Tuesday, December 23, 2014

A first-of-its-kind a giant polypoidal lesion measuring of 8 cms X 2.5 cms was removed without any surgery by Dr Vipulroy Rathod

The patient was suffering with dysphagia (difficulty in swallowng) and severe chest pain off and on for more than 2 months. After undergoing several barium tests, endoscopies, CT scans and MRIs, he was advised surgical intervention either in the form of Thoracoscopy or Thoracotomy as the only measure to excise his tumour by several experts from India. However, Endoscopic treatment option was not considered before the patient met Dr V Rathod

In what could be the first-of-its-kind surgery in India, a Mumbai-based surgeon, Dr Vipulroy Rathod, Endoscopy Surgeon and Director, Endoscopy Asia successfully performed a rare case of Endoscopic Resection of a Giant Polypoidal Lesion recently at Endoscopy Asia

IMG_8563 (1)“This is the first ever case of its kind in India, which has enabled us to a new lease of life to Hitesh Gupta. ( name changed ) by removing a 8cms x 2.5cms tumour from his esophagus,” says Dr V  Rathod

On endoscopy and endoscopic ultrasound <EUS> evaluation by Dr. Vipulroy Rathod, it appeared to him that an endoscopic treatment option can be considered in this case and hence all the pros and cons of such an option were discussed with the patient and the relatives

“We have seen several cases of polypoidal lesions in the stomach, duodenum, and colon and have been successfully treated with Endoscopy & Endoscopy Ultrasound (EUS), however such a giant polypoidal lesion of the size 8.0 cms x 2.5 cms, with a 2 cms thick stalk in the esophagus was observed for the first time”, says Dr.V Rathod, Pioneer of Endoscopic Ultrasound (EUS) and Interventional Pancreato-Biliary EUS in India and who has performed more than 17000 EUS Procedures till date which is the largest individual experience in India

“I did not want to undergo massive open surgeries, which would have left me with lifelong disability along with heavy scars on my body”, says 37 year old Mr. Hitesh Gupta. (Name changed ). “I was extremely disappointed and lost hope that I can ever get cured without such  a supramajor surgical intervention, till I met Dr.V Rathod. He advised me Endoscopy Procedure for removal of my tumour. The thought of a surgery without a single scar made me instantly ready for the procedure,” the  patient further said.

IMG_8564This resection was carried out in two sessions and the entire tumour was successfully resected from the stalk.  There was no blood loss and the tumour was delivered from the mouth. The histopathological examination confirmed that it was a benign tumour

In the above case, if the patient would have attempted Thoracoscopy, Dr.V Rathod felt that there was a possibility that he would have ended up in thoracotomy and esophageal resection anastomosis as the tumor was not in the layers of the esophageal wall but hanging in the lumen of the esophagus. An open surgery would have probably caused prolonged recovery and patient would not have felt normal ever

Endoscopy is the most accurate form of diagnosis for early detection of cancer of Gastrointestinal tract. Endoscopic Ultrasound (EUS) helps in accurate staging of cancers. Endoscopy can also offer safe and quick form of treatment as well. Endoscopic treatments  reduce the morbidity that usually comes with conventional surgeries, and are also cost effective and time saving as they are mostly done on an OPD basis

In case of Mr. Hitesh Gupta, after the removal of the lesion he was given oral food within next 24 hrs and was discharged after 48 hrs after the endoscopic surgery. This was possible as there was absolutely no blood loss, patient did not require blood transfusions or ICU admission as the endoscopic treatment was without any complications

Endoscopy Asia is a world-class state-of-the-art Tertiary Institute for Diagnostic and Therapeutic Gastrointestinal and Pancreato-Biliary Endoscopy & Gastroenterology

Gastroenterology and Endoscopy have evolved into a subspecialty and over the last five decades the technological advancements have made it possible to detect, diagnose, stage and treat several gastrointestinal and pancreato-biliary ailments now without conventional surgery

Apart from routine diagnostic and therapeutic OGD Scopy, Colonoscopy, ERCP and Endoscopic Ultrasound (EUS), Endoscopy Asia has also acquired the much needed Single Balloon Enteroscope. This will allow us detailed evaluation of the entire small bowel (intestine) thus there are no blind areas in the gastrointestinal tract for the endoscopist as the entire tract from mouth to rectum is now accessible with a flexible endoscope and with the ability of biopsy as well as therapeutic interventions. Single Balloon Enteroscopy scores over Capsule Endoscopy which is only a diagnostic tool as Biopsy and Interventions are not possible at present with the commercially available Capsule Endoscopy Technology