Docs perform rare surgery on 75-yr-old | delhi | Hindustan Times
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Docs perform rare surgery on 75-yr-old

The abnormally large size prostrate gland will no longer will be a deterrent for the medical experts as the city hospital docs recently removed a melon-sized gland weighing 424gm using laparoscopic process. The surgery was performed on a 75-year-old KL Sehgal, a resident of Rohtak, Haryana.

delhi Updated: Jun 15, 2011 23:53 IST
Rhythma Kaul

The abnormally large size prostrate gland will no longer will be a deterrent for the medical experts as the city hospital docs recently removed a melon-sized gland weighing 424gm using laparoscopic process. The surgery was performed on a 75-year-old KL Sehgal, a resident of Rohtak, Haryana.

A normal prostrate gland, located beneath the urinary bladder in men provides nourishment to sperm cells, weighs 18 gm, and is the size of a walnut.

Doctors at south Delhi’s RG Stone Urology and Laparoscopy Hospital, on Friday, successfully removed the enlarged gland in a using the latest Holmium Laser Enucleation of the Prostate (HOLEP) technology. Instead of making an incision, the gland is removed with the help of laser equipment inserted through the urinary tract along with a telescope.

Sehgal developed the problem in 1990, and since 2006, he had been dependent on catheter. “I was advised an open surgery and was too scared to opt for it. Last year, at a workshop in Rohtak Medical College, I came to know about this technique and thought of not getting a long slit was a great relief,” said Sehgal, a retired branch manager, State Bank of India. The surgery was performed in two phases. In the first phase, that lasts for four hours was done on June 7. The gland was cut and left in the bladder. In the second phase that lasted a little over an hour, the gland was crushed within the bladder and then sucked out.

“The best part about this technique is that the procedure can be performed in phases. When we realised during the surgery that the patient was getting a little unstable, we decided to postpone the remaining procedure. He is doing fine post-operation,” said Dr Anil Varshney, chief urologist at the hospital, who led a four-member operative-team.

The technique also has other advantages over open surgery such as, short hospital stay, minimum blood loss, so no blood transfusion is required, no scarring or risk of developing hernia, reduces the possibility of contracting infection and quicker recovery.
“The procedure is safe for high risk people like those with diabetes, hypertension, heart disease etc. However, the cost is more or less the same as that of the conventional style of surgery,” said Dr Varshney.

The time taken to remove a gland laprascopically can be as less as 10min and costs between 50,000 and 1 lakh, while an open surgery may take up to three hours and normally cost about a lakh and a half. “I have virtually stopped doing open surgeries, and the result is near perfect,” said Dr Varshney.

The removal process

First phase
The equipment-comprising a telescope, fibre for laser and morcellator (crusher) and suction device is inserted through the urinary tract. Exact movement within is observed on the computer screen while cutting the gland to avoid any removal of or tampering with healthy tissues.

The removed is gland left within the bladder.

Second phase
The crusher is used to split the gland into small pieces of about 4mm. A suction device is used to suck the residue from the bladder.