Ministry of Health introduces laparoscopic surgery |12 June 2019

The press conference

Faster recovery times,

less pain and scarring

Patients requiring surgical interventions to treat appendicitis, slipped discs and hip fractures among others are benefitting from more advanced and minimally-invasive surgical procedures on offer at the Seychelles Hospital.

In a press conference held yesterday afternoon, Minister for Health Jean-Paul Adam, accompanied by chief executive of the Health Care Agency (HCA) Danny Louange and Dr Danisela Chetty detailed the numerous improvements within the services offered by the ministry, particularly for patients requiring surgical interventions.

In a bid to improve the quality of service and quality of care for patients, the Ministry of Health has, over the past two years, invested in new equipment including operating tables, and training of nursing and health professionals, and introduced laparoscopic surgery, also known as keyhole surgery.

Laparoscopic surgery is a low-risk, minimally invasive procedure that only requires small incisions as compared to the traditional methods of open surgery which are often more painful and presents higher risks for the patient.

Dr Danisela Chetty, a laparoscopic surgeon at the Seychelles Hospital, explained that minimally invasive surgery is a way to approach the abdomen or the chest whereby small incisions are made through the abdominal wall and instruments are used to diagnose abdominal organs and to treat certain diseases without the need for long open surgeries.

“Basically the surgical technique for any operation remains the same surgical technique as before when performing a cut but the only difference is that you approach the abdomen through small holes in the abdominal wall or the chest. This gives patients quite a lot of benefit, less pain, shorter recovery times, shorter time periods before they can resume with work and their daily lives, reduced risk of infections and of course this reduces the strain on the hospital and reduce costs,” Dr Chetty noted.

According to Dr Chetty, most surgeries can be performed using this method and the Ministry of Health intends to expand the types of surgeries gradually, as it continues to invest in acquiring new equipment and training and development of staff.

Currently, since December 2018, 48 such operations have been performed including two appendectomies and gynaecological laparoscopy.

Asides from being used to treat abdominal organs, the Ministry of Health also offer patients suffering from spinal problems and hip fractures keyhole surgery.

Dr Danny Louange remarked that since November 2018, keyhole surgery has been introduced in the orthopaedic section as it permits for better and more effective results with less impact on the patients. With the donation of a special piece of equipment costing $25,000, donated to the ministry by a Seychellois individual, the ministry is now able to offer minimally-invasive spine surgery to rectify slipped discs.

“We can now treat slipped discs through only a small incision of about 2cm. As compared to before, where a large cut would be made, the procedure does not damage the muscles under the skin, as they can be separated until we reach the spine. Once at the spine, the equipment is placed and the exposure is adequate to perform the slipped disc surgery. Together with other equipment we have, we can access and remove the disc, through the device, and upon removing the device, the muscles go back together and the small incision is sewn. This means that patients can be up and mobile on the very same day, and can be discharged fairly quickly, possibly the next day,” Dr Louange explained.

He added that the procedure is safe and is practised in many countries, since its introduction around 10 years ago. The procedure minimises the risks of infection and does not cause as much damage as traditional surgeries where the muscles are also dissected, which usually causes patients lots of pain, meaning patients often do not even require painkillers. Furthermore, if there is a need to maybe re-operate on the same area in future, the muscles are not damaged and seem as though they have never been operated on.

Another procedure introduced in the orthopaedic section is for patients who have suffered from a hip fracture, possibly after a fall.

“Similarly it is not necessary to have big cuts but with a small incision, the equipment is introduced, a metal rod that can enter the bone and it is secured with little screws. If the patient is operated on the first day that they are admitted, they can be back on their feet or home early and they do not lose any function they had before the fall,” Dr Louange noted.

Compared to open surgical procedures, these smaller incisions and tools cause less disruption to the hip joint and related soft tissues and result in less pain and scarring, fewer complications and less risk of infection and as with other laparoscopic surgical procedures, results in shorter recovery times for the patient.

These advantages also allow surgeons to preemptively treat conditions that cause osteoarthritis, thus, in some cases, delaying the onset of hip arthritis and delaying or eliminating the need for later hip replacement.