fight ageing with weekend facelift pulse_july_final_aw.pdf · blk super speciality hospital...

BLK Super Speciality Hospital

Pusa Road, New Delhi-110005 (India)

24-Hour Helpline: 011- 3040 3040 | Email- [email protected] | www.blkhospital.com

BRINGING BACK SMILESAND A LOT MORE

How ECMO Technique savedthe lives of two kids

REVERSE AGEING

Fight Ageing withWeekend Facelift

w w w . b l k h o s p i t a l . c o m

NEWSLETTER OF BLK SUPER SPECIALITY HOSPITAL

JULY 2016 | ISSUE 4

05

Cytoreductive Surgery and Hyperthermic Intraperitoneal

Chemotherapy (CRS and HIPEC)

09

Bedridden youth walks again after Bilateral Total Hip Replacement

08

Resurgence of Radical Perineal Prostatectomy

04

Reverse Ageing with Weekend Facelift

BLK in NEWS

11

06 - 07

Bringing back smiles and a lot more: How ECMO technique saved two kids

Dear Readers,

It is truly heartening to see that every month we are getting more

articles and stories than we can possibly print in each edition. Our

editorial team is working efciently to get the best pieces to reach you.

The cover story this month is indeed very emotional and heartwarming.

As you go through it, you will be acquainted with two adorable children

who are today smiling and enjoying like any other child. Making use of

the ECMO Technology and the expertise of our Paediatric team, we are

happy to have played a substantial role in their lives after they were

presented with serious lung infection. It is cases like these that give us

satisfaction and encouragement to achieve greater heights.

Last month, continuing our international outreach program, we had

signed MOUs with Jakaya Kikwete Cardiac Institute (JKCI), Dar Es

Salaam, Tanzania and Republican Scientic Centre of Neurosurgery –

Uzbekistan. We have also become the rst Indian hospital to perform

cardiac surgery and procedure at the Jakaya Kikwete Cardiac Institute

(JKCI), Tanzania.

This will be the rst issue where we are featuring a guest article by

Dr. Pradeep P. Bhosale, Director, Arthritis and Joint Replacement

Surgery from Nanavati Super Speciality Hospital, a member of our

Radiant Life Care family. I know this is just the beginning and we can

look forward to many such articles.

As always, we would be happy to receive your valued inputs and

s u g g e s t i o n s . Y o u c a n w r i t e t o t h e e d i t o r i a l t e a m a t

[email protected] and continue to support us.

Wishing you all great health.

FROM THE ED’S DESK

10

Paradigm shift in the

Management of Renal Cancer

BLK expands its Horizon

EDITOR-IN-CHARGE PARUL CHHABRA

CREATIVE CONCEPT PARUL CHHABRA / SHIKHA GIRGLA / SUNIL KUMAR DESIGN & VISUALISATION SUNIL KUMAR

CONTENT SHIKHA GIRGLA / MAMTA SINGH

03BLK Super Speciality Hospital

July 2016BLK PULSE | Newsletter

Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal

Chemotherapy (HIPEC) is an innovative technique to treat GI &

Gynae Cancers which spread but are conned to a peritoneal cavity,

usually carrying a dismal prognosis. However, there are chances of improved

survival and cure in select patients. It is being performed in select centres

across India including BLK Cancer Centre and abroad.

Cytoreductive Surgery (CRS) is aggressive removal of all or most visible

Tumours in the abdomen and preventing growth of microscopic cells which are

left behind. Hyperthermic Intraperitoneal Chemotherpy (HIPEC) is instilled

via a machine which circulates Chemotherapy solution in the peritoneal cavity oat 42 Celsius for 60-90 minutes.

THE CASE

A 65-year-old hypertensive lady with Carcinoma Ovary post three cycles of

Chemotherapy was admitted to BLK Cancer Centre. Despite undergoing

Chemotherapy her disease was present with nearly two liters of ascites and

thickened omentum and peritoneum.

THE PROCEDURE

She underwent TAH + BSO + Pelvic and Para-aortic Lymphedenectomy +

Peritonectomy + Supraacolic Omentectomy + extended right Hemicolectomy to

achieve a CC0 score followed by Hyperthermic Intraperitoneal Cisplatin

(HIPEC) for 90 minutes.

THE RESULT

She made steady post-operative progress, was discharged after two weeks and

is now completing her remaining three Chemotherapy cycles. This procedure

has considerably improved her chances of survival.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy(CRS and HIPEC)Developing new concept in the treatment ofPeritoneal Metastases

Weekend Facelift is an attractive alternative to surgical correction

of ageing facial skin. The procedure rejuvenates the face for a

fraction of the cost of surgery, with far less risk and recovery time.

In fact, this is done as a day care procedure and does not even require

hospitalisation.

PROCEDURE

What separates Weekend Facelift from Traditional Full Facelift is that

incisions are kept to an absolute minimum. Many times there are no cuts

involved in this procedure. Basically, there are two techniques used in

Weekend Facelift which are:

Ÿ An endoscopic Weekend Facelift that uses three or more tiny incisions and

a small camera, which the surgeon uses to nd his or her way around the

area under treatment. The surgeon is then able to reshape muscles and

trim away excess skin with the help of a monitor.

Ÿ Non-endoscopic procedure is done with the help of barbed sutures which

are strategically placed under the skin to give a subtle lift.

Many variants based on these two techniques exist. But it is best to consult

your doctor who can decide which technique or combination of techniques will

work best for you.

RISKS

The most common risks of Weekend Facelift are:

Ÿ Bruising • Allergies to the anaesthesia

Ÿ Swelling • Excessive bleeding

Ÿ Infection • Clotted blood at the incision site

These are actually not risks but after-effects of the procedure and in case any

of these occur, it is easily treatable with minimum medication.

RECOVERY

Normal recovery time is 48 to 72 hours. Your actual recovery time may vary,

though, depending on whether or not you experience any infection or healing

complication. After the procedure, you should avoid overexposure to the sun

and ensure you moisturise and care for your skin diligently. Post the

procedure, you can easily enjoy its benets for the next ve to seven years.

REVERSE AGEINGFight Ageing with Weekend Facelift

Dr. Lokesh Kumar

Director & HOD

BLK Centre for Plastic &

Cosmetic Surgery


Dr. Kapil Kumar

Director - BLK Cancer Centre

& HOD - Surgical Oncology

BLK Cancer Centre


Co -authored by:

Dr. Pankaj Kumar PandeSr. ConsultantSurgical Oncology

Dr. Ashish GoelSr. ConsultantSurgical Oncology

Dr. Prerna LakhwaniAssociate ConsultantSurgical Oncology

Similar procedure was also

performed on a 43 year old

African patient, diagnosed

with Carcinoma Ovary with

incomplete staging surgery

done in Kenya. At BLK, she

received three cycles of

C h e m o t h e r a p y a n d

underwent TAH + BSO+

Enblock resection of mid

rectum with Colorectal

A n a s t a m o s i s w i t h

O m e n t e c t o m y +

Peritonectomy and Axillary

Node Excision and had

nineteen liters of chylous

ascites drained. She is

making steady progress now

and has hope of improved

survival despite stage IV

Ovarian Cancer.

Coliseum Cytoreductive Surgery

Weekend Facelift is most

effective on patients who

are just beginning to

experience the initial signs

of ageing. Because the

procedure is less invasive, it

is also used only to treat

relatively minor age-related

symptoms.



THE CASE

A 15 month old boy and a 3 year old girl survived a critical condition of

severe Heart and Lungs disorder. Baby Joy, the boy, was diagnosed

with acute blood infection and congestion in his Heart while the girl

named Naina had severe u. This was made possible with the successful

application and use of a life saving technique called ECMO or Extracorporeal

Membrane Oxygenation. The unique ECMO technique mimics the articial

Lungs and pumps oxygenated blood to the Heart, thereby taking over the

functions of the Lungs and Heart.

Baby Joy after the surgery

BRINGING BACK SMILES AND A LOT MOREBLK Super Speciality Hospital recently treated children with severe Heart and Lungs disorder

THE PROCEDURE

At the time of admission baby Joy was found with Septicemia and acute

Respiratory Distress Syndrome or ARDS. He also had poor Heart function.

In the case of Naina, she was going through acute breathing problems due to

severe u. Joy’s condition was critical, as his BP had plummeted to a scary

low of 35 on maximum medication and ventilatory support at the outlying

hospital. Since Joy’s pupils were incoherent, it indicated some disorder in

the brain as well. Given the precarious condition in both the cases, the kids

were transported by BLK's team in a very critical state. An urgent call on

the use of ECMO was taken, which is an extreme form of life support for

such patients.

THE RESULT

After their successful treatment using ECMO, Joy and Naina started to

recover soon afterwards. Joy’s Heart function recovered by 40% within 48

hours and Lung function started to show improvement after about a week.

Naina also reported remarkable signs of improvement. ECMO was removed

from both the kids after 10 days along with the ventilator. After careful

observation, they were discharged, turning the worries of their parents into

smiles.

The team of doctors at BLK were upbeat after the success they achieved in

these two cases. While ECMO technology is present at many centers, its

successful application has been an issue. Although, the use of ECMO in

patients with Heart ailments was prevalent, its successful usage in life

threatening medical conditions like that of Joy and Naina – Septicemia and

ARDS – was rare.

Dr. S. C. Arya, Emeritus

Consultant, BLK Centre of

Neonatal, Paediatric and

Adolescent Medicine has been

recognised and awarded the

p r e s t i g i o u s " L i f e t i m e

Achievement Award" for his

contribution to the eld of

Paediatrics and its progress to a

Multi Speciality eld of

m e d i c i n e a t t h e I M F

(International Microbiota

Forum) meeting held in

Gurgaon.

CONGRATULATIONS!

BLK Doctor Honoured

With Lifetime

Achievement Award

Dr. Rachna Sharma

Sr. Consultant

Paediatric Intensive Care

and Pulmonology

BLK Centre of Neonatal,

Paediatric & Adolescent

Medicine

We are extremely pleased to

have successfully used this

life saving ECMO technique

to treat these two children.

This is indeed a path-

breaking news for many

other children suffering from

acute Lung infection.

I see this as a beacon of hope for thousands of children who succumb to

these problems. We wish the story of Joy and Naina to reach out to as

many people as possible.

Dr. Ajay Kaul

Chairman and HOD- Cardiothoracic & Vascular Surgery

BLK Heart Centre, BLK Super Speciality Hospital

Blood Oxygenator (ECMO)



Incidence of Prostate Cancer is on the rise in the Indian sub-continent.

According to the National Cancer Registry, 'Prostate' is the second

leading site of Cancer among males in large Indian cities like Delhi,

Kolkata, Pune and Thiruvananthapuram; third leading site of Cancer in

cities like Bangalore and Mumbai and is among the top ten leading sites of

Cancer in the rest of the population-based Cancer registries. There has

also been a shift in the stage of diagnosis and now more and more patients

are being diagnosed in the early curable stage.

Radical Prostatectomy is the current gold standard treatment for

management of localised Prostate Cancer. It was traditionally performed

by the Open Retropubic method RRP (Radical Retropubic Prostatectomy)

and later by Laparoscopy. Now Robotic Assisted Laparoscopic Radical

Prostatectomy is emerging as new standard of treatment for Prostate

Cancer.

There is a resurgence of Radical Perineal Prostatectomy as a Minimally

Invasive Surgery for Prostate Cancer. It has all the advantages of Robotic

Surgery with equal surgical outcomes and the advantage of a Minimal

Perineal Incision. The cost of Radical Perineal Prostatectomy (RPP) is one-

fth the cost of Robotic Surgery with no requirement of special equipment.

The functional outcome of RPP vs Robotic is essentially the same, though

the latter claims to have better potency but substantial data is lacking.

RPP was found to be the most cost effective with an easy learning curve

when compared to RRP. We have operated three cases by Radical Perineal

Prostatectomy wherein the operating time was three hours. During the

operation no blood transfusion was required in any patient and the

average hospital stay was for 4 days. We found negative margins in all

cases and the patients attained continence within three months.

Hence, we can condently conclude that Radical Perineal Prostatectomy is

a safe, effective, minimally invasive and economical procedure with

promising result and an equally better alternative to Radical Robotic

Prostatectomy.

Resurgence of Radical

Perineal Prostatectomy

Ankylosing Spondylitis (similar group like Rheumatoid Arthritis) is

a common condition in Asia. It affects mainly young males leading

to complete closure of mobility of Spine and Hips. Hips are usually

fused in deformed position of both the legs.

THE CASE

A 22-year old man had been suffering from 'Ankylosing Spondylitis' for the

past 10 years and became bedridden in the last two years. He studied till

high school but could not pursue further education due to his medical

condition. Both his hips were xed in 60 degree bent position with bony

fusion having '0' movement.

THE PROCEDURE

The patient had approached Dr. Bhosale in Nanavati Super Speciality

Hospital, Mumbai. On examination, it was found, his bones were soft and

soft tissues around hips contracted in deformed position. Hence, there was a

risk of injuring bones, blood vessels and nerves during surgery. When the

hip is mobile, the surgery is easier. In this case, the bone had to be cut rst

because the anatomy was not very clear. Dr. Pradeep Bhosale performed

the Bilateral Total Hip Replacement in a single stage with release of all

tight structures.

THE RESULT

The patient's hips have now become straight and mobile without any

deformity. After nearly a decade, he has started walking straight with full

weight bearing. Both the patient and his father were elated and expressed

their gratitude to the doctor.

Cost Effective, Minimally Invasive Radical

Prostatectomy by Perineal Approach

Dr. Pradeep P. Bhosale

Director, Arthritis and Joint

Replacement Surgery

Nanavati Super Speciality

Hospital, Mumbai

Post Operation Straighted-up

Dr. H. S. Bhatyal Advisor & Sr. ConsultantUrology, Andrology and Renal TransplantBLK Centre for Renal Sciences and Kidney TransplantBLK Super Speciality Hospital

Bedridden youth walks

again after Bilateral Total

Hip Replacement

I have done extensive

research on this condition

and have performed more

than 240 Fused Hip

Conversions over the last

3 0 y e a r s . I h a v e

developed a special dual

surgical Hip approach

used in fused Hips with

e x t e r n a l r o t a t i o n

deformity.

Dr. Vineet Narang

Consultant, Urology, Andrology and Renal Transplant

BLK Centre for Renal Sciences and Kidney Transplant


Advantages o f Radical

Perineal Prostatectomy:

Ÿ Easy access to Prostate –

located close to skin

Ÿ Less discomfort

Ÿ Less operative time

Ÿ Rapid post-operative

recovery

Ÿ Better visualisation of

urethral dissection and

anastomosis resulting in

better urinary continence

Ÿ Less blood loss

Ÿ Benecial for patients

with previous abdominal /

pelvic surgeries

Post Operation X-ray



BLK in NEWSB

LK Super Speciality Hospital has signed a special pact with

R e p u b l i c a n S c i e n t i c Centre of Neurosurgery of Uzbekistan and Jakaya Kikwete Cardiac Institute (JKCI), Dar Es Salaam, Tanzania with an aim to d e v e l o p e d u c a t i o n a l , s c ient ic and medica l cooperation in various spheres.

We have also become the

rst Indian hospital to

perform cardiac surgery and

procedure at the Jakaya

Kikwete Cardiac Institute

(JKCI), Tanzania.

Mr. Naresh Kapoor,

Executive Director,


PARADIGM SHIFT IN

THE MANAGEMENT OF

RENAL CANCER

Dr. Aditya Pradhan

Sr. Consultant, Urology, Andrology and Renal Transplant, BLK Centre for

Renal Sciences and Kidney Transplant, BLK Super Speciality Hospital

The best known treatment for Renal Cancer is Radical Nephrectomy, although

it can also be effectively treated by resecting the tumour while preserving the

normal portion of the Kidney. This gives equally good Oncological outcome

without increasing the risk of chronic Kidney damage. BLK Uro-Oncology

Centre has utilised this concept of Partial Nephrectomy in many of its Kidney

Tumour patients. We have given the benet of Laparoscopy in this complex

surgical procedure to most of our patients so that they have less pain in post-

operative period and are able to resume their normal duties early.

A detailed compilation of 20 cases on Renal Tumours managed with Partial

Nephrectomy were presented in the National Conference of Urology Society of

India, USICON 2016. The ndings of this study will possibly enhance surgical

treatment and clinical outcome of patients with Renal Cancer.

Benets of the surgery:

Ÿ Preservation of normally functioning Kidney portion

Ÿ Complete removal of Tumour

Dr. Yajvender Pratap Singh Rana

Consultant, Urology, Andrology and Renal Transplant, BLK Centre for Renal

Sciences and Kidney Transplant, BLK Super Speciality Hospital

BLK expands its Horizon

Uzbekistan and Tanzania

We are indeed happy to enter

into these partnerships. We

shall promote exchange of

professors for educational

and sc ient ic research

p r o g r a m s , b e s i d e s

organising development of

joint international projects

and conducting research on

areas of common interest.

Most cases have been done Laparoscopically

with preservation of good Kidney function in

the operative Kidney. So far, there has been no

Tumour recurrence, attesting to the fact that

Partial Nephrectomy was able to save the

Kidney and achieve the desired Oncological

outcome.

MoU signed by Prof. Gayrat Kariev, Director,

Republican Scientic Centre of Neurosurgery

of Uzbekistan and Mr. Naresh Kapoor,

Executive Director, BLK Super Speciality

Hospital, New Delhi.



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