At Apollo Cancer Centres, our surgical oncology program represents the pinnacle of cancer surgery excellence. Our highly trained surgical teams perform complex procedures with remarkable precision and consistently superior outcomes.
Advanced Surgical Expertise
Comprehensive Surgical Capabilities:
Our surgical teams excel in:
- Complex tumor resections requiring multidisciplinary approach
- Skull base surgeries
- Advanced liver resections and reconstructions
- Microvascular reconstructive procedures
- Limb-preserving surgeries for bone tumors
- Minimally invasive cancer surgeries
Specialized Surgical Procedures
Our surgical expertise encompasses a wide range of complex procedures, each performed with the highest level of precision and care:
- Commando Operations (Combined Mandibulectomy and Neck Dissection): These complex head and neck procedures involve simultaneous removal of jaw bone and lymph nodes, requiring intricate surgical expertise. Our surgeons employ advanced reconstruction techniques to maintain both function and aesthetics, ensuring optimal outcomes for patients with advanced oral and maxillofacial cancers.
- Complex Hepatic Tumor Resections Our liver surgery program specializes in both traditional and minimally invasive approaches to liver tumors. Using state-of-the-art imaging and surgical navigation systems, our teams perform precise resections while maximizing healthy tissue preservation and optimizing functional outcomes.
- Advanced Thoracic and Lung Procedures Combining video-assisted thoracoscopic surgery (VATS) with robotic approaches, our thoracic surgical team performs complex lung resections with minimal invasiveness. These procedures utilize real-time imaging guidance and sophisticated navigation systems for optimal precision.
- Abdominal and Pelvic Surgeries Our expertise includes complex procedures for gastrointestinal, gynecologic, and urologic cancers. Using advanced laparoscopic and robotic techniques, we achieve superior outcomes while minimizing recovery time and improving quality of life.
- Bone and Soft Tissue Procedures Our orthopedic oncology team specializes in limb-sparing surgeries and complex reconstructions. Using cutting-edge techniques and materials, we focus on both cancer removal and functional preservation, offering hope to patients with challenging bone and soft tissue tumors.
- Laparoscopic Staging and Diagnostic Procedures Utilizing minimally invasive approaches, our diagnostic procedures provide crucial information for treatment planning while minimizing patient discomfort. Advanced imaging integration enables precise staging and optimal treatment selection.
- Head and Neck Reconstruction Our specialized teams perform complex reconstructive procedures using advanced microsurgical techniques. These procedures focus on both functional restoration and aesthetic outcomes, improving patients' quality of life after cancer surgery.
- Complex Gastrointestinal Procedures Combining traditional surgical expertise with innovative techniques, our GI surgical team handles complex cases including esophageal, gastric, and colorectal cancers. Advanced reconstruction methods ensure optimal functional outcomes.
- Advanced Gynecologic Oncology Our gynecologic oncology program offers comprehensive surgical solutions for complex pelvic tumors. Using robotic and minimally invasive approaches, we achieve excellent outcomes while preserving fertility when possible.
- Neurosurgical Oncology Specializing in brain and spine tumors, our neurosurgical team employs advanced navigation systems and intraoperative monitoring. Fluorescence-guided techniques ensure maximum tumor removal while protecting critical structures.
Robotic Surgery Program
The Apollo Institutes of Robotic Surgery represents the forefront of minimally invasive surgical innovation, centered around the da Vinci Si surgical system.
Advantages:
- Enhanced 3D visualization with 10x magnification
- Tremor filtration for precise movements
- Wristed instrumentation for enhanced dexterity
- Ergonomic control system
- Advanced surgical planning tools
Read More about Robotic Surgery Program
Specialty Applications
Urologic Oncology:
- Radical prostatectomy
- Partial nephrectomy
- Radical cystectomy
- Complex kidney procedures
Gynecologic Oncology:
- Radical hysterectomy
- Complex pelvic procedures
- Lymph node dissections
- Fertility-preserving surgeries
Gastrointestinal Procedures:
- Esophageal cancer surgery
- Gastric cancer procedures
- Colorectal cancer operations
- Complex hepatobiliary surgeries
Innovative Surgical Techniques
Oncoplastic Surgery
Oncoplastic surgery is a specialized approach in breast cancer treatment that integrates oncological surgery (removal of cancerous tissue) with plastic and reconstructive techniques. The goal is to not only ensure effective removal of cancer but also to preserve or restore the natural appearance of the breast, improving both functional and aesthetic outcomes for patients.
Key Features
1. Cancer Removal:
• Involves lumpectomy (partial mastectomy) or mastectomy to remove the tumor with clear margins, ensuring cancer is effectively treated.
2. Aesthetic Reconstruction:
• Combines plastic surgery techniques to minimize cosmetic deformities, reshaping the breast for a natural appearance.
3. Comprehensive Approach:
• A multidisciplinary team of oncologists, plastic surgeons, and radiation specialists collaborate for optimal outcomes.
Techniques in Oncoplastic Surgery
1. Breast-Conserving Surgery (BCS) with Oncoplasty:
For patients undergoing lumpectomy, the surrounding breast tissue is reshaped to fill the defect left by the tumor removal.
2. Therapeutic Mammoplasty:
Combines lumpectomy with breast reduction techniques, often used for larger breasts.
Includes repositioning the nipple and reshaping the breast for symmetry.
3. Skin-Sparing and Nipple-Sparing Mastectomy:
Preserves the skin and/or nipple while removing the underlying breast tissue.
4. Bilateral Symmetry Surgery:
In cases of significant asymmetry, surgery may be performed on the opposite breast (e.g., reduction, lift, or augmentation) for balanced appearance.
Indications for Oncoplastic Surgery
• Patients with early-stage breast cancer opting for breast-conserving surgery.
• Individuals undergoing partial or total mastectomy who desire breast reconstruction.
• Patients with large tumors in proportion to their breast size.
• Patients at high risk of cosmetic deformities due to tumor location or extensive tissue removal.
Fluorescence Guided Surgery (FGS)
This innovative technique enhances surgical precision through advanced visualization technology. The technique uses fluorescent dyes and imaging technology to enhance visibility of tumors in surgery.
Technical Features:
- Real-time tumor visualization
- Enhanced margin detection
- Selective fluorescence uptake
- Integration with surgical microscopy
- Advanced imaging processing
Clinical Benefits:
- Improved tumor resection rates
- Reduced complications
- Better functional outcomes
- Shorter recovery times
- Enhanced surgical precision
Surgical Microscopy Integration
Integration with surgical microscopy refers to the combination of advanced imaging technologies (e.g., fluorescence imaging, 3D visualization) with surgical microscopes to enhance the precision, accuracy, and outcomes of surgical procedures. This approach enables surgeons to see detailed, real-time visualizations of anatomical structures, tumors, and critical tissues that may not be visible with the naked eye.
How Integration Works
1. Advanced Surgical Microscopes:
• Modern surgical microscopes are equipped with high-resolution optics and real-time imaging capabilities.
• They provide magnified views of the surgical field, often with additional enhancements like fluorescence or augmented reality.
• Technologies like fluorescence imaging, near-infrared (NIR) imaging, or digital overlays are incorporated into the microscope.
• Surgeons can view enhanced images of specific tissues, tumors, or blood vessels directly through the microscope.
• Surgeons receive live feedback on the tissue’s condition, blood flow, or tumor boundaries while operating.
• This minimizes guesswork and ensures precise intervention.
HIPEC
Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an advanced treatment for certain abdominal cancers. It combines surgery and heated chemotherapy to treat cancer that has spread within the peritoneal cavity (the lining of the abdominal organs). HIPEC is performed after surgical removal of visible tumors, allowing the chemotherapy to target microscopic cancer cells.
How HIPEC Works
1. Cytoreductive Surgery:
• Surgeons perform a procedure to remove visible tumors from the abdominal cavity.
• The goal is to achieve complete or near-complete removal of macroscopic (visible) cancer.
2. Heated Chemotherapy:
• After surgery, a heated chemotherapy solution is circulated directly into the abdominal cavity.
• The solution is typically heated to 41–43°C (105–109°F) and circulated for 30–90 minutes.
3. Targeting Microscopic Cancer:
• The heated chemotherapy kills residual cancer cells that remain after surgery, reducing the risk of recurrence.
Advantages of HIPEC
1. Localized Treatment:
Chemotherapy is delivered directly to the abdominal cavity, minimizing exposure to the rest of the body.
Reduces systemic side effects compared to traditional intravenous chemotherapy.
2. Enhanced Effectiveness:
Heating increases the effectiveness of chemotherapy drugs by:
Enhancing drug penetration into tissues.
Increasing the sensitivity of cancer cells to chemotherapy.
The heat itself can damage cancer cells.
3. Lower Recurrence Risk:
Effective for targeting microscopic cancer cells left behind after surgery.
Indications for HIPEC
HIPEC is used for cancers confined to the abdominal cavity, including:
1. Peritoneal Carcinomatosis:
• Cancers that spread to the peritoneum, often from:
• Colorectal cancer.
• Gastric (stomach) cancer.
• Appendiceal cancer.
2. Ovarian Cancer:
• Advanced-stage ovarian cancer with peritoneal involvement.
3. Mesothelioma:
• A rare cancer of the peritoneal lining.
4. Pseudomyxoma Peritonei:
• A rare condition characterized by mucus-producing tumors in the peritoneal cavity.
Procedure
1. Pre-Procedure:
• Comprehensive evaluation to assess the extent of the cancer and overall patient health.
• Imaging (CT or MRI) and biopsies are performed.
2. During the Procedure:
• Cytoreductive Surgery: Removes visible tumors.
• HIPEC: Heated chemotherapy is infused into the abdominal cavity using specialized equipment.
• The solution is circulated to ensure even distribution.
3. Post-Procedure:
• Patients are monitored in the intensive care unit (ICU) for complications.
• Recovery time varies but is typically longer than for standard abdominal surgeries.
PIPAC: Pressurized Intraperitoneal Aerosol Chemotherapy
Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is an innovative, minimally invasive procedure used to treat advanced abdominal cancers that have spread to the peritoneum (peritoneal carcinomatosis). PIPAC delivers chemotherapy as a pressurized aerosol directly into the abdominal cavity, enhancing drug absorption and minimizing systemic side effects.
How PIPAC Works
1. Laparoscopic Access:
The procedure is performed through minimally invasive laparoscopic surgery.
Two small incisions are made in the abdomen for the introduction of the laparoscope and the aerosol device.
2. Pressurized Delivery:
Chemotherapy drugs are aerosolized (converted into a fine mist) and delivered under high pressure (usually 12 mmHg).
The pressure helps the drugs penetrate deeper into cancerous tissues.
3. Targeted Action:
The aerosolized chemotherapy ensures uniform distribution across the peritoneum, reaching even microscopic cancer cells.
4. Short Duration:
The chemotherapy is circulated in the abdominal cavity for about 30 minutes before being evacuated.
Indications for PIPAC
PIPAC is typically used for patients with advanced or recurrent cancers involving the peritoneum, including:
1. Ovarian Cancer
2. Gastric Cancer
3. Colorectal Cancer
4. Peritoneal Mesothelioma
5. Pancreatic Cancer
6. Appendiceal Cancer
It is often considered when systemic chemotherapy or other treatments have failed or are not suitable.
Benefits of PIPAC
1. Enhanced Drug Penetration:
• The pressurized aerosol allows deeper penetration of chemotherapy into cancerous tissue, improving its effectiveness.
2. Minimized Side Effects:
• Since the chemotherapy is localized to the abdominal cavity, systemic exposure is significantly reduced, resulting in fewer side effects like nausea, fatigue, or organ toxicity.
3. Uniform Drug Distribution:
• The aerosol ensures even distribution across the peritoneal surfaces, including hard-to-reach areas.
4. Repeatable Procedure:
• PIPAC can be repeated multiple times (every 6–8 weeks) to control disease progression.
5. Preservation of Quality of Life:
• Minimally invasive and well-tolerated by most patients, it allows better quality of life compared to systemic therapies.
Radiofrequency Ablation (RFA) for Precision Cancer Cell Destruction
Radiofrequency ablation (RFA) is a minimally invasive treatment that uses heat generated by high-frequency electrical currents to destroy cancer cells. It is commonly used for small, localized tumors in organs such as the liver, lungs, kidneys, and bones. RFA is a precision technique, as it targets only the cancerous tissue while sparing surrounding healthy structures.
How RFA Works
1. Placement of Electrodes:
A thin needle-like probe (electrode) is inserted into the tumor using imaging guidance such as CT, ultrasound, or MRI.
The probe is carefully positioned to ensure precision targeting of the tumor.
2. Energy Delivery:
High-frequency electrical currents are delivered through the probe, generating heat in the targeted area.
3. Cancer Cell Destruction:
The heat destroys the cancer cells by causing coagulative necrosis (a form of cell death due to protein denaturation).
Temperatures typically reach 50–100°C in the tumor, ensuring effective destruction.
4. Thermal Margin:
A small margin of surrounding healthy tissue is often ablated to ensure complete tumor eradication and minimize recurrence.
Applications of RFA
RFA is particularly effective for cancers that are localized or where surgery is not feasible. Common applications include:
1. Liver Cancer:
Hepatocellular Carcinoma (HCC) and liver metastases.
Particularly useful for patients with cirrhosis or those who are not candidates for surgery.
2. Lung Cancer:
Early-stage non-small cell lung cancer (NSCLC) or metastases in patients unable to undergo surgery or radiation.
3. Kidney Cancer:
Small renal tumors, especially in patients with poor kidney function or high surgical risk.
4. Bone Tumors:
Effective for painful metastatic bone lesions resistant to other treatments.
5. Other Solid Tumors:
Pancreatic tumors, adrenal gland tumors, and breast cancers in selected cases.
Advantages of RFA
1. Minimally Invasive:
Performed through small incisions or percutaneously, reducing recovery time and complications.
2. Precision Targeting:
Destroys only the cancerous tissue, sparing adjacent healthy structures.
3. Outpatient Procedure:
Can often be performed on an outpatient basis or with a short hospital stay.
4. Preserves Organ Function:
Ideal for patients with compromised organ function who cannot undergo extensive surgery.
5. Repeatable:
Can be performed multiple times if new tumors develop.
6. Pain Management:
For bone metastases, RFA not only destroys cancer cells but also alleviates pain by disrupting nerve signals.
Bone Marrow Transplant (BMT)
A bone marrow transplant (BMT), also known as a stem cell transplant, is a medical procedure used to replace damaged or diseased bone marrow with healthy stem cells. It is often used to treat patients with blood disorders, certain cancers, and other conditions affecting the bone marrow’s ability to function.
Purpose of a Bone Marrow Transplant
Bone marrow is responsible for producing:
• Red blood cells: Carry oxygen throughout the body.
• White blood cells: Fight infections.
• Platelets: Help blood clot.
When bone marrow is damaged or diseased, it can no longer produce these cells effectively. A BMT aims to:
1. Replace damaged or destroyed bone marrow.
2. Restore the production of healthy blood cells.
3. Treat or cure certain diseases, including cancer.
Types of Bone Marrow Transplants
1. Autologous Transplant:
• Uses the patient’s own stem cells.
• Commonly used when bone marrow is not diseased, but high-dose chemotherapy or radiation is required (e.g., for certain cancers).
• Stem cells are collected, stored, and re-infused after treatment.
2. Allogeneic Transplant:
• Uses stem cells from a donor (related or unrelated) whose tissue type closely matches the patient.
• Requires immunosuppressive therapy to prevent rejection.
• Often used for diseases involving the bone marrow itself, such as leukemia.
3. Syngeneic Transplant:
• Uses stem cells from an identical twin.
• Rare, but there is no risk of rejection since the donor and recipient are genetically identical.
Conditions Treated with BMT
1. Blood Cancers:
• Leukemia (e.g., acute myeloid leukemia, acute lymphoblastic leukemia).
• Lymphoma (e.g., Hodgkin’s and non-Hodgkin’s lymphoma).
• Multiple myeloma.
2. Non-Cancerous Blood Disorders:
• Aplastic anemia.
• Thalassemia.
• Sickle cell anemia.
3. Immune System Disorders:
• Severe combined immunodeficiency (SCID).
• Autoimmune diseases like lupus (in select cases).
4. Metabolic Disorders:
• Conditions like Hurler syndrome or adrenoleukodystrophy.
Procedure
1. Preparation (Conditioning):
• High-dose chemotherapy or radiation therapy is administered to:
• Destroy diseased bone marrow.
• Suppress the immune system to prevent rejection of the transplanted cells.
2. Stem Cell Collection:
• For autologous transplants: Stem cells are collected from the patient’s blood or bone marrow.
• For allogeneic transplants: Donor stem cells are collected from peripheral blood, bone marrow, or umbilical cord blood.
3. Transplantation:
• Healthy stem cells are infused into the patient’s bloodstream through an intravenous (IV) catheter, similar to a blood transfusion.
4. Engraftment:
• The transplanted stem cells travel to the bone marrow, where they begin to grow and produce healthy blood cells.
• Engraftment usually occurs within 2–4 weeks.
Surgical Support Infrastructure
Our surgical excellence is supported by comprehensive facilities:
Advanced Operating Suites:
- State-of-the-art surgical equipment
- Advanced imaging integration
- Real-time pathology support
- Advanced anesthesia monitoring
- Specialized surgical instruments
Post-Operative Care:
- Dedicated surgical ICUs
- Specialized nursing teams
- Advanced monitoring systems
- Comprehensive rehabilitation services
- Integrated pain management
Each surgical procedure is carefully planned and executed by our multidisciplinary team, ensuring optimal outcomes and rapid recovery for our patients. Our success rates in oncology surgeries match those of the world's leading cancer centers, reflecting our commitment to excellence in cancer care.
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