Laparoscopic Videos from World Laparoscopy Hospital

Robotic Dermoid Ovarian Cystectomy

This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities

How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra

This video demonstrate How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra. Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.

How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/robotic-surgery.html This video demonstrate How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/ Demonstration of Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra. Knowledge of Laparoscopic Telescope that is also called as laparoscope, Laparoscopic Camera, Laparoscopic Light Source and Laparoscopic Light Cable is necessary for a laparoscopic surgeon to perform safe minimal access surgery.

Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent

https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.

Infrared Ureteral Stenting in Gynecological Laparoscopy

https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.

Endoscopy - Upper GI Endoscopy and Colonoscopy

https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.

Indocyanine green (ICG) Cholecystectomy

https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.

Umbilical and Paraumbilical Hernia Surgery

https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.

Laparoscopic Varicocelectomy

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.

Laparoscopic Salpingotomy for Ectopic Pregnancy

This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.

How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.

Laparoscopic Removal of Paraovarian Endometrioma with application of Intercede

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Paraovarian Endometrioma, Ovarian cystectomy. Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses. Here Intercede is applied to prevent adhesion. Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions.

Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra. A thorough knowledge of the fundamentals of electrosurgery by the entire team in the operating room is essential for patient safety and for recognizing potential complications. Newer hemostatic technologies can be used to decrease the incidence of complications. INTRODUCTION A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care.1 Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery.2 The surgical team should have a good understanding of the principles of electrosurgery and tissue effects to avoid complications.

Laparoscopic Bilateral Ovarian Cystectomy

https://www.laparoscopyhospital.com This video demonstrate laparoscopic ovarian cystectomy by Dr R K Mishra at World Laparoscopy Hospital. An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen. The incisions in your abdomen will be closed with skin adhesive or stitches and may be covered with Band-Aids. If you have bandages, they can be removed 24 hours after surgery, and the adhesive or stitches will dissolve on their own. If you have small bandage trips on your incisions, leave them on and they will fall off on their own. If they do not fall off you can remove them seven days after your procedure. Do not soak your incisions in the bathtub or go swimming. You may shower, but do not rub your incisions.

Sleeve Gastrectomy Full Length Step by Step Video

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

IPOM Inguinal Hernia Surgery

https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.

Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/roboticsurgerytraining.html This video demonstration is about Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra. Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

Laparoscopic Appendectomy for Fecalith of Appendix

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Appendectomy for Fecalith of Appendix performed by Dr R K Mishra at World Laparoscopy Hospital. This is a rare, but frustrating complication. During dissection of a distended, gangrenous appendix, a fecalith may drop into the peritoneal cavity. Retained fecaliths may cause an intrabdominal abscess. Therefore fecaliths need to be dealt with carefully and cautiously to avoid them being lost between the loops of the intestine and the pelvis. Fecatliths should be thrown into an endobag and careful lavage performed. This complication will be found more often as laparoscopic appendectomy becomes a more common method in the treatment of acute appendicitis. Surgeons should be aware of this complication in order to treat fecalith adequately when recognized intra or postoperatively. Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contraindicated or is not feasible.

Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/admission.php This video demonstration is about Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra. Rather than the traditional four to five small incisions, a single small incision can be used at the entry point. All surgical instruments are placed through this small incision and also the incision site is located in the left abdomen or umbilicus. Providing the benefits of fewer scars, the opportunity of less pain, and shorter recovery periods, SILS is one of the newest laparoscopic techniques and it is regarded as non-invasive. In general, SILS techniques take about the same amount of time to do as traditional laparoscopic surgeries. However, SILS is recognized as to be a more complicated procedure because it involves manipulating three articulating instruments through one access port.

Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra. Electrosurgical units are the most common type of electrical equipment in the operating room. A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care. The risk of complications is linked to the surgeon's fundamental knowledge of instruments, surgical technique, biophysics, relevant anatomy, and safe technical equipment. The risk of complications is linked to fundamental surgical knowledge of instruments, surgical technique, biophysics, and relevant anatomy. Appropriately applied, electrosurgery is safe and effective. Electrothermal injury may result from direct application, insulation failure, direct coupling, and capacitive coupling.

Dermoid Cyst of Ovary - Laparoscopic Removal Without Spillage

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic ovarian cystectomy for dermoid cyst by Dr R K Mishra at World Laparoscopy Hospital. A dermoid cyst is a sac-like growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin. Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermoid cyst The dermoid cyst occasionally converts into cancer if untreated.

Access Technique and Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com This video demonstrate Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra. We investigated the optimal position of the optical port of laparoscope in relationship to the working ports. The manipulation angle, defined as the angle formed by the line of action determined by the two working ports and the azimuth angle line of vision determined by the laparoscope, was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal range of the manipulation angle is 60 degrees and azimuth angle is 30 degree to left and 30 degrees to the right of the optimal position of 0 degree.

Hysterectomy - Surgical removal of the uterus full video

https://www.laparoscopyhospital.com/ This video demonstrate hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient's abdomen. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy.

Advantage, Disadvantage and Contraindication of Laparoscopic Surgery - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/currentbatch.html Laparoscopic or “minimally invasive” surgery is where the surgeon makes a very small incision, often in the patient’s belly button, and uses this incision to insert a camera, called a laparoscope, into the abdominal cavity. The surgeon then looks at a television screen to perform the operation. Carbon dioxide, a nontoxic and odorless gas, is then used to create an air pocket within the abdomen for the surgeon to operate. There are many advantages of laparoscopic surgery compared with traditional surgery, which is performed through large incisions. Patients have much less discomfort and require less pain medicine. They are able to get up and walk around sooner and get back to their regular activities earlier. With long incisions, patients are usually restricted in their activities when they go home to prevent developing a hernia at the incision site. Hernias rarely occur at laparoscopic incision sites, so patients can exercise and lift a lot earlier. They are also less likely to develop wound infections because the incisions are so small. Because patients are able to get out of bed sooner they are less likely to develop blot clots or pneumonia than with traditional surgery. Patients undergoing bowel surgery are able to drink and eat earlier than in the past. After the incisions have healed the scars are almost invisible so patients don’t have to feel self-conscious at the beach or pool.

Robotic Surgery - Past Present and Future of Robotic Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Robotic Surgery - Past Present and Future - Lecture by Dr R K Mishra. Robotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Robot the world’s most advanced surgical robot, these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure. The surgeon also operates a footswitch that provides additional options, such as the ability to switch between two different energy sources. Touchpads allow the surgeon to easily adjust video, audio and system settings, while the ergonomic console and the alignment of the controls and monitor are designed to keep the surgeon in a relaxed, focused position at all times.

Laparoscopic Removal of Intramural and Broad Ligament Myoma

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.

Laparoscopic Fundoplication for GERD

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication surgery performed at World Laparoscopy Hospital. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic antireflux surgery remains a highly effective treatment in 80%-90% of patients with gastroesophageal reflux disease (GERD). Despite this, 10%-20% of patients continue to have symptoms postoperatively. Of these, some 3%-6% require a second surgery.

Laparoscopic Surgery for Subacute Small Bowel Obstruction

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

Laparoscopic management of Peritoneal Inclusion Cyst

https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.

Incisional Hernia IPOM Repair with Dual Mesh

https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.

How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra. Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%).

How to create safe Pneumoperitoneum - Lecture by Dr R K Mishra

This video demonstrate in Laparoscopic surgery how to create safe Pneumoperitoneum - Lecture by Dr R K Mishra. Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 12–15 mm Hg. Safe insufflation is important for a laparoscopic surgeon.

How to do Safe Laparoscopic Ovarian Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe Ovarian Surgery - Lecture by Dr R K Mishra. This video include all the ovarian surgery including, oophorectomy, dermoid cyst, simple cyst, endometrioma and ovarian torsion. Laparoscopic surgery of the ovary can be performed for a variety of indications ranging from simple, benign, and common general gynecological problems to complicated, difficult, or rare pathologies specific to gynecologic oncology or reproductive endocrinology. Although laparoscopic ovarian surgery carries the attendant risks of minimally invasive surgical procedures of the abdomen and pelvis, occasional problems specific to ovarian surgery may arise. We review the utility of and indications for laparoscopic surgery of the ovary as well as specific problems associated with these procedures.

How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra. Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our this presentation is designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer. Repair of duodenal perforation by Graham patch plication was described in 1937 represents an excellent alternative approach. Perforated duodenal ulcer is a surgical emergency. In 1990 Mouret et al. reported the first laparoscopic sutureless fibrin glue omental patch for perforated duodenal ulcer.

Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography

This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.

Axillary Lymph Node Resection and Thyroidectomy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/tables.html This video demonstrate Lymph Node Resection and Thyroidectomy Axilla and Breast Approach - Lecture by Dr R K Mishra. Only 16% of axilloscopy patients reported pain on the first postoperative day compared to 38% of open surgery patients. The incidence of seroma following endoscopic axillary retrieval was 6%, wound infection in 5% of patients. Conclusion: The axilloscopic approach with liposuction to axillary region presents a safe.

How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubaibach.php This video demonstrate How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra. Diagnostic laparoscopy is a surgical procedure that doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. During laparoscopy, the surgeon makes a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), usually near your belly button. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate abdomen. A diagnostic procedure is an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness.

How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra. Knowledge of Laparoscopic Instruments are necessary for a laparoscopic surgeon. Safe use of instruments need a complete knowledge of Instrument design.

TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk

https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.

Recurrent Hernia Laparoscopic Repair

https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.

How to Perform Cervical Cerclage - Lecture by Dr R K Mishra

This video demonstrate How to Perform Cervical Cerclage - Lecture by Dr R K Mishra. Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Treatment for cervical incompetence is a surgical procedure called cervical cerclage, in which the cervix is sewn closed during pregnancy. The cervix is the lowest part of the uterus and extends into the vagina.

How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra

This video demonstrates the steps in performing a common bile duct exploration for gall stones, choledochoscopy and either primary closure or repair over a T-tube. How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra. In the era of laparoscopic surgery, treatment strategies for common bile duct stones remain controversial. Laparoscopic choledochotomy is usually indicated only when transcystic duct exploration is not feasible. However, laparoscopic choledochotomy provides complete access to the ductal system and has a higher clearance rate than the transcystic approach. In addition, primary closure of the choledochotomy with a running suture and absorbable clips facilitates the procedure. Therefore, to avoid postoperative biliary stenosis, all patients with bile duct stones can be indicated for choledochotomy, except for those with non dilated common bile duct. Placement of a C-tube also provides access for the clearance of possible retained stones by endoscopic sphincterotomy as a backup procedure.

Hysterectomy Procedure Video

https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).

Laparoscopic Management of Chronic Ectopic Pregnancy

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.

Robotic Surgery - DaVinci and TransEnterix

https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements

Mucocele of Gallbladder with Impacted Stone at Neck Operated by Mishra's Knot

https://www.laparoscopyhospital.com This video demonstrate Mucocele of Gallbladder with Impacted Stone at the Neck Performed by Mishra's Knot. A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge.

TLH - Ligasure is better than Enseal

https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal

How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra. The Totally Extraperitoneal Repair (TEP) is a keyhole technique for inguinal hernia repair. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall. The TEP repair is particularly recommended for the repair of bilateral inguinal hernias and recurrent inguinal hernias. The procedure is performed under general anaesthesia (Asleep). Three small incisions are made in the midline between the umbilicus and the pubic bone.

https://www.laparoscopyhospital.com/

Laparoscopic Surgery for Subacute Small Bowel Obstruction

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

Laparoscopic Appendectomy for Fecalith of Appendix

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Appendectomy for Fecalith of Appendix performed by Dr R K Mishra at World Laparoscopy Hospital. This is a rare, but frustrating complication. During dissection of a distended, gangrenous appendix, a fecalith may drop into the peritoneal cavity. Retained fecaliths may cause an intrabdominal abscess. Therefore fecaliths need to be dealt with carefully and cautiously to avoid them being lost between the loops of the intestine and the pelvis. Fecatliths should be thrown into an endobag and careful lavage performed. This complication will be found more often as laparoscopic appendectomy becomes a more common method in the treatment of acute appendicitis. Surgeons should be aware of this complication in order to treat fecalith adequately when recognized intra or postoperatively. Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contraindicated or is not feasible.

Infrared Ureteral Stenting in Gynecological Laparoscopy

https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.

Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/roboticsurgerytraining.html This video demonstration is about Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra. Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/robotic-surgery.html This video demonstrate How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography

This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.

Indocyanine green (ICG) Cholecystectomy

https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.

Laparoscopic Varicocelectomy

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

TLH - Ligasure is better than Enseal

https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal

Recurrent Hernia Laparoscopic Repair

https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.

How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra. Knowledge of Laparoscopic Instruments are necessary for a laparoscopic surgeon. Safe use of instruments need a complete knowledge of Instrument design.

Endoscopy - Upper GI Endoscopy and Colonoscopy

https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.

How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra. The Totally Extraperitoneal Repair (TEP) is a keyhole technique for inguinal hernia repair. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall. The TEP repair is particularly recommended for the repair of bilateral inguinal hernias and recurrent inguinal hernias. The procedure is performed under general anaesthesia (Asleep). Three small incisions are made in the midline between the umbilicus and the pubic bone.

How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra

This video demonstrates the steps in performing a common bile duct exploration for gall stones, choledochoscopy and either primary closure or repair over a T-tube. How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra. In the era of laparoscopic surgery, treatment strategies for common bile duct stones remain controversial. Laparoscopic choledochotomy is usually indicated only when transcystic duct exploration is not feasible. However, laparoscopic choledochotomy provides complete access to the ductal system and has a higher clearance rate than the transcystic approach. In addition, primary closure of the choledochotomy with a running suture and absorbable clips facilitates the procedure. Therefore, to avoid postoperative biliary stenosis, all patients with bile duct stones can be indicated for choledochotomy, except for those with non dilated common bile duct. Placement of a C-tube also provides access for the clearance of possible retained stones by endoscopic sphincterotomy as a backup procedure.

How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.

Laparoscopic Salpingotomy for Ectopic Pregnancy

This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.

Laparoscopic Bilateral Ovarian Cystectomy

https://www.laparoscopyhospital.com This video demonstrate laparoscopic ovarian cystectomy by Dr R K Mishra at World Laparoscopy Hospital. An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen. The incisions in your abdomen will be closed with skin adhesive or stitches and may be covered with Band-Aids. If you have bandages, they can be removed 24 hours after surgery, and the adhesive or stitches will dissolve on their own. If you have small bandage trips on your incisions, leave them on and they will fall off on their own. If they do not fall off you can remove them seven days after your procedure. Do not soak your incisions in the bathtub or go swimming. You may shower, but do not rub your incisions.

How to do Safe Laparoscopic Ovarian Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe Ovarian Surgery - Lecture by Dr R K Mishra. This video include all the ovarian surgery including, oophorectomy, dermoid cyst, simple cyst, endometrioma and ovarian torsion. Laparoscopic surgery of the ovary can be performed for a variety of indications ranging from simple, benign, and common general gynecological problems to complicated, difficult, or rare pathologies specific to gynecologic oncology or reproductive endocrinology. Although laparoscopic ovarian surgery carries the attendant risks of minimally invasive surgical procedures of the abdomen and pelvis, occasional problems specific to ovarian surgery may arise. We review the utility of and indications for laparoscopic surgery of the ovary as well as specific problems associated with these procedures.

Hysterectomy Procedure Video

https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).

TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk

https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.

How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubaibach.php This video demonstrate How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra. Diagnostic laparoscopy is a surgical procedure that doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. During laparoscopy, the surgeon makes a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), usually near your belly button. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate abdomen. A diagnostic procedure is an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness.

Robotic Surgery - Past Present and Future of Robotic Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Robotic Surgery - Past Present and Future - Lecture by Dr R K Mishra. Robotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Robot the world’s most advanced surgical robot, these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure. The surgeon also operates a footswitch that provides additional options, such as the ability to switch between two different energy sources. Touchpads allow the surgeon to easily adjust video, audio and system settings, while the ergonomic console and the alignment of the controls and monitor are designed to keep the surgeon in a relaxed, focused position at all times.

Laparoscopic Management of Chronic Ectopic Pregnancy

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.

Mucocele of Gallbladder with Impacted Stone at Neck Operated by Mishra's Knot

https://www.laparoscopyhospital.com This video demonstrate Mucocele of Gallbladder with Impacted Stone at the Neck Performed by Mishra's Knot. A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge.

Laparoscopic Removal of Paraovarian Endometrioma with application of Intercede

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Paraovarian Endometrioma, Ovarian cystectomy. Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses. Here Intercede is applied to prevent adhesion. Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions.

Robotic Surgery - DaVinci and TransEnterix

https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements

Access Technique and Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com This video demonstrate Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra. We investigated the optimal position of the optical port of laparoscope in relationship to the working ports. The manipulation angle, defined as the angle formed by the line of action determined by the two working ports and the azimuth angle line of vision determined by the laparoscope, was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal range of the manipulation angle is 60 degrees and azimuth angle is 30 degree to left and 30 degrees to the right of the optimal position of 0 degree.

Robotic Dermoid Ovarian Cystectomy

This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities

Hysterectomy - Surgical removal of the uterus full video

https://www.laparoscopyhospital.com/ This video demonstrate hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient's abdomen. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy.

How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra. Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our this presentation is designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer. Repair of duodenal perforation by Graham patch plication was described in 1937 represents an excellent alternative approach. Perforated duodenal ulcer is a surgical emergency. In 1990 Mouret et al. reported the first laparoscopic sutureless fibrin glue omental patch for perforated duodenal ulcer.

Advantage, Disadvantage and Contraindication of Laparoscopic Surgery - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/currentbatch.html Laparoscopic or “minimally invasive” surgery is where the surgeon makes a very small incision, often in the patient’s belly button, and uses this incision to insert a camera, called a laparoscope, into the abdominal cavity. The surgeon then looks at a television screen to perform the operation. Carbon dioxide, a nontoxic and odorless gas, is then used to create an air pocket within the abdomen for the surgeon to operate. There are many advantages of laparoscopic surgery compared with traditional surgery, which is performed through large incisions. Patients have much less discomfort and require less pain medicine. They are able to get up and walk around sooner and get back to their regular activities earlier. With long incisions, patients are usually restricted in their activities when they go home to prevent developing a hernia at the incision site. Hernias rarely occur at laparoscopic incision sites, so patients can exercise and lift a lot earlier. They are also less likely to develop wound infections because the incisions are so small. Because patients are able to get out of bed sooner they are less likely to develop blot clots or pneumonia than with traditional surgery. Patients undergoing bowel surgery are able to drink and eat earlier than in the past. After the incisions have healed the scars are almost invisible so patients don’t have to feel self-conscious at the beach or pool.

How to Perform Cervical Cerclage - Lecture by Dr R K Mishra

This video demonstrate How to Perform Cervical Cerclage - Lecture by Dr R K Mishra. Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Treatment for cervical incompetence is a surgical procedure called cervical cerclage, in which the cervix is sewn closed during pregnancy. The cervix is the lowest part of the uterus and extends into the vagina.

How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.

Dermoid Cyst of Ovary - Laparoscopic Removal Without Spillage

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic ovarian cystectomy for dermoid cyst by Dr R K Mishra at World Laparoscopy Hospital. A dermoid cyst is a sac-like growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin. Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermoid cyst The dermoid cyst occasionally converts into cancer if untreated.

How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra. Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%).

Laparoscopic management of Peritoneal Inclusion Cyst

https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.

Incisional Hernia IPOM Repair with Dual Mesh

https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.

Axillary Lymph Node Resection and Thyroidectomy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/tables.html This video demonstrate Lymph Node Resection and Thyroidectomy Axilla and Breast Approach - Lecture by Dr R K Mishra. Only 16% of axilloscopy patients reported pain on the first postoperative day compared to 38% of open surgery patients. The incidence of seroma following endoscopic axillary retrieval was 6%, wound infection in 5% of patients. Conclusion: The axilloscopic approach with liposuction to axillary region presents a safe.

How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra

This video demonstrate How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra. Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.

Laparoscopic Fundoplication for GERD

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication surgery performed at World Laparoscopy Hospital. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic antireflux surgery remains a highly effective treatment in 80%-90% of patients with gastroesophageal reflux disease (GERD). Despite this, 10%-20% of patients continue to have symptoms postoperatively. Of these, some 3%-6% require a second surgery.

Sleeve Gastrectomy Full Length Step by Step Video

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

How to create safe Pneumoperitoneum - Lecture by Dr R K Mishra

This video demonstrate in Laparoscopic surgery how to create safe Pneumoperitoneum - Lecture by Dr R K Mishra. Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 12–15 mm Hg. Safe insufflation is important for a laparoscopic surgeon.

Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/ Demonstration of Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra. Knowledge of Laparoscopic Telescope that is also called as laparoscope, Laparoscopic Camera, Laparoscopic Light Source and Laparoscopic Light Cable is necessary for a laparoscopic surgeon to perform safe minimal access surgery.

Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/admission.php This video demonstration is about Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra. Rather than the traditional four to five small incisions, a single small incision can be used at the entry point. All surgical instruments are placed through this small incision and also the incision site is located in the left abdomen or umbilicus. Providing the benefits of fewer scars, the opportunity of less pain, and shorter recovery periods, SILS is one of the newest laparoscopic techniques and it is regarded as non-invasive. In general, SILS techniques take about the same amount of time to do as traditional laparoscopic surgeries. However, SILS is recognized as to be a more complicated procedure because it involves manipulating three articulating instruments through one access port.

Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra. Electrosurgical units are the most common type of electrical equipment in the operating room. A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care. The risk of complications is linked to the surgeon's fundamental knowledge of instruments, surgical technique, biophysics, relevant anatomy, and safe technical equipment. The risk of complications is linked to fundamental surgical knowledge of instruments, surgical technique, biophysics, and relevant anatomy. Appropriately applied, electrosurgery is safe and effective. Electrothermal injury may result from direct application, insulation failure, direct coupling, and capacitive coupling.

Umbilical and Paraumbilical Hernia Surgery

https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.

Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent

https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.

IPOM Inguinal Hernia Surgery

https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.

Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra. A thorough knowledge of the fundamentals of electrosurgery by the entire team in the operating room is essential for patient safety and for recognizing potential complications. Newer hemostatic technologies can be used to decrease the incidence of complications. INTRODUCTION A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care.1 Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery.2 The surgical team should have a good understanding of the principles of electrosurgery and tissue effects to avoid complications.

Laparoscopic Removal of Intramural and Broad Ligament Myoma

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.

https://www.laparoscopyhospital.com/

Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent

https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.

Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography

This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.

IPOM Inguinal Hernia Surgery

https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.

Laparoscopic Appendectomy for Fecalith of Appendix

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Appendectomy for Fecalith of Appendix performed by Dr R K Mishra at World Laparoscopy Hospital. This is a rare, but frustrating complication. During dissection of a distended, gangrenous appendix, a fecalith may drop into the peritoneal cavity. Retained fecaliths may cause an intrabdominal abscess. Therefore fecaliths need to be dealt with carefully and cautiously to avoid them being lost between the loops of the intestine and the pelvis. Fecatliths should be thrown into an endobag and careful lavage performed. This complication will be found more often as laparoscopic appendectomy becomes a more common method in the treatment of acute appendicitis. Surgeons should be aware of this complication in order to treat fecalith adequately when recognized intra or postoperatively. Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contraindicated or is not feasible.

Laparoscopic management of Peritoneal Inclusion Cyst

https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.

How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra

This video demonstrates the steps in performing a common bile duct exploration for gall stones, choledochoscopy and either primary closure or repair over a T-tube. How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra. In the era of laparoscopic surgery, treatment strategies for common bile duct stones remain controversial. Laparoscopic choledochotomy is usually indicated only when transcystic duct exploration is not feasible. However, laparoscopic choledochotomy provides complete access to the ductal system and has a higher clearance rate than the transcystic approach. In addition, primary closure of the choledochotomy with a running suture and absorbable clips facilitates the procedure. Therefore, to avoid postoperative biliary stenosis, all patients with bile duct stones can be indicated for choledochotomy, except for those with non dilated common bile duct. Placement of a C-tube also provides access for the clearance of possible retained stones by endoscopic sphincterotomy as a backup procedure.

How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.

How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.

Incisional Hernia IPOM Repair with Dual Mesh

https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.

Laparoscopic Surgery for Subacute Small Bowel Obstruction

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra. Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our this presentation is designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer. Repair of duodenal perforation by Graham patch plication was described in 1937 represents an excellent alternative approach. Perforated duodenal ulcer is a surgical emergency. In 1990 Mouret et al. reported the first laparoscopic sutureless fibrin glue omental patch for perforated duodenal ulcer.

Laparoscopic Salpingotomy for Ectopic Pregnancy

This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.

Robotic Surgery - Past Present and Future of Robotic Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Robotic Surgery - Past Present and Future - Lecture by Dr R K Mishra. Robotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Robot the world’s most advanced surgical robot, these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure. The surgeon also operates a footswitch that provides additional options, such as the ability to switch between two different energy sources. Touchpads allow the surgeon to easily adjust video, audio and system settings, while the ergonomic console and the alignment of the controls and monitor are designed to keep the surgeon in a relaxed, focused position at all times.

Laparoscopic Varicocelectomy

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

How to do Safe Laparoscopic Ovarian Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe Ovarian Surgery - Lecture by Dr R K Mishra. This video include all the ovarian surgery including, oophorectomy, dermoid cyst, simple cyst, endometrioma and ovarian torsion. Laparoscopic surgery of the ovary can be performed for a variety of indications ranging from simple, benign, and common general gynecological problems to complicated, difficult, or rare pathologies specific to gynecologic oncology or reproductive endocrinology. Although laparoscopic ovarian surgery carries the attendant risks of minimally invasive surgical procedures of the abdomen and pelvis, occasional problems specific to ovarian surgery may arise. We review the utility of and indications for laparoscopic surgery of the ovary as well as specific problems associated with these procedures.

Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/ Demonstration of Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra. Knowledge of Laparoscopic Telescope that is also called as laparoscope, Laparoscopic Camera, Laparoscopic Light Source and Laparoscopic Light Cable is necessary for a laparoscopic surgeon to perform safe minimal access surgery.

How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubaibach.php This video demonstrate How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra. Diagnostic laparoscopy is a surgical procedure that doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. During laparoscopy, the surgeon makes a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), usually near your belly button. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate abdomen. A diagnostic procedure is an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness.

Access Technique and Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com This video demonstrate Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra. We investigated the optimal position of the optical port of laparoscope in relationship to the working ports. The manipulation angle, defined as the angle formed by the line of action determined by the two working ports and the azimuth angle line of vision determined by the laparoscope, was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal range of the manipulation angle is 60 degrees and azimuth angle is 30 degree to left and 30 degrees to the right of the optimal position of 0 degree.

How to create safe Pneumoperitoneum - Lecture by Dr R K Mishra

This video demonstrate in Laparoscopic surgery how to create safe Pneumoperitoneum - Lecture by Dr R K Mishra. Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 12–15 mm Hg. Safe insufflation is important for a laparoscopic surgeon.

Advantage, Disadvantage and Contraindication of Laparoscopic Surgery - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/currentbatch.html Laparoscopic or “minimally invasive” surgery is where the surgeon makes a very small incision, often in the patient’s belly button, and uses this incision to insert a camera, called a laparoscope, into the abdominal cavity. The surgeon then looks at a television screen to perform the operation. Carbon dioxide, a nontoxic and odorless gas, is then used to create an air pocket within the abdomen for the surgeon to operate. There are many advantages of laparoscopic surgery compared with traditional surgery, which is performed through large incisions. Patients have much less discomfort and require less pain medicine. They are able to get up and walk around sooner and get back to their regular activities earlier. With long incisions, patients are usually restricted in their activities when they go home to prevent developing a hernia at the incision site. Hernias rarely occur at laparoscopic incision sites, so patients can exercise and lift a lot earlier. They are also less likely to develop wound infections because the incisions are so small. Because patients are able to get out of bed sooner they are less likely to develop blot clots or pneumonia than with traditional surgery. Patients undergoing bowel surgery are able to drink and eat earlier than in the past. After the incisions have healed the scars are almost invisible so patients don’t have to feel self-conscious at the beach or pool.

Mucocele of Gallbladder with Impacted Stone at Neck Operated by Mishra's Knot

https://www.laparoscopyhospital.com This video demonstrate Mucocele of Gallbladder with Impacted Stone at the Neck Performed by Mishra's Knot. A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge.

Laparoscopic Management of Chronic Ectopic Pregnancy

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.

Dermoid Cyst of Ovary - Laparoscopic Removal Without Spillage

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic ovarian cystectomy for dermoid cyst by Dr R K Mishra at World Laparoscopy Hospital. A dermoid cyst is a sac-like growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin. Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermoid cyst The dermoid cyst occasionally converts into cancer if untreated.

Laparoscopic Bilateral Ovarian Cystectomy

https://www.laparoscopyhospital.com This video demonstrate laparoscopic ovarian cystectomy by Dr R K Mishra at World Laparoscopy Hospital. An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen. The incisions in your abdomen will be closed with skin adhesive or stitches and may be covered with Band-Aids. If you have bandages, they can be removed 24 hours after surgery, and the adhesive or stitches will dissolve on their own. If you have small bandage trips on your incisions, leave them on and they will fall off on their own. If they do not fall off you can remove them seven days after your procedure. Do not soak your incisions in the bathtub or go swimming. You may shower, but do not rub your incisions.

Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/admission.php This video demonstration is about Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra. Rather than the traditional four to five small incisions, a single small incision can be used at the entry point. All surgical instruments are placed through this small incision and also the incision site is located in the left abdomen or umbilicus. Providing the benefits of fewer scars, the opportunity of less pain, and shorter recovery periods, SILS is one of the newest laparoscopic techniques and it is regarded as non-invasive. In general, SILS techniques take about the same amount of time to do as traditional laparoscopic surgeries. However, SILS is recognized as to be a more complicated procedure because it involves manipulating three articulating instruments through one access port.

Robotic Surgery - DaVinci and TransEnterix

https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements

Hysterectomy Procedure Video

https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).

TLH - Ligasure is better than Enseal

https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal

How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra. Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%).

Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/roboticsurgerytraining.html This video demonstration is about Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra. Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

Infrared Ureteral Stenting in Gynecological Laparoscopy

https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.

Recurrent Hernia Laparoscopic Repair

https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.

How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/robotic-surgery.html This video demonstrate How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

Laparoscopic Removal of Paraovarian Endometrioma with application of Intercede

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Paraovarian Endometrioma, Ovarian cystectomy. Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses. Here Intercede is applied to prevent adhesion. Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions.

How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra. The Totally Extraperitoneal Repair (TEP) is a keyhole technique for inguinal hernia repair. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall. The TEP repair is particularly recommended for the repair of bilateral inguinal hernias and recurrent inguinal hernias. The procedure is performed under general anaesthesia (Asleep). Three small incisions are made in the midline between the umbilicus and the pubic bone.

Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra. Electrosurgical units are the most common type of electrical equipment in the operating room. A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care. The risk of complications is linked to the surgeon's fundamental knowledge of instruments, surgical technique, biophysics, relevant anatomy, and safe technical equipment. The risk of complications is linked to fundamental surgical knowledge of instruments, surgical technique, biophysics, and relevant anatomy. Appropriately applied, electrosurgery is safe and effective. Electrothermal injury may result from direct application, insulation failure, direct coupling, and capacitive coupling.

Laparoscopic Fundoplication for GERD

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication surgery performed at World Laparoscopy Hospital. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic antireflux surgery remains a highly effective treatment in 80%-90% of patients with gastroesophageal reflux disease (GERD). Despite this, 10%-20% of patients continue to have symptoms postoperatively. Of these, some 3%-6% require a second surgery.

How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra. Knowledge of Laparoscopic Instruments are necessary for a laparoscopic surgeon. Safe use of instruments need a complete knowledge of Instrument design.

Robotic Dermoid Ovarian Cystectomy

This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities

TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk

https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.

Laparoscopic Removal of Intramural and Broad Ligament Myoma

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.

Axillary Lymph Node Resection and Thyroidectomy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/tables.html This video demonstrate Lymph Node Resection and Thyroidectomy Axilla and Breast Approach - Lecture by Dr R K Mishra. Only 16% of axilloscopy patients reported pain on the first postoperative day compared to 38% of open surgery patients. The incidence of seroma following endoscopic axillary retrieval was 6%, wound infection in 5% of patients. Conclusion: The axilloscopic approach with liposuction to axillary region presents a safe.

Indocyanine green (ICG) Cholecystectomy

https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.

Umbilical and Paraumbilical Hernia Surgery

https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.

Sleeve Gastrectomy Full Length Step by Step Video

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra

This video demonstrate How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra. Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.

How to Perform Cervical Cerclage - Lecture by Dr R K Mishra

This video demonstrate How to Perform Cervical Cerclage - Lecture by Dr R K Mishra. Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Treatment for cervical incompetence is a surgical procedure called cervical cerclage, in which the cervix is sewn closed during pregnancy. The cervix is the lowest part of the uterus and extends into the vagina.

Endoscopy - Upper GI Endoscopy and Colonoscopy

https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.

Hysterectomy - Surgical removal of the uterus full video

https://www.laparoscopyhospital.com/ This video demonstrate hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient's abdomen. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy.

Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra. A thorough knowledge of the fundamentals of electrosurgery by the entire team in the operating room is essential for patient safety and for recognizing potential complications. Newer hemostatic technologies can be used to decrease the incidence of complications. INTRODUCTION A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care.1 Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery.2 The surgical team should have a good understanding of the principles of electrosurgery and tissue effects to avoid complications.

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Laparoscopic Salpingotomy for Ectopic Pregnancy

This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.

Sleeve Gastrectomy Full Length Step by Step Video

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

Access Technique and Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com This video demonstrate Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra. We investigated the optimal position of the optical port of laparoscope in relationship to the working ports. The manipulation angle, defined as the angle formed by the line of action determined by the two working ports and the azimuth angle line of vision determined by the laparoscope, was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal range of the manipulation angle is 60 degrees and azimuth angle is 30 degree to left and 30 degrees to the right of the optimal position of 0 degree.

Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/admission.php This video demonstration is about Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra. Rather than the traditional four to five small incisions, a single small incision can be used at the entry point. All surgical instruments are placed through this small incision and also the incision site is located in the left abdomen or umbilicus. Providing the benefits of fewer scars, the opportunity of less pain, and shorter recovery periods, SILS is one of the newest laparoscopic techniques and it is regarded as non-invasive. In general, SILS techniques take about the same amount of time to do as traditional laparoscopic surgeries. However, SILS is recognized as to be a more complicated procedure because it involves manipulating three articulating instruments through one access port.

Hysterectomy - Surgical removal of the uterus full video

https://www.laparoscopyhospital.com/ This video demonstrate hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient's abdomen. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy.

How to do Safe Laparoscopic Ovarian Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe Ovarian Surgery - Lecture by Dr R K Mishra. This video include all the ovarian surgery including, oophorectomy, dermoid cyst, simple cyst, endometrioma and ovarian torsion. Laparoscopic surgery of the ovary can be performed for a variety of indications ranging from simple, benign, and common general gynecological problems to complicated, difficult, or rare pathologies specific to gynecologic oncology or reproductive endocrinology. Although laparoscopic ovarian surgery carries the attendant risks of minimally invasive surgical procedures of the abdomen and pelvis, occasional problems specific to ovarian surgery may arise. We review the utility of and indications for laparoscopic surgery of the ovary as well as specific problems associated with these procedures.

How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra. Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%).

Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra. Electrosurgical units are the most common type of electrical equipment in the operating room. A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care. The risk of complications is linked to the surgeon's fundamental knowledge of instruments, surgical technique, biophysics, relevant anatomy, and safe technical equipment. The risk of complications is linked to fundamental surgical knowledge of instruments, surgical technique, biophysics, and relevant anatomy. Appropriately applied, electrosurgery is safe and effective. Electrothermal injury may result from direct application, insulation failure, direct coupling, and capacitive coupling.

Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography

This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.

How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.

Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra. A thorough knowledge of the fundamentals of electrosurgery by the entire team in the operating room is essential for patient safety and for recognizing potential complications. Newer hemostatic technologies can be used to decrease the incidence of complications. INTRODUCTION A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care.1 Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery.2 The surgical team should have a good understanding of the principles of electrosurgery and tissue effects to avoid complications.

How to create safe Pneumoperitoneum - Lecture by Dr R K Mishra

This video demonstrate in Laparoscopic surgery how to create safe Pneumoperitoneum - Lecture by Dr R K Mishra. Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 12–15 mm Hg. Safe insufflation is important for a laparoscopic surgeon.

How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra. Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our this presentation is designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer. Repair of duodenal perforation by Graham patch plication was described in 1937 represents an excellent alternative approach. Perforated duodenal ulcer is a surgical emergency. In 1990 Mouret et al. reported the first laparoscopic sutureless fibrin glue omental patch for perforated duodenal ulcer.

Robotic Surgery - Past Present and Future of Robotic Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Robotic Surgery - Past Present and Future - Lecture by Dr R K Mishra. Robotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Robot the world’s most advanced surgical robot, these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure. The surgeon also operates a footswitch that provides additional options, such as the ability to switch between two different energy sources. Touchpads allow the surgeon to easily adjust video, audio and system settings, while the ergonomic console and the alignment of the controls and monitor are designed to keep the surgeon in a relaxed, focused position at all times.

Axillary Lymph Node Resection and Thyroidectomy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/tables.html This video demonstrate Lymph Node Resection and Thyroidectomy Axilla and Breast Approach - Lecture by Dr R K Mishra. Only 16% of axilloscopy patients reported pain on the first postoperative day compared to 38% of open surgery patients. The incidence of seroma following endoscopic axillary retrieval was 6%, wound infection in 5% of patients. Conclusion: The axilloscopic approach with liposuction to axillary region presents a safe.

Endoscopy - Upper GI Endoscopy and Colonoscopy

https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.

Laparoscopic Management of Chronic Ectopic Pregnancy

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.

Hysterectomy Procedure Video

https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).

Dermoid Cyst of Ovary - Laparoscopic Removal Without Spillage

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic ovarian cystectomy for dermoid cyst by Dr R K Mishra at World Laparoscopy Hospital. A dermoid cyst is a sac-like growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin. Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermoid cyst The dermoid cyst occasionally converts into cancer if untreated.

How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubaibach.php This video demonstrate How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra. Diagnostic laparoscopy is a surgical procedure that doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. During laparoscopy, the surgeon makes a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), usually near your belly button. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate abdomen. A diagnostic procedure is an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness.

Laparoscopic Fundoplication for GERD

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication surgery performed at World Laparoscopy Hospital. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic antireflux surgery remains a highly effective treatment in 80%-90% of patients with gastroesophageal reflux disease (GERD). Despite this, 10%-20% of patients continue to have symptoms postoperatively. Of these, some 3%-6% require a second surgery.

Laparoscopic Bilateral Ovarian Cystectomy

https://www.laparoscopyhospital.com This video demonstrate laparoscopic ovarian cystectomy by Dr R K Mishra at World Laparoscopy Hospital. An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen. The incisions in your abdomen will be closed with skin adhesive or stitches and may be covered with Band-Aids. If you have bandages, they can be removed 24 hours after surgery, and the adhesive or stitches will dissolve on their own. If you have small bandage trips on your incisions, leave them on and they will fall off on their own. If they do not fall off you can remove them seven days after your procedure. Do not soak your incisions in the bathtub or go swimming. You may shower, but do not rub your incisions.

How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/robotic-surgery.html This video demonstrate How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.

TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk

https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.

Robotic Dermoid Ovarian Cystectomy

This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities

How to Perform Cervical Cerclage - Lecture by Dr R K Mishra

This video demonstrate How to Perform Cervical Cerclage - Lecture by Dr R K Mishra. Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Treatment for cervical incompetence is a surgical procedure called cervical cerclage, in which the cervix is sewn closed during pregnancy. The cervix is the lowest part of the uterus and extends into the vagina.

Umbilical and Paraumbilical Hernia Surgery

https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.

Laparoscopic Varicocelectomy

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

Recurrent Hernia Laparoscopic Repair

https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.

Advantage, Disadvantage and Contraindication of Laparoscopic Surgery - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/currentbatch.html Laparoscopic or “minimally invasive” surgery is where the surgeon makes a very small incision, often in the patient’s belly button, and uses this incision to insert a camera, called a laparoscope, into the abdominal cavity. The surgeon then looks at a television screen to perform the operation. Carbon dioxide, a nontoxic and odorless gas, is then used to create an air pocket within the abdomen for the surgeon to operate. There are many advantages of laparoscopic surgery compared with traditional surgery, which is performed through large incisions. Patients have much less discomfort and require less pain medicine. They are able to get up and walk around sooner and get back to their regular activities earlier. With long incisions, patients are usually restricted in their activities when they go home to prevent developing a hernia at the incision site. Hernias rarely occur at laparoscopic incision sites, so patients can exercise and lift a lot earlier. They are also less likely to develop wound infections because the incisions are so small. Because patients are able to get out of bed sooner they are less likely to develop blot clots or pneumonia than with traditional surgery. Patients undergoing bowel surgery are able to drink and eat earlier than in the past. After the incisions have healed the scars are almost invisible so patients don’t have to feel self-conscious at the beach or pool.

Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent

https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.

Mucocele of Gallbladder with Impacted Stone at Neck Operated by Mishra's Knot

https://www.laparoscopyhospital.com This video demonstrate Mucocele of Gallbladder with Impacted Stone at the Neck Performed by Mishra's Knot. A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge.

TLH - Ligasure is better than Enseal

https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal

Robotic Surgery - DaVinci and TransEnterix

https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements

IPOM Inguinal Hernia Surgery

https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.

Laparoscopic Removal of Intramural and Broad Ligament Myoma

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.

Laparoscopic Removal of Paraovarian Endometrioma with application of Intercede

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Paraovarian Endometrioma, Ovarian cystectomy. Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses. Here Intercede is applied to prevent adhesion. Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions.

How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra

This video demonstrate How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra. Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.

Laparoscopic management of Peritoneal Inclusion Cyst

https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.

How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra

This video demonstrates the steps in performing a common bile duct exploration for gall stones, choledochoscopy and either primary closure or repair over a T-tube. How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra. In the era of laparoscopic surgery, treatment strategies for common bile duct stones remain controversial. Laparoscopic choledochotomy is usually indicated only when transcystic duct exploration is not feasible. However, laparoscopic choledochotomy provides complete access to the ductal system and has a higher clearance rate than the transcystic approach. In addition, primary closure of the choledochotomy with a running suture and absorbable clips facilitates the procedure. Therefore, to avoid postoperative biliary stenosis, all patients with bile duct stones can be indicated for choledochotomy, except for those with non dilated common bile duct. Placement of a C-tube also provides access for the clearance of possible retained stones by endoscopic sphincterotomy as a backup procedure.

How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra. Knowledge of Laparoscopic Instruments are necessary for a laparoscopic surgeon. Safe use of instruments need a complete knowledge of Instrument design.

Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/ Demonstration of Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra. Knowledge of Laparoscopic Telescope that is also called as laparoscope, Laparoscopic Camera, Laparoscopic Light Source and Laparoscopic Light Cable is necessary for a laparoscopic surgeon to perform safe minimal access surgery.

Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/roboticsurgerytraining.html This video demonstration is about Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra. Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

Laparoscopic Appendectomy for Fecalith of Appendix

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Appendectomy for Fecalith of Appendix performed by Dr R K Mishra at World Laparoscopy Hospital. This is a rare, but frustrating complication. During dissection of a distended, gangrenous appendix, a fecalith may drop into the peritoneal cavity. Retained fecaliths may cause an intrabdominal abscess. Therefore fecaliths need to be dealt with carefully and cautiously to avoid them being lost between the loops of the intestine and the pelvis. Fecatliths should be thrown into an endobag and careful lavage performed. This complication will be found more often as laparoscopic appendectomy becomes a more common method in the treatment of acute appendicitis. Surgeons should be aware of this complication in order to treat fecalith adequately when recognized intra or postoperatively. Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contraindicated or is not feasible.

Infrared Ureteral Stenting in Gynecological Laparoscopy

https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.

Indocyanine green (ICG) Cholecystectomy

https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.

Laparoscopic Surgery for Subacute Small Bowel Obstruction

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

Incisional Hernia IPOM Repair with Dual Mesh

https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.

How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra. The Totally Extraperitoneal Repair (TEP) is a keyhole technique for inguinal hernia repair. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall. The TEP repair is particularly recommended for the repair of bilateral inguinal hernias and recurrent inguinal hernias. The procedure is performed under general anaesthesia (Asleep). Three small incisions are made in the midline between the umbilicus and the pubic bone.

https://www.laparoscopyhospital.com/

Laparoscopic Fundoplication for GERD

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication surgery performed at World Laparoscopy Hospital. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic antireflux surgery remains a highly effective treatment in 80%-90% of patients with gastroesophageal reflux disease (GERD). Despite this, 10%-20% of patients continue to have symptoms postoperatively. Of these, some 3%-6% require a second surgery.

Laparoscopic Removal of Intramural and Broad Ligament Myoma

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.

Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part I - Lecture by Dr R K Mishra. Electrosurgical units are the most common type of electrical equipment in the operating room. A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care. The risk of complications is linked to the surgeon's fundamental knowledge of instruments, surgical technique, biophysics, relevant anatomy, and safe technical equipment. The risk of complications is linked to fundamental surgical knowledge of instruments, surgical technique, biophysics, and relevant anatomy. Appropriately applied, electrosurgery is safe and effective. Electrothermal injury may result from direct application, insulation failure, direct coupling, and capacitive coupling.

Incisional Hernia IPOM Repair with Dual Mesh

https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.

How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/robotic-surgery.html This video demonstrate How to do Safe Laparoscopic Fundoplication - Lecture by Dr R K Mishra. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus. This procedure creates a new “functional valve” between the esophagus and the stomach and prevents reflux of the acid and bile (non-acidic fluid) from the stomach into the esophagus. It is well studied that patients with typical (common) symptoms of gastroesophageal reflux disease – heartburn, regurgitation and dysphagia (difficulty swallowing) – who respond well to antacid therapy and have a positive esophageal pH assessment (evidence of acid in the esophagus) have the best outcome after laparoscopic Nissen fundoplication.

Laparoscopic Bilateral Ovarian Cystectomy

https://www.laparoscopyhospital.com This video demonstrate laparoscopic ovarian cystectomy by Dr R K Mishra at World Laparoscopy Hospital. An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen. The incisions in your abdomen will be closed with skin adhesive or stitches and may be covered with Band-Aids. If you have bandages, they can be removed 24 hours after surgery, and the adhesive or stitches will dissolve on their own. If you have small bandage trips on your incisions, leave them on and they will fall off on their own. If they do not fall off you can remove them seven days after your procedure. Do not soak your incisions in the bathtub or go swimming. You may shower, but do not rub your incisions.

How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe TEP Hernia Surgery - Lecture by Dr R K Mishra. The Totally Extraperitoneal Repair (TEP) is a keyhole technique for inguinal hernia repair. With this technique hernias are repaired using a piece of mesh which is placed behind the muscle of the abdominal wall. The TEP repair is particularly recommended for the repair of bilateral inguinal hernias and recurrent inguinal hernias. The procedure is performed under general anaesthesia (Asleep). Three small incisions are made in the midline between the umbilicus and the pubic bone.

Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/roboticsurgerytraining.html This video demonstration is about Vesicovaginal Fistula Repair VVF - Lecture by Dr R K Mishra. Vesicovaginal fistulas (VVFs) are a devastating consequence of prolonged labor in developing countries and pelvic surgery in developed countries. Clinical history, physical examination, and pertinent radiographic studies are necessary for proper diagnosis. Endoscopic management can lead to successful closure of small fistulas; the advent of tissue bioglues has made this modality more promising. However, the majority of patients will require transvaginal or transabdominal repair of the fistula. This article reviews the basic principles of fistula closure and discusses adjuvant techniques with tissue interposition grafts; techniques for successful closure of fistulas; and newer modalities for repair using tissue bioglues, laparoscopy, and robotic surgery.

Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/admission.php This video demonstration is about Single Incision Laparoscopic Surgery SILS - Lecture by Dr R K Mishra. Rather than the traditional four to five small incisions, a single small incision can be used at the entry point. All surgical instruments are placed through this small incision and also the incision site is located in the left abdomen or umbilicus. Providing the benefits of fewer scars, the opportunity of less pain, and shorter recovery periods, SILS is one of the newest laparoscopic techniques and it is regarded as non-invasive. In general, SILS techniques take about the same amount of time to do as traditional laparoscopic surgeries. However, SILS is recognized as to be a more complicated procedure because it involves manipulating three articulating instruments through one access port.

Access Technique and Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com This video demonstrate Optimal Position of Ports in Laparoscopy - Lecture by Dr R K Mishra. We investigated the optimal position of the optical port of laparoscope in relationship to the working ports. The manipulation angle, defined as the angle formed by the line of action determined by the two working ports and the azimuth angle line of vision determined by the laparoscope, was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal range of the manipulation angle is 60 degrees and azimuth angle is 30 degree to left and 30 degrees to the right of the optimal position of 0 degree.

Robotic Dermoid Ovarian Cystectomy

This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities

TLH - Ligasure is better than Enseal

https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal

How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra

This video demonstrates the steps in performing a common bile duct exploration for gall stones, choledochoscopy and either primary closure or repair over a T-tube. How to do Safe Laparoscopic Choledocotomy - Lecture by Dr R K Mishra. In the era of laparoscopic surgery, treatment strategies for common bile duct stones remain controversial. Laparoscopic choledochotomy is usually indicated only when transcystic duct exploration is not feasible. However, laparoscopic choledochotomy provides complete access to the ductal system and has a higher clearance rate than the transcystic approach. In addition, primary closure of the choledochotomy with a running suture and absorbable clips facilitates the procedure. Therefore, to avoid postoperative biliary stenosis, all patients with bile duct stones can be indicated for choledochotomy, except for those with non dilated common bile duct. Placement of a C-tube also provides access for the clearance of possible retained stones by endoscopic sphincterotomy as a backup procedure.

Laparoscopic Appendectomy for Fecalith of Appendix

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Appendectomy for Fecalith of Appendix performed by Dr R K Mishra at World Laparoscopy Hospital. This is a rare, but frustrating complication. During dissection of a distended, gangrenous appendix, a fecalith may drop into the peritoneal cavity. Retained fecaliths may cause an intrabdominal abscess. Therefore fecaliths need to be dealt with carefully and cautiously to avoid them being lost between the loops of the intestine and the pelvis. Fecatliths should be thrown into an endobag and careful lavage performed. This complication will be found more often as laparoscopic appendectomy becomes a more common method in the treatment of acute appendicitis. Surgeons should be aware of this complication in order to treat fecalith adequately when recognized intra or postoperatively. Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contraindicated or is not feasible.

Robotic Surgery - DaVinci and TransEnterix

https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements

How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe TVT, TOT and TVTO Lecture by Dr R K Mishra. Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%).

How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubaibach.php This video demonstrate How to Perform Safe Diagnostic Laparoscopy - Lecture by Dr R K Mishra. Diagnostic laparoscopy is a surgical procedure that doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. During laparoscopy, the surgeon makes a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), usually near your belly button. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate abdomen. A diagnostic procedure is an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness.

Advantage, Disadvantage and Contraindication of Laparoscopic Surgery - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/currentbatch.html Laparoscopic or “minimally invasive” surgery is where the surgeon makes a very small incision, often in the patient’s belly button, and uses this incision to insert a camera, called a laparoscope, into the abdominal cavity. The surgeon then looks at a television screen to perform the operation. Carbon dioxide, a nontoxic and odorless gas, is then used to create an air pocket within the abdomen for the surgeon to operate. There are many advantages of laparoscopic surgery compared with traditional surgery, which is performed through large incisions. Patients have much less discomfort and require less pain medicine. They are able to get up and walk around sooner and get back to their regular activities earlier. With long incisions, patients are usually restricted in their activities when they go home to prevent developing a hernia at the incision site. Hernias rarely occur at laparoscopic incision sites, so patients can exercise and lift a lot earlier. They are also less likely to develop wound infections because the incisions are so small. Because patients are able to get out of bed sooner they are less likely to develop blot clots or pneumonia than with traditional surgery. Patients undergoing bowel surgery are able to drink and eat earlier than in the past. After the incisions have healed the scars are almost invisible so patients don’t have to feel self-conscious at the beach or pool.

Mucocele of Gallbladder with Impacted Stone at Neck Operated by Mishra's Knot

https://www.laparoscopyhospital.com This video demonstrate Mucocele of Gallbladder with Impacted Stone at the Neck Performed by Mishra's Knot. A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge.

How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate How to use Laparoscopic Trocar, Graspers and Dissectors - Lecture by Dr R K Mishra. Knowledge of Laparoscopic Instruments are necessary for a laparoscopic surgeon. Safe use of instruments need a complete knowledge of Instrument design.

Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra

https://www.laparoscopyhospital.com/ Demonstration of Laparoscopic Telescope, Camera, Light Source and Light Cable - Lecture of Dr R K Mishra. Knowledge of Laparoscopic Telescope that is also called as laparoscope, Laparoscopic Camera, Laparoscopic Light Source and Laparoscopic Light Cable is necessary for a laparoscopic surgeon to perform safe minimal access surgery.

TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk

https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.

Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent

https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.

Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography

This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.

Dermoid Cyst of Ovary - Laparoscopic Removal Without Spillage

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic ovarian cystectomy for dermoid cyst by Dr R K Mishra at World Laparoscopy Hospital. A dermoid cyst is a sac-like growth that is present at birth. It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin. Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur on the face, inside the skull, on the lower back, and in the ovaries. While all ovarian cysts can range in size from very small to quite large, dermoid cysts are not classified as functional cysts. Dermoid cysts originate from totipotential germ cells (which are present at birth) that differentiate abnormally, developing characteristics of mature dermoid cyst The dermoid cyst occasionally converts into cancer if untreated.

How to do Safe Laparoscopic Ovarian Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to do Safe Ovarian Surgery - Lecture by Dr R K Mishra. This video include all the ovarian surgery including, oophorectomy, dermoid cyst, simple cyst, endometrioma and ovarian torsion. Laparoscopic surgery of the ovary can be performed for a variety of indications ranging from simple, benign, and common general gynecological problems to complicated, difficult, or rare pathologies specific to gynecologic oncology or reproductive endocrinology. Although laparoscopic ovarian surgery carries the attendant risks of minimally invasive surgical procedures of the abdomen and pelvis, occasional problems specific to ovarian surgery may arise. We review the utility of and indications for laparoscopic surgery of the ovary as well as specific problems associated with these procedures.

Robotic Surgery - Past Present and Future of Robotic Surgery - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Robotic Surgery - Past Present and Future - Lecture by Dr R K Mishra. Robotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Robot the world’s most advanced surgical robot, these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure. The surgeon also operates a footswitch that provides additional options, such as the ability to switch between two different energy sources. Touchpads allow the surgeon to easily adjust video, audio and system settings, while the ergonomic console and the alignment of the controls and monitor are designed to keep the surgeon in a relaxed, focused position at all times.

How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.

How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.

Axillary Lymph Node Resection and Thyroidectomy - Lecture by Dr R K Mishra

https://www.laparoscopyhospital.com/tables.html This video demonstrate Lymph Node Resection and Thyroidectomy Axilla and Breast Approach - Lecture by Dr R K Mishra. Only 16% of axilloscopy patients reported pain on the first postoperative day compared to 38% of open surgery patients. The incidence of seroma following endoscopic axillary retrieval was 6%, wound infection in 5% of patients. Conclusion: The axilloscopic approach with liposuction to axillary region presents a safe.

How to create safe Pneumoperitoneum - Lecture by Dr R K Mishra

This video demonstrate in Laparoscopic surgery how to create safe Pneumoperitoneum - Lecture by Dr R K Mishra. Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 12–15 mm Hg. Safe insufflation is important for a laparoscopic surgeon.

Hysterectomy - Surgical removal of the uterus full video

https://www.laparoscopyhospital.com/ This video demonstrate hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Total Laparoscopic Hysterectomy (TLH) is an operation to remove the uterus with the aid of an operating telescope known as a laparoscope. This tiny instrument is inserted through a small cut within the abdominal wall and allows the surgeon to see inside patient's abdomen. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy. Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. Total laparoscopic hysterectomy is a safe and effective procedure for women needing a hysterectomy.

How to Perform Cervical Cerclage - Lecture by Dr R K Mishra

This video demonstrate How to Perform Cervical Cerclage - Lecture by Dr R K Mishra. Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Treatment for cervical incompetence is a surgical procedure called cervical cerclage, in which the cervix is sewn closed during pregnancy. The cervix is the lowest part of the uterus and extends into the vagina.

Sleeve Gastrectomy Full Length Step by Step Video

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra

This video demonstrate How to Perform Safe Laparoscopic Duodenal Perforation - Lecture by Dr R K Mishra. Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our this presentation is designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer. Repair of duodenal perforation by Graham patch plication was described in 1937 represents an excellent alternative approach. Perforated duodenal ulcer is a surgical emergency. In 1990 Mouret et al. reported the first laparoscopic sutureless fibrin glue omental patch for perforated duodenal ulcer.

Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra

This video demonstrate Safe Use of Electrosurgery in Laparoscopy Part II - Lecture by Dr R K Mishra. A thorough knowledge of the fundamentals of electrosurgery by the entire team in the operating room is essential for patient safety and for recognizing potential complications. Newer hemostatic technologies can be used to decrease the incidence of complications. INTRODUCTION A basic understanding of electricity is needed to safely apply electrosurgical technology for patient care.1 Electrosurgery is one of the most commonly used energy systems in laparoscopic surgery.2 The surgical team should have a good understanding of the principles of electrosurgery and tissue effects to avoid complications.

Recurrent Hernia Laparoscopic Repair

https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.

Indocyanine green (ICG) Cholecystectomy

https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.

Laparoscopic Salpingotomy for Ectopic Pregnancy

This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.

Laparoscopic Management of Chronic Ectopic Pregnancy

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.

Infrared Ureteral Stenting in Gynecological Laparoscopy

https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.

Laparoscopic management of Peritoneal Inclusion Cyst

https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.

Laparoscopic Surgery for Subacute Small Bowel Obstruction

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

Hysterectomy Procedure Video

https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).

IPOM Inguinal Hernia Surgery

https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.

Laparoscopic Removal of Paraovarian Endometrioma with application of Intercede

https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Paraovarian Endometrioma, Ovarian cystectomy. Paraovarian cysts (POCs) are remnants of Wolffian duct in the mesosalpinx that do not arise from the ovary. They account for ~10-20% of adnexal masses. Here Intercede is applied to prevent adhesion. Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions.

Laparoscopic Varicocelectomy

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.

Endoscopy - Upper GI Endoscopy and Colonoscopy

https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.

How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra

This video demonstrate How to do Safe Laparoscopic Orchidopexy - Lecture by Dr R K Mishra. Orchiopexy (or orchidopexy) is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.

Umbilical and Paraumbilical Hernia Surgery

https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.

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