Apollo Hospitals Bangalore has announced the successful completion of 100 robotics cardiac surgeries at its dedicated Robot-Assisted Cardiac Surgery Unit; a milestone in the history of cardiovascular surgery in the country. The hospital also announced that the team had performed a Complex Mitral Valve surgery using robotic-assisted minimally invasive cardiac surgery with the da Vinci robotic system in under 70 minutes, a landmark achievement in interventional cardiology. Dr. Sathyaki Nambala, Sr. Consultant, Cardiothoracic and Vascular Surgeon and HoD, Robotic Cardiac Surgery Unit said, “Cardiovascular diseases tend to affect patients in the most productive years of their lives result in catastrophic social and economic consequences. The establishment of a Robot-Assisted Cardiac Surgery program requires a tremendous amount of dedication and preparation, and we are proud to be India’s first hospital to complete 100 robotic cardiac surgeries since the program’s inception in late 2019. In comparison to traditional open-heart surgery, which involves opening up the chest by splitting the breastbone, the da Vinci Xi’s innovative technology allows for complex cardiovascular surgeries to be performed through smaller incisions and precise motion control. “In addition, a high-definition camera provides a clear, 3D view of the chest to the surgeon on a console screen. With the help of the system, we were also successful in conducting the fastest Robotic Complex Mitral Valve repair in under 70 minutes as opposed to the global benchmarks. We hope to achieve more such milestones in the near future.” Robotic cardiac surgery is a minimally invasive procedure that helps patients return to their everyday life much faster than open-heart surgeries. Surgeons use the da Vinci Surgical System to operate through 8 mm holes called ports and a magnified 3D high-definition vision as well as tiny wristed instruments that bend and rotate much more than the human hand aid in surgery. As a result, surgeons have better vision, precision, and control. Other benefits include decreased pain, fewer post-operative wound infections, less post-operative scarring, and improved breathing. Recovery is rapid, with lesser hospitalisation, faster mobilisation and rehabilitation. Reducing the chance of infection makes it an ideal procedure for people with diabetes and older patients. Dr. Sangita Reddy, Joint Managing Director, Apollo Group of Hospitals said, ” Our goal has always been to bring the most cutting-edge medical technology to India for the benefit of our patients. We want more patients to benefit from the most advanced surgical and medical care available at our hospital. The da Vinci Surgical System has assisted us in providing the best possible surgical outcomes, and the completion of more than 100 successful robotic cardiac surgeries attests to our commitment to providing the most recent and highest quality of care. The patient is at the heart of all our efforts at Apollo Hospitals to provide accessible and affordable world-class treatment, and the addition of the da Vinci Xi robotic surgical system is a step toward that goal. We are confident that by achieving the two milestones of 100 surgeries and performing the robotic complex mitral valve repair in under 70 minutes, we will change the lives of many more patients who cannot undergo conventional cardiac surgery.” Commenting on this, Mr. Mandeep Singh Kumar, VP and General Manager, Intuitive India, said, “It gives us great pleasure to be part of this exemplary milestone of 100 successful robotic-assisted cardiac surgeries. At Intuitive, we believe technology should enhance a surgeon’s ability to perform complex procedures with ease and help improve clinical outcomes. Surgeons today are increasingly vouching for robotic-assisted surgery and the da Vinci system for its potential to enhance precision, improve visualisation, flexibility, and its potential to improve clinical outcomes. The dedicated Robotic Cardiac Unit at Apollo (Bengaluru) is one amongst the very few such centres globally that provide robotic cardiac surgery as a treatment option. That coupled with Dr. Sathyaki’s expertise in minimally invasive cardiac surgery is a true testament to the world-class standards set by the organisation and its care teams. It also speaks highly of Apollo’s ongoing commitment to leveraging the power of technology towards providing quality care. We are proud of our association with the Apollo Group of Hospitals towards making robotic-assisted surgery accessible to the greater patient community.” Cardiovascular diseases (CVDs) have overtaken cancer as the leading cause of death in India. This epidemiological shift is primarily due to an increase in the prevalence of cardiovascular diseases (CVDs) and cardiovascular risk factors in India. According to studies, the estimated prevalence of CVDs in India in 2016 was approximately 54.5 million, with 1 in 4 deaths in India being caused by CVDs, with ischemic heart disease and stroke accounting for more than 80% of this burden. According to a study published in The Lancet Global Health, Indians now have one of the highest rates of mortality after a heart failure diagnosis, higher than people in several developing countries around the world. According to the study, heart failure patients in India had one of the highest mortality rates after one year of diagnosis, at 23%. This was higher than the mortality rates in Southeast Asia (15%), China (7%), South America (9%), and West Asia (3%). (9 percent). The study also found that heart failure patients in India, Africa, and Southeast Asia were about ten years younger than patients in developed countries like the United States and Europe. The Robot-Assisted Cardiac Surgery Unit at Apollo provides patients with complex cardiac disease with access to the best cardiac care available. Dr. Sathyaki P Nambala, Senior Consultant, Cardio-thoracic and Vascular Surgeon and Head of the Department, Robotic Cardiac Surgery Unit, leads the Robot-Assisted Cardiac Surgery Unit, which is equipped with the advanced fourth-generation versatile ‘da Vinci Xi’ robotic surgical system and a dedicated team.

Indraprastha Apollo Hospitals successfully performed liver transplant procedures for 11 children from Philippines who were suffering from chronic liver diseases. These children were between the age of 12 months – 15 years, in grave health conditions and needed immediate organ transplants along with specialised medical treatment, as any further delay could have been fatal. A team from Apollo assisted the families in acquiring permissions for travel while ensuring safety and brought the children to Delhi in specialised chartered flights and got them transferred back to their country post recovery. After compulsory quarantine the children underwent successful lifesaving liver transplant procedures at Indraprastha Apollo Hospitals. With post-operative observation and care these children have returned to their country on 23rd August. Dr Anupam Sibal, Group Medical Director, Apollo Hospitals, said, “At Indraprastha Apollo Hospitals we have been regularly receiving patients from Philippines and South Asia in the pre-COVID times, but ever since countries imposed restrictions on travel and movement due to the pandemic, a lot of patients have been deprived of life saving treatments. We were fortunate to have immense support from the Embassies of both the countries who helped ease the process. The first group of patients arrived on 15th August last year. While the last of the group had their transplant several months ago, the families could not travel as there were no flights. “ Dr. Neerav Goyal, Senior Liver Transplant Surgeon, Indraprastha Apollo Hospitals, said, “In liver transplant, surgery is performed when patients have a high risk of dying from their disease in the ensuing weeks to month. Since COVID-19 is not going away anytime soon, many of these patients were unlikely to survive the period of pandemic without a liver transplant and the patients, despite several challenges, travelled to us. The youngest baby was 12 months and 8 were less than 18 months of age. In 7 cases, and the mothers were the donors.”

Apollo Hospitals has launched an Institute of Hernia Surgery and Abdominal Wall Reconstruction at Chennai which is a comprehensive specialty centre for hernia care. The Institute of Hernia Surgery and Abdominal Wall Reconstruction at Chennai was inaugurated by Minister for Health and Family Welfare, Thiru. MA. Subramaniam. Speaking about the advancement in Hernia treatment, Dr. Premkumar Balachandran, Senior Consultant Minimal Access, Bariatric and Robotic Surgeon, Apollo Hospitals, said, “The management of hernia has now undergone a paradigm shift. The advent of minimal access or laparoscopic surgery has been a boon to both the surgeon and the patient. The nomenclature of ventral hernia management is now referred to as “abdominal wall reconstruction”. Complex reconstructions, abdominal wall component separation surgeries, regular groin and ventral hernia can now be treated with minimal morbidity by the laparoscopic and robotic techniques.” Read more about the Institute of Hernia Surgery and Abdominal Wall Reconstruction at Chennai

Indraprastha Apollo Hospitals, New Delhi has performed a rare life-saving heart surgery on a two-day old newborn for removal of a rare tumor. Baby Virin, whose parents are residents of Noida, was born with a rare congenital tumor called Intrapericardial teratoma (arising from the surface of heart) which was detected while he was in his mother’s womb. The infant’s tumor was detected on a routine ultrasound of his mother at 20 weeks of gestation. It was found to be arising from the surface of his heart and had the potential of impacting growth within the womb. Hence, after the detection, his condition was monitored regularly every week by the means of fetal echocardiogram (to assess the growth of tumor and any effects on the functioning of heart). To reduce the pressure on his heart and carry his mother’s pregnancy to term, excessive amount of fluid surrounding his heart was needed to be removed once. At birth, the baby weighed 3.2 kg but had trouble in breathing. He was immediately intubated and put on a ventilator. A CT Angio was conducted, and showed a 7 cm across, lobulated giant intrapericardial tumor that was pushing the heart to the left and compressing the lung. Dr. Rajesh Sharma, Senior Pediatric Cardiac Surgeon, Indraprastha Apollo Hospitals, New Delhi said, “The baby’s condition was precarious, and we planned to operate on him immediately. On day 2 after birth, we successfully removed the tumor which was larger than the heart and was found to be attached to the surface of heart, displacing the heart to the left. It had an attachment to the aorta and the right AV groove. Since tumor manipulation was causing a fall in the blood pressure, and due to its proximity to the right coronary artery, the removal of the tumor was accomplished by putting the baby on the heart-lung machine, on cardiopulmonary bypass. We managed to remove the tumor in one piece.” Dr. Ashutosh Marwah, Consultant Surgeon, Pediatric Cardiology, Indraprastha Apollo Hospitals, New Delhi said, “Fortunately there have been no significant deleterious effects of the tumor on the functioning of lungs or heart. Though the removal of tumor is supposed to be curative in most cases, due to the rarity of the diagnosis, the baby will need regular follow-ups with tumor marker levels and regular echocardiographic examinations in the future. For now, the baby has shown good recovery and has been discharged.” An intrapericardial teratoma arising from the heart is an exceedingly rare tumor of the fetus and the newborn. A major concern with such tumors during pregnancy is the life-threatening pressure that the tumor puts on the fetus’ heart and lungs. The baby has been discharged and is normal and healthy.

Baby Somya Tiwari, a seven-year-old girl, from Valsad, Gujarat, had her neck fixed at an almost 90 degrees angle after two consecutive surgeries failed to address her neck tilt caused by a neck muscle tumour. The presence of this tumor led to neck tilting and rotation which is called as Torticollis, also known as wry neck. However, in this case the muscle had calcified, and the collar bone and skull bone were united by a bony bar which had fixed her head to body without any movement. Such a complicated case has not been reported in any orthopaedic/ medical journal/ literature and this for the first time a multi-staged surgery for the condition has been performed. The child was successfully treated at Apollo Hospitals Navi Mumbai through a complex multi-stage surgery carried out by a specialized multi-disciplinary team. Before visiting Apollo Hospitals Navi Mumbai, she had been suffering from this condition for over five and a half years. The family brought the girl to Apollo Hospitals Navi Mumbai as their last hope to correct the deformity so that the girl could live a normal life. The girl was examined by team of doctors from Spine Surgery and Paediatric Orthopaedic units. A detailed treatment plan of multi-stage correction was drafted but it needed support from ENT, pediatrics, pediatrics, plastic surgery department. The child’s head was completely tilted and fixed with no movement at all. MRI / CT scan imaging showed a bony bar extending from the collarbone to the mastoid bone located behind the ear. After detailed consultation, a complex multi-stage surgery was planned. Dr. Agnivesh Tikoo, Spine Surgeon, Apollo Hospitals Navi Mumbai said, “When the child was six months of age, the family had noticed a lump on the right side of neck which gradually started increasing in size and caused a tilt in the neck. At 9 months of age, she underwent her first surgery. This appears to have been a condition called as benign fibrobastic proliferation of sternocleidomastoid muscle, also known as fibromatosis colli. This is a congenital fibrotic process that is rarely seen and affects infants with an incidence of 0.4% of live births. It is usually on one side, affects the right side in 3/4th of cases, and usually, male infants are affected slightly more often than the females. Dr. Swapnil Keny, Paediatric Orthopaedic Surgeon, Apollo Hospitals Navi Mumbai added that in the cases of Fibromatosis Colli there usually is a history of complicated delivery and birth injury in more than half of the cases. This causes an injury to the neck muscle that scars as it heals, with the amount of scar in the muscle determining the tightness of the muscle and severity of the torticollis. The child in this case underwent a second surgery at 15 months of age elsewhere, but she had a fall and could not follow up the treatment and this resulted in severe neck deformity. “The neck tilt and rotation were so bad that the 1st and 2nd cervical spine bones (vertebra) had slipped from their original position” said Dr. Tikoo. The family took the child to many hospitals, which refused intervention citing high risk. The family gave up any hope of getting better and stopped seeking medical intervention. The patient was then brought to Apollo Hospitals Navi Mumbai as the last hope for treatment. The multi-stage surgery was carried out in three stages, led by Dr Agnivesh Tikoo, Spine surgeon and Dr. Swapnil Keny, Paediatric Orthopaedic Surgeon. The sternocleidomastoid, a rope shaped muscle that extends from the inner end of collar bones to part of skull behind the ears, had become contracted and calcified. In the first stage, the bony bar was excised and removed and the tight muscle fibres were removed with help of the ENT and plastic surgery team. The first stage of the surgery resulted in an immediate partial correction of the neck tilt but it was just the beginning of the treatment. Correcting the neck in one stage could make the child completely paralyzed. A Pediatric Halo, which holds the head via metal pins was applied to child’s skull and gradual traction with weights was applied which was given gradually over the next three weeks to correct the deformity. The second stage was carried out 3 weeks after the first stage surgery. The second stage involved fixing the slipped cervical vertebrae which was performed under neuromonitoring (a device/ system which monitors the spinal cord and nerves during the surgery). The child was protected in Halo Vest to let the bones heal. The child remained in the Halo Vest for three months before it was removed to be replaced with a specially made collar. The child underwent a third minor procedure few days ago to make her neck more flexible to aid in physiotherapy. The child can see straight with both the eyes after 5 and a half years of ‘one eyed vision’ and can hold her neck straight. Mr. Nilesh Tiwari, Father of the Child, said, “It was a difficult time for the family, to see the child suffering. We went to multiple places across India, but nobody was willing to operate considering it was a high risk case. One of my colleagues recommended to meet the specialists at Apollo Hospitals. The Doctors, explained the case in detail and multiple surgeries were performed. We are happy to see our daughter to hold her head straight and be normal like any other child.” Mr. Santosh Marathe, COO and Unit Head, Apollo Hospitals Navi Mumbai said, “The child’s deformity is today significantly better. She is able to live a normal life without the neck deformity and is able to move her neck without any limitation. We are happy that we were able to treat the child and live up to the family’s hopes and expectations with which they had brought her to Apollo Hospitals. It is cases like this that inspire us to continue to create accessibility to advanced medical technology for our team of finest medical experts to consistently deliver best in class clinical outcomes and set new benchmarks in healthcare delivery and patient experience.”

Apollo Hospitals, has successfully conducted MitraClip implant surgery on a 41-year-old male farmer who had waited for over three months in other hospitals for a heart transplant. The patient was back on his feet within a few days after the procedure, and might not even need a heart transplantation. Dr. Sai Satish, Senior Interventional Cardiologist, Apollo Hospitals, Chennai said, The MitraClip is a small metal clip with a polyester fabric that is inserted in place to fix the leaky mitral valve, thereby ensuring that the blood flow is in the right direction. It is a globally accepted procedure for patients with heart failure. Patients with moderate to severe or severe primary and secondary mitral regurgitation who are not improving on medical treatment can opt for this minimally invasive solution that offers them a vastly improved quality of life and health. Read more about the life-saving procedure performed at Apollo Hospitals, Chennai

Apollo Proton Cancer Centre (APCC) has successfully operated on a female patient from Bangladesh suffering from rectal cancer, using Robotic Stapler for the first time. The patient with rectal cancer visited Apollo Proton Cancer Centre in March 2021. She was diagnosed with locally advanced rectal cancer and received chemotherapy with radiotherapy to shrink the cancer. She was re-evaluated in June 2021. Since the tumour had shrunk considerably with the previous treatment, the patient was counselled to undergo a robot-assisted surgical procedure, known as a low anterior resection. The surgery was performed by Dr. Ajit Pai, Senior Consultant, Lead GI Surgical Oncology and his team at Apollo Proton Cancer Centre on 3rd July 2021. The patient recovered well from the procedure and was discharged without any complications in 3 days. Read more about Rectal Cancer surgery performed with the Robotic Stapler

Apollo Speciality Hospitals, Vanagaram launched a Quaternary Care, Level FOUR Epilepsy Care Center to help people living with epilepsy. The advanced epilepsy care centre was launched by Honourable Minister Thiru. S M Nasar, Milk and Dairy Development Department, Tamil Nadu Government and Dr Alby John Varghese, IAS District Collector & District Magistrate Tiruvallur. The level FOUR Epilepsy Care Centre will localize (finding the lesion location in the brain), classify (Type of seizure), accelerate therapies to control seizures, further evaluate and offer higher level of care including Epilepsy Surgeries. Read more about the level Four Epilepsy Care Centre at Apollo Speciality Hospitals, Vanagaram

The Department of Pediatric Cardiology and Pediatric Cardiac Surgery of Apollo Children’s Hospital, Chennai has partnered with Rotary Club of Madras East to help underprivileged children requiring lifesaving heart surgery. Of every 1000 babies born, 8 are born with congenital heart disease. In India, on an average, 2.5 lakh children are born annually with heart disease. About half will die before the first birthday, if they do not have access to timely surgery and intervention. The Pediatric Cardiac program caters to children with heart disease from all socioeconomic classes. The program is run with the help of the Tamil Nadu Chief Minister’s Comprehensive Health Scheme, donations from the Save a Child’s Heart Initiative (SACHI Trust) run by Apollo Hospitals, crowdfunding platforms and the kindness, dedication and magnanimity of Rotarians like those belonging to Rotary Club of Madras East (RCME) and the generosity and unlimited support from the Apollo top-management. The joint program between Apollo Children’s Hospital and RCME was launched on July 5, 2021 with an initial target of helping at least 500 poor children over a period of 1 year. Read more about the Healing Tiny Hearts Project

Doctors at Apollo Proton Cancer Centre has successfully performed India’s first Megaprosthesis Fixation for femur and Laparoscopic Radical nephrectomy as a single stage surgery through a Multimodal approach. A 54-year-old female from Assam visited the Apollo Proton Cancer Centre on June 13, 2021. She had sustained fracture of her left thigh bone and suffered a trivial injury two months ago, after which she was bedridden and completely immobile. On evaluation and a biopsy, she was diagnosed with metastatic left renal cell carcinoma which is a cancerous lesion of the kidney. It is a type of metastasis in which cancer cells from the original (primary) tumor travel through the body and form a small number of new tumors (metastatic tumors) in other parts of the body. Specialists at Apollo Proton Cancer Centre planned for surgical resection of the tumor in the thigh bone and the removal of the affected kidney through minimally invasive methods to stabilize the patient and get her to walk again. Read more about the challenging surgery performed at Apollo Proton Cancer Centre.

Apollo Hospitals and Dr. Reddy’s Laboratories (Dr. Reddy’s) has launched a limited pilot program for the Sputnik V vaccine as part of the soft launch by Dr. Reddy’s in India. The first phase of vaccination program was started in Hyderabad on May 17, 2021 and in Visakhapatnam on May 18, 2021 at separate facilities at the Apollo Hospitals in those cities. The vaccination program followed all the SOPs as recommended by the Government including registration on CoWIN. Dr. K. Hari Prasad, President – Hospitals Division, Apollo Hospitals Enterprises Limited said, “With the opening up of the vaccination program for the private sector, we have intensified our efforts to accelerate the rate of vaccination through opening vaccination centers across our hospital network and are also in discussions with corporates to undertake vaccination on their premises. We are currently administering COVID vaccine at 60 locations across the country including Apollo Hospitals, Apollo Spectra Hospitals and Apollo Clinics. This pilot phase will allow Dr. Reddy’s and Apollo Hospitals test the arrangements and cold chain logistics and prepare for the launch. We are confident that with the Sputnik V vaccine, we will be able to make a significant contribution to ease availability and access to COVID vaccines to the community at large.” Mr. M.V. Ramana, CEO – Branded Markets (India & Emerging Markets), Dr. Reddy’s Laboratories said: “We are pleased to collaborate with Apollo Hospitals as part of our soft pilot launch of the Sputnik V vaccine in India. We are working to scale up the pilot and take the vaccine to other cities, and in the upcoming months we hope to inoculate as many Indians as possible.” The Sputnik V vaccines for the pilot program would be supplied by Dr. Reddy’s from the first batch of 1,50,000 vaccine doses imported by them for the soft launch. After Hyderabad and Visakhapatnam, the pilot program will be extended to Delhi, Mumbai, Bangalore, Ahmedabad, Chennai, Kolkata, and Pune.

Apollo Hospitals, Hyderabad has successfully performed a complex combined liver and kidney transplant, using organs from two different living donors, for the first time in India. The Complex surgery was performed by Dr Manish Varma, Chief Transplant Surgeon and Dr Naveen Polavarapu, Chief Transplant Hepatologist at Apollo Hospitals, Hyderabad, on a fifty-seven-year-old Tanzanian patient, Mr. Gabriel Ceaser Sisa. The uniqueness of the case was further compounded by the usage of a non-matching blood group organ, the liver. That made the task extremely perilous, but the hands-on experience and the immense expertise, the Transplant and Support Teams at Apollo Hospitals command, steered the outcome to success. The patient has since recovered and is all set to be discharged. This case is unique, as it is the first time in our country that a multi-organ transplant has been performed using one organ that is non matching blood group and the other organ of a matching blood group. Monitoring such patients, especially for rejection is a big challenge. As it is, blood group unmatched transplant of a single organ is a complex endeavor, undertaken only in select centers globally. It is noteworthy that the same team had performed the first unmatched blood group transplant of the city about six months ago. Mr. Gabriel Ceaser Sisa first visited Dr Naveen Polavarapu, Apollo Hospitals, Hyderabad in 2017 with Liver related problems. It soon transpired that he had chronic Liver and chronic Kidney disease. Over the course of the next three years, his Liver and Kidney diseases progressed despite being on active medical treatment and close monitoring. As he reached end stage Liver disease and end stage Kidney disease requiring hemodialysis, he was advised to undergo a combined liver and kidney transplant. Usually, such transplants are performed using organs from a single cadaveric donor, which avoids complications associated with multiple living donors including blood group mismatch, post-surgery donor recovery etc. In fact, rejection of the blood group unmatched organ by the recipient is very high and is an immense challenge, needing constant monitoring. This patient being a foreign national was ineligible for a cadaveric organ in India as only Indian citizens can avail cadaver organs as per the law. The doctors had no choice but to harvest organs from two different donors from the patient’s family. Though his brother and nephew accompanied him as possible blood group matching donors for liver and kidney respectively, the brother was found medically unfit to donate either liver or kidney. The search mounted for a same blood group liver donor turned out to be futile. It was his fifty-two-year-old wife with a different blood group was the option on hand and a slice of liver was sourced from her and the twenty-nine-year-old nephew donated the kidney. He was admitted on February 9th, 2021, though preparations, administering special medicines and conducting various procedures as a part of the treatment protocol were all begun three weeks ahead of surgery. The surgery, done on February 12th, 2021, took 23 hours, with three teams of surgeons operating simultaneously in three operation theatres. The kidney donor was discharged on the fourth day, liver donor on the sixth day and the recipient after sixteen days after the surgery on February 28th, 2021. The patient and both the donors are healthy and ready to fly back home. The challenges faced by the medical team were enormous because of multiple health and procedural complications. The patient had to be prepared for blood group nonmatched transplant, which required a special treatment protocol. This surgery itself was high risk because of multiple reasons like blood group mismatch, patient on dialysis, dual organ transplant and both organs from living donors, says Dr. Manish Varma, Chief Transplant Surgeon, Apollo Hospitals, Hyderabad. The expert team of doctors was supported by Dr Ravi Andrews, Consultant Nephrologist; Dr K. Soma Sekhar, Consultant Gastroenterologist; Consultant Transplant Surgeons Dr Sasidhar Reddy and Dr Rajshri; Dr Manjunath B, Consultant Anesthetist and Dr Navakanth, Consultant Intensivist, among others. “This is a very rare and unique case of its kind particularly because of the blood group not matching and the complex combined Liver and kidney transplant done successfully on the same patient. Even on thorough literature search by our medical team, only one such case was done earlier in the world. This required meticulous planning and execution and it wouldn’t have been possible without the efforts of our multidisciplinary team. We are happy to see that the patient is going back to his country safely after a successful outcome” says Dr Naveen Polavarapu, Chief Transplant Hepatologist, Apollo Hospitals, Hyderabad.