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Doctors at Apollo Cancer Centre

Breakthrough Achievement: India’s First Robotic Cytoreductive Surgery

In a landmark medical feat, surgical oncologists at the Apollo Cancer Centre (ACC) have accomplished India's inaugural Robotic Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for peritoneal surface cancer. This pioneering approach, leveraging minimally invasive robotic assistance, heralds a paradigm shift in treating Pseudomyxoma Peritonei (PMP), an aggressive form of appendix cancer. The procedure sets a new standard of care, promising swifter recovery and enhanced quality of life for patients.

Led by Dr. Ajit Pai, Senior Consultant in Surgical Oncology and Robotic Surgery, the ACC team orchestrated this groundbreaking endeavor. Their collaborative clinical expertise and unwavering commitment to transformative technological innovations proved instrumental in achieving this remarkable milestone.

The journey began with a 51-year-old female patient diagnosed with bilateral ovarian masses, necessitating extensive surgical intervention, including the removal of the uterus, ovaries, appendix, and part of the omentum. Subsequent histopathological examination unveiled a high-grade mucinous tumor of the appendix with PMP, mandating further surgical intervention. Despite prior procedures, residual mucinous implants persisted in the pelvis and around the cecum, prompting a novel approach.

Given the unique propensity of appendix cancer to spread to the abdomen's lining (peritoneum), Dr. Ajit Pai and his team executed a minimally invasive Robotic Cytoreductive Surgery. This procedure, coupled with right hemicolectomy and complete mesocolic excision, aimed to reduce cancer cell presence in the abdominal cavity. The addition of Hyperthermic Intraperitoneal Chemotherapy ensured the elimination of microscopic residual tumors, maximizing treatment efficacy.

Traditionally, CRS/HIPEC involved open surgery with extensive incisions and prolonged hospital stays. The robotic approach, however, offered significant advantages. Utilizing tiny 8mm incisions for robotic instruments minimized pain, blood loss, scarring, and discomfort. Furthermore, a single 5cm incision facilitated tumor removal and HIPEC delivery. This innovative approach translated into expedited recovery and a swift return to normalcy for the patient, who remains in excellent health and cancer-free at one year follow-up.

Dr. Ajit Pai lauded Robotic CRS as a transformative approach, blending traditional and robotic techniques for precise tumor resections. With reduced post-operative morbidity and quicker recovery, this method emerges as a viable option for patients with limited peritoneal surface cancer. The successful clinical outcome underscores its potential to improve the lives of individuals grappling with various peritoneal surface malignancies.

Expressing gratitude, the patient, under the pseudonym Subarna, hailed the pioneering robotic approach for offering hope and facilitating a faster recovery. She credited the ACC team for their exceptional care, which propelled her toward a renewed sense of optimism.

Dr. Preetha Reddy, Executive Vice Chairperson of Apollo Hospitals Enterprises Ltd, emphasized the pivotal role of technology and clinical expertise in Apollo's cancer care paradigm. This synergy, she noted, distinguishes Apollo, empowering millions worldwide to overcome cancer.

Mr. Dinesh Madhavan, President Group Oncology and International at Apollo Hospitals Enterprises Ltd, highlighted the transformative potential of robotics in cancer care. He underscored ACC's commitment to leveraging technology to enhance treatment outcomes and reduce recovery times, ensuring patients receive the finest care available.

With an estimated incidence of 1 to 4 cases per million annually, PMP poses a formidable challenge. ACC's relentless pursuit of innovation underscores its dedication to providing cutting-edge care to patients grappling with these complex cancers, particularly prevalent among women.

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