Media Release
Udupi, Sep 1: In one of the most complex operations in abdominal surgery, doctors at Kasturba Hospital, Manipal, have successfully removed a pancreatic cancer from a 58-year-old woman using a combination of keyhole surgery and an advanced surgical robot, sending her home within just seven days.
The patient had come to the hospital with yellowing of the eyes and skin, a sign of obstructive jaundice, which occurs when a tumour blocks the flow of bile from the liver. Scans revealed a bulky periampullary tumour, a cancer that forms at the point where the bile and pancreatic ducts open into the small intestine. It had spread to the wall of the intestine and the head of the pancreas.
The case was made far more difficult by an unusual quirk of the patient's anatomy. One of the arteries supplying the liver was following an abnormal path directly through the surgical field, close to the tumour. Seen in only a small number of people, this variation greatly raises the risk of bleeding and injury during surgery.
To treat the cancer, the team performed a pancreaticoduodenectomy, better known as Whipple's procedure, widely regarded as among the most demanding operations a surgeon can undertake. It involves removing the head of the pancreas, part of the small intestine, the bile duct, and the gallbladder, and then painstakingly reconnecting the digestive tract so that food and digestive juices can flow normally again.
Instead of the traditional open operation, which needs a large incision and usually means more pain and a longer recovery, the surgeons opted for a hybrid, minimally invasive approach. The tumour was removed through small keyhole cuts, and the intricate reconstruction was carried out using the Hugo RAS robotic system, which gives the surgeon a magnified, three-dimensional view of the operating field and instruments that bend and rotate far more freely than the human wrist.
“Cases like this are technically very demanding, especially when an abnormal artery runs directly through the area where we are operating, leaving very little margin for error,” said Dr Naveena Kumar A N, head of the department of surgical oncology. “By combining keyhole removal with robotic reconstruction, we were able to complete the entire operation safely and with a high degree of precision, while sparing the patient the pain and the long recovery of a large open surgery. Being able to offer this kind of advanced, minimally invasive cancer surgery close to home, rather than sending patients to faraway cities, is a significant step forward for the people of this region.”
The team also included Dr Nawaz Usman, Dr Preethi S Shetty, Dr Akhil Palod, and Dr Ananthakrishnan Balakrishnan, and was supported by the department of anaesthesia and OT staff.
The entire procedure was completed without any need to switch to open surgery. It lasted around eight hours, with a blood loss of just 200 ml. The patient recovered without any major complications and was discharged on the seventh day. She is now on regular follow-up as per standard cancer care protocols.
“Our vision has always been to bring the very best of medical technology and infrastructure to this region, so that patients here can access the same standard of care available at the finest centres anywhere in the world, without having to travel far from home,” said Dr Sudhakar Kantipudi, chief operating officer, MAHE teaching hospitals.
“Investing in advanced robotic surgery platforms, modern operating theatres and highly skilled multidisciplinary teams is central to that commitment. An outcome like this, where a patient undergoes one of the most complex cancer operations and walks home within a week, is exactly what world-class infrastructure in experienced hands is meant to deliver. We remain committed to continually strengthening these capabilities, so that advanced, high-quality cancer care is never out of reach for the people of coastal Karnataka and beyond,” he said.
The successful surgery underscores the growing investment in world-class surgical infrastructure at Kasturba Hospital, Manipal. Though located well away from the country's large metros, the Manipal Academy of Higher Education (MAHE) teaching hospital has steadily built up international-standard facilities, from advanced robotic surgical systems and modern operating theatres to specialised, multidisciplinary oncology teams. This commitment ensures that patients in coastal Karnataka and the surrounding region can receive the most advanced cancer care right at their doorstep without having to travel to distant cities or overseas, and stands as a strong example of a smaller town delivering care that matches the best in the world.