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Disease Management Groups

Head Neck Cancer

Oral Cancer


Scope of Services


  • Radical & Composite resections with function preservation &/or restoration; Salvage surgery for recurrent cancers
  • Laser resections; Organ preserving treatment protocols
  • Reconstruction with microvacular/pedicled/local flaps
  • Jaw reconstructions and dental implants
  • Mucosa and salivary gland sparing IMRT/IGRT
  • Neoadjuvant, Concurrent and Palliative Chemotherapy/Targeted therapy
  • Corrective and rehabilitative procedures for deformities and disabilities; Immediate Prosthesis for palatal defects
  • Supporive dietary services; Screening & early detection program

USPs


  • No visible facial scar for oral resections/composite resections
  • No visible neck scar for neck dissections (selected cases)
  • One in-house Team of Oncologists, reconstructive and Prosthodontics specialists to plan, execute, follow-up and restore and rehabilitate
  • Best Technologic support (Robot, Lumenis Laser , Microscope, Physiotherapy, Most modern Radiotherapy, Frozen Section)
  • Largest experience with PDT
  • Computer-aided treatment planning
  • Special program and devices for speech and swallowing preservation and restoration; osseo-integrated implants
  • Best R0 resection rate and cancer control


Throat (Larynx & Pharynx) Cancer


Scope of Services


  • Voice and Laryngeal Preservation program:
  • Early laryngeal cancer management program:
    • Voice-preserving partial laryngectomies, TOLS, TORS;
    • Hypofractionated Radiotherapy
  • Surgical & Non-surgical Laryngeal preservation for locally advanced laryngeal/pharyngeal cancers
  • Total and Salvage laryngectomy for advanced & recurrent cancers
  • Pedicled, and free microvascular tissue transfers for reconstructions
  • Natural and prosthetic voice restoration: TEP, NTL-TPSS
  • Phonosurgery and Speech Pathologist services
  • PEG for swallowing dysfunction

USPs


  • One of the largest and longest experience with NTL
  • Earliest experience with NSVP (since 1994)
  • Only centre with most advanced Lumenis Laser WITH FIBER and daVinci Robotic system
  • Fully integrated team for multidisciplinary management
  • Innovation: Hybrid technique of Supraglottic & Pharyngeal Laser excisions
  • Flexible endoscope with NBI for accurate tumor mapping


Thyroid & Parathyroid


Scope of Services


  • Open, partial/Total, Radical, Re-operative and Complicated Thyroidectomies
  • Robotic and Minimally Invasive (no neck scar) Thyroidectomies
  • Minimally invasive Parathyroidectomy (MIP)
  • Extended resections for advanced disease : Tracheal, voice preserving laryngeal resections
  • Genetic screening and molecular testing
  • Program for management of vocal paralysis

USPs


  • Safe tracheal and extended resections for locally advanced thyroid cancers
  • Razor edge technology (Da Vinci Robot)
  • Documented over 98% success till date in cure of Hyperparathyroidism over >14 years
  • In-house Radio-iodine therapy planning


Salivary Gland, PNS & Skull Base


Scope of Services


  • Nerve preserving and Radical Parotidectomies
  • Tumors of maxilla, ethmoid, orbit, temporal bone
  • Anterior and lateral craniofacial & cranio=orbital resections
  • Parapharyngeal tumors
  • Endoscopic skull base surgeries
  • Primary, recurrent and complicated Nasopharyngeal Angioma surgery & Radiotherapy
  • Prosthetic rehab ilitation after maxillary/palatal resections and free microvascular reconstructions

USPs


  • Facial form and function preserving – avoiding hollow after Parotidectomy, avoiding facial incisions for maxillectomies
  • Swallowing and speech rehab after palatal resections with free microvascular reconstructions and prosthodontic rehabilitation
  • Navigation –guided surgery for skull base lesions
  • Coblation and Robotics for selected cases

Breast Cancer

Scope of Services


  • Oncoplasty with Breast Conservation and Total Mastectomies
  • Skin sparing &Nipple-Areola-Sparing Mastectomy+ immediate reconstruction
  • SLNB
  • Prosthetic and autogenous reconstructions and augmentations/ reduction mammoplasty
  • Prophylactic risk reducing Mastectomy for genetic mutation carriers
  • Standard and Short course Radiotherapy;
  • Partial breast Irradiation after BCS
  • Totally implantable VAD/chemoport
  • Stereotactic and Needle localization biopsies for non-palpable lesions

USPs


  • Integrated reconstruction options
  • Experience of 15 years with Sentinel Node technique
  • Multidisciplinary protocols for reducing arm edema and neuralgias
  • Counselling services by Cancer support group and survivors
  • Integrated Physiotherapy and rehabilitative services
  • Partnering Cancer Telescreening and on-site screening programs
  • The first and only Digital Mammography service in Gujarat
  • Molecular and Genetic assessment and all cyto- & Histopathology in-house

Lung Cancer, Trachea, Pleura & Mediastinum

Scope of Services


  • Invasive Mediastinal staging for PET-positive mediastinum: TBNA, Mediastinoscopy
  • All surgeries for lung & pleural cancer including chest wall resections, Pancoast tumors, sleeve resections, Extrapleural Pneumonectomy
  • VATS and Robotic-assisted surgeries for lung, mediastinal tumors
  • Adjuvant and palliative chemotherapy and targeted therapy
  • Definitive, adjuvant and palliative radiotherapy
  • SBRT for medically unfit resectable/curable disease
  • Pulmonary metastasectomy (multiple/bilateral) – open/VATS/Robotic
  • Tracheal resection-anastomosis for benign and malignant disease
  • Palliation for intractable pleural effusion/ endobronchial obstruction by endobronchial debulking/stenting
  • SVC stenting for SVC syndrome

USPs


  • Invasive and minimally invasive staging of mediastinum: Long experience of 15 years
  • PET-basedRT
  • Cutting edge technology for surgery (Robotics) and radiotherapy (Truebeam)
  • Low complication and zero mortality rates; > decade of experience in tracheal resections
  • Experience of ~15 years with systematic mediastinal staging
  • Largest number of single stage pulmonary metastasectomy (44 from one lung)
  • Vast experience with pulmonary metastasectomy (>15 years)
  • Molecular testing and Personalized therapy

Esophageal and Gastric Cancer

Scope of Services


  • Open and Minimally Invasive (Laparoscopic-Thoracoscopic/ robotic assisted) resections
  • D2 Gastrectomies
  • Lung-sparing IGRT, 3DCRT, SBRT as neo-adjuvant/definitive/palliative radiotherapy
  • Neo-adjuant, Adjuvant, Pallaitive Chemo- & Targeted therapy
  • Esophageal stenting, EUS guided biopsies and staging
  • Staging Laparoscopy for gastric cancer
  • PET-based response evaluation and staging
  • Intra-peritoneal chemotherapy for intractable malignant ascites

USPs


  • High lymph node yield rates
  • Supracarinal lymph node dissection for esophageal cancers (extended 2-field)
  • Multi-modality treatment protocols
  • Frozen section, molecular pathology based treatment planning and delivery

Liver & Biliary tract Cancer

Scope of Services


  • All types of liver resections, repeat liver resections for primary liver tumors –Open, laparoscopic and Robotic assisted.
  • Extended and staged resections for Hilar Chalngiocarcinomas and Gall bladder Cancers
  • Resections of metastatic liver tumors
  • Neo-adjuvant Chemotherapy and adjuvant, and palliative targeted and chemo-therapy
  • PTBD/ERCP stenting of unresectable obstructing cancers
  • RFA, Chemoembolisation of Liver Tumors
  • SBRT for selected tumors

USPs


  • Nearly three decades of experience
  • Simultaneous hepatic and colorectal resections
  • State of the art equipment
  • Multidisciplinary and critical care support

Pancreatic Cancer

Scope of Services


  • Whipple’s operation- Classic and Pylorus –preserving; extended with Vascular resection for adenocarcinoma and Neuroendocrine tumors
  • Duodenum-Preserving Pancreatic Head Resection (DP-PHR);
  • Pancreas-preserving Duodenectomy
  • Cluster excision for cancers of body of pancreas
  • Laparoscopic/Robotic-assisted distal pancreatectomy
  • Surgery for IPMN, MCN
  • SBRT for unresectable pancreatic tumors
  • Neo-adjuvant and adjuvant chemotherapy
  • EUS for diagnosis and staging ; Pancreatic and bliary stenting stenting
  • Image-guided Celiac block for pain palliation

USPs


  • Very low mortality and leak/fistula rates
  • High R0 resection rates
  • One-stop solution reduces cost and improves effectiveness of treatment

Colorectal Cancer

Scope of Services


  • All radical colon resections
  • Sphincter preserving surgeries for rectal cancer
  • Transanal resections, sacral excision and recurrent cancer surgery
  • Risk-reducing restorative proctocolectomies for hereditary syndromes
  • Multivisceral resections and exeneterations or locally advanced tumors
  • All laparoscopic and Robotic surgeries for CRC
  • Surgery & HIPEC for peritoneal disease
  • Adjuvant and Palliative chemotherapy & targeted therapy
  • Neo-adjuvant , Adjuvant and Palliative Radiotherapy
  • Endoscopic polypectomies
  • Genomic testing for hereditary risk and tumor genome
  • Stoma care support and guidance; Chemoport for long-term chemotherapy

USPs


  • Large experience with complex multivisceral resection
  • Large cohesive team for efficient management of all clinical scenarios
  • Cutting edge technology & infrastructure
  • Multispecialty & critical care support for high-risk patients
  • Integrated fertility-preserving protocols

Uterine Cervical Cancer

Scope of Services


  • Screening for cervical cancer with LBV & HPV testing
  • Genetic screening for hereditary uterine cancer
  • Laparoscopic, Robotic & open Surgery for early cervical cancer
  • Radiotherapy with brachytherapy
  • Exenterative surgery for radiotherapy failure in advanced disease
  • Neoadjuvant and palliative chemotherapy
  • Fertility preserving protocols for young patients

USPs


  • Prevention to palliation coverage by focussed team
  • Best laboratory, technology and infrastructure support
  • Teamwork by gynecologists, oncologists, pathologists
  • Experienced, certified professionals
  • Advanced programs for fertility preservation and iatrogenic menopause

Ovarian Cancer and Peritoneal Surface Malignancies

Scope of Services


  • Offered for Ovarian, colonic, appendicial cancers with limited or widespread peritoneal spread & For pseudomyxoma peritonei & peritoneal mesothelioma and subtypes of endometrial cancer
  • Diagnosis & staging of peritoneal carcinomatosis & mesothelioma
  • All Peritonectomy procedures (a la Sugarbaker) in primary setting
  • HIPEC & EPIC
  • Complex simultaneous en bloc bowel resections without stoma
  • Salvage resections after chemotherapy &/or recurrence
  • Palliative intraperitoneal chemotherapy

USPs


  • Nearly decade of experience with peritonectomies
  • Proven results with HIPEC after CSS-0 resections
  • Low to nil complications with intraperitoneal chemotherapy till date
  • Oldest patient treated 91 years
  • Excellent multispecialty & critical care support
  • Long experience with use of chemoports

Bone Cancer

Scope of Services


  • All pediatric and adult bone cancers
  • Limb-preserving protocols for limb sarcomas
  • Mega Prosthetic bone & joint reconstructions in bone cancer
  • Hemipelvectomies for pelvic sarcomas
  • Sacral resections
  • Surgery for tumor-like & benign bone tumors
  • Neo-adjuvant and adjuvant chemotherapy
  • External and brachytherapy
  • Surgery for lung metastases
  • MDT of bone metastases including surgical fixation of pathologic fractures of limb and spine

USPs


  • Largest state experience with metastasectomy for sarcomas metastatic to lung
  • Largest experience with limb-preserving internal hemipelvectomies
  • Largest number of single sitting metastasectomy (44 in one surgery)
  • Largest experience with megaprosthetic reconstructions

Soft tissue and Retroperitoneal Sarcomas

Scope of Services


  • Radical & Limb preserving surgery-Limb sarcoma
  • Resection of retroperitoneal sarcomas including multi-visceral and major vascular resections
  • Surgery and combined modality treatment of truncal sarcomas
  • Adjuvant Brachy therapy and Tele-Radiotherapy
  • Neoadjuvant radiotherapy (tumor painting) and Palliative RT
  • Neo-adjuvant, Adjuvant and Pallaitive Chemotherapy and Targeted therapy
  • Expert Histopathology with Molecular/Genetic analysis
  • Reconstructive surgery and Rehabilitation

USPs


  • High Radical resection rates
  • High limb-preservation rates
  • Very low treatment related adverse events
  • Modern laboratory and infrastructure support
  • In-house rehabilitation

Paediatric Solid tumors

Scope of Services


  • All Pediatric solid tumor surgeries: Wilm’s, Neuroblastoma, Hepatoblastoma, Retinoblastoma, Ewing’s, Osteosarcoma
  • All Pediatric Hematologic malignancies and solid tumors chemotherapy
  • Allogenic, Autologous & Stem Cell Transplant
  • IGRT, IMRT, Brachytherapys

USPs


  • Qualified specialists
  • Largest experience in Gujarat
  • Customized infrastructure and essential laboratory support

Hereditary and Familial Cancers

Scope of Services


  • Assessment of risk of hereditary cancer
  • Prevention and Risk-reduction of Hereditary Cancers for at risk families
  • Genetic testing for Hereditary Cancers
  • Molecular and genetic testing for drug selection in treatment of affected individuals
  • Surveillance program and early detection for patients and families

USPs


  • Focussed and dedicated team
  • Comprehensive coverage of services by one team and one one infrastructure
  • Most modern technology:NGS
  • Trained and certified professionals
  • In collaboration with expert from one of the most advanced program in the world

Minimally Invasive Cancer Surgery Division

Scope of Services


  • All regions covered: throat and larynx cancers, thyroid surgery, cancers of intestines, liver, pancreas; cancers of uterus, cervix and early ovarian cancers; VATS lobectomy and VATS metastasectomy; Thoracoscopic esophageal and mediastinal tumor resections; kidney cancers; prostate cancer; endobronchial treatment for airway lesions
  • Robotic, & Laparoscopic approaches
  • Laser Surgery
  • Sentinel node biopsy
  • Mediastinoscopy and EUS directed biopsies, TBNA; Pleuroscopic biopsy and Pleurodesis

USPs


  • Trained, experienced team of surgeons
  • Cutting edge infrastructure:
  • Multidisciplinary management
  • Dedicated, motivated and trained paramedics

Breast & Thoracic Services

Scope of Services


  • 3D Mammography/Tomosynthesis
  • Sentinel node biopsy
  • Oncoplasty (breast conservation)
  • Partial breast radiation (APBI)
  • Stereotactic biopsy
  • Marker placement before chemotherapy
  • Post-mastectomy reconstruction
  • Genetic assessment
  • Screening & Risk reduction

Brig Cancer


  • VATS- lung cancer & metastases
  • IGRT & SBRT, PET-based Radiotherapy
  • Chest wall resection
  • Mediastinal node dissection & Mediastinoscopy
  • CT-guided biopsy


Esophageal Cancer


  • Thoracoscopic and Robotic surgery
  • Extended 2-field lymph node dissection
  • Pre-operative and adjuvant radiotherapy

Others


  • Thymectomy-open/VATS/Robotic
  • Tracheal resection
  • Bronchial artery embolisation