes pain and since you only make a single incision here, there is minimal pain. The recovery is faster too. The patient didn’t even realise that the surgery was complete.”
The single-incision laparoscopic surgery employs the same tools and techniques as conventional laparoscopic surgery and can be used on both men and women. The only difference is a specially-designed port that accommodates the tools, at no extra cost. The risk of injury caused due to torcar, an instrument used in the surgery, is not too high either.
“I have used a 5mm direct entry port, so the incidence of a bowel injury isn’t any greater than that during a traditional laparoscopic surgery,” says Dr Kulkarni. The choice of patient is important for the surgery. Patients who have had multiple surgeries and have a scarred abdomen and bowel adhesions may not be able to undergo this kind of an operation. The surgery is practical for people with problems like ovarian cysts, gallstones, appendicitis and hernia.
“If there is a requirement for conversion (another surgery if the first one fails) then the patient will have to go in for traditional laparoscopy the second time. However, a conversion becomes imperative only if there are too many adhesions inside or the uterus is very big and we are not able to manipulate it from the vagina,” adds Dr Kulkarni.
A single incision laparoscopy for hysterectomy (surgical removal of the uterus) at Kokilaben Dhirubhai Ambani Hospital costs around Rs75,000. The single incision is the next step in promoting safe organ donation, adds Dr Kulkarni. “As the surgery doesn’t leave behind any scars, people will be encouraged to donate. With good training to doctors, Mumbaikars can donate organs through the surgery soon.”
