Palakkad Ahalia Hospital Scripts History with India’s First STEP/MaSTEP Intestinal Lengthening Surgery in an Infant

KOCHI:
In an extraordinary tale of resilience and medical triumph, a newborn baby girl named Amana has successfully undergone a rare bowel elongation surgery at Ahalia Hospital in Palakkad, marking the first time such a complex procedure has been performed on a neonate in India.

The historic achievement was announced by the Ahalia Hospital authorities during a press conference held here. The ordeal began immediately after birth when Baby Amana exhibited persistent green-colored vomiting, prompting her immediate transfer to the Neonatal Intensive Care Unit (NICU) at Ahalia Hospital.

Upon a detailed evaluation, Dr. Muthulingam, Neonatologists and head of the department, diagnosed the infant with an exceedingly rare and severe congenital intestinal anomaly. The examination revealed that the baby possessed only five to six tiny segments of the small intestine. Surgeons immediately performed a reconstructive surgery, making every possible effort to preserve the maximum available portions of the tract.

However, even after this reconstruction, the total length of her intestine stood at a mere 15 centimeters. In comparison, a healthy newborn typically has an intestinal length ranging between 150 to 180 centimeters. Within the first month of her life, the infant’s deteriorating condition necessitated two additional emergency surgeries.

Following these initial interventions, a dedicated pediatric medical team led by Dr. Padmesh Vadakkepatt and Dr. Ratna Pradeep took charge of her advanced care. The baby’s condition repeatedly turned life-threatening, as even minimal oral intake of milk induced severe vomiting and diarrhea. Multiple dietary strategies were attempted but yielded no success, leaving the infant entirely dependent on Total Parenteral Nutrition (TPN) delivered via a central venous catheter. Throughout these 11months, specially formulated TPN solutions were prepared under strict aseptic conditions in a laminar airflow chamber by the dedicated NICU nursing team. Doctors noted that throughout this grueling journey, the infant displayed a miraculous fighting spirit.

Recognizing the limitations of available treatments within the country, the hospital management consulted top pediatric surgery centers across India before looking globally. They eventually enlisted the expertise of Dr. Basem A. Khalil, a world-renowned British surgical expert practicing in Dubai, and Dr. Salim Mammu, a distinguished pediatric surgeon based in Qatar. Since both are foreign citizens, special National Medical Commission clearances were obtained to allow them to supervise and execute the procedure in India.

When the baby turned 11 months old, a grueling six-hour-long STEP (Serial Transverse Enteroplasty) and MaSTEP surgical procedure was performed at the Ahalia Women and Children’s Hospital. The landmark surgery was jointly executed by Dr. Basem A. Khalil, Dr. Salim Mammu, and Dr. Muthulingam. The immense financial burden of the prolonged treatment and surgery was successfully met through a crowdfunding campaign.

Speaking at the press conference, Head of Neonatology Dr. Padmesh Vadakkepatt confirmed that the baby’s health condition is now perfectly stable. “The child is now able to comfortably consume 120 to 150 ml of milk every three hours without any complications, and we have successfully initiated solid foods as well,” he said. He further emphasized that successfully implementing the advanced STEP and MaSTEP techniques including the duodenum in a newborn is a monumental milestone in Indian medical history. The press briefing was attended by Dr. Suresh Babu, Chief Medical Director of Ahalia Hospital; Dr. Padmesh Vadakkepatt, Head of the Neonatal Department; Dr. Salim Mammu, Pediatric Surgeon from Qatar; and Preetha, the Hospital Administrator.