Udaipur : Pioneering techniques developed for the treatment of gynaec cancer and bowel endometriosis by a doctor in Ahmedabad have been published in a reputed international journal. The techniques were developed by Dr Dipak Limbachiya and his team, a leading laparoscopic &oncology surgeon and founder of Eva Women’s Hospital& Endoscopy Centre.

Dr. Dipak Limbachiya has worked extensively in the field of gynecology cancers with proper and complete laparoscopic surgical management as per international cancer guidelines.

Oncology Paper

Cervical cancer is the most common genital cancer in females in the Indian population. Endometrial cancer is the most common genital cancer in females in the western world. According to statistics, 6,04,127 women were reported with cervical cancer in 2020, and 3,41,831 women died from the disease globally.

According to Globocan 2020 data for India, 1,23,907 cases of carcinoma cervix were registered in 2020. There were 45,300 female deaths due to cervical cancer in India in 2019. This is the only gynecological malignancy for which government-run screening programmes are executed so that the disease can be recognized at an early stage and proper treatment can be done.

Dr. Limbachiya and his team have developed novel surgical techniques that can lead to a better surgical outcome along with an enhanced prognosis. The novel technique involves closing the vagina before colpotomy in cervical and endometrial cancer surgery (uterus cancer surgeries), which prevent spillage of tumor cells inside the abdomen and in the vagina, there by preventing the recurrence of the disease.

Dr. Limbachiya’s study –“Vaginal Closure before colpotomy with Endo-staplers to prevent tumor spillage in Laparoscopic surgeries for Gynecological malignancies: Rationale and Technique” has been published in pub med indexed“Journal of the Society of Laparoscopic & Robotic Surgeons”.

The aim of the study was to define new techniques for performing vaginal closure with endo-staplers to prevent tumour spillage during laparoscopic surgeries for endometrial cancer and early-stage cervical cancer which will further have a favourable oncologic outcome.

Dr. Limbachiya’s another study – Surgico-pathological Outcomes and Survival in Carcinoma Body Uterus: A Retrospective Analysis of Cases Managed by Laparoscopic Staging Surgery in Indian Women – has been published in pub med indexed journal “Gynecology and Minimally Invasive Therapy”. To our knowledge, this study is the first from India to analyze the surgico-pathological outcomes following laparoscopic surgery in endometrial carcinoma.

 

Aarti Kankadiya, 40 said, “I used to suffer from endometriosis earlier. I used to suffer from unbearable pain. I faced a lot of physical problems for 6-7 years. My periods were also very irregular, but I am absolutely fine since undergoing this surgery two years ago.”

Endometriosis paper

Endometriosis is a disease where tissue similar to the lining of the uterus grows outside the uterus, causing pain and/or infertility. It affects roughly 10% (190 million) of women and girls of reproductive age globally. It is a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.

The exact origins of endometriosis are thought to be multifactorial, meaning that many different factors contribute to its development. The most common mechanism postulated is retrograde menstruation, which is when menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity at the time that blood is flowing out of the body through the cervix and vagina during periods. Retrograde menstruation can result in endometrial-like cells being deposited outside the uterus where they can implant and grow.

The variable and broad symptoms of endometriosis mean that healthcare workers do not easily diagnose it and many individuals suffering from it have limited awareness of the condition. This can cause a lengthy delay between the onset of symptoms and diagnosis. Access to early diagnosis and effective treatment of endometriosis is important.

Endometriosis has significant social, public health and economic implications. It can decrease quality of life due to severe pain, fatigue, depression, anxiety, and infertility. Some individuals with endometriosis experience debilitating endometriosis-associated pain that prevents them from going to work or school.

Bowel endometriosis (disease involving the bowel superficial/ deep) is very common nowadays but often not diagnosed, due to lack of proper knowledge about the disease symptomatology. Complete removal of the disease, even from the diseased bowel involves removal of the diseased bowel followed by joining of normal bowel parts for comprehensive management of endometriosis.

Usually, for the above-mentioned procedure till now, a part of the bowel is taken out of the abdomen during the surgery and then re-inserted into the abdomen. But Dr. Limbachiya and his team have developed a complete laparoscopic treatment of the procedure in which the part of the bowel is not required to be taken out of the abdomen during the surgery, which can lead to enhanced recovery of the patients following such a tedious and exhaustive surgery.

The study “Bowel Endometriosis Management by Colorectal Resection: Laparoscopic Surgical Technique &Outcome” isthe first of its kind in the world as per our knowledge, has been published in an international American journal.