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Surgeons carying out laporoscopic surgery


Surgery that heals fast and leaves minimal scars

NAIROBI, Kenya, Aug 19 – Have you ever heard of a situation where a patient undergoes major surgery and goes home the same day?

Well, thanks to technology there is a type of surgery known as laparoscopic surgery that heals fast and leaves negligible scars on the body.

Although already used in up to 90 percent of surgical procedures in developed countries, laparoscopic surgery is still very new in Kenya.

I had the opportunity to witness a laparoscopic surgery being performed on an elderly woman to remove her uterus at the International Centre for Minimal Access Surgery (ICMAS) located at Parklands Mediplaza in Nairobi.

“I even do tumour surgery; we do early cancers, removal of fibroids, uterus, and cyst of the ovary,” explains Dr Rafique Parkar, ICMAS Proprietor.

In laparoscopic surgery – also referred to as Minimally Invasive Surgery – surgeons are guided by video cameras to perform the procedure.

During the surgery, three small cuts, about half an inch each are made on the part of the body where the surgery will be performed and plastic tubes inserted through the openings.

The camera and instruments are then set up through the plastic tubes which allow access to the inside of the patient.

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“The first thing that we do is inject about two litres of gas into the abdomen. If we don’t use gas, we don’t have space to operate. Like you saw right now when we lost the gas, there was no space in the abdomen,” Dr Parkar says.

The surgeon then uses the images from the video camera positioned inside the patients’ body to perform the procedure. This can be done on all operations including cardiac surgeries and ectopic pregnancies. However, it cannot be performed on caesarean section births.

“It is quicker provided if you have the skills,” Dr Parkar who is an obstetrician gynaecologist informs adding that this type of surgery is 25 to 30 percent cheaper compared to the traditional open surgery.

Dr Parkar however regrets that majority of patients are not told about this option when they go to hospitals.

“Patients have a right to be given full information about the choices they have. Many go through open surgery because they are not aware of laparoscopic,” he says.

Unfortunately, this type of surgery is not offered in our public hospitals.

When Kezia, a 45-year-old mother of three was told that she had fibroids, it was shocking to her. Kezia operates a small business and her fears were that going through surgery would mean missing out on trade.

Then a friend told her about lapascropic surgery.

“I understand this one (laparoscopic) the healing process is faster and being a small business person I feel it is better because I will be able to go back to the office sooner than the other one(open surgery),” Kezia tells us less than an hour after she has undergone laparoscopic surgery.

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Unlike in open surgery where a patient stays in hospital for up to a week healing the wound, in lapascropic surgery a patient goes home the same day no matter how difficult the procedure was.

This is because there is less post operative discomfort since the incisions are very small compared to open surgery.

There is also minimal loss of blood.

“There are basically two reasons (for minimal loss of blood), one is the instruments that we use, but the other important thing is in lapascropic surgery we can avoid areas where there are blood vessels,” Dr Parkar explains.

Opened in January this year, ICMAS which is a privately owned facility has since performed about 100 lapascropic surgeries. Majority of them are walk-in patients and others are referred by other patients who have gone through the procedure.

The facility also offers lapascropic training to doctors from the region. It has so far trained over 50 doctors from Kenya, Sudan, Zimbabwe, Uganda, Tanzania and Rwanda.

“The idea of setting up a facility is to have all these doctors come here for training which is at a cheaper price,” he says.

For a three day workshop at the facility, each trainee pays Sh85,000 compared to Sh324,000 (2400 Euros) they would pay for the same training in Europe.

ICMAS also invites students from the University of Nairobi and Moi Teaching and Referral Hospital who are trained free of charge.

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Dr Wanjiru Ndegwa is an obstetrician Gynaecologist at a mission hospital. We find her in one of the training sessions.

“There is very minimal training in medical schools, it is more for post graduate level but still also very minimal,” she tells us.

“Centres like these are very well needed because this is the way forward,” Dr Ndegwa adds.

ICMAS doctors also go to public hospitals once every six months to perform the surgery for free on those who are less privileged.

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