Oncology Surgery cost in India

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What is surgical Oncology?

Surgical oncology is the branch of surgery applied to oncology; it focuses on the surgical management of tumors, especially cancerous tumors. As one of several modalities in the management of cancer, the specialty of surgical oncology has evolved in steps similar to medical oncology (pharmacotherapy for cancer), which grew out of hematology, and radiation oncology, which grew out of radiology. 

Types of Surgical Oncology

These are the most common types and forms of oncological surgery:

• surgery to diagnose cancer
• surgery to stage cancer
• curative surgery
• radical surgery
• surgery to debulk cancer
• palliative surgery
• supportive surgery
• reconstructive surgery
• Preventive (prophylactic) surgery.

Surgical Oncology technique

Newer surgical techniques are less invasive, use different types of surgical instruments, and lead to less pain and shorter recovery times. The most effective surgical oncology techniques are:

• Laser surgery
• cryosurgery
• electro surgery
• radio frequency  ablation
• mohs surgery
• laparoscopic surgery
• thoracoscopic surgery
• Robotic surgery and other forms of surgery.

Surgical Oncological Procedures

Appendectomy

Surgery to remove an appendix is known as an appendectomy. It is usually an emergency procedure performed when the appendix, a small organ attached to the large intestine, becomes irritated and inflamed. The condition is called appendicitis. The appendix swells when it becomes blocked by infection, cancer, a foreign material or stool.

When an appendectomy is performed and an appendix tumor is discovered, and lab tests confirm it is appendix or appendiceal cancer, additional surgery to remove more tissue may be necessary. In addition to appendix surgery, patients may receive chemotherapy, and in rare cases, radiation therapy.

Bowel resection

Bowel resection is a surgical procedure used to treat and prevent cancer and other diseases of the colon by removing part of the large intestine. It is also known as a colectomy, colon resection or colon removal. Surgery is a common treatment for colorectal cancer. Bowel resection involves the surgical removal of colorectal tumors, as well as surrounding tissue and several nearby lymph nodes. A bowel resection that involves removing the entire colon is called a total colectomy. A subtotal colectomy removes most of the colon. When a portion, or segment, of the colon is removed, it is known as a segmental colectomy.

ERBEJET

ERBEJET2 uses a high-pressure water jet to selectively target and dissect water-soluble tissue and provide precise margins along the line of dissection. This technique is designed to help spare critical structures, like blood vessels, nerves and ducts and may help reduce the potential for blood loss. ERBEJET2 may be used in both open and laparoscopic surgical procedures, typically with shorter operating times.

Flexible robotic surgery

The Flex Robotic System is a surgical system with a flexible robotic endoscope. The minimally invasive technology allows surgeons to access hard-to-reach areas of the mouth, throat, rectum and colon. In the throat, the system's flexible scope is designed to allow surgeons to view and reach areas of the throat that aren’t typically or easily accessible with standard instruments. A traditional endoscope moves in straight lines and is limited to lines of sight. In the rectum and colon, the scope allows surgeons to view and reach areas that were previously only accessible by surgery. 

Hyperthermic intraperitoneal chemotherapy (HIPEC)

HIPEC is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery. Unlike systemic chemotherapy delivery, which circulates throughout the body, HIPEC delivers chemotherapy directly to cancer cells in the abdomen.

Before patients receive HIPEC treatment, doctors perform cytoreductive surgery to remove visible tumors in the abdomen. Cytoreductive surgery is accomplished using various surgical techniques. Once as many tumors as possible have been removed, the heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy remaining cancer cells.

Surgical options for lymphedema

Lymphedema is a condition in which excess lymphatic fluid collects and causes swelling, usually in the arms or legs. The condition is a result of damaged lymph nodes following cancer treatment. Two surgical options to treat lymphedema include:

• Vascularized lymph node transfer surgery: This is an intricate microsurgical procedure used to treat patients with advanced lymphedema affecting the skin tissue in the arms or legs. Our plastic surgeons transfer working lymph nodes from another part of the body, typically the upper groin or lower abdomen, to the damaged site. We then divide the existing blood vessels that supply the nodes and connect them at the site where the lymph nodes are needed. We use reverse lymphatic mapping to reduce the chance of lymphedema occurring in the areas where lymph nodes were harvested.
• Lymphaticovenular bypass surgery: This surgery is an intricate super-microsurgical procedure used to treat patients with mild to moderate lymphedema. Our plastic surgeons perform the surgery by shunting, or moving, fluid from several dilated lymphatics in the affected limb to adjacent venules (tiny veins) to reduce pressure.

Pneumonectomy

A pneumonectomy is a surgery performed to remove an entire lung. It may be performed to to treat non-small cell lung cancer and conditions such as chronic obstructive pulmonary disease (COPD) and tuberculosis. The types of pneumonectomy procedures include:

• Standard pneumonectomy: Only the diseased left or right lung is removed.
• Extrapleural pneumonectomy: The diseased left or right lung is removed, in addition to portions of the diaphragm, pericardium (the membrane covering the heart) and the pleura (the membrane lining the chest cavity). An extrapleural pneumonectomy is typically performed to treat mesothelioma.

Pneumonectomy procedures may be invasive and complex. Patients receive general anesthesia so that they sleep through the procedure. Patients also have an endotracheal tube placed in their mouths, which allows a ventilator to breathe for them during the surgery.

Robotic surgery

This surgery offers a minimally invasive alternative to both open surgery and laparoscopy. Because it requires only a few tiny incisions and offers greater vision, precision and control for the surgeon, patients can often recover sooner, move on to additional treatments if needed, and get back to daily life quicker. Potential benefits of the da Vinci system for patients include less pain, lower risk of infection, less blood loss and less scarring.

Thoracotomy

A thoracotomy is a surgical procedure performed to open the chest cavity. It uses an incision made in the chest that allows surgeons to access the throat, lungs, heart and diaphragm. A thoracotomy incision can be made:

• Between the ribs on the front or side of the chest (limited anterior or lateral thoracotomy)
• Down the front of the chest, through the breastbone (sternal splitting thoracotomy)
• Across the side and around the back of the chest (posterolateral thoracotomy)

A thoracotomy may be part of a patient’s surgical treatment if he or she has been diagnosed with lung cancer or other cancers, or other diseases of the heart and lungs. Depending on the type of disease or disorder a patient has been diagnosed with, a surgeon will perform a thoracotomy followed by another surgical procedure, such as a lobectomy (removal of one or more lobes of the lungs), esophagectomy (removal of all or part of the eosphagus) or a wedge resection (removal of part of a lung lobe).

Thyroidectomy

In this procedure, most or all of the thyroid gland is surgically removed (total, near-total or subtotal thyroidectomy). Many patients with thyroid cancer have a thyroidectomy.

The three types of thyroidectomy procedures are:

• Conventional thyroidectomy: A small incision is made in the front of the neck to remove your thyroid gland.
• Endoscopic thyroidectomy: Your surgeon will make a few incisions in the neck through which surgical instruments and a small camera will pass. This camera will help guide your surgeon during the procedure.
• Robotic thyroidectomy: Incisions are made in the chest and armpit or high up on the neck.

Tracheoesophageal puncture

A tracheoesophageal puncture, or TEP, may be an option for patients who undergo a laryngectomy (removal of the larynx/voice box) either because they have laryngeal cancer (cancer of the voice box) or because they have a non-functioning larynx, from radiation or trauma. To perform a tracheoesophageal puncture, a head and neck surgeon places a small, one-way valve between the trachea and the esophagus, either during the laryngectomy or during a secondary surgery that may be performed any time after the laryngectomy. The valve allows for air to travel from the wind pipe (trachea) into the esophagus, but it blocks food, saliva and liquids from the airway. As air enters the esophagus, it produces a vibratory signal that the patient may use for voicing.

Video-assisted thoracic surgery (VATS)

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat symptoms in the chest, including lung cancer. During the VATS procedure, one or more small incisions, or “ports,” are made in the chest. Then, a thorascope (a type of endoscope with a small video camera) and surgical tools are inserted through the incision(s). The thorascope transmits an image of the chest cavity onto a video monitor to help guide the procedure. VATS may be used to biopsy lung tissue and to perform complex procedures, such as lung resections (lobectomy). This innovative procedure may result in less post-operative pain, fewer complications, and a shorter hospital stay than traditional surgical approaches, like thoracotomies, which require a single large incision in the chest.

Recovery

The Advanced Surgical Recovery Program (ASURE) is designed to help patients recover from surgery more quickly and with fewer complications. ASURE is intended to improve surgical outcomes and enhance the patient experience before, during and after surgery, while also reducing patients’ overall hospital stay. Typically, ASURE protocols involve nutrition, pain management with non-narcotic pain relievers and physical activity within 24 hours after surgery.

Compared with traditional care, the ASURE program is designed to improve patients’ quality of life immediately after surgery and in the long term. The use of enhanced recovery methods like those used in ASURE has been shown to reduce fatigue; post-surgery complications and the amount of narcotics used in post-surgical care, while helping patients resume their everyday activities more quickly.

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