Ahmedabad, Aug 26

EPIC Multispecialty Hospital a leading 280-bed hospital situated in the heart of Ahmedabad, on Wednesday announced a clinical partnership with Chennai-based MGM Healthcare to strengthen its existing heart-transplant programme and advanced heart-failure care.

Dr Anil Jain, Founder Director, EPIC Multispecialty Hospital, said, “EPIC has an established heart-transplant programme, and this partnership will strengthen the specialist expertise available to our patients. Having MGM Healthcare’s transplant specialists at EPIC will add further depth to the clinical management of complex transplant cases. The two institutions will also work together on LVAD implantation, providing an important treatment option for eligible patients with advanced heart failure.”

Dr K. R. Balakrishnan, Chairman – Cardiac Sciences and Director, Institute of Heart & Lung Transplant and Mechanical Circulatory Support, MGM Healthcare, Chennai, said, “Patients with advanced and end-stage heart failure may require different forms of advanced therapy depending on their clinical condition, including heart transplantation or mechanical circulatory support. The clinical decision-making involves careful assessment, optimisation and multidisciplinary management. Through this partnership, our specialists will work with the EPIC team on heart-transplant procedures as well as LVAD implantation for eligible patients. This will bring our experience in advanced heart-failure and transplant care to patients from Gujarat and neighbouring states at EPIC.”

For patients with advanced heart failure, LVAD implantation can provide mechanical circulatory support when conventional treatment is no longer sufficient. In patients who are candidates for transplantation, an LVAD can also serve as a bridge to transplant while their candidacy is being evaluated or while they await a suitable donor heart.

Why This Procedure Matters 

In the past, patients with a badly damaged heart valve who were too old or too frail for open surgery had very few options. Medicines could ease some symptoms, but they could not fix the valve itself. Today, that has changed.

TAVR — which stands for Transcatheter Aortic Valve Replacement, also called TAVI — lets us replace the damaged valve through a small tube inserted in the groin. There is no cutting open of the chest, and the heart does not need to be stopped. Many patients who were once told nothing more could be done are now walking out of the hospital within a few days with a new, working valve.

At EPIC Multispecialty Hospital, Ahmedabad, I am proud to be part of a team that offers this procedure with the same standards applied in the best cardiac centres anywhere in the world. 

What Is Aortic Stenosis? (In Simple Terms)

Think of the aortic valve as a one-way door inside your heart. Every time your heart beats, this door opens to let blood flow out to the rest of your body, then closes so blood doesn’t flow backward.

Over time, this “door” can become coated with calcium, like limescale building up inside a pipe. It gets stiff and the opening becomes narrower. Your heart then has to push much harder to force blood through the small gap — like trying to breathe through a narrow straw. Eventually, the heart gets tired and cannot keep up. This condition is called aortic stenosis. 

Common warning signs include:

• Getting breathless doing things that used to be easy, like climbing stairs
• Tightness or pain in the chest
• Feeling dizzy or light-headed
• Fainting or blacking out

If these symptoms are present, it’s important to get the valve treated — simply waiting and watching is not safe once symptoms appear, because the condition tends to get worse quickly. The encouraging news is that this can now usually be treated without major surgery, through TAVR.

How the TAVR Procedure Works

Step 1: Planning and Scans

Before anything else, we do a detailed CT scan. This gives us a precise 3D map of your heart and the blood vessels leading up to it from the groin. It tells us exactly what size the new valve should be, and confirms there is a safe pathway for the catheter (a thin, flexible tube) to travel through.

Step 2: The Procedure Itself

On the day of the procedure, you will be given sedation to keep you comfortable and relaxed — most patients are not fully put to sleep, though general anaesthesia can be used if needed. A thin tube is gently guided from an artery in the groin up to the heart, using live X-ray images to see exactly where it is going.

The new valve — made of biological tissue mounted on a small metal frame, a bit like a spring — is carried through this tube and placed precisely inside your old, damaged valve. Once released, it opens up and starts working immediately, pushing the old valve tissue out of the way.

Step 3: No Cuts, No Stopped Heart

Unlike open-heart surgery, there is no incision in the chest and the heart never stops beating. The whole procedure usually takes 60 to 90 minutes, and most patients notice they are breathing more easily within a day or two.

Who Should Consider TAVR?

TAVR was first designed for patients who could not safely undergo open surgery — typically older patients, or those with other health issues such as lung disease, kidney disease, a previous heart surgery, or general frailty. As results have been consistently excellent worldwide, TAVR is now also offered to many patients at moderate or even lower surgical risk, depending on individual anatomy.

No single doctor decides on TAVR alone. At EPIC Multispecialty Hospital, Ahmedabad, every patient is discussed by a full “heart team” — the cardiologist, a cardiac surgeon, an imaging specialist, and an anaesthetist — who together review the scans and agree on the safest, most suitable plan for that person. This team-based approach is considered the gold standard around the world.

In simple terms: if a doctor has told you or your family member that a heart valve is severely narrowed, and that open surgery would be risky, it is well worth getting a TAVR assessment before assuming nothing can be done.

Recovery: What to Expect, Day by Day

One of the most reassuring things about TAVR is how quickly patients bounce back — nothing like the long recovery of open-heart surgery. Here is a simple timeline families can expect:

• Day of the procedure: You will be monitored closely in a recovery area. The entry point in the groin is just a small puncture, not a cut, so there is minimal pain.
• Day 1: Most patients are already sitting up and walking. You will move from the monitoring unit to a regular room.
• Before going home: We perform an echocardiogram (an ultrasound of the heart) to confirm the new valve is sitting correctly and working well.
• Day 3 to 5: Most patients are discharged home.
• At home: You will take a blood-thinning medicine such as aspirin — and sometimes a second tablet for a few months — to protect the new valve while it settles in.

The improvement in how patients feel is often immediate and noticeable. Someone who was breathless just walking across a room often finds they can move freely again within days. For many families, watching a parent or loved one regain their independence and energy is an emotional and welcome change.

Common Questions Patients and Families Ask

Is TAVR the same as TAVI, or TAVAR?

Yes. TAVR, TAVI, and TAVAR are simply different short names used for the same procedure. At EPIC Multispecialty Hospital, Ahmedabad, we use them interchangeably. Don’t worry about the name — what matters is whether it’s the right treatment for you.

Will it hurt?

No. You will be given sedation or anaesthesia, so you will be comfortable throughout the procedure. Afterwards, there may be mild soreness at the small puncture site in the groin, which usually settles within a day or two.

How long will the new valve last?

Current evidence shows these valves performing well for more than ten years in most patients, and this data keeps improving as more experience is gathered worldwide. For younger patients, the heart team will discuss how valve life expectancy compares with open surgery, so the right choice can be made together.

What happens if the new valve wears out one day?

It can usually be treated with a second, smaller valve placed inside the first one — called “valve-in-valve” TAVR. This means even a future problem can often be managed without open surgery.

Is it safe for elderly or frail patients?

Yes — in fact, TAVR was developed specifically for elderly and frail patients who cannot safely undergo open surgery. Age alone is not a barrier; every patient is individually assessed.

How much does it cost, and is it covered by insurance?

Cost depends on the type of valve used and the length of hospital stay, and our team will explain this clearly before the procedure. Many insurance policies do cover TAVR when severe aortic stenosis is documented — our patient services team can help you check your specific coverage.

Talk to Us at EPIC Multispecialty Hospital, Ahmedabad

If you or someone in your family has been told that a heart valve is severely narrowed, or that open heart surgery would be risky, it is worth getting a TAVR assessment at EPIC Multispecialty Hospital, Ahmedabad before assuming nothing more can be done. You are welcome to book an appointment, call our team with your questions, or share your echocardiography report for an initial review. A new valve — and a real improvement in day-to-day life — may be more within reach than you think.

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The Injury That Stops Athletes in Their Tracks 

An ACL tear is one of the most common significant sports injuries I see at EPIC Multispecialty Hospital, Ahmedabad — and one of the most feared. Activa Riders, Cricketers, badminton players, football players, gym-goers who land badly from a jump — the mechanism varies, but the moment of injury is almost always distinctive: a sudden pain, a pop, sometimes an audible crack, followed by the knee swelling within hours. 

If you have had this experience, or are worried that someone you know has, this article is for you. I want to explain what an ACL tear actually is, what the treatment options are, and most importantly — because this is the question every athlete asks — what it means for getting back to your sport. 

The honest answer is: with the right surgery and the right rehabilitation, most people get back to the sport they love. It takes time. It takes commitment to the rehab process. But it is achievable, and I see it happen regularly in my practice. 

What the ACL Does and Why Its Injury Matters 

The anterior cruciate ligament runs diagonally through the centre of the knee, connecting the thigh bone to the shin bone. Its primary job is to prevent the shin bone from sliding forward relative to the thigh bone and to control rotational stability of the knee — the stability that allows you to cut, pivot, change direction, and land from a jump without the knee giving way. 

When the ACL tears — fully or partially — this rotational control is lost. The knee feels unstable, particularly with activities that involve cutting movements. Many patients describe a feeling of the knee wanting to give way, or actual episodes of giving way during normal activity like walking downstairs or turning suddenly. 

An MRI scan confirms the diagnosis and shows whether there are any associated injuries — the meniscus is often injured at the same time as the ACL, and the cartilage on the joint surfaces may be involved. These associated injuries affect the treatment planning. 

Non-Operative Treatment: One of the treatment options (we have used it successfully at Epic) is Advanced PRP injection followed by specific supervised Physiotherapy and excellent quality ACL Knee Brace Support with Full immediate mobility. 

Does Every ACL Tear Need Surgery? 

This is genuinely an individual decision, and I want to be honest about the fact that not everyone with an ACL tear needs surgery. An older patient who is not involved in pivoting sports and has no functional instability may do well with physiotherapy-based rehabilitation and activity modification, without reconstruction. 

For younger, active individuals in Ahmedabad who want to return to sports that involve cutting, pivoting, or contact — cricket, badminton, football, basketball, kabaddi — the prevalent opinion is typical: ACL reconstruction significantly reduces the risk of recurrent giving way episodes, associated meniscal and cartilage injury from repeated instability, and long-term knee osteoarthritis compared to non-surgical management in this group. 

The question is not always “should I have surgery?” It is “what do I want to be able to do with this knee?” If the answer is anything that involves rotational load, the answer to surgery can be almost always yes. 

Current Thinking: Previous belief was to wait 4 to 6 weeks after injury before the operation, but current evidence-based  best practise is that surgery (Arthroscopic ) can be done any time immediately after injury too. 

ACL Reconstruction — What the Operation Involves 

ACL reconstruction at EPIC Multispecialty Hospital, Ahmedabad, is performed arthroscopically — through two or three small incisions using a camera and fine instruments, without opening the knee. A graft — typically from the patient’s own hamstring tendons (gracilis and semitendinosus) or occasionally the patellar tendon — is harvested and used to replace the torn ligament, anchored in bone tunnels drilled at the anatomical positions of the original ACL. 

The choice of graft is something I discuss with every patient. Hamstring autograft is my most frequently used option — it is strong, has good long-term outcomes, and the donor site recovers well. Patellar tendon graft is an alternative with excellent results, particularly in high-demand athletes, but involves a more painful donor site recovery. 

The arthroscopic approach means minimal scarring, lower infection risk, and faster recovery of knee motion compared to open surgery. Most patients are weight-bearing with crutches within a day or two of surgery and discharged home the following day. 

Type of graft matters: Hamstring Tendons Graft or Bone-Tendon-Bone grafts are time-tested gold standard. Newer grafts haven’t got long term results yet. Graft-like materials (Open Weave Polyester implant) has already shown good early results and might be used in selected patients although it is more expensive. 

Augmenting ACL graft: In patients with high end Sports demand or those with very loose joints; additional procedure to strengthen the knee by tissue graft /transfer from around the knee (Lateral Extraarticular Tenodesis) are proven to be beneficial. It increases the surgical time and is more expensive, but saves the knee better from further damage!!! 

Rehabilitation — The Part That Determines the Outcome 

I tell every ACL patient I operate on at EPIC Multispecialty Hospital, Ahmedabad, the same thing: the surgery is the easy part. The rehabilitation is where the outcome is determined. 

ACL reconstruction involves transplanting a graft that has to undergo a biological process called ligamentisation — the graft, initially strong, goes through a period of relative weakness as it remodels into a ligament-like structure, becoming strong again over six to nine months. This process is why the return-to-sport timeline for ACL reconstruction is nine to twelve months — not because of the surgery, but because of the biology of graft maturation. 

Returning to pivoting sports before the graft has matured, and before specific strength and movement quality criteria have been met, significantly increases the risk of re-injury. I work with physiotherapists who understand these criteria and apply objective testing — single-leg hop tests, quadriceps strength ratios, movement quality assessment — before clearing any patient for return to sport. 

My patients who commit to this process — who do their exercises consistently, who are patient with the timeline, who return to sport only when they are genuinely ready — get back to their sport at close to the level they were before. That is the outcome I want for every athlete who comes to see me. 

Common Questions Patients Ask 

How soon after an ACL injury should I have surgery? 

There is no advantage to operating immediately after an ACL injury — the swelling and inflammation in the acute phase make surgery technically more difficult and recovery harder. I generally recommend a period of four to six weeks before surgery, using physiotherapy to reduce swelling, restore knee motion, and build quadriceps strength. This pre-operative physiotherapy improves post-operative outcomes. 

Can an ACL tear heal without surgery? 

The ACL has very limited healing capacity due to poor blood supply. While some partial tears may produce functional stability, complete tears do not heal reliably without reconstruction. Conservative management without surgery can work for selected patients who are not involved in pivoting sports and have no functional instability — but this needs to be assessed individually. 

Will I need a brace after ACL surgery? 

I use a rehabilitation-based approach rather than relying heavily on bracing after ACL reconstruction. Early controlled movement is better for the graft and for muscle recovery than prolonged immobilisation in a brace. A hinged knee brace may be used for comfort in the first few weeks, but the emphasis is on progressive physiotherapy from day one. 

Can the ACL be injured again after reconstruction? 

Re-injury of the reconstructed ACL is possible — the risk is approximately five to fifteen percent, depending on the patient’s age, activity level, and return-to-sport readiness. This is why the return-to-sport criteria and timeline matter so much. Athletes who return to sport before meeting functional criteria have significantly higher re-injury rates. 

Is ACL surgery available at EPIC Hospital Ahmedabad? 

Yes. EPIC Multispecialty Hospital, Ahmedabad, performs arthroscopic ACL reconstruction with hamstring or patellar tendon autograft, with in-house physiotherapy for ACL rehabilitation and objective return-to-sport assessment.

The Revolution That Changed General Surgery 

When I completed my advanced surgical training—both in India and in Australia where I obtained my Fellowship of the Royal Australasian College of Surgeons (FRACS)—laparoscopic surgery was completely transforming what patients experienced after operations. 

The shift from a ten-centimetre cut to tiny puncture marks is not just cosmetic. It is a massive clinical leap forward. Minimally invasive techniques reduce pain, lower infection risks, shorten hospital stays, and let people return to their normal work and family routines in days rather than weeks. 

At EPIC Multispecialty Hospital, Ahmedabad, we perform advanced laparoscopy guided strictly by high-quality medical evidence. However, because these keyhole techniques are highly detailed, the specialized skill, volume, and training of the surgeon matter just as much as the modern equipment used. 

 

 How Laparoscopic Surgery Works 

Laparoscopic surgery is performed through tiny cuts in the skin, typically measuring between 4 to 12 millimetres wide. 

1. Anesthesia & Airflow: The operation takes place under general anesthesia so you are completely asleep. The abdomen is gently inflated with carbon dioxide gas to lift the belly wall, creating a clear space for the surgeon to work safely. 

1. High-Definition Views: A thin tube containing a specialized camera (the laparoscope) is placed through one incision. This beams a highly magnified, 4K high-definition live view of your organs onto a monitor. It reveals microscopic details that are difficult to see with the naked eye during standard open surgery. 

1. Micro-Instruments: Long, slender surgical tools are inserted through the remaining small incisions to perform the structural repairs. 

1. Clean Closure: Once the work is done, the gas is safely released, the instruments are removed, and the tiny skin openings are closed with just one or two stitches or medical glue. 

 

 Evidence-Based Insights for Complex Procedures 

While standard keyhole surgery is widely used for routine gallbladder removals and basic appendicitis, we specialize in high-complexity, advanced laparoscopy across three major anatomical areas. Here is what the latest clinical trials and international surgical data show: 

1. Advanced Surgery for Large Hiatus Hernias & Reflux

A hiatus hernia occurs when the upper stomach slides upward through a widened gap in the diaphragm muscle (the crural pillars) and into the chest cavity. This causes severe chronic acid reflux. 

• The Advanced Technique: The surgeon performs crural repair, tightly stitching the diaphragm muscle back to its natural boundaries. Next, laparoscopic fundoplication is performed. This involves wrapping the upper curve of the stomach 360 degrees around the lower esophagus to create a brand-new, functional valve. This requires advanced intracorporeal suturing skills (stitching precisely inside the body using keyhole tools) to prevent injury to the esophagus. 
• What the Clinical Data Shows: Massive patient database reviews published via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines prove that laparoscopic hiatal repair has a clear edge over open thoracic (chest) or open abdominal surgery. Data points to far fewer post-operative breathing complications and wound breakdowns because the chest wall is left completely untouched. Successful keyhole repairs allow patients to entirely stop taking long-term acid suppression medications. 

2. Laparoscopic Surgery for Colon Cancer (Oncological Safety)

Historically, there were concerns that minimally invasive surgery could leave cancer cells behind or cause tumors to seed into small skin cuts. Major, long-term international trials have completely put those fears to rest. 

• The Advanced Technique: We perform a radical resection to isolate and remove the cancerous segment of the colon with wide, safe margins. Simultaneously, a complete lymphadenectomy is done to harvest the surrounding lymph node basins for precise staging. The remaining healthy segments of the intestine are then securely reconnected (primary anastomosis) using specialized micro-vascular stapling. 
• What the Clinical Data Shows: The landmark Clinical Outcomes of Surgical Therapy (COST) study group trial tracked colon cancer patients over a 5-year period. The peer-reviewed medical data compiled by the Cochrane Database of Systematic Reviews confirms that keyhole surgery is completely equivalent in cancer safety to open surgery, while speeding up systemic healing: 

3. Laparoscopic Management of Benign Colorectal Conditions

Non-cancerous, structural diseases of the lower digestive tract often require intricate bowel reshaping. 

• Complicated Diverticular Disease: Recurrent, severe inflammation can form deep scar tissue, narrow pockets, or dangerous blockages in the colon wall. Advanced laparoscopy cleanly isolates and removes these highly inflamed, scarred segments. 

• Inflammatory Bowel Disease (IBD): Severe Crohn’s disease or Ulcerative Colitis can cause deep tissue destruction. Minimally invasive resections cut away diseased bowel loops while purposefully minimizing future internal scarring. 

• Rectal Prolapse: A structural failure where the lower rectum slips out of its normal pelvic boundaries. We perform a laparoscopic rectopexy, which gently lifts the dropped organ and secures it back onto the sacral bone framework using specialized mesh or micro-sutures. 

• What the Clinical Data Shows: Studies published through NCBI PubMed Central show that keyhole methods directly preserve long-term pelvic function. The highly magnified, 4K camera view lets the surgeon clearly see and protect the pelvic autonomic nerves, which directly control bladder and sexual health. Additionally, minimizing internal handling reduces the duration of post-operative ileus (temporary bowel sleep), letting patients eat solid foods much sooner. It also drastically lowers the lifetime risk of developing emergency bowel obstructions caused by internal scar bands (adhesions). 

 

 The Safety Question: Training & Surgical Volume 

A very common question patients ask me in Ahmedabad is whether laparoscopic surgery is truly as safe as open surgery. The answer is yes—and in many situations safer—but only when performed by a surgeon with appropriate training and high surgical volume. 

Laparoscopic surgery is technically demanding. Operating while looking at a two-dimensional screen, using instruments that work through a fulcrum pivot effect, and dealing with reduced touch feedback requires thousands of hours of practice to master hand-eye coordination. A surgeon performing only five laparoscopic procedures a year is in a very different position from an expert performing over one hundred. 

I believe in complete transparency with my patients. If your unique anatomy, severe scarring, or emergency condition makes open surgery a safer option, I will tell you directly. Shifting from a laparoscopic approach to an open surgery mid-operation is not a complication. It represents mature, correct surgical judgment made entirely to protect the patient’s life. 

 

 Recovery: What to Expect After Keyhole Surgery 

Recovery from keyhole surgery consistently surprises our patients. 

• Hospital Timelines: Most routine gallbladder removals and hernia repairs allow you to return home the same day or the following morning. Major colorectal cancer operations require a brief stay of just 4 to 5 days, compared to the 7 to 10 days expected with traditional open wounds. 

• Pain Management: Patients generally describe mild discomfort that is easily controlled with simple oral pain relievers. Some experience temporary shoulder tip pain, which is caused by residual carbon dioxide gas tickling the diaphragm nerve; this fades completely within 24 to 48 hours. 

• Returning to Daily Life: Desk work can usually be resumed within 3 to 5 days. Heavy physical labor, strenuous exercise, or active sports should be avoided for 3 to 4 weeks. Because there is no large muscle wound to heal, your deep internal healing dictates your timeline—not your skin. 

• Early Movement: I actively encourage patients to start gentle walking on the very day of surgery. The human body mends much faster when it is kept gently active. 

 

 Direct Patient Safety Notice 

Verification Checklist for Your Recovery
Always double-check your physical hospital discharge label, your customized take-home prescription sheets, and the specific post-operative care sheets provided by our medical team. Confirming your specific medication dosages, physical activity boundaries, and dietary staging timelines is vital for a safe, complication-free recovery. 

 

 Frequently Asked Questions 

• Is laparoscopic surgery available for complicated cases?

  Yes. It can be performed safely for many complex situations, including patients with obesity, advanced cancers, emergency trauma, or multiple past abdominal surgeries. However, if an open approach is safer for your specific condition, we will always discuss it honestly. 

• Can gallstones come back after laparoscopic gallbladder removal?

  No. Once the gallbladder is surgically removed, gallstones cannot form there because the organ is entirely gone. Very rarely, a stone can form independently inside the main bile duct (a condition called choledocholithiasis), but this is a separate medical issue and is unrelated to your original surgery. 

• What type of anesthesia is used?

  Almost all laparoscopic procedures are performed under general anesthesia. The operation typically takes between 60 to 150 minutes depending on the complexity, and you will wake up comfortably in the recovery room shortly after it is complete. 

• Is laparoscopic hernia repair better than open repair?

  For bilateral inguinal hernias (hernias on both sides of the groin), laparoscopy has massive advantages because both sides can be fully repaired through the exact same three tiny incisions, resulting in much less pain. For a single-sided hernia, both keyhole and open techniques have excellent outcomes, and the choice depends on your specific health factors. 

• What is the cost of surgery at EPIC Multispecialty Hospital, Ahmedabad?

  Costs vary depending on the complexity of the procedure. Routine gallbladder and hernia repairs are the most affordable, while advanced colorectal or redo anti-reflux surgeries require highly specialized instruments and are priced accordingly. Standard health insurance policies completely cover laparoscopic procedures when they are clinically required. Our patient billing desk provides a fully itemized, transparent cost breakdown before you admit.