(MENAFN- Khaleej Times) The first surgeon to perform endoscopic thyroid surgery in Gulf says procedure gaining popularity
Dubai — Dr R. Padmakumar a specialist surgeon at International Modern Hospital Dubai who performed the first ever endoscopic thyroid surgery of the Gulf region has more reasons to celebrate. He has crossed a milestone by performing 100 such minimally invasive procedures in 2014 alone.
The senior consultant surgeon and medical director of Sunrise Hospital Cochin said the achievement of 100 keyhole thyroid surgeries was inclusive of cases both in India and Dubai.
Dr Padmakumar’s first procedure here was on a 40-year-old lady expatriate who developed a disease and nodules affecting both sides of her thyroid. As an ultrasound scan was showing features suspicious of cancer they opted for surgical removal of the thyroid. She underwent a keyhole surgery through tiny cuts in the armpit and the entire thyroid was removed successfully.
Dr Padmakumar said his first few successful surgeries gave other patients lots of confidence in endoscopic thyroidectomy a minimally invasive technique which leaves no large transverse cut across the lower part of the neck as is the case with the conventional open thyroidectomy.
Dr Padmakumar one of the few doctors in the world to have mastered this technique successfully said that generally the surgical solution available in most of the places across the globe is open thyroidectomy. This leads to an unsightly scar which is not acceptable to patients especially women. So the endoscopic thyroid surgery done only at a handful of hospitals in the world is a boon for working professionals Dr Padmakumar told Khaleej Times.
“Redundancy scare always haunts expatriates here. Visible scars after a thyroid surgery proclaim to the world they had undergone a procedure. My first patient in Dubai was also concerned that a scar around the neck could make her redundant” Dr Padmakumar explained.
He said he has been inundated with enquiries from patients of different nationalities in the UAE after word got around of the advantages of the technique.
The surgeon said that apart from an excellent cosmetic outcome the endoscopic thyroidectomy reduces the period of hospitalisation to around 24 hours. These patients can resume all kinds of activities in a few days.Dr Padmakumar said they will also have less wound-related problems compared to the open surgery group. He said that since the surgery — which costs anywhere between Dh30000 to Dh40000 in Dubai inclusive of hospitalisation charges — is fully covered by insurance there is no burden on working expatriates here. And if the procedure is done in India it costs between Rs100000 to Rs150000 rupees which is less than Dh10000.
The procedure
Dr Padmakumar explained that endoscopic thyroidectomy by axillary approach involves the following steps — a 10mm trocar placement in the axilla towards the neck for the telescope which initially helps in creating the plane and visualisation of structures with magnification precision and clarity.
Two 5mm trocars are introduced into the dissected space which are used as working ports. “We can open the investing layer in midline and reach the thyroid gland. The gland is mobilised by blunt dissection and vital structures identified.
“The blood vessels are divided and gland detached from trachea. A specimen bag is used to place the thyroid and removed by dilating the 10mm trocar” Dr Padmakumar explained.
The investing layer is then sutured back a drain placed and the trocar sites closed. Patients are only required to stay in the hospital for 24 hours and can resume normal activities in a few days the surgeon said.
Dr Padmakumar rejected the myth that endoscopic surgery is an option for thyroid swellings of less than 4cm size.
He said swellings of even 12-15cm can be tackled very successfully through this method provided the surgeon has the technical skill and experience both in laparoscopic and thyroid surgeries.
Dr Padmakumar said he has no plans to extend this procedure to other parts of the Gulf as he is bogged down with coaching responsibilities at international conferences and major hospitals in India including the All India Institute of Medical Sciences Delhi; Madurai Medical College; and Christian Medical College Vellore.
Dr Padmakumar is also vice-president Indian Hernia Society; founder member Obesity and Metabolic Surgery Society Of India; founder member Association of Minimal Access Surgeons of India; and International Faculty of IASGO on Hernia and Diabetic Surgery.