Best Doctors in India for J-Pouch Surgery

Profile Highlights:

  • Dr. Yogesh Batra is one of the best medical gastroenterologists in New Delhi, India.
  • Dr. Batra specializes in therapeutic endoscopy (EUS, ERCP), hepatology, pancreatic disease, and inflammatory bowel disease (IBD). He has successfully performed a variety of diagnostic and therapeutic GI procedures on hundreds of patients throughout his career.

Profile Highlights:

  • Dr. Pawan Rawal continued to work in PGIMER, Chandigarh after completing his DM for the next few years and gained proficiency in clinical Gastroenterology, Hepatology, and its application to patient care.
  • He has performed several adults and pediatric upper G I endoscopies/ colonoscopies, ERCPs, capsule endoscopies, and push and double-balloon enteroscopy. Dr. Pawan Rawal is quite experienced in performing all kinds of therapeutic procedures.

Profile Highlights:

  • Dr. Subhash Gupta is one of the finest Gastrointestinal and Liver Transplant Surgeons in the country. He has garnered an outstanding reputation in the field of Biliary, pancreas, and liver transplantation.
  • He has conducted over 300 Living Donor Liver Transplants in the year 2013 each lasting 10-16 hours long.
  • Dr. Subhash Gupta is also known to pioneer the development of Living Donor Transplant or LDLT.

Profile Highlights:

  • Dr. Avnish Kumar Seth is a well-renowned name in the field of gastroenterology. With fellowships in Liver transplant (Birmingham, UK) and Endoscopic ultrasound (South Carolina Alabama, USA), Dr. Avnish Seth’s areas of interest include treatment of hepatitis B, Hepatitis C, liver transplantation, and advanced GI endoscopic procedures.
  • Dr. Avnish Kumar Seth has over two decades of experience in Gastroenterology Hepatobiliary Sciences. An expert in Diagnostic Therapeutic GI Endoscopy, Colonoscopy, ERCP, and Liver Transplantation.

Profile Highlights:

  • Dr. Deepak Govil is one of the best Surgical Gastroenterologists in India, having over 29 years of experience in GI procedures. He has worked as a senior Gastro and laparoscopic surgeon at Indraprastha Apollo Hospitals.
  • Dr. Govil, the founder of PSRI’s Department of GI Surgery, has done a lot of significant GI surgical interventions.
  • He is well-known for having done liver transplants upon living donors. At Apollo Hospital, he has performed over 2000 surgeries that include the liver, gastrointestinal tract, and laparoscopic procedures.
  • In addition to his fieldwork, Dr. Govil has taught at prestigious medical institutes in Delhi.

Profile Highlights:

  • Dr. D K Bhargava is a Medical Gastroenterologist working at Indraprastha Apollo Hospitals, New Delhi.
  • He has 45 years of experience in his field.
  • Dr. Bhargava was a Professor of Gastroenterology at the All India Institute of Medical Sciences, New Delhi formerly.
  • Some of the services he provides are Colonoscopy, Gastroenteritis Treatment, Acidity Treatment, and Irritable Bowel Syndrome Treatment.
  • Exceptionally qualified Dr. D K Bhargava has received the Padma Shri Award and Dr. B C Roy National Award from the President of India.
  • He has published more than 150 articles, papers, and journals throughout his career.
  • He is a member of the American Gastroenterological Association, Indian Society of Gastroenterology and American College of Gastroenterology.

Profile Highlights:

  • Dr. Anupam Sibal is one of the best Pediatric Gastroenterologists in Delhi, having nearly 26 years of experience in treating GI and liver disorders.
  • He is a senior consultant for Pediatric Gastroenterology and Hepatology at Indraprastha Apollo Hospital, Delhi. Additionally, he is working as Group Medical Director of Apollo Hospitals.
  • He has expertise in Congenital Disorders Evaluation & Treatment, Growth & Development Management, injuries in children, and complete Paediatric health checkups.
  • Dr. Sibal went for International certifications and training to improvise.
  • Dr. Sibal won many National and International Awards for his excellent work.
  • Besides authoring 99 medical writing Dr. Sibal has written a bestselling book, “Is Your Child Ready to Face the World?” and edited/proofread a textbook on Gastroenterology & Hepatology.

Profile Highlights:

  • Dr. Giriraj Singh Bora is a liver transplant surgeon, who is known for being the founder member of the Liver Transplant Society of India.
  • He is the first doctor to transplant a liver in Rajasthan. He is also known for carrying out the first deceased donor and the first living donor liver transplants in Rajasthan and has also been instrumental in starting a liver transplant program in the region.

Profile Highlights:

  • Dr. Gourdas Choudhuri is a gastroenterologist, medical educator, researcher of national eminence, as well as a columnist and philanthropist.
  • He completed his training at the All India Institute of Medical Sciences in New Delhi and was the first specialist to start Endoscopic Ultrasound (EUS) and Extra Corporeal Shockwave Biliary Lithotripsy (ESWL) in India.
  • It was under Dr. Gourdas Choudhuri’s expert leadership and supervision the prestigious department of Gastroenterology at Sanjay Gandhi PostgraduateInstitute of Medical Sciences, Lucknow, developed into one of the top five in the country.

Best Hospitals in India for J-Pouch Surgery

Indraprastha Apollo Hospital, New Delhi

Hospital Highlights:

  • Indraprastha Apollo Hospital is a 700-bedded multispecialty hospital in the heart of the capital of India. It is a part of Apollo Hospital group, one of India’s most reputed healthcare chains. Indraprastha Apollo Hospital has been accredited by Joint Commission International, making it the first internationally accredited hospital in the country in 2005.
  • There are 52 specialties in the hospital with one of the best cardiology centers in the country. The hospital is also equipped with State of the art infrastructure facilities with the largest Sleep Lab in Asia and the largest number of ICU bed facilities in India.
  • The hospital also has one of the largest dialysis units in India along with a dedicated Bone Marrow Transplant unit.
  • The latest and highly advanced technologies that are installed in the hospital include Da Vinci Robotic Surgery System, PET-MR, PET-CT, Cobalt-based HDR Brachytherapy, Brain Lab Navigation System, Tilting MRI, Portable CT scanner, 3 Tesla MRI, 128 Slice CT scanner, DSA Lab, Endosonography, Hyperbaric Chamber and Fibro scan.

Fortis Memorial Research Institute, Gurugram

Hospital Highlights:

  • Fortis Memorial Research Institute is a multi-super-specialty, quaternary care hospital with 1000 beds. The hospital comprises reputed clinicians, and international faculty and is also equipped with cutting-edge technology. The hospital is a part of Fortis Healthcare Limited, a reputed chain of private hospitals in India.
  • It is a NABH-accredited hospital that is spread across 11 acres of land and has a capacity of 1000 beds. The hospital has 55 specialties and is one of the premier health care centers in the Asia Pacific region popularly known as “the Mecca of Healthcare”.
  • The hospital has 260 diagnostic centers and is also equipped with the latest and advanced techniques that include 3 Telsa which is the world’s first Digital MRI technology. The hospital also has world-class Radiation Therapy techniques which have been developed by leading technology experts from Elekta and Brain Lab.

Apollo Hospital, Chennai

Hospital Highlights:

  • Apollo Hospitals, Chennai, is one of the best hospitals for heart care in India. Over the years, Apollo has expanded all over India, as a healthcare chain.
  • India’s first ‘Only Pancreas’ transplant was performed in Apollo Hospital. The hospital is known for successfully performing Asia’s first en-bloc combined heart and liver transplant, and over the years, it has attained a remarkable achievement in the global healthcare space. Around 3-4 organ transplants are performed in the hospital per day.
  • Equipped with over 500 beds, this hospital in Chennai was established in 1983 and since then has been among the most preferred hospital for patients from all over the world.
  • The hospital holds accreditation of the NABH and JCI and is the first hospital in India to be ISO 9001 and ISO 14001 certified. It is also the first South Indian Hospital to receive subsequent reaccreditation from the JCI USA 4 times.

Medanta-The Medicity, Gurgaon

Hospital Highlights:

  • One of India’s best and largest multi-specialty hospitals, Medanta was built with the aim to bring India to the highest standards of medical care. The hospital has been providing the best medical services to its patients, since its inception, with care, commitment, and compassion.
  • Equipped with 1250 beds, the hospital was founded by Dr. Naresh Trehan in the year 2009 with an aim to provide the best medical care at affordable costs. The hospital is spread across 43 acres and includes 45 operation theatres and 350 beds dedicated solely to ICU. The hospital includes over 800 doctors, and more than 22 specialty departments and has a dedicated floor for individual specialty in order to offer the best services under one roof.
  • The hospital is considered one of the premier institutes in India for Cardiac Care and includes staffs and members of high caliber. The hospital has 6 distinct centers of excellence.

Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • One of the well-regarded providers in India committed to the highest standards of clinical excellence and patient care, Max Super Specialty Hospital is a part of Max Healthcare, which is the second-largest healthcare chain in India. Regarded as one of the most well-regarded healthcare providers in the country, Max Super Specialty Hospital is committed to the highest standards of clinical excellence as well as patient care. The hospital is also equipped with the latest technology as well as cutting-edge research. The hospital is known to deliver and ensure the highest level of patient care.
  • The hospital has more than 500 beds and offers treatment for over 35 specialties. The hospital also holds the credit of having installed the first Brain Suite in Asia. This is a highly advanced Neurosurgical machine that allows MRI to be taken while surgery is ongoing.
  • Other advanced and latest technologies are also installed in the hospital such as the 1.5 Tesla MRI machine, 64 Slice CT Angiography, 4D ECHO, LINAC, and 3.5T MRI machine.

Artemis Hospital, Gurugram

Hospital Highlights:

  • One of the most well-known hospitals in the Delhi NCR, Artemis Hospital is the first hospital in Gurugram to get accredited by the Joint Commission International.
  • With more than 40 specialties, the hospital has been designed to be one of the most technically advanced hospitals in the country, with the best medical and surgical health care. The hospital has eleven special and dedicated centers, for Heart, Cancer, Neurosciences, etc.
  • The latest technologies in the hospital include Endovascular Hybrid Operating Suite and Flat panel Cath Labs for the cardiovascular department, 3 Tesla MRI, 16 slice PET CT, 64 Slice Cardiac CT Scan, HDR Brachytherapy, and highly advanced Image Guided Radiation Therapy techniques (LINAC) are installed in the hospital.
  • The hospital has won several awards as well, since its inception.

BLK Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • Equipped with 650 beds, BLK Superspecialty Hospital is the largest stand-alone private sector hospital in Delhi.
  • With over 1500 healthcare providers and 150 globally renowned super specialists, the hospital is one of Asia’s largest Bone Marrow Transplant Centres. The hospital is known for having some of the best cancer doctors in the country.
  • The hospital is NABH and NABL accredited and was inaugurated by the first Prime Minister of India. Pt. Jawahar Lal Nehru.

Gleneagles Global Hospitals, Chennai

Hospital Highlights:

  • Established in 1999, Gleneagles Global Hospital, Chennai, is one of the top healthcare facilities in Southern India. It is part of the Gleneagles Hospital Chain, which is the fourth largest healthcare chain in the country. The hospital specializes in multi-organ transplants of kidneys, liver, lungs, heart, etc.
  • The hospital has an excellent infrastructure and state-of-the-art lab and equipment set-up. The hospital boasts cutting-edge technologies, a highly skilled team of doctors and surgeons, and trained support staff. Located in Perumbakam, Chennai, it is one of India’s premier health care destinations. The hospital has performed some of the most complex surgical and clinical procedures in India including multi-organ transplantations.
  • The hospital’s lung transplantation program is one of the best in the country. The hospital is known for having performed India’s first single lung transplant and first minimal invasive lung transplant. It is also the only Indian hospital to be associated with King’s College Hospital, London, United Kingdom for liver transplantations.

Fortis Hospital, Mulund, Mumbai

Hospital Highlights:

  • Fortis Hospital in Mulund is a 315-bed multi-speciality tertiary care hospital with five JCI accreditations that offers a wide variety of diagnostic and therapeutic services. The Fortis Hospital in Mulund delivers patient-centred treatment with cutting-edge technology, highly skilled and experienced surgeons, and paramedical staff.
  • This institution houses Maharashtra’s largest multi-organ transplant centre. It is also the first heart transplant centre in western India to conduct 100 or more consecutive heart transplants in under four years. It is the only hospital in the city to have multi-organ transplants and has handled the youngest patient for angioplasty. Fortis Hospital Mulund now boasts the first advanced surgical robot in central Mumbai.
  • Cardiology and heart surgery, urology, nephrology, neurosciences, orthopaedics, digestive care, emergency and critical care, and maternity care are among the services provided by the hospital.

Kokilaben Dhirubhai Ambani Hospital, Mumbai

Hospital Highlights:

  • Kokilaben Dhirubhai Ambani Hospital, Named after the wife of Indian industrialist Dhirubhai Ambani, the founder of Reliance Industries, this is one of the top hospitals in Mumbai. This 750-bed multi-specialty hospital became operational in 2009. Known as one of India’s most advanced tertiary care facilities, the hospital is designed to raise India’s global standing as a healthcare hub, with an emphasis on excellence in clinical services.
  • Kokilaben Dhirubhai Ambani Hospital uses Protocol and Care Pathway based treatment models to ensure the best outcomes for patients.
  • The hospital represents a confluence of top-notch talent, cutting-edge technology, state-of-the-art infrastructure, and, most importantly commitment.
  • The hospital also holds the accreditation of the NABH, NABL, CAP, and JCI.
  • The hospital has been recognized as the No. 1 Multispecialty Hospital in Mumbai and the West Zone for the fifth year in a row in 2020 by The Week.

J-Pouch Surgery

Ileonala anastomosis surgery, which is commonly termed as a J-pouch surgery allows you to eliminate waste material normally after your entire large intestine is removed. The procedure involves constructing a J-pouch after your surgeon removes your colon and rectum.

This procedure avoids the need for a permanent opening in the abdomen i.e. stoma for passing any bowel movements.

Purpose

J-Pouch surgery is generally used for treating chronic ulcerative colitis and inherited conditions, like familial adenomatous polyposis, which carries a high risk of colon and rectal cancer.

In some instances, the procedure might be done when medications for treating ulcerative colitis are not successful in controlling the condition. It might also be done if precancerous changes or colon cancer is detected. The surgery is also used for treating colon cancer and rectal cancer.

Preparation

Before the procedure, you should talk with your doctor if you use alcohol, tobacco any other drugs, as these can affect your healing and recovery.

Your healthcare team will examine you before your surgery to mark the ileostomy site. Several factors can affect ileostomy site selection, which includes your natural skin folds, scars, navel, muscles in your abdomen, waistline, hip bone and visibility of the site when you are sitting. It is important to select the location properly so that you can care for the ileostomy after your surgery.

Procedure

During the procedure

J-pouch surgery is generally performed using minimally invasive (laparoscopic) methods. Instead of opening your abdomen with a relatively large incision (open surgery), surgeons usually prefer to create more than one smaller abdominal incision through which surgical instruments can be inserted. Next, your surgeon will also be inserting a laparoscope, which is a long, narrow tube with a camera at the tip.

During the surgery, first, the surgeon will remove your entire colon and rectum, preserving the muscles, sphincter and opening the anus at the end of your rectum.

Then he/she will construct a pouch-shaped like the letter J from the end of the small intestine. It will be attached to the opening at the end of the rectum. Next, for the elimination of waste, a temporary opening will be constructed in the abdominal wall, which is known as an ileostomy.

After around three months of healing, another procedure will be performed by your surgeon for closing the ileostomy, which will allow you to pass stool normally.

After the procedure

You will need to spend a little time in the hospital recovering as well as learning how to care for your ileostomy. You will likely receive pain medication or antibiotics as well.

Your doctor may recommend you to drink lots of fluids, which can be water or electrolyte replacement drinks, for avoiding dehydration as well as the loss of electrolytes. For around six to eight weeks, you will have to avoid certain kinds of foods, which can include raw fruits and vegetables, nuts, popcorn or any such food high in roughage. These kinds of foods can cause irritation in the anal area. If your stool is watery, then it is recommended that you eat certain kinds of foods such as rice, bananas or peanut butter.

For around four to six weeks after the surgery, try to avoid lifting or any kind of strenuous activity.

Results

For the majority of people, children and adults alike, they can see an improvement in their quality of life, after the surgery. However, people who are over 45 years of age might experience more incontinence and may need to go to the bathroom more frequently at night. On average, most of the people who undergo this procedure generally have around six bowel movements a day and one at night. It is estimated that around 90 percent of people who undergo this surgery, can be satisfied with the results.

Though this surgery can’t affect a woman’s ability to have a regular pregnancy and delivery, it might sometimes affect fertility.

Risks and complications

Though J-Pouch surgery is generally successful in treating your ulcerative colitis, sometimes there might be few complications that can require follow-up treatment. If you experience any of these conditions, inform your doctor immediately-

Pouchitis: Inflammation of the pouch can be considered the most common complication of j-pouch surgery and it is known to occur in around 50 percent of patients. It should occur within the first two years and is treatable with antibiotics. Diarrhea, fever, crampy abdominal pain, increased stool frequency, joint pain, and dehydration are the symptoms of this complication.

Small Bowel Obstruction: This is less common, but it can develop due to adhesions, which are fibrous bands that can occur between tissue and organs after your surgery. Around two-thirds of people who develop a small bowel obstruction should be able to be treated with bowel rest, such as not taking food for a few days. However, others might require surgery for removing the blockage. Symptoms of this complication include crampy abdominal pain, inability to pass stool, vomiting, and nausea.

There are few other possible conditions that might also develop post-surgery, which include pelvic abscesses and pouch fistulas.

Pouch failure, which generally occurs only in a tiny percentage of patients, requires surgery for removing the pouch and to create a permanent ileostomy.

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