Laparoscopic Surgery

  

KIDNEY STONES :-

KIDNEY STONES  REMOVED WITHOUT BREAKING !

We remove Kidney stones without breaking using a technique called Laparoscopic Pyelolithotomy. Use of this technique, eliminate chances of residual stones. Even large stones can be taken out successfully using this procedure.

Stones in the ureter are taken out using a ureteroscope. The larger stones and the stones that are in the upper third of the ureter are better taken out laparoscopically, without breaking.

 

How is the above technique better than older techniques?

Some of the older techniques have inherent disadvantages.

For instance:

PCNL – In this procedure the stone is taken out thro’ 1 cm scope sheath. Any stone which is larger than this size, needs be broken first. Broken pieces are then taken out one by one. During this process, some of the fragments can scatter around and hide in some corners (calyces) of the kidney, thus leaving the chances of left out stones.

ESWL- Extra corporeal shock wave lithotripsy – This technique utilizes sound waves to break the stone. The stone keeps on clearing slowly after its broken. Patient needs to visit hospital multiple times and the harder stones don’t break up. Soft stones that break up have high chances of scattering into the calyces, thus leaving high chances of residual calculi. This technique is good for selected few cases only and not for all kidney stones.

Stones in the ureter can be taken out with the help of the ureteroscope, the larger stones and the stones which are in the upper third of the ureter are better taken out laparoscopically, as such without breaking.

HERNIAS:-

Inguinal Hernias , Incisional Hernias, Umblical hernias:- We provide laparoscopic mesh repair for these conditions.

Hiatus Hernias:- If you have a hiatus hernia diagnosed by a gastroenterologist. We can repair it using a laparoscope.

Laparoscopic techniques, we use to repair Hernias

TEP Technique (Total Extraperitoneal mesh repair):- This is an advanced surgery available for the inguinal hernias. In this technique, a mesh is inserted in the two layers of the abdomen, thus the mesh is sandwiched between the two layers. No need of fixing the mesh with the screws( tackers )/ staples. This eliminates chances of pain later on.

TAPP (Trans abdominal preperitoneal mesh repair):- In this technique the mesh is implanted from inside the abdominal layers. The mesh is fixed with the help of tackers and then the peritoneum is sutured over the mesh.

 

 

 

Gall Bladder Stones

Gall Bladder Stones:- Gall bladder can be taken out with the help of the laparoscope and the stones come out as such within the gall bladder. This is the gold standard procedure for the gall bladder stones. In cases where the gall stones have slipped into the CBD( a duct coming from the liver) ..jaundice can ensue……these CBD stones can be taken out with  the  help of endoscope.

 

Uterus - Fibroids / DUB / Adenomyosis

Uterus – Fibroids/DUB/Adenomyosis etc:

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The latest procedure available these days is the Total Laparoscopic Hysterectomy This procedure is better than the old technique LAVH.in the following manners:

  • Full length of the vagina .. the birth canal ….can be maintained..so that the patient has no problem in sexual intercourse later on.
  • Full vaginal sensation is retained.. The vaginal sensation comes from the nerves which are present only in the upper one third of the vagina. In TLH this upper third of the vagina can be saved, but this is not possible in LAVH..because in LAVH the surgeon has to pull down the uterus into the vagina thus the upper third of the vagina comes out with the uterus, thereby shortening the vaginal canal as well as making it insensitive to anything.. thus causing feeling of numbness during the intercourse.
  • In TLH the uterus can be removed with complete fibroid and even the ovaries Can be removed very easily wherever required.
  • Even the larger fibroids can be removed.
  • TLH is possible in cases where some earlier surgery like caesarian(C-Section) has been performed.

In cases where the patient needs to have children, then only the fibroid can be taken out with the help of laparoscopic myomectomy

Prostate surgery, appendectomy etc.

Other routine surgeries like Prostate surgery, appendectomy etc are available.


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