Since 1941 the Department of Surgery has lead the country in the field of Surgical Oncology. With a strong heritage the department has continued to evolve while restructuring to address the challenges of specialization and yet maintaining the core values of Service, Research and Education. Operative services are comprehensive for cancers at all sites and are offered both at TMH and ACTREC. The department performs about 9000 major surgeries and 14000 minor procedures annually.
As part of the hospital’s ethos of encouraging multidisciplinary management of cancers each surgical specialty also participates in their respective DMG (Disease Management Group) thus enhancing overall patient care
Specific unique strengths of the department include an increasing application of minimally invasive surgery, skull-base procedures, major vascular replacements, limb salvage, post-oncologic reconstruction and microvascular surgery. The department extended its outreach program to various other regions as well providing surgical oncology expertise in under-served areas.
TMH has entered into a MoU with Lifeline Express to offer Head Neck surgical services on the world’s first hospital on a train.
Committed to state of the art post-oncologic reconstruction. The number of Reconstructions done is the highest in the Indian Subcontinent and has comparable figures with any such centre in the world with results matching international standards. On an average 3 to 4 free tissue transfer and bout 4-5 pedicled flaps are done every day for various Reconstructions from head to toe.
Journal reading and presentation takes place twice a week in the Department. Every Friday, The cases operated in the previous week, morbidity if any and the cases to be operated in the coming week, the plan of action are discussed. The faculties participate actively in national & International conferences and have performed live surgical demonstration in various workshops.
Dual training scheme with Two posts for M.Ch. in Plastic and Reconstructive surgery and three posts for Specialist registrars, the department offers options for human resource development in cancer reconstruction in the country. Regular teaching classes, case presentations and journal club presentations are organized for the benefit of the students and faculty.
A dual training scheme with parallel training in overall surgical oncology and specialist two-year fellowships in individual specialties offers various options for human resource development in cancer surgery for the country.
The department regularly conducts training initiatives for post-graduate students and practicing surgeons. Departmental staff participates as faculty at national and international conferences and as examiners for academic degree courses. Members of the department also function as editors, members of editorial boards and peer reviewers for renowned national and international medical journals. Departmental faculty are core members in several public health initiatives like anti tobacco campaigns, Government of India and Ministry of Health task force to evolve treatment guidelines for cancer, expert groups to disseminate information about cancer, besides serving on various international committees and task forces.
The department conducts various investigator-initiated and sponsored research studies. Large randomized trials in Head and Neck, Esophageal, Breast, Lung, Gastric Cancer and Cervix Cancer are underway and collaborative studies including translational research with investigators at various national and international centers are ongoing.
The department members edited and authored a book “Atlas of Operative Surgical Oncology 2016”. This book is an effort to give surgical oncologists access to the principles of surgery and detailed steps of established operative techniques.
The department has an impressive list of international and national peer reviewed publications, book chapters and books written or edited by the faculty.
Specific Disease Management groups have varied research interests as under:
The unit has also successfully completed “TOSS”, the only prospective randomized trial for surveillance in sarcomas. This study demonstrates that in surgically operated patients with extremity sarcoma, an increased frequency of follow up with expensive imaging does not improve overall survival. This finding has significant financial implications for healthcare, both in terms of costs and missed work hours for patients.
The unit has also pioneered development of an indigenous low-cost mega-prosthesis used to reconstruct skeletal defects after tumor excision and was awarded Golden Peacock award by the Government of India.
The breast unit is committed to evaluate low cost options in the management of breast cancer. There are multiple ongoing clinical research trials addressing questions on peri-operative or neoadjuvant intervention and surgical techniques. Some of the past practice changing research, include the successful completion of studies like:
Proluton trial, wherein the benefit in disease-free and overall survival with a single pre-operative injection of IM depot hydroxyprogesterone in operable breast cancer was demonstrated.
Exercise study: Randomized Controlled Trial Evaluating the Role of Exercise in Women Undergoing Treatment for Breast Cancer. The results of the study were presented at ASCO 2017 meeting in Chicago and showed an improvement in quality of life in the women on exercise arm.
VGSC study (multicentre trial): A Randomized controlled trial to assess blockade of voltage gated sodium channels during surgery in operable breast cancer. This study is being carried out at 20 other centres in India under the aegis of National Cancer Grid (NCG). 30% of the accrued patients are from the other centres.
The unit is currently running the ELANCE trial comparing D2 v/s D3 radical gastrectomy in the era of perioperative chemotherapy and peri-operative therapy (pre op chemo vs CTRT) in locally Advanced gall bladder cancer (POLCA-GB)
Basic and translational research interest focusses on understanding biological heterogeneity of gliomas. Clinical research focusses on testing and developing novel methods for intraoperative imaging and visualization of tumors as well as understanding brain functional plasticity using preoperative and intraoperative mapping techniques. Additionally the department is also involved in developing an indigenous robotic guidance system.
“Customized approach for childhood renal tumors” and “Role of PET scan in staging pediatric round cell tumors” are the areas of special interest
Enrollment is underway for one of the largest trials comparing two field versus three field lymphadenectomy for esophageal cancer and more than 600 patients have already been randomized of the required 700. Collaborating with the Medical Research Council, UK, we are lead investigators in a large multicentric randomized trial evaluating the role of Aspirin after radical treatment for esophagogastric and breast cancers.
“Prospective randomized trial of Adjuvant radiotherapy following surgery and chemotherapy in muscle invasive transitional cell carcinoma of urinary bladder (BART)” and another project on “Hormone receptor status in adrenocortical carcinomas” are currently ongoing trials.
“Elective versus Therapeutic Neck Dissection in the treatment of early node negative squamous cell carcinoma of the oral cavity” and “Randomized controlled trial assessing addition of neoadjuvant and maintenance oral metronomic chemotherapy to standard surgery and adjuvant therapy in Stage III/IV Operable Oral cancers” are 2 of the many trials in this DMG
The department has obtained permission to start an anatomy laboratory at Tata Memorial Center from the government of Maharashtra & MUHS (Maharashtra University of Health Sciences). We expect the anatomy laboratory to start functioning soon. The department has contributed significantly in oncoreconstruction through publications in reputed national and international journals. The faculty is involved in training programs and as resource persons in various meetings and workshops.
Many cancers require excision of the diseased part resulting in loss of form or function. Plastic surgery aims to reconstruct and restore the function and cosmesis for improved quality of life. The most common procedures requiring reconstructive surgery are head and neck cancers, breast cancers, bone and soft tissue etc. Most of the cases require free tissue transfers and our success rate matches the international standards of about 97%. Our centre has experience close to about 5000 free tissue transfers.
Department Office Number: (+9122) 24177000 / Ext.No. 4035
2nd Floor, Main Building,
TATA MEMORIAL HOSPITAL, Dr.Earnest Borges Marg, Parel, Mumbai-400-012
Hospital Fax Number: (+9122) 24146937