Best hospitals in India : Medical Treatment in India

Badaru and his wife Malama Badariyya of Nigeria had lost all hope of saving their eight-month-old twin daughters, Hussaina and Hassana, who were born with their spinal cord fused together. The doctors in Nigeria had told them that they might have to sacrifice one daughter to save the other. Malama, however, had doubts if one twin would survive without the other. “I think it is one life governing the other. They cannot live without each other,” she told Dr Prashant Jain, consultant paediatric surgery at BLK Super Speciality Hospital in Delhi, where the couple took their daughters six months ago in the hope of seeing a miracle.

Jain had not handled a case like this before, so he was not too confident initially. But Malama’s concern for her daughters encouraged him to do research on the surgery. He found just four to five such documented cases in the world. So, he held a brainstorming with his colleagues.

The surgery was going to be a complicated one that involved life-threatening risks. Jain, however, decided to do it. With the help of modern 3D imaging techniques, Jain and his team of 12 doctors studied each vessel and nerve involved in the surgery. They rehearsed for hours on clay dummies.

On the day of the surgery, the monitors, wires and instruments to be used in the surgery were colour-coded. The surgery lasted 16 hours. The separation surgery took 12 hours and reconstructing the twins’ vagina, anus and rectum took another four hours.

Four months later, the girls returned to India to celebrate their first birthday with the people who changed their lives. They were cheerful and in perfect health. “Looking at them now, you cannot tell that they were joined once,” says a doctor, who was part of the team.

This is just one among the many success stories that are being written in hospitals across india. Take, for instance, the case of a three-year-old boy who suffered from a birth defect called craniosynostosis, where the skull bones get fused before the brain develops fully. Such children, if not given timely treatment, could suffer from mental retardation, blindness and loss of sensory abilities. Dr Dinesh Kumar of Jawaharlal Institute of Postgraduate Medical Education and Research in Puducherry successfully corrected the condition with the help of 3D imaging.

India's best hospitals

In most Best hospitals in India today, doctors still depend on CT scan images, which provide only a two-dimensional view of an organ. However, the 3D images¯made from polylactic acid¯provide a better view of the vessels, bones and tissues involved in the surgery.

“It was like holding the skull in my hands. I could see the bones from every possible angle,” says Kumar. “It helped me in designing my surgery with precision.”

The use of 3D imaging has changed the way surgeries are being approached. Doctors now know in advance what to expect on the operation table and are, therefore, better prepared. Apart from 3D imaging, doctors are using 3D printing surgical instruments, which are cheaper and can be customised according to the surgery.

Three-dimensional prosthetics is another area that holds promise. For people who lose their limbs to an accident or disease and can’t afford costly prosthetics, 3D printed prosthesis could be a good alternative.

SPY imaging is another technique that allows the doctors to capture, review, print and archive high-quality image sequences of blood flow in vessels and micro-vessels, tissue and organ perfusion in real time during surgery.

Dr Sunil Choudhary, director of aesthetic and reconstructive surgery at Max Hospital, Saket in New Delhi, used SPY imaging while treating a case of head and neck cancer. “It was a complex case. The complete lower jaw was to be removed with the entire inner cheek,” says Choudhary. “To rebuild it, we had to transplant a flap containing a leg bone called fibula using microsurgery technique. This flap also had to split into two bones and one skin paddle segment. SPY imaging could show us whether all three elements had good blood supply before and after they were transferred to the face and joined by microsurgery. The images of real time blood perfusion in all the transplanted segments confirmed the success of the surgery on the operation table itself.”

Another success story is that of Praveen Kumar, 56, of Delhi, who lost his leg in an accident in 1984. Kumar could not get a prosthesis because the remaining stump on his leg had turned 90 degrees, pointing towards the ceiling.

Years later, while visiting a friend, who was admitted in B.L.K. Super Speciality Hospital, Kumar met Dr Yash Gulati, an orthopaedic surgeon. Kumar’s case made Gulati curious. So, he offered to do a free check-up on him. A CT scan revealed that Kumar had ankylosing spondylitis because of which his hips and spine had fused together. He underwent a hip replacement surgery following which the twisted stump came back to its normal position. Kumar then got himself a prosthetic leg. “He is now on physiotherapy to mobilise his thigh muscles, which have not been in use for the past 30 years. Soon, he would be walking,” says Gulati.

Doctors say they have never felt more empowered, thanks to new technological advancements. They are now experimenting with treatments they could not try earlier. Dr Raman Sardana, microbiologist at Indraprastha Apollo Hospitals in Delhi, treated a six-year-old boy who had ulcerative colitis with Microbiota transfer, a process of transplanting faecal bacteria from a healthy individual into a recipient.

At Indraprastha Apollo Hospitals in Delhi, Dr Rajendra Prasad performed a surgery that has a few firsts to its credit. He performed a robotic surgery on a 10-year-old boy, Shivam, to drain out TB abscess from his spine. It was the first robotic spinal surgery performed outside the US, where it is still at an experimental stage. And, it was the first such surgery for TB.

“India has had many firsts as far as medicine is concerned. And, we have modified many other techniques to suit our population,” says Dr Abraham Thomas, director of Christian Medical College in Ludhiana.

Thomas performed the world’s first full-face replant surgery in 1994 on a nine-year old girl, Sandeep Kaur, whose entire face and scalp got ripped off when her braid got caught in a threshing machine. Thomas replanted her face with the help of microsurgery. Sandeep now works as a nurse at CMC.

Thomas is excited about the prospects of tissue re-engineering. “We are pioneers in organ replant, be it hand, finger, penis or scalp. A lab-grown organ would be better than a replant or transplant,” he says. “It doesn’t have the risk of rejection and a person doesn’t have to take immuno-suppressants.”

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