First “Keyhole Skull Expansion” done on a 5 month old baby in Bangalore Indo- Japanese Hospital performs Endoscopic skull expansion and 3D printing of helmet. “FIRST IN INDIA”

Bengaluru, 24th September, 2015: The joyous smiles on the faces of Mr. and Mrs. Rajendra (Name changed) who hail from Chitradurga are testimony to the fantastic work of the team, Dr. Derick Mendonca, Consultant Plastic Surgeon, Dr. Swaroop Gopal, Head of Neurosciences & Senior Consultant Neurosurgeon and Dr. M N Chidananda Swamy, Senior Consultant & Head of Department, Neuro Anesthesia has taken treatment of craniosynostosis to the next level.

“Knowing about our baby’s condition, we dint know what’s next. We were not sure if we could even afford a surgery. Today, I feel like a dream come true and my heartfelt gratitude and regards to team of doctors at Sakra World Hospital, who have given a new life to my child” – Mr. Rajendra

The couple’s five month old baby was suffering from Craniostenois, a congenital deformity of the skull that results from premature closure of the sutures between the cranial bones. Parents brought the child to Sakra World Hospital, Bangalore and consulted the craniofacial team. After going through the case reports, the team had two options,

To immediately operate on the baby using “Keyhole Skull Expansion” technique, or to wait for another seven months till the baby turns one year old and then perform an open craniosynostosis repair.

Dr. Derick and Dr. Swaroop decided to opt for the first option and perform keyhole skull expansion technique which would offer a great advantage for the patient over the conventional technique and performed the surgery on August 21, 2015.

It is necessary that the babies are brought in for a health check up before the age of 6 months to under go this surgery

“Lot of these babies do not get treated at the right time nor do many parents know about the option available for treatment “– Dr. Derick Mendonca

In normal course the cost of this particular surgery would range from INR 2.5 lakhs to INR 3 lakhs, with an additional cost of about INR 1.5 to INR 2 lakhs post-surgery for a specialized helmet (imported from USA) which would aid in normal growth and shaping of the skull.

What’s unique about the surgery?
  • First procedure in India
  • Made in India helmet using 3D Printing: less expensive
  • Shorter duration of hospital stay (3 days stay over 1 week stay in conventional surgery)
  • Faster recovery
  • Small scar and minimal aesthetic concern
  • Less painful and minimal post-operative management
  • Skull repair at an early stage aids in normal growth and development of the brain

However, considering the financials of the patient the surgery was discounted at Sakra World Hospital and the doctors ‘customized a special helmet by using 3D printing’ from a Bangalore based company. This reduced the total cost by 85%.

“At Sakra, we believe in delivering top quality healthcare at affordable costs, using high end technology with a Desi twist which dramatically reduces the cost for the patient, thus portraying “Made in India” concept!” – Dr. Swaroop Gopal

This successful and uneventful surgery has made Dr. Derick Mendonca and Dr. Swaroop Gopal become the first surgeons in India to have performed an Endoscopic Craniosynostosis Surgery.

About Craniosynostosis

Craniosynostosis is the premature fusion of one or more of the joints between the bony plates of the skull. The most frequent type of fusion is called the sagittal Synostosis. This premature fusion causes problems with normal brain and skull growth. Further more, it increases pressure inside the head and causes the skull or facial bones to become abnormally shaped.

Endoscopic strip craniotomy

A child who is younger than six months where only one suture is fused, the child has an option of endoscopic craniectomy. During this procedure, a strip of the bone is taken out adjacent to the effective suture by a small incision, minimizing operative time with minimal blood loss, pain and post-operative swelling. The patient is required to wear a helmet for at least nine months after the surgery in order to mould the head into a better shape.

Open Repair v/s Endoscopic repair

Open repair Endoscopic repair
Hospital stay one week Hospital stay 3 days
Blood transfusion 95% Blood transfusion less than 6%
Cut from ear to ear across skull About an 1" cut
More pain and swelling Minimal pain and swelling
Complications more Fewer complications

The advantages to endoscopic surgery are many. The surgery has less blood loss than the traditional repair and, in many cases, prevents the need for blood transfusion during the surgery. The endoscopic technique also results in less post-operative swelling, decreases operative time, and hospital stay by several days. Patients are usually discharged 24 hours post-surgery. Post- operative pain is also significantly reduced by this operation. The other advantage of endoscopic surgery is that there are no internal screws or plates that are required to hold the bone in place after surgery. This decreases the risk of plate induced pain, infection, swelling, or allergic reaction in the child.

Typically, endoscopic surgery involves inserting a tiny endoscopic telescope into the body. The telescope, usually five millimeters in diameter, features an attached video camera. Using this tube-like instrument, surgeons are able to make small, hidden incisions and using cutting instruments able to cut and remove the fused suture.

The results strongly indicate that pediatric endoscopic craniectomy surgery will soon become the standard norm for a variety of pediatric disorders, for both aesthetic and reconstructive in nature.

    For further information. Please contact:

Mr.Abhishek Saran (9535046900)/ abhishek@theprview.com

Mr. Nagesh BP (9611123553) / nagesh@theprview.com

Pavan (9538870987) / pavankumar.bs@sakraworldhospital.com

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