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Read more at: Doctors reconstruct tongue with flesh from thigh Using flesh from the thigh, doctors at a private hospital have reconstructed the tongue of a patient suffering from oral cancer. Though the patient’s speech quality has improved post surgery, his new tongue is devoid of taste buds. The patient, a native of Faridabad, was suffering with pain in the mouth, inability to eat and difficulty in speech for the last two and half months. “On evaluation, he was found to be having cancer arising from ventral aspect of the tongue going into the floor of mouth involving almost entire tongue and abutting the jaw bones in its entire extent,” said Dr Nitin Singhal, surgical oncologist at Fortis Hospital. The patient was a chronic smoker and tobacco chewer and also took alcohol occasionally. The patient was diagnosed with cancer in the tongue at some other hospital and was given the option of surgery but he did not opt for it fearing it would lead to a significant deformity of his face. He was also told that his entire jaw bone might have to be removed for removal of cancer. However, as his condition worsened and pain became unbearable, the patient approached the doctors at Fortis Hospital in October. “He was in tremendous pain and was unable to eat at all. After complete evaluation, we convinced him that we can give a try to remove the tumour while preserving his jaw bone. But surgery was a must to save his life,” Dr Singhal said. So as a part of the surgery, his entire tongue and the floor of mouth along with upper half of the entire jaw bone was removed by marginal mandibulectomy while preserving the lower contour of the jaw bone. “What made the surgery challenging was that when you try to do this marginal mandibulectomy for such a long segment, it is technically difficult as there is significant risk of fracture of the jaw bone. Fracture of jaw bone would have defeated the purpose of surgery for which patient had come to us,” Dr Singhal explained. A new tongue and floor of the mouth was made with the help of skin and flesh from the thigh. The surgery took place on October 25. agencies “We did the reconstruction with anperolateral thigh flap. The patient was started on oral feeds on day 5 and discharged on day 8,” said Dr Surendra Chawla, senior consultant, Plastic and Reconstructive Surgery, Fortis. Post surgery he is able to take all liquids and most of the semi solid food. “The final report showed complete removal of the tumour and patient is on radioterapy,” Dr Chawla said.India has high incidence of oral cancers as 4 in 10 of all cancers are mouth cancers. As many as 14 deaths occur every hour in India because of oral cancers.

Ahmedabad surgeons set record, remove ‘heaviest’ kidney tumour in child A team of doctors led by senior surgical oncologist Dr. Nitin Singhal, has set the record for surgically removing the “heaviest kidney tumor” in a child and has been recognised by the India Book of Records (IBR). Notably, the team successfully removed a large Wilms’ tumor weighing 3.1 kg from the left kidney of a 3-year-old child, providing a new lease of life to her.  Following the surgery, a claim was registered with the IBR. It was thoroughly scrutinised by a team from the IBR after which a post-attempt felicitation and final approval have been provided.  Commenting on the development, Dr. Singhal said, “It was a very challenging surgery for us, but thankfully, we could successfully execute it. After one-and-a-half-year of the surgery, the child is living a normal life like any other kid.”  As per the case details, the child was brought to hospital when her parents noticed a huge increase in the size of her belly over a period of 2-3 weeks. On consulting senior pediatrician Dr. Pushkar Srivastava, they were referred to consultant pediatric oncologist Dr Hemant Meghani.  Dr. Meghani investigated the child and found a rare condition in which a huge mass was arising from the horseshoe kidney. The mass was pushing the diaphragm, causing the child to have severe breathing difficulties. The case was then discussed with the Multidisciplinary Tumor Board. In normal circumstances, such huge masses are generally diagnosed by a biopsy and treated by chemotherapy respectively. But since there were several risks with this approach, emergency surgery was decided in this case as an exception.   The four-hour long surgery was performed by Dr. Singhal and his team which included anesthetist Dr. Ankit Chauhan and pediatric surgeon Dr. Kirti Prajapati.  Dr. Singhal said, “This case highlights the lack of awareness in our society in relation to paediatric tumours which have a good prognosis if treated properly and on time. In fact, it is interesting to know that such tumours in this age group have much better survival chances than adult tumours.”  The surgery was done at Apollo hospital, Ahmedabad.

Sterling Hospitals achieves milestone with complex Robotic Whipple Surgery Sterling Hospitals, Ahmedabad – has successfully performed a highly complex Robotic Whipple Surgery, marking a significant advancement in minimally invasive pancreatic cancer treatment. Led by renowned Robotic Surgeon Dr. Nitin Singhal and his team, the procedure offered new hope to a 55-year-old female patient from Anand district, Gujarat. The patient presented with persistent jaundice, fever with chills, and intermittent pain over several months. Initially suspected to be gallstones, thorough diagnostics revealed an ampullary mass with pancreatic involvement. A biopsy confirmed malignancy, prompting bile duct stenting for jaundice relief. After consulting multiple doctors locally – who deemed open surgery risky due to anatomical challenges involving a critical vein from the heart to the liver – the family sought advanced care at Sterling Hospitals following social media recommendations. Dr. Nitin Singhal, Consultant Robotic Onco-surgeon, Sterling Hospitals, explained, “This was an extremely challenging case requiring utmost precision. The tumour’s location demanded careful preservation of vital vascular structures to avoid life-threatening complications. We had recommended robotic-assisted surgery for its superior accuracy, minimal invasiveness, and enhanced recovery profile.” The intricate Robotic Whipple procedure lasted 8-10 hours. Utilizing cutting-edge robotic technology, the team meticulously removed the tumour while preserving the essential vein, reconstructing digestive organs, and ensuring no internal leakage. Only a six-centimetre incision was required, resulting in negligible blood loss, no need for painkillers, and virtually scar-less outcomes. The surgery’s complexity lies in its technical demands which involves precise organ reconnection, management of anatomical variations, and liver preservation. Sterling Hospital’s expertise ensured a seamless execution. Post-operatively, the patient’s recovery was remarkable. She required no prolonged ICU stay, resumed normal oral intake swiftly, and was discharged in stable condition – just 12 days after surgery, with impressive mobility and minimal discomfort. Mr Santosh Marathe, MD & CEO Sterling Hospitals said that this procedure represents the first such complex Robotic Whipple at Sterling Hospitals, underscoring the institution’s pioneering role in robotic oncology. Sterling Hospitals comprehensive Oncology services at 3 locations in Gujarat envisions a future where robotic assistance becomes standard for complex surgeries, including those for lung and liver cancers, offering patients precision, reduced pain, and faster returns to normal life. Sterling Hospitals continues to lead in advanced oncological care, combining state-of-the-art technology with expert multidisciplinary teams to deliver life-changing outcomes. In Western India, Sterling Hospitals, a private hospital network, dominates the market and offers top-notch medical care. Since its founding in 2001, the hospital has been a leader in the field by offering patients the best possible medical and surgical care. The Sterling Group has successfully constructed state-of-the-art secondary care facilities in Ahmedabad, Vadodara, Rajkot and Gandhidham, as well as tertiary care multi-specialty hospitals. The fact that Sterling Hospitals is the first corporate hospital in Gujarat to receive NABH accreditation is evidence of its dedication to providing the highest quality medical treatment. The hospital offers a variety of crucial disciplines, such as cardiology and CVTS surgery, neurology and neurosurgery, nephrology and urology, Orthopaedics and Trauma, liver and renal transplantation (cadaveric and live), GI medicine and surgery, haematology, bone marrow transplant, and oncology.

The Robotic Whipple Procedure: High-Tech Precision for Complex Pancreatic Surgery What Exactly Happens During a Whipple? To understand the value of the robot, we first have to understand the complexity of the task. The pancreas sits in a very “crowded neighborhood,” tucked behind the stomach and surrounded by major blood vessels. In a standard Whipple procedure, the surgeon must remove: The head of the pancreas. The first part of the small intestine (duodenum). The gallbladder and part of the bile duct. Nearby lymph nodes. Once the tumor is out, the “reconstruction” begins. The surgeon must carefully sew the remaining pancreas, bile duct, and stomach back to the small intestine so that the patient can still digest food. The Robotic Edge: Why “High-Tech” Means “Better Care” The da Vinci Robotic System used by Dr. Nitin Singhal isn’t a replacement for the surgeon; it is a sophisticated tool that enhances his natural capabilities. Here is how that precision translates to patient benefits: 1. 10x Magnified 3D Vision :In traditional surgery, the surgeon looks into the abdomen with the naked eye. The robot provides a high-definition, 3D view that magnifies the surgical field up to ten times. This allow Dr. Singhal to see tiny blood vessels and nerves that are nearly invisible during open surgery, ensuring the tumor is removed with “clear margins” while sparing healthy tissue.2. Wristed Dexterity in Tight Spaces :The human hand has limit – it can’t rotate 360 degrees or fit into the tiny crevices around the pancreas without a large opening. The robotic instruments have “EndoWrists” that can move with more agility than a human hand. This is particularly vital for the reconstruction phase, where the surgeon must make waterproof stitches in ducts that are sometimes only 3 millimeters wide.3. Eliminating the Tremor :Even the most skilled surgeon has a microscopic natural tremor in their hands. The robotic system filters this out completely, providing a level of steadiness that is critical when working near the portal vein and the aorta. Why Choose Robotic Over Traditional Surgery? For many patients, the choice of a robotic approach under an expert like Dr. Nitin Singhal comes down to the recovery experience. Feature Traditional Open Whipple Robotic Whipple Incision Size 6–10 inch large cut Several tiny “keyhole” ports Blood Loss Significant Minimal Pain Levels High (often requires epidural) Low to moderate Hospital Stay 10–14 days 5–7 days Recovery 2–3 months 4–6 weeks Who is ideal Patient for this surgery? While the robotic Whipple offers incredible benefits, Dr. Nitin Singhal emphasizes that the best surgery is the one that is safest for the individual. During a consultation, Dr. Singhal evaluates the tumor’s size, its proximity to major blood vessels, and the patient’s overall health to determine if the robotic approach is the most effective path forward A Message of Hope Pancreatic cancer is a formidable opponent, but technology is closing the gap. By combining world-class training from Tata Memorial Hospital with the precision of robotic surgery, Dr. Nitin Singhal is providing patients in Gujarat with treatment options that were once only available in the world’s most advanced medical centers. Are you or a family member seeking a second opinion on pancreatic surgery? Precision is the key to better outcomes. Reach out to Dr. Nitin Singhal’s team to schedule an in-depth evaluation and see if the robotic approach is right for your journey to recovery.

Precision in the Chest: The Role of Robotic Surgery in Thoracic Oncology The human chest is often described by surgeons as a “crowded neighborhood.” Packed tightly within the ribcage are some of the body’s most critical structures: the heart, the lungs, major blood vessels like the aorta, and the esophagus. They all live millimeters apart, moving constantly as we breathe and our hearts beat. For a cancer surgeon, operating in this delicate space requires a level of steadiness and precision that borders on the artistic. In the past, accessing these organs meant “open” surgery – large incisions and significant recovery time. But today, the field of Thoracic Oncology has been revolutionized by technology. As a leading Robotic Cancer Surgeon in Ahmedabad, Dr. Nitin Singhal is at the forefront of this shift. By combining his extensive training from Tata Memorial Hospital with advanced robotic systems, he is changing how complex chest cancers are treated – prioritizing not just survival, but quality of life. The Challenge: Why Chest Surgery is Difficult Traditionally, if a patient needed lung cancer surgery (like a lobectomy) or esophageal surgery, surgeons performed a procedure called a Thoracotomy. This involves a long incision on the side of the chest, often spanning 6 to 10 inches. To reach the lungs, the surgeon must spread the ribs apart. While this method is effective for removing tumors, the trauma to the muscles and ribs is significant. Recovery can be painful, and it often takes weeks for patients to return to their normal breathing patterns and daily routines. The Solution: Enter the Robot There is a common misconception that “robotic surgery” means a machine is performing the operation. This is not the case. In Dr. Nitin Singhal’s operating room, the robot is not the surgeon it is a high-tech extension of his hands. Using the da Vinci Surgical System, Dr. Singhal sits at a specialized console just a few feet away from the patient. He controls robotic arms that are positioned over the patient with absolute command. Every movement he makes with his hands is translated instantly and precisely to the instruments inside the patient. Here is why this technology changes the game for thoracic cancer: 1. Seeing the Unseen (3D Visualization) :In traditional “keyhole” surgery (like standard VATS), surgeons look at a flat 2D monitor. It’s similar to watching a movie; depth perception is often lost.With the robotic system, Dr. Singhal looks into a viewfinder that provides a magnified, high-definition, 3D view inside the chest. He can see tiny blood vessels, nerves, and tissue planes as if he were standing right inside the ribcage. This clarity is crucial when peeling a tumor off a vital structure like the windpipe or the aorta.2. Wristed Instruments for Tight Spaces :The human hand is amazing, but it has limits. It cannot rotate 360 degrees, and it is too large to fit into tiny spaces without a large incision.The robotic instruments used by Dr. Singhal are miniaturized about the size of a wrist and feature “EndoWrists.” These instruments can bend and rotate far beyond the capabilities of the human hand. This allows Dr. Singhal to navigate around the heart or behind the esophagus to remove lymph nodes with incredible precision, without needing to force the ribs apart. Why “Precision” Matters for the Patient When Dr. Singhal talks about precision, he isn’t just discussing technical skill. He is talking about the patient’s life after surgery. Significantly Less Pain: Because the ribs are not spread, post-operative pain is drastically reduced. Patients are often surprised at their comfort levels just days after the procedure. Faster Recovery: Smaller incisions mean less trauma to the body. Patients undergoing robotic thoracic surgery typically leave the hospital sooner and return to their families and work much faster than those who undergo open surgery. Better Cancer Outcomes: The superior 3D view allows for a more thorough removal of lymph nodes (lymphadenectomy), which is essential for accurate cancer staging and reducing the risk of recurrence. What Conditions Does Dr. Singhal Treat Robotically? Dr. Nitin Singhal utilizes this advanced technology for a variety of complex thoracic conditions, including: Lung Cancer: Procedures like Lobectomies (removing a lobe of the lung) or Segmentectomies (removing smaller segments). Esophageal Cancer: Complex surgeries such as Esophagectomy, where part of the food pipe is removed and reconstructed. Mediastinal Tumors: Removal of masses like Thymomas (tumors of the thymus gland) which sit directly over the heart. A Human Touch Behind High-Tech Care While the technology is impressive, Dr. Singhal always emphasizes a core truth: A robot is only as good as the surgeon controlling it.Cancer surgery is not just about cutting; it is about decision-making. Knowing when to operate, how to spare healthy tissue, and how to ensure the cancer is completely removed comes from years of experience, not a machine.Dr. Nitin Singhal uses the robot as a tool to deliver that expert care with the gentlest touch possible.

The Science of Survival: How HIPEC Targets Advanced Abdominal Cancers When cancer spreads to the lining of the abdominal cavity (the peritoneum), it has historically been viewed as a terminal stage with limited treatment options. Traditional intravenous (IV) chemotherapy often struggles to reach these areas because the “blood-peritoneal barrier” prevents medicine in the bloodstream from effectively penetrating tumor nodules in the abdomen. However, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has emerged as a revolutionary “science of survival.” Performed by specialists like Dr. Nitin Singhal, a leading Surgical Oncologist in Ahmedabad, this procedure offers a powerful alternative for patients with advanced abdominal malignancies. What is HIPEC? HIPEC is a two-step “combination” treatment that takes place during a single surgical session. It is not just a drug treatment, nor is it just a surgery – it is an integrated approach designed to “sterilize” the abdominal cavity. 1. Cytoreductive Surgery (CRS) : Dr. Singhal first performs a meticulous surgery to remove all visible tumor masses from the abdominal cavity.2. The “Chemo Bath” : Once the visible tumors are gone, a heated, highly concentrated chemotherapy solution is circulated throughout the abdomen for 60 to 90 minutes. The Science: Why “Hot” Chemotherapy? The “Hyperthermic” (heated) component of HIPEC is not accidental. There are three primary scientific reasons why heating the chemotherapy to approximately 41°C to 43°C (106°F – 109°F) makes it more effective: Increased Penetration : Heat expands the blood vessels and makes cancer cells more “leaky,” allowing the chemotherapy to penetrate deeper into the remaining microscopic tissues (up to 3mm). Direct Cytotoxicity : Cancer cells are more sensitive to heat than healthy cells. The high temperature itself can impair the DNA repair mechanisms of cancer cells, leading to their death. Synergistic Effect : Many chemotherapy drugs (like Cisplatin or Mitomycin C) become significantly more potent and lethal to cancer cells when applied at elevated temperatures. Why HIPEC is More Effective than Standard Chemo For cancers like Ovarian, Colorectal, Gastric, and Appendiceal cancer, HIPEC offers distinct advantages over traditional IV chemotherapy: Feature Traditional IV Chemotherapy HIPEC Treatment Delivery Via the bloodstream Directly into the abdomen Concentration Diluted by the whole body High-dose, localized Side Effects Systemic (hair loss, nausea, etc.) Minimized systemic toxicity Target General/Whole body Microscopic abdominal seeds Frequency Multiple sessions over months Usually a one-time procedure When patient needs HIPEC? As a pioneer in HIPEC and Robotic Surgery, Dr. Nitin Singhal emphasizes that patient selection is the most critical factor for success. HIPEC is generally most effective for: Advanced Ovarian Cancer: Especially for patients who have had a good response to initial chemotherapy. Colorectal Cancer: When the spread is limited to the peritoneal surface. Pseudomyxoma Peritonei: A rare “jelly belly” tumor where HIPEC is the gold-standard treatment. Appendiceal & Gastric Cancers: In selected cases where the disease is localized within the abdomen. “The goal of HIPEC is not just to extend life, but to offer a chance at long-term remission for patients who were previously told they had no surgical options.” – Dr. Nitin Singhal Recovery and Outcomes While HIPEC is an intensive procedure – often lasting 6 to 10 hours – the outcomes can be life-changing. Studies show that for certain cancers, adding HIPEC to surgery can double the survival rate compared to surgery or chemotherapy alone. Because the chemotherapy is localized, patients often avoid many of the debilitating side effects of systemic chemo, though they will require a dedicated recovery period in the hospital to monitor organ function and gastrointestinal healing. If you or a loved one is facing an advanced abdominal cancer diagnosis, specialized expertise is essential. Dr. Nitin Singhal combines years of training from Tata Memorial Hospital with the latest in robotic and HIPEC technologies to provide world-class oncology care.