Advanced laparoscopic procedure successfully performed at GPH
A 54-year-old woman recently benefitted from an advanced laparoscopic procedure performed by doctors at the Georgetown Public Hospital.
Yourajpatti Stanwyck on Friday told Stabroek News that she was informed that the procedure, a laparoscopic adrenalectomy, was never performed in Guyana before and at first she was worried about having the procedure done.
“At first I was you know thinking that it has never been done here like the doctor said… they said to me they did before but in an open [surgery] but it has never been done laparoscopically so that had me thinking a bit, what if anything goes wrong,” Stanwyck said. However, she was given the assurance by doctors that they would have physicians on standby to have the operation done in an open setting.
A laparoscopic procedure is done with the use of small incisions in which instruments are inserted into the patients including a camera to have the surgery done. General and Advanced Laparoscopic surgeon, Dr Hemraj Ramcharran explained that four small cuts of about 1 centimeter each were made on the abdomen and cameras and other instruments were inserted and the physicians were able to remove the gland with the use of the camera and instruments.
Stanwyck during a telephone interview noted that this all began in February of this year when she started to experience tummy pain and sought medical attention for it. It was then that she was told that she had something connected to her adrenal gland and was further advised to have an MRI done. Adrenal glands are located on top of both kidneys and produce hormones that regulate one’s immune system, blood pressure, metabolism, and other essential functions.
Following the MRI which was done the following month, she was told that she had a pheochromocytoma, which is a mass on the adrenal gland. The mass is usually a noncancerous tumor that develops in an adrenal gland.
In her case, the mass on her adrenal gland which she was told is very rare, was elevating her blood pressure. At that time Stanwyck was placed on medication to regulate her blood pressure. However, as time went by, the situation worsened. “I didn’t had any anxiety during that time March to June, except for the high blood pressure and then I start feeling very frightened, my heart beat would start racing off so when I went back to see the doctor, then is when he referred me [to another doctor] and I didn’t realise it was so serious,” she recounted.
With that, the woman stated that she was seeing an endocrinologist and was placed on other medication to stabilise the high blood pressure as surgery could not be done while her blood pressure was high.
Following the procedure, Stanwyck stated that when she woke up the following day she thought nothing was done as she felt normal. It was not until she saw the drainage tubes that she realised that the surgery was actually done. “I said something was done but I didn’t expect it to be that simple, I did not expect it at all but in the end I’m so happy and so grateful. I had surgery done in the past where I had to stay at the hospital for weeks,” while noting that this was not like before.
During a press conference on Thursday, one of the general surgeons on the case, Dr Delon Ramnarine, told members of the media that if the mass was not removed, the patient would have had a morbid life which means that she would have had all the complications that come with high blood pressure but in a more exacerbated manner.
“With that being said, adrenalectomy or removal of the adrenal gland has been done in Guyana for multiple years. But what we did… they normally do it in an open surgery meaning you make a big cut in the abdomen and go in and remove the mass. In our case we did it laparoscopically, where we make four incisions about 1 cm and remove the mass,” Dr Ramnarine explained.
Advanced laparoscopic surgeon, Dr Ramcharran clarified that the procedure was a laparoscopic adrenalectomy of the right side. This he noted was an
advanced procedure and he added that the team was able to do it under three hours.
Dr. Ramcharran added, “The fact that everything went smoothly represents that Georgetown Public Hospital has reached a milestone where we are doing advanced laparoscopic surgery. This is the type of surgery that someone in North America would have, they are no longer having open surgery.”
He pointed out that the larger Caribbean countries are also now doing these procedures and as such Guyana is on par with some of the Caribbean and North American countries.
The surgeon reported that everything went smoothly and the team was able to remove the entire gland successfully. He credits the achievement to the skill of the surgery team and mentioned that they had significant support from the head of the department along with the Hospital’s CEO who ensured that they had all that was necessary to have the procedure done.
According to Ramcharran, the patient recovered well and was kept in the Intensive Care Unit for one night and was subsequently discharged two days after the procedure. This, he credits as one of the benefits of having laparoscopic surgery. If she had an open surgery she would have been in hospital for about three to five days and would have been able to go back to a regular diet some three to four days after.
“With laparoscopic surgery
she was actually walking six hours after surgery and she was on a diet the next morning so she is presently at home doing well,” Dr. Ramcharran revealed.
He said “Our basic surgeries presently which are like gallbladders and appendectomies are being done laparoscopically… we have had some research done and we are seeing that patients are fully ambulant by the next day, they are fully back to diet the next day. We’re now trying to do advanced surgeries laparoscopically so the adrenalectomy represents a great milestone for us because this is one of the more difficult surgeries to do laparoscopically and the fact that we have done this it means that we can do many others.”
Stanwyck agreed that this was the way to go, adding that her recovery has been smooth. She told Stabroek News that she had done some light walking and a few small chores around the house. Although she feels normal, doctors have advised her to take at least two weeks to fully recover before returning to work.
“This is their first surgery they have done and I tell myself if I did not allow them to do this they would never know how to go through another one, now they can handle another one if it arises with comfort,” she expressed.
The 54-year-old expressed gratitude for the skillful doctors and noted that while some choose to go overseas for healthcare, there are knowledgeable and skilled doctors here in Guyana.