malaysia day exclusive
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The HEALTH | OCTOBER, 2018
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(From left) Photos 1 - 3:
Dr Nada Sudhakaran
training paediatric
surgeons on laparoscopic
surgery at Sultanah
Bahiyah Hospital, Alor
Setar Kedah.
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Paediatric
laparoscopic
surgery
by NURUL AIN
HUDA ABDULLAH
ainhuda@revonmedia.com
Dr Nada Sudhakaran aims to make keyhole surgery
accessible for all children in public hospitals
AEDIATRIC laparoscopic
surgery is not new. The mini-
mally invasive procedure
of treating children with
surgical conditions began in
the 70’s and started evolving in
the late 1990’s, yet the benefits and the
vast potential of this approach is yet to
be explored by parents as well as the
paediatric surgeons here in Malaysia.
Pantai Hospital Kuala Lumpur
Paediatric and Neonatal surgeon, Dr
Nada Sudhakaran is one among the five
surgeons in Malaysia who specialises
in reconstructive paediatric surgery
with emphasis on minimally invasive
(keyhole surgery) on infants and children.
“The procedure allows the surgeon to
access the inside of the abdomen without
having to make large incisions in the skin
where three or more small cuts approxi-
mately of three millimetres are made to
allow the laparoscopic instrument to be
inserted into the abdomen of the child.
The operation is done on sight and the
instruments removed.”
“This is an advantage compared to
an open surgery where it involves a cut
from two to eight centimetres, enough
for the surgeon’s hand to go inside and
manipulate the organ or to manoeuvre
the structure out of the body. So the cut
has to be big enough.”
“The minimally invasive procedure is
also less painful and less traumatic for
both parents and the child, in addition to
the faster recovery period.”
“I’ve taken the lobes and lungs out in
babies and watch them recover in two
days. In an open surgery, it would take
anywhere between five to seven days to
go home.”
“My analogy for this is, why would
any parent want their child to go through
more pain, suffering and scarring if they
chose traditional open surgery over
keyhole or minimally invasive surgery.”
“No parents would want any harm to
their child. Surgery is harm - so, when the
condition is significant enough to war-
rant surgery, we do the procedure with
least harm. That is what keyhole surgery
is about.”
“Why would parents want to do
something to their child that involves
lots of collateral damage - going through
the muscles, tummy and so on before
the surgeon is able to get into the organ
when you could actually minimise the
damage?”
P
Early education
“My analogy for this
is, why would any
parent want their
child to go through
more pain, suffering
and scarring if they
chose traditional
open surgery
over keyhole or
minimally invasive
surgery.”
– Dr Nada Sudhakaran
“When I was under six years old, I was
more of a hands-on person who liked to
meddle and create things. I was living
with my family at that time and we moved
away to Singapore when I was eight years
old.”
Noticing that Nada took to helping his
mother with her medications whenever
she was ill, she encouraged him to go
further, although he never taught of
medicine as a vocation at that time.
Making progress in science – espe-
cially in biology and chemistry at Monks
Hill Secondary School, Singapore at the
age of 16, he then proceeded to United
Kingdom (UK) to do A Level, prior to
enrolling as an MBBS student at the
University of Wales, Cardiff where he
later graduated in 1995.
“During that time, I found working
with children quite entertaining. It gave
me a sense of satisfaction doing some-
thing for them. Hence, I went towards the
path of being a children’s doctor but along
the way, I found surgery.”
From there, he continued with
surgical training at The Royal College
of Surgeons, Glasgow where he passed
the intercollegiate exams in paediatric
surgery and got specialist recognition by
the general medical council in UK. He
also received the FRACS in paediatric
surgery from the Australian College of
Surgeons in 2017.
“As soon as I started with paediatric
surgical training, I found that keyhole
surgery was far superior in terms of
the recovery in children. There were
fantastic outcomes with minimal injury,
stress and pain. We could see a complete
difference in how they recovered – the
keyhole surgery versus open surgery.”
“At that time, keyhole surgery was
still evolving in the late 90’s in the UK.
It wasn’t well known but people were
slowly starting to recognise it. However,
older surgeons did not want to take it up
because it is slightly more technical and
tricky.”
“Nevertheless, younger surgeons
took it up readily because they knew the
outcome as being so much better.”
Throughout 2003 to 2009, he trained
at the Great Ormond Street Hospital for
Sick Children in the United Kingdom as
well as other prestigious hospitals around
London where he not only picked-up lots
of skills, creating ways of learning key-
hole surgery but teaching junior doctors
as well.
Upon completion, I found that there
was a need for training in Malaysia. So
I returned in 2012 as a professor in Uni-
versity Malaya to train Master’s students
after two years serving at St Georges
University Hospital in London.”
“Subsequently, I was involved with
training surgeons at other public hospi-
tals such as Sultanah Bahiyah Hospital
Alor Setar Kedah, Penang General
Hospital, Taiping, Ipoh and Likas Sabah.
In addition to that, I have been around
the region to Indonesia and Myanmar as
well.”