Dr. K G Mathew

Dr. K G Mathew is a specialized General Laparoscopic Surgeon, having 38yrs surgical experience General surgery, Advanced surgical, Gastroenterology, Laparoscopic Surgery, Advanced Hernia surgery

Dr K G MATHEW completed his MBBS from Bombay University in 1976, and, after a stint of 5 years in the Army Medical Corps did his MS (General Surgery) from Delhi University in 1985.

He subsequently went on to attain the prestigious FRCS (Ireland), and then the FRCS (Edinborough).

He has been practicing surgery for the last 38years, and he has headed Dept of Gastrointestinal surgery doing advanced Gastrointestinal surgery that included surgery for cancers in stomach, colon etc.

Dr K G Mathew started laparoscopy surgery in 1990 when the technique was still in its infancy.

For the last 17years he was head of the surgery divisin at NMC Specialy Hospital, Dubai (a major tertiary referral Centre)

Since 2010 Dr K G Mathew apart from his usual surgeries,has been working on developing techniques of Hernia surgery, and has conducted many conferences, training programmes, and published papers on the subject.

Key Achievements:

Established NMC Specialty Hospital, Dubai, as a Centre of Excellence in Hernia surgery, accredited by the Asia Pacific Hernia Society (HQ in Singapore) in 2017.

Established a Hernia register and follow up of all groin hernia patients. Only such register in the UAE.

Chief faculty and organizer of Hernia workshops at the Sharjah Surgical University.

Conducted a number of international conferences in Dubai.

Overall operative experience

Complex gastrointestinal surgeries

• Have done more than 50 Whipple’s pancreatic duodenectomies
• Radical resections for cancer stomach
• Complex colorectal surgeries including APER and anterior resections
• Adrenal surgeries

Head and neck surgeries including various thyroidectomies

Ano rectal surgeries

• Various hemorrhoid (piles) surgeries including PPH, THD, LASER
• Advanced surgeries for anal fistula including VAAFT and LASER

Pilonidal sinus surgeries

• Karydakis procedure and minimally invasive procedures

Have developed expertise in all types of complex and advanced Hernia surgeries including

• Component separation, TAR and various laparoscopic approaches

Laparoscopic Surgeries

• Laparoscopic cholecystectomy, appendectomy and other routine laparoscopic surgeries
• Laparoscopic CBD exploration
• Laparoscopic excision liver hydatid cyst
• Laparoscopic cyst gastrostomy
• Laparoscopic adhesiolysis
• Laparoscopic colorectal resections
• Laparoscopic hernia surgery: TAPP, IPOM, eTEP

Lectures At International Conferences

• Essentials of TAPP Surgery: conference GCC Hernia Society and APHS: Dubai: 8 May 2015
• Dilemmas in Ventral Hernia Repair: Updates in Ventral Hernia Repair: NMC Specialty Hospital and APHS: 7 oct 2016
• Investigation protocol in umbilical hernia for optimum treatment planning: 16th Middle East Surgery Conference (Arab Health) 30 Jan to 2 Feb 2017.
• Principles of component separation techniques Organizing committee: 2nd annual NMC Hernia

conference on Core requirements for abdominal wall hernia: 27 & 28 oct 2018

• eTEP versus IPOM for small and medium sized umbilical hernias at the 14th Asia Pacific Hernia Society World Conference 29 Nov to 1 Dec 2018 at Dubai
• eTEP vs laparoscopic IPOM for medium sized midline primary ventral hernias. 41st Annual International Congress of the European Hernia Society at Hamburg, Germany 11 to 14 sept 2019
• Mesh infection after laparoscopic inguinal hernia surgery — a review of our experience: 41st Annual International Congress of the European Hernia Society at Hamburg, Germany 11 to 14 sept 2019
• Changing trends in Groin Hernia Repair: American College of Surgeons, Dubai chapter: 07 Dec 2021

Organized and conducted National and International conferences at Dubai

• Organized Workshop on Laparoscopic Inguinal Hernia: a joint venture by NMC Specialty Hospital Dubai and Asia Pacific Hernia Society. This was the first major international conference on Hernia by a private hospital in the UAE with live transmission of Hernia surgeries from our operation theatres.
• Organized and conducted conference on: Updates in Ventral Hernia Repair: NMC Specialty Hospital and APHS: presented paper” Dilemmas in Ventral Hernia Repair”: 7 oct 2016
• Organizing committee: 2nd annual NMC Hernia conference on Core requirements for abdominal wall hernia: and presented paper on” Principles of component separation techniques” 27 & 28 oct 2018
• Organizing committee of the 14th Asia Pacific Hernia Society World Conference at Dubai: 28 Nov to 1 Dec 2018. Conducted a full day Hernia essentials workshop on behalf of the APHS
• Organized and conducted a two-day Hernia Essential workshop on behalf of APHS at the Sharjah Surgical University, in Nov 2019

Workshops Conducted

• Workshop on Laparoscopic Inguinal Hernia: a joint venture by NMC Specialty Hospital Dubai and Asia Pacific Hernia Society. This was the first major international conference on Hernia by a private hospital in the UAE with live transmission of Hernia surgeries from our operation theatres. 2010
• Organized and conducted conference on: Updates in Ventral Hernia Repair: NMC Specialty Hospital and APHS: presented paper” Dilemmas in Ventral Hernia Repair”: 7 oct 2016
• Advanced Surgery training and Hands on at the Sharjah Surgical University, Sharjah: 29 june 2018
• Conducted full day lecture sessions and Live animal workshop on” Techniques of Laparoscopic surgery in groin * Hernia 5 May 2017 at Surgical training centre: University of Sharjah.
• Organizing committee: 2nd annual NMC Hernia conference on Core requirements for abdominal wall herni nd presented paper on” Principles of component separation techniques” 27 & 28 oct 2018 IN groim Hernia os May 2017 Surgical training centre . university or Sharjah.
• Organizing committee: 2nd annual NMC Hernia conference on Core requirements for abdominal wall hernia: and presented paper on” Principles of component separation techniques” 27 & 28 oct 2018
• Advanced Surgery training and Hands on at Sharjah Surgical University, Sharjah: 23 Nov 2018
• Full day Hernia Essentials Workshop on 28 Nov 2018 at the Sharjah Surgical University, Sharjah: on behalf of the 14th Asia Pacific Hernia Society World Conference at Dubai: 28 Nov to 1 Dec 2018.
• Workshop on Core Techniques in Groin Hernia Repairs: Sharjah Surgical University, Sharjah 01-02 April 2021
• Workshop on Core Techniques in Groin Hernia Repairs Series 2; Sharjah Surgical University, Sharjah25-26 Nov 2021.

Publications

Hernia Journal: The Official Journal of The European Hernia Society a New Technique to Treat a Difficult Condition. The Technique Was Innovated by Dr K G Mathew

Abstract

Purpose: Peritoneal tears occurring during TAPP and TEP are common, and can cause difficulty in continuing surgery, or, if left open can cause postoperative been described. These techniques are difficult, and add to the operating time, and may not be successful in closing the opening in the peritoneum. We describe a simple, effective, fast technique of repairing these tears using the bipolar diathermy.

Method: We have used bipolar diathermy to seal inadvertent peritoneal tears occurring during TAPP/TEP repairs. This method of sealing the peritoneum has been used by us since 2015. We decided to review our results of sealing the tears in the peritoneum at TAPP/TEP from 01 Jan 2017 to 31 Dec 2019. Results A total of 152 laparoscopic inguinal hernia repair (TAPP/TEP) procedures were done by the authors from 01 January 2017 to 31 December 2019, and of these, 101 cases had some degree of peritoneal tear. All peritoneal tears were very simply sealed using bipolar diathermy.

Conclusions: Peritoneal tears occurring inadvertently during Laparoscopic TAPP/TEP procedure for repair inguinal hernia can be effectively sealed with simple bipolar diathermy

Keyword: Peritoneal tear sealing technique Bipolar sealing Laparoscopic TAPP TEP

With advances in medicine helping more people to live longer lives, we have more older people to take care of, and WHO “population ageing report” 2009 has predicted that by 2050, 21% of the population will be over 60 years of age. Increased number of older people in the world will have financial and social implications, and, in medicine, care for this age group and developing strategies of care for them will make sound investment and financial sense (British Hernia Society Commissioning Guide: Groin Hernia. 2016). Advancements in surgical technique and anesthesia as also the overall perioperative care means that increasingly older patients can be treated even for complex surgical conditions and could continue a meaningful and productive social life. However, we do not have defined guidelines on hernia care in the elderly, and this chapter will attempt to have a closer look at the physiology of ageing today and the evidence of hernia surgery in this population. The subheadings will be (1) Defining the elderly; (2) Pathophysiology of wound healing in the elderly; (3) Groin hernias: is watchful waiting an option in the elderly? and (4) Principles of hernia surgery in elderly.

Groin Hernia

Started Laparoscopic Groin Hernia surgery in 2005. The procedure I started off with was the TEP repair and at that time was one the few surgeons in Dubai doing this type of work

Visted The Marien Hospital at Stuttgart (Germany) 2010, on invitation by Prof Reinhard Bittner a world-renowned leader for Laparoscopic Hernia Surgery. After that, I modified my approach to Groin Hernia and adopted the TAPP method. The TAPP method has been my choice to repair groin hernias since then and have added my own refinements and conducted various workshops on this technique.

I have to date done more than 600 cases of groin hernia repair by the TAPP procedure. Since 2017 all cases are entered in a Hernia register with meticulous follow up. The Hernia register that I had developed is the only such register in the UAE.

The advancements on the TAPP procedure which I do are:

• Recurrent inguinal hernias
• Giant inguinoscrotal hernias: done by the Hybrid approach
• Selective fixation of the mesh
• Cost effective protocols
• Developed my own method of repairing peritoneal tears which I have submitted for publication

Ventral hernia

1. Laparoscopic IPOM
2. Newer approaches to ventral hernia Open Rives Stoppa repair TAR procedure and other methods of component separation

eTEP procedure: This is a new approach which was described by Jorge Daes in 2012. The approach offered an excellent alternative to IPOM. However, it is a difficult procedure and hence took time for major centres to follow.

I started eTEP in 2018 and probably the first in Dubai to offer the advantages of this technique to patients in the UAE. Have presented my initial results at International connferences.

Can offer repair of giant ventral hernias

PUBLICATION OF THE NEW MINIMALLY INVASIVE PROCEDURE OF THD (Trans Hemorrhoidal Dearterialisation) to treat Hemorrhoids/Piles

OUR EXPERIENCE WITH TREATING PILES WITH THD

Dr Faris Dawood Alas wad, Dr Gyan Pokharel, Dr KG Mathew

• Hemorrhoids are the most common anal disease. Depending on its symptoms, noninvasive treatments such as band ligation, cryotherapy and sclerotherapy and invasive treatments such as a hemorrhoidectomy have been used to treat hemorrhoids.
• Hemorrohoidectomy had been the most commonly used, but with the disadvantage of severe postoperative pain, longer recovery time and complications such as bleeding and anal stricture.
• To overcome this disadvantage new treatment methods such as PPH or THD have been introduced.
• THD has been reported to have a recurrence rate of less than 10%, and with 90% of patient satisfaction.
• The simultaneous conduct of artery ligation and recto-anal repair has been recently introduced and has been reported to achieve good treatment outcomes.

This is a prospective study conducted on 50 patients who underwent a one year follow up from among among patients who had undergone THD operations in our hospital from Oct. 2011 to Oct 2012.

Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine

Indian Society of Critical Care Medicine

Acute Suppurative Thyroiditis with Thyroid Abscess by Klebsiella pneumoniae: An Unusual Presentation

Prashant Nasa, K. G. Mathew, […], and Vikas Singhal

Additional article information

Acute suppurative thyroiditis with thyroid abscess is very uncommon cause of thyroiditis. Thyroid infection in a diabetic patient is commonly labeled to the relative immunosuppressive state of diabetes mellitus. We present a case of a diabetic patient showing clinical symptoms of acute thyroiditis with progressing dysphagia, who was diagnosed as thyroid abscess as a result of Klebsiella pneumoniae. The infection in the absence of other significant history was initially considered de novo; however, on extensive evaluation was associated with other distant primary source of the same microbe. The patient was managed with minimally invasive drainage of abscess and intravenous antibiotics.

Keywords: Acute suppurative thyroiditis, Klebsiella pneumoniae, thyroid abscess

Research Article

Identifying Pathological Pneumoperitoneum After Laparoscopic Surgery

Laparoskopik Cerrahi Sonrası Patolojik Pnömoperitoneumun Belirlenmesi

• KG Mathew1
• Faris Alaswad1
• Saajan Ignatius Pius2

1.NMC Specialty Hospital, Dubai, United Arab Emirates

2.General Surgery NMC Specialty Hospital Alnahda, Dubai, United Arab Emirates

Aim: The study aims to analyze the frequency and extent of pneumoperitoneum after laparoscopic surgery and to differentiate routine post laparoscopy pneumoperitoneum from pneumoperitoneum due to possible bowel perforation.

Method: Pneumoperitoneum after laparoscopic surgery persists for a variable number of days and can mask pathological pneumoperitoneum due to the complication of bowel perforation at laparoscopic surgery. This study aims to find a simple radiological solution to this issue, so that pathological bowel perforation can be detected at the earliest and corrective action taken.

Results: We had four cases of bowel perforation after laparoscopic surgery, and, the clinical signs were subtle and not clearly indicating any peritonitis. Radiological tests on post operative day 1were inconclusive, as free gas was attributed to persisting carbon dioxide pneumoperitoneum. Hence a relook laparoscopy was delayed for 48 hrs, when clinical signs were obvious. This scenario presented a challenge to distinguish persisting carbon dioxide pneumoperitoneum post laparoscopy from pathological pneumoperitoneum.

Conclusion: We decided to measure by X-ray chest the width of gas under diaphragm in the usual laparoscopic procedures, on the first post operative day and compare this with the width of gas under diaphragm in the four cases of iatrogenic bowel perforation post laparoscopic surgery. It was found that iatrogenic bowel perforation at laparoscopy is characterized by a wider gas under diaphragm, with the width at widest point ranging from 1.5 cms to 2.0 cms. Hence a simple xray chest could raise suspicion of a bowel perforation complication, and dictate further investigations like computed tomography scan or relook laparoscopy at the earliest post operative period.

Keywords: Pneumoperitoneum post laparoscopy surgery, bowel perforation at laparoscopy diagnosis, radiology for post laparoscopy complication

Case report

Abdominal cocoon: precipitated by laparoscopic gas insufflation

D Karingattil George Mathew 1, Shakeel Akhtar 2 and Saajan Ignatius Pius 3

Correspondence to Dr Karingattil George Mathew; mathkg@gmail.com

A young male in his early 30s presented to us with increasing swelling at the umbilicus, and an umbilical hernia was diagnosed. At laparoscopic intraperitoneal onlay mesh (IPOM) repair, an unexpected finding of a thin innocuous-looking fibrous film over the small bowel was noted. This finding presented a dilemma as to the probable pathology of this material, and a decision had to be made on whether laparoscopic IPOM could be continued. It was prudently decided to abandon the plan of placing a mesh intraperitoneally and an open repair of the umbilical hernia was done. In retrospect this was a wise decision, as, after 7 months he had to have a laparotomy for intestinal obstruction, when the classic thick fibrous encapsulating abdominal cocoon was seen. Hence here we have followed the evolution of the abdominal cocoon from its original asymptomatic phase to the classic encapsulating sclerosing peritonitis with probably laparoscopic gas insufflation being the precipitating factor.

https://casereports.bmj.com/content/14/4/e240024