PESHAWAR: The Khyber Teaching Hospital doctors have saved a teenage boy’s life through a rare surgery.

The Laparoscopic Adrenalectomy meant for the removal of adrenal gland was performed on the 18-year-old last week by Dr Mohammad Zareen, an associate professor at the Surgical E Unit of the KTH.

The patent was discharged three days later.

Mansoor Khan, a mechanic from Kohat, came to the hospital complaining about abdominal pain and low grade fever.

Dr Zareen told Dawn he treated a condition called pheochromocytoma through removal of adrenal glands located on the top of each kidney by laparoscopy.

He said one or both adrenal glands needed removal when there was tumour in them or in case of increased hormonal secretion, which causes high blood pressure.

“The removal can be done by open surgery through a large incision under the respective rib cage. In laparoscopic method, three to four inches incisions are given to complete the procedure,” he said.

Say laparoscopic procedure means rapid recovery, less complication

He added that in open surgery, 10-15 incisions were given.

“The Laparoscopic Adrenalectomy is the gold standard in expert hands. There is the minimum handling of the glands and thus, avoiding dreadful complications due to the excessive release of hormones,” he said.

Dr Zarin said patients with such sickness should be referred to the hospitals concerned if laparoscopic facilities weren’t available.

He said Professor Mahmud Aurangzeb pioneered the basic laparoscopic procedures at the KTH in 2000 for removal of appendices and gallbladders.

The surgeon however said the procedures for removal of kidney, stone and uterus spleen, repairs of hernias and removal of tumours from large intestines and gallbladder began in 2012 after the installation of new equipment.

He said laparoscopy, a modern technology used for operations, didn’t involve trauma, large incisions and pain, while in open surgery, patients faced many complications, including low immunity.

“Laparoscopic surgery has gained currency worldwide. Most patients approve of it at the KTH, which currently offers services to 30 per cent of patients due to unavailability of machines in adequate number. Only two machines are available at the hospital. Six operation theatres at the hospital required as many laparoscopes,” he said.

According to him, trainee surgeons are also inclined to laparoscopic procedures in light their effectiveness.

A senior surgeon said in most developed countries, doctors underwent proper training and examination in laparoscopy but in Pakistan, seniors trained juniors and that there was no examination for it.

He suggested postgraduate degree in laparoscopic surgery saying surgeons currently do FSCP in general surgery but get training under the supervision of consultants and refine their skills and techniques.

“The non-existence of skill lab for training of doctors has been hampering the plan to transfer the new techniques for better healthcare. The training also requires software, use of internet-based technology, seminars and workshops to produce more experts and expand the services to the district hospitals,” he said.

KTH medical director and laparoscopic surgeon Prof Roohul Muqim said all trainees had shown keen interest in performing all general surgical procedures through laparoscopy.

He said laparoscopic technique meant rapid recovery, less complication and cosmetic benefit for patients.

“We plan to establish a laparoscopic skills lab for hands-on practice for trainees to prepare them for future challenges when open surgical methods will be replaced by advanced methods,” he said.

Prof Roohul Muqim also said the KTH also intended to introduce laparoscopic bariatric surgery to manage morbid obesity, excessive body fat and cope with diseases of bone and joints, diabetes, high blood pressure and heart ailments.

Published in Dawn, February 12th, 2017