Mumbai: Consider this. A small cut of about 1cm is made on the lower abdomen, through which a trocar or a sharp instrument is introduced. Carbon dioxide is inserted into the abdomen through the trocar, following which a telescope is placed inside.
The telescope carries with it a fibre optic light source with a powerful xenon light and is also connected to a TV monitor and a camera.
Now by viewing the TV monitor, an entire operation is done to remove fibroids (non-cancerous ball like growth) on the outside of the uterus through the 1 cm cut made on the abdomen.
This is how Renuka BR (name changed), a 44-year-old professional from New Delhi, explains the manner in which she was operated last week and sent home after just a night's stay at the hospital.
With minimal post-operative pain and hardly any marks or scars, she cruised back to work as a social sciences professor in an educational institute almost immediately.
Called minimally invasive surgeries (MIS) in popular parlance, the technique of operating through incisions as small as a few millimetres to a centimetre is fast pinking up in the $40 billion healthcare sector in the country.
With healthcare costs rising through the roof, MIS is seen as a cheaper and more effective alternative, as compared to open surgeries.
As per estimates by the management consulting firm Technopak (healthcare division), by 2027, about 13% of the total annual household expenditure in India would be spent on healthcare costs, up from about 7% in 2007.
M Jayashankar, head of department and consultant, minimally invasive surgery, Manipal Hospital, Bangalore, says, "MIS is cost-effective. It is generally done in urology, orthopaedic and thoracic procedures. It's also done for removal of appendix, removal of gall bladder, hernia repairs, etc."
According to Nikita Trehan, gynaecologist & laparoscopic surgeon, Trinity Healthcare Centre, New Delhi, the MIS technique can be used in cervical cancer surgery, removal of uterus, chronic pelvic pain, and so on.
It is also being used for eye surgery, says S Natarajan, chairman and managing director, Aditya Jyot Eye Hospital, Mumbai. "MIS is used for vitrectomy, or removal of the vitreous humour (gel that fills the space between lens and retina of the eye). Vitrectomy is needed to remove foreign material, to clear intervening material which prevents passage of light, etc."
The advantages of MIS are multiple. Natarajan says that the benefit of the technique is that the eyes heal faster, regain vision faster and cause in less post-operative inflammation.
According to Jayashankar, other than shorter stay in hospital and early return to work, MIS entails very little pain and no wound infections.
Against conventional surgery where the recovery time can extend to 6-8 weeks or more, recovery time for a MIS patient is much less, and patients can resume work within a week.
Moreover, through the use of the microscope, surgeons can get a magnified view of the area that is being operated upon on the TV monitor, says Trehan. "Also there is minimal blood loss."
Most importantly, the costs are much lower for MIS than for open surgeries. According to Ankur Bharti, consultant, Technopak, there is about 47-50% price difference between open surgeries and MIS. "This is on account of factors like less operation time, thus lower operation theatre charges, minimal stay in hospitals, etc."
Currently, approximately 20% of surgical procedures in India are done on outpatients, and that figure is likely to rise to 65% by 2020, says Bharti.
Says Jayashankar, "At present, these procedures are mostly done in cities and are slowly making their way into rural areas."


