Lilavati Hospital & Research Centre, Mumbai, has achieved a groundbreaking milestone by successfully performing a first-of-its-kind minimally invasive colonoscopic cecostomy on Merlyn D’Mello, a 28-year-old IT professional living with spina bifida-related neurogenic bowel. The innovative, incision-free procedure created percutaneous access to the cecum using colonoscopic guidance and a 24 Fr PEG catheter, allowing the patient to independently perform antegrade colonic irrigation without open surgery or abdominal incisions.
Restoring Independence Through Innovation
Merlyn D’Mello has been under medical care since childhood for congenital spina bifida, a condition that caused chronic constipation, fecal incontinence, and dependence on caregiver-administered enemas. A previous Malone Antegrade Continence Enema (MACE) procedure failed to offer sustainable bowel control, prompting the need for an advanced and less invasive intervention.
Under the expert guidance of Dr. Ravikant Gupta, Consultant – Endoscopy Interventions, and Dr. Santosh Karmarkar, Consultant Paediatric Surgeon and Spina Bifida Expert, the multidisciplinary team adopted a colonoscopic-only approach to percutaneously access the cecum. This method eliminated the need for laparotomy, minimized perioperative risk, and successfully navigated adhesions from prior surgeries. Remarkably, the entire procedure was completed in under one hour, highlighting its efficiency and safety.
Rapid Recovery and Remarkable Outcomes
Within 24 hours, the patient achieved spontaneous stool evacuation through an antegrade saline flush via the cecostomy tube. She experienced minimal discomfort, required no postoperative analgesia, and was discharged the following day in stable condition.
Dr. Ravikant Gupta emphasized the transformative nature of the technique, stating,
“This procedure represents a paradigm shift in treating complex neurogenic bowel dysfunction. For patients with spina bifida, bowel control issues impact not only physical health but also independence and dignity. Colonoscopic cecostomy offers a safe, incision-free solution with faster recovery and lasting functional benefits.”
Empowering Patients Beyond Medicine
Echoing this sentiment, Dr. Santosh Karmarkar highlighted the profound psychosocial impact of the procedure:
“This patient, once dependent on caregivers, has now achieved true independence. Beyond clinical success, the improvement in her confidence, autonomy, and mental well-being is extraordinary. Medicine is not just about surgical technique—it’s about restoring dignity and self-reliance.”
Commitment to Medical Innovation
Dr. Niraj Uttamani, COO, Lilavati Hospital & Research Centre, reaffirmed the institution’s dedication to advancing patient-centered innovation:
“At Lilavati Hospital, we take pride in translating medical innovation into better patient outcomes. This pioneering colonoscopic cecostomy reflects our ongoing commitment to minimally invasive care. Our expert team continues to set new benchmarks in clinical excellence while empowering patients to live with confidence and dignity.”
Clinical Significance and Broader Impact
Spina bifida, a neural tube defect, affects thousands of individuals in India each year, with over 30,000 new cases annually. The condition often results in lifelong neurogenic bowel and bladder dysfunction. Conventional treatments such as MACE or open cecostomy, though effective, are associated with higher complication risks, longer hospital stays, and reduced long-term success rates.
As per the press release, the colonoscopic cecostomy performed at Lilavati Hospital demonstrates a new, minimally invasive alternative that minimizes tissue trauma, shortens recovery time, and offers hope to patients who have exhausted conventional options.
A Centre of Excellence for Spina Bifida Care
Lilavati Hospital serves as a major referral centre for spina bifida management. It works closely with the Spina Bifida Foundation to provide specialized and comprehensive treatment.
With every such pioneering effort, Lilavati Hospital & Research Centre reaffirms its mission to deliver advanced, compassionate, and patient-centric healthcare, setting new standards in clinical innovation and holistic recovery for the citizens of Mumbai and beyond.