In a path-breaking surgery here, an elderly woman suffering from multiple nodules and cysts in her thyroid gland was relieved of the diseased parts without any trauma on the neck.
A team of surgeons led by B. Ramana performed the two-hour-long operation - Bloodless Endoscopic Thyroidectomy - through the anterior chest or breast approach at Apollo Gleneagles Clinic last week.
"Endoscopic approaches are being used worldwide as part of the minimal invasion revolution sweeping the world of surgery. The breast approach, however, is rarer than approaches using the neck. This is the first such instance in the country," Ramana told IANS.
"The essential principle of this surgery is that your access route is different. We go under the skin only through the fat," Ramana said.
"The breast approach involved creating a space in the chest and neck via a tiny cut over the breast through which a balloon was introduced and inflated. Two more 5 mm cuts were made on the chest to introduce instruments to dissect the thyroid gland," Ramana said.
The thyroid gland is a butterfly-shaped organ located in the front of the neck. It commonly develops nodules or becomes very big. Its removal is complicated by the presence of multiple vessels, including the vessels supplying the brain and head, and nerves, which affect speech.
Conventional operation leads to a long incision (collar incision) stretching from one side of the front of neck to the other side while bleeding and injury to the nerves of the voice box (larynx) are operative hazards.
"The advantage of this approach is the total invisibility of the scars and the clear magnified images seen during the endoscopic operation. The safety of the operation rested largely on the superb quality of the images captured on the world's latest and best endoscopic high-definition camera," Ramana said.
High-tech laparoscopic equipment includes 1.9 mm thin instruments for performing needlescopic procedures.
"Modern laparoscopic surgery is cost effective, 25 percent cheaper than open surgery," Ramana said. "The cost of this operation is around Rs.40,000 and a patient can be even discharged after 24 hours."
Ramana hoped that once people come to know of the bloodless surgery it would catch on.
"Thyroid swellings, known as goitres, are a major healthcare issue in India, especially the sub-Himalayan belt of the states, stretching 2,400 km from Kashmir to the Naga Hills in the east.
"Considering that a large number of goitres needing surgery occur in young and middle aged women, there is a major role for endoscopic surgery in the modern management of this disease," Ramana said.