[www.keralites.net] : : Mumbai-born doc set to revolutionise heart surgery

 

    

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Life is short. Make use of it   Amazing…         Mumbai-born doc set to revolutionise heart surgery Malathy Iyer | TNN Mumbai: When Dr Ranjit Deshpande gets ready to perform a cardiac bypass surgery in London's King's College, there is no role for the saw that has traditionally been used to cut open the breast bone in order to expose the heart. The Bandra boy instead uses an endoscopic camera and a huge LCD TV to get a 'close' look at the beating heart.     His patients go home within 48 hours without the tell-tale eight-inch scar on their chest. "They only have a 3- to 5-cm scar on the left side of their chest,'' says the former Nair Hospital-trained surgeon, who evolved the 'coronary bypass surgery via a keyhole' technique a few months ago.     The technique that could, in the near future, revolutionise the way heart surgeries are performed has so far been used on 14 patients in London. "Each of the patients is doing well,'' said the doctor, who was on a fortnight-long visit to his general practitioner father P R Deshpande's MIG Colony home in Bandra East. Keyhole heart op to bypass EXPENSIVE ROBOTICS Mumbai: Cardiac surgeon Dr Ranjit Deshpande says he owes his innovation to medical practices in India. "I worked with Dr Nitu Mandke at Hinduja Hospital when beating heart surgery was still new. Before that, I worked at Tata Memorial Hospital where video-assisted thoracic surgery was common,'' he says. It is this experience on the video-assisted surgery (now an LCD TV monitor) that Deshpande now draws to perform his minimally invasive cardiac surgery. It is the workmanship he picked up as Mandke's team member that helps him in drawing out the internal mammary artery through a 3mm-hole.   There is another India angle that Deshpande is proud of. "When most centres across the world are investing in buying expensive infrastructure used for robotic surgeries, my method is relatively cheaper.'' The commonplace video—as against the exotic Da Vinci robotic arm—is suited for Indian budgets, he says.     "In fact, the procedure's USP is that it doesn't require costly equipment like a surgical robot. In the UK, the cost of this robot is 1.5 million pounds. But my technique requires an initial set-up cost of 50,000 pounds,'' he adds.   At present, Deshpande uses the technique only for persons with single-vessel or double-vessel problems. "When I get back to London, I plan to use it on a patient with triple-vessel blockages.''     Will his technique find wide acceptance? Deshpande is confident: "The world of surgery is changing and so are patients. Many people hate big scars and can't afford to stay out of work.''     Dr S Bhattacharya, the country's leading heart surgeons, points out that many new techniques using minimally invasive ways are coming up. "But they are still in their infancy. Maybe, at a later date, they will become good enough to handle the complex nature of heart problems among Indians, but not now,'' he says. "I am not satisfied if I don't physically touch the mammary artery and tighten it adequately,'' he adds.     Deshpande's technique evolved from his training in a Belgium centre known for its minimally invasive heart surgeries for heart valves. "To keep pace with the rapid advances, I went to the Belgium centre that has performed over 2,000 minimally invasive cardiac surgery procedures for valves,'' he says. Back in London, he used the same methodology for performing minimally invasive beating heart surgery. He inserts a special camera through a 3-mm incision to see ee pictures of the heart. "I pass three probes through the second, fourth and sixth space between the ribs. Using the camera and the probes, I dissect the internal mammary artery and bring it down to the artery that needs the bypass,'' he says. Then the lowermost incision is widened to 3 to 5 cm to use the harmonic scalpel to clear the blockage before joining the dissected mammary artery with the problem artery.     RARE VALVE SURGERY      SAVES RWANDAN'S LIFE     Looking at 32-year-old Martin Butarama's lean frame, it is difficult to imagine that for five years he would get so bloated that he could barely move. A malfunctioning heart meant the Rwadan interpreter's body — "right from my toes to chest''— would fill up with liquid. After diagnosis at Uganda, Tanzania and South Africa failed to specially diagnose the problem, he flew down to Mumbai's Wockhardt Hospital in Mulund for help. "After talking to him, we realised he had suffered from rheumatic fever in his childhood. As he had stopped taking preventive medicine after 15 years of age, he developed a rare problem called the rheumatic isolated tricuspid stenosis of heart,'' said cardio-thoracic surgeon Dr Ajay Chaughule from Wockhardt. Due to the defect in the tricuspid valve, he had developed a thrombus or clot which was of 6 cm in size on the right atrium, restricting the blood flow to his heart. "We are planning to get a research paper published on this rare case,'' said Dr Chaughule. TNN Dr Ranjit Deshpande

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