Minimally Invasive Surgery Gives Spina Bifida Patient New Independence at Lilavati Hospital

Mumbai: Lilavati Hospital & Research Centre has successfully performed a minimally invasive colonoscopic cecostomy on 28-year-old Merlyn D’mello, an IT professional living with spina bifida-related neurogenic bowel.

Using an advanced endoscopic technique, doctors created percutaneous cecum access with colonoscopic guidance and introduced a 24 Fr PEG catheter. This allowed the patient to independently perform antegrade colonic irrigation, eliminating the need for open surgery or abdominal incisions.

Merlyn, who has been under medical care since childhood for congenital spina bifida, faced chronic constipation, incontinence, and dependence on caregivers for bowel management.

A previous surgical procedure (Malone Antegrade Continence Enema/MACE) had not provided lasting control, prompting the need for a less invasive, sustainable approach.

Under the supervision of Dr. Ravikant Gupta and Dr. Santosh Karmarkar, the multidisciplinary team performed the colonoscopy-only procedure to access the cecum safely. The method avoided laparotomy, reduced surgical risk, and was completed in under an hour.

Within 24 hours, the patient achieved spontaneous bowel movement through an antegrade saline flush, reported minimal discomfort, and was discharged the next day.

“This technique changes how we approach complex neurogenic bowel dysfunction,” said Dr. Ravikant Gupta, Consultant, Endoscopy Interventions, Lilavati Hospital. “For individuals with spina bifida, bowel management is not only a medical concern but also a vital aspect of independence and dignity.

Colonoscopic cecostomy provides a safe, incision-free solution with faster recovery and long-term benefits.”

Dr. Santosh Karmarkar, Consultant Paediatric Surgeon & Spina Bifida Specialist, added, “This procedure has given our patient long-awaited independence. Beyond the medical success, the impact on self-esteem and quality of life is profound. Medicine, at its core, is about restoring dignity and autonomy to patients.”

Dr. Niraj Uttamani, COO, Lilavati Hospital & Research Centre, stated, “At Lilavati Hospital, we focus on clinical excellence that enhances patient outcomes and overall well-being. This colonoscopic cecostomy reflects our commitment to advancing minimally invasive care in India through skilled, compassionate, and patient-centered practice.”

Spina bifida, a congenital neural tube defect, often results in lifelong bowel and bladder dysfunction. India records over 30,000 new cases annually, highlighting a persistent public health challenge. Traditional approaches like the Malone ACE or open cecostomy, while effective, involve higher risks and longer recovery.

The colonoscopy-guided endoscopic cecostomy performed at Lilavati Hospital demonstrates a fully endoscopic method for antegrade colon access. This minimally invasive technique reduces tissue trauma, shortens hospitalization, and provides a reproducible alternative for patients who have not benefited from prior surgeries.

Lilavati Hospital serves as a key referral center for spina bifida care in collaboration with the Spina Bifida Foundation, continuing its mission to deliver advanced, patient-focused healthcare and improve quality of life for individuals across Mumbai.