Laparoscopic Videos from World Laparoscopy Hospital

Mishra's Knot - Ideal for Laparoscopic Cholecystectomy

This video demonstrate Mishra's Knot used in laparoscopic cholecystectomy. This is an Ideal for Laparoscopic Cholecystectomy. Tying extracorporeal knot to the cystic duct has many advantages. This knot is also can be used for in mass ligation and partial cholecystectomy.

Laparoscopic Tayside Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tayside Knot. This is an extracorporeal knot can be used to ligate tubular structure. The Tayside knot is suitable for use with all braided sutures (2/0 or stronger) as well as dacron. It is used with Dacron for ligation of vessels such as the azygous vein, splenic artery/vein or the inferior mesenteric artery/vein. A variety of slipknots are used by various professions and in certain leisure activities. Some of these have been adapted for use in endoscopic surgery. The holding strength of individual types of slipknots is influenced by a number of factors including the ligature material used and its caliber. Thus a slipknot may be secure when tied in catgut but unsafe with other materials. In addition, some slipknots are difficult to tie or jam lock too easily for reliable placement by push rod before locking.

Laparoscopic Roeder's knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Roeder's knot is one of the oldest knot used in laparoscopic surgery. Laparoscopic Roeder's knot is one of the most popular extracorporeal knot. This technique of the extracorporeal knotting is simple, easy, and reproducible with good knot and loop security and can be used with multifilament suture material of 90cm. Laparoscopic extracorporeal knot is popular for appendectomy, cholecystectomy, and any tubular structure upto 8mm structure.

Dundee Jamming Knot and Aberdeen Termination demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This Video demonstrate Dundee Jamming Knot Continuous Suturing and Aberdeen Termination. Continuous suturing is required in laparoscopic surgery to close delicate long suture line. It can be started with Dundee Jamming Knot. The final knot of a continuous suture can be accomplished in the traditional way of open surgery as Aberdeen Termination. Dundee Jamming Knot and Aberdeen Termination are two surgical knots in the same direction and a final one in the opposite direction, tying the final loop of the continuous suture with the end of the suture with the needle, or it is possible to recur to the “Aberdeen knot,”8 in which a final knot is accomplished by creating a new loop in the already existing one. The final loop of the suture is kept loosely; then, grasping the needle with the assistant needle holder, the needle holder is inserted into the loop, and the suture thread is grasped at its middle and retracted without the grasper dropping the needle. This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder. This procedure is repeated twice. Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. If, at the end of the suture, the thread were too short to accomplish one of the described procedures.

Laparoscopic Tubal Patency Test Hysteroscopy and Ovarian Drilling

This surgery was performed to evaluate the effectiveness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile

Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstrate Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia. by Dr R K Mishra at World Laparoscopy Hospital. Recovery from laparoscopic repair of bilateral recurrent inguinal hernia repair is usually very quick. Patient will be mobile very soon after the laparoscopic procedure and will be encouraged to increase how much you walk around over the first few days post surgery. Many patients return to normal day to day activities within the first week.

Laparoscopic Surgery for Peritoneal Inclusion cyst with Bilateral Endometrioma

This Video demonstrate Laparoscopic Management of Inclusion cyst with Bilateral Endometrioma. Peritoneal inclusion cyst (PIC) is defined as a fluid-filled mesothelial-lined cysts of the pelvis and it is most frequently encountered in women of reproductive age. The treatment options are observation, hormonal management, imaging-guided aspiration, image-guided sclerotherapy and surgical excision. Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in reproductive age group women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts.

Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test

https://www.laparoscopyhospital.com/international-patients.html Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test thus not only helps in regulating ovulation and enhancing conception rates but also provides an opportunity to assess the pelvis for other potential causes of subfertility which could be treated at the same time. We therefore believe that diagnostic hysteroscopy and laparoscopy should be offered quite high-up in the hierarchy of infertility investigations and treatment. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile.

Laparoscopic Nephrectomy Lecture by Dr R K Mishra

This video is of Laparoscopic Nephrectomy Lecture by Dr R K Mishra. A laparoscopic nephrectomy is minimally invasive operation to remove kidney. A laparoscopic nephrectomy involves removing an entire kidney through keyhole incisions in the flank, the side of the body between the ribs and the hip. A laparoscopic nephrectomy removes the kidney by using laparoscopic equipment. Long thin instruments are passed through up to five small incisions made in the flank, each about 1cm in length. The abdomen is first filled with carbon dioxide, which separates the tissues to allow for vision during the surgery. A camera is then passed, giving the urologist a detailed picture inside the abdomen. The other incisions are used to pass cutting and suturing instruments so the blood supply to the kidney can be isolated and tied off and the kidney removed either with or without its surrounding structures. A wound drain is then inserted to drain any wound ooze. This is usually stitched in place and stays in for 1 – 2 days. A nephrectomy is usually done for one of two reasons, either for cancer of the kidney or because of a non- functioning kidney. In the case of kidney cancer a radical laparoscopic nephrectomy is done. This is done in an attempt to rid the body of cancer by removing the entire kidney and adrenal gland, with its surrounding fat and attached vessels. In more advanced cases it may be done to stop continued bleeding from the effected kidney. For non-functioning kidneys, which are either caused by large stones, a lack of blood supply or abnormal kidney structure, a simple laparoscopic nephrectomy is done. This is where only the kidney itself is taken and the adrenal gland and other structures are left behind. A simple nephrectomy is usually done to avoid recurrent infection and pain and the possibility of severe illness because of infection.

Laparoscopic Surgeon's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic knot-tying is an advanced skill. The traditional surgeon's knot is often used in laparoscopic surgery for every tissue. Surgeons knot is most versatile knot in laparoscopic surgery. It can be used in many situations like bowel anastomosis, pyeloplasty, tubal recanalization etc... Surgeons knot can be terminated at the end of a continuous suture line in laparoscopic surgery by again surgeons knot or square knot. The Aberdeen knot has been shown to be stronger and more secure than the surgeon's knot for ending a suture line but is rarely used in laparoscopic surgery. We have developed a new technique to make the surgeons knot laparoscopically. Any surgeon's concern about the ease and safety of laparoscopic knotting is natural, and knots performed laparoscopically must be as safe as those traditionally performed. A knot should secure proper tissue approximation, and be simple, easy, quick, and reliable.

Laparoscopic Tumble Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tumble Square Knot. Laparoscopic Tumble Square Knot is the only knots that can be used when the suture does not slide freely through the tissue and anchoring device. Laparoscopic Tumble Square Knot configurations also theoretically avoid suture damage from abrasion and tissue damage during sliding. The major disadvantage of static knots is the propensity of the loop to loosen before the second half-hitch is seated to the point that it provisionally “locks” the knot. One method of minimizing this effect is by using a maryland to push the square knot on which one limb is tumbled which holds the tissue loop tight as it advances sequential half-hitches.

Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra. Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be "open," meaning the surgeon has to make a larger cut, healing takes longer. In gastric sleeve surgery your surgeon creates a small stomach "sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%. This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above). There is no rearrangement of the bowel with a gastric sleeve surgery therefore dumping, which may occur to gastric bypass patients when their undigested stomach contents are “dumped” into their small intestine too quickly, should not a problem. Also a sleeve gastrectomy doesn’t affect the absorption of food, so nutritional deficiencies are less likely to occur.

Laparoscopic Surgery for Large Endometrioma

For most of the gynecologist Laparoscopic ovarian cystectomy remains a first-line choice for the surgical treatment of endometriotic cysts. Laparoscopy for endometrioma is performed through an umbilical incision and two or three lower abdominal incisions. This video demonstrate laparoscopic surgery for large right sided endometrioma performed for an unmarried girl by Dr R K Mishra at World Laparoscopy Hospital. Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

Laparoscopic Removal of Huge Ovarian Cyst

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html Laparoscopic surgery has been increasingly applied to different gynecologic ovaries surgical problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall. With proper patient selection, the size of an ovarian cyst should not constitute a contraindication to laparoscopic surgery. Experience in advanced laparoscopic surgery and the availability of a gynecologic oncologist should make the procedure safely applicable to a broader patient population.

Laparoscopic Radical Hysterectomy

https://www.laparoscopyhospital.com/ This video is lecture of Laparoscopic Radical Hysterectomy by Dr R K Mishra. This procedure is used to treat stage I or IIA cervical cancer. Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. Laparoscopic radical hysterectomy is a feasible alternative to laparotomy for early stage cervical cancer. Similar surgical outcomes are achieved with significantly less morbidity.

Unedited Laparoscopic Hysterectomy - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.

Laparoscopic Myomectomy for Multiple Myoma

Laparoscopic myomectomy in multiple fibroids. Myomectomy is the surgery of choice for women who have symptomatic fibroids and who wish to retain their uterus. ... It is known that uterine fibroids are estrogen dependent. During pregnancy these fibroids increase in size, whereas in the puerperium and menopause they shrink. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console. Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic Extracorporeal Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Extracorporeal Square Knot. Laparoscopic Square knot is used for any structure which is tough and under tension. It can be used for approximation of vaginal vault, Rectus Divarication, Myomectomy, Crural Approximation etc...

Lecture PPH Stapler piles surgery Step by Step by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate PPH stapled Piles Surgery step by step by Dr R K Mishra. PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement. Haemorrhoidal disease is the most frequent and ancient proctological pathology. Haemorrhoidectomy is always feared for intensive post-operative pain and complications. Stapled hemorrhoidopexy is good procedure but may be followed by severe postoperative complications of which haemorrhage is one of the most serious early events. Surgical techniques have advanced more and more with the aim of reducing the post-surgical complications and to help a faster recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan procedure, has been the most used method in Europe, also in the “Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”, according to Ferguson procedure, has been the most used method in the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative method to conventional surgical procedures. It has many advantages such as less pain, faster recovery and a quicker return to normal activities. PPH stapler procedure for treatment of haemorrhoidal prolapse.

Laparoscopic Suturing Melzer's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic suturing and knot tying require a lot of patience and practice and can be difficult, time consuming, and frustrating in spite of the advances made in the fields of instrumentation, optics, and imaging. The new technique described here is an effort to make the procedure simpler by providing extracorporeal control of one limb of the suture. It involves percutaneous placement of the needle end of the suture in the abdomen and its removal using a modified 10 cm long cloth-sewing needle.

Dangerous way of Performing Laparoscopic Cholecystectomy

https://www.laparoscopyhospital.com/ This Video demonstrate a dangerous way of Performing Laparoscopic Cholecystectomy by Harmonic Scalpel In Mass Shearing. Ideally a nice dissection of calot's triangle with critical view of safety should be done. World wide laparoscopic cholecystectomy (LC) has become the customary method for treating gallstones, some incidents and complications appear rather more frequently than with the open technique. Several aspects of these complications and their treatment possibilities are analysed and clipless cholecystectomy with Harmonic scalpel is one of them. During the past decade world wide laparoscopic cholecystectomy has become the procedure of choice in the surgical treatment of symptomatic gallstone. The operation is not completely risk-free, some incidents and complications being more frequent than with open cholecystectomy. The use of the Harmonic scalpel is deemed safe and comparable to clip placement at the discretion of the surgeon for cystic duct ligation. According to the article published by many author, harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. Further research with larger homogeneous studies and assessments of cost-effectiveness would further enhance the increasing use of the Harmonic scalpel in laparoscopic cholecystectomy.

Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Laparoscopic Surgery for Ectopic Pregnancy - Lecture by Dr R K Mishra

This video is lecture of Dr R K Mishra on laparoscopic management of ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity. Laparoscopic Salpingostomy or Salpingectomy is the method of choice for the management of ectopic pregnancy. In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth. An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss. According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths. Ectopic surgery The fallopian tubes can be repaired or removed with surgery. Keyhole surgery can be performed to remove the ectopic tissue. This is also known as a laparoscopy. In a laparoscopy, the surgeon makes a small incision in or near the navel and inserts a device called a laparoscope to view the area. Other surgical instruments are inserted into a tube, or through other small incisions, to remove the ectopic tissue. If the area is damaged, surgeons might be able to repair the fallopian tubes, but they will probably have to remove the affected tube as part of this procedure. If the other fallopian tube is still intact, a healthy pregnancy is still possible. If severe internal bleeding has occurred, a larger incision may be needed. This procedure would be called a laparotomy.

Torted Ovarian Dermoid Cyst in Pregnant Patient

https://www.laparoscopyhospital.com/ This video is Laparoscopic management of Torted Ovarian Dermoid Cyst in Pregnant Patient. Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant in 5% of cases. The incidence of torsion in pregnant patients with ovarian cyst persisting during pregnancy is approximately 15%. Benign dermoid cysts/teratomas are the most frequent ovarian tumors, with an incidence ranging from 5% to 25% of all ovarian neoplasms [3]. They are of germ cell origin and composed of multiple types of tissue. Torsion of the cystic contents and ovary may occur in them, thus leading to vascular infarction and necrosis. Torsion of the pedicle has been reported to be the most frequent complication, occurring in 16.1% of cases [3]. Traditional risk factors for ovarian torsion are increased ovarian size, ovarian tumors, ovarian hyperstimulation, and pregnancy

Laparoscopic Ventral and Incisional Hernia Repair: Pros and Cons

https://www.laparoscopyhospital.com/ This video is lecture of Pros and Cons of Laparoscopic Ventral and Incisional Hernia Repair by Dr. R. K. Mishra at World Laparoscopy Hospital. The purpose of this lecture is to analyse the surgical techniques, perioperative complications, and recurrence rate of laparoscopic ventral hernia repair (LVHR) including incisional Hernia, in comparison with the open ventral hernia repair (OVHR), based on the international literature. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. The laparoscopic technique has numerous variations of the methodology used by surgeons, although several common steps are followed by all. The procedure starts with entering the peritoneal cavity by using a Veress needle, an open Hasson method, or an optical trocar allowing view of the abdominal wall layers during penetration. Palmer's point is the best place to access. This lecture indicates that LVHR is a safe and effective approach to abdominal wall hernias. The technique offers the advantages of the laparoscopic approach, ie, a short hospital stay, less postoperative pain, and early convalescence. The procedure carries an acceptable risk of complications compared to open surgery, a low risk of recurrence, and an excellent cosmetic result. It is considered a good alternative to its open counterpart, at least in experienced hands.

IPOM Inguinal Hernia Repair by Laparoscopy

https://www.laparoscopyhospital.com/SERV01.HTM Laparoscopic inguinal hernia repair originated in the early 1987 by GER as laparoscopy gained a foothold in general surgery. Inguinal hernias account for 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Although TAPP and TEP, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons IPOM inguinal hernia repair, produces excellent results comparable to those of TAPP or TEP repair.

Laparoscopic Repair of Epigastric Hernia by Two Ports

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Repair of Epigastric Hernia by Two Ports performed by Dr R K Mishra at World Laparoscopy Hospital. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It's above the belly button and just below the sternum of your rib cage. This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias.

Hysterectomy by Laparoscopic Technique

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html A TLH or Total Laparoscopic Hysterectomy is defined by the laparoscopic dissection of the ovarian arteries and veins with the removal of the uterus vaginally or abdominally, along with laparoscopic closure of the vaginal cuff. This is in contrast to other methods of removing the uterus, fallopian tubes, and ovaries abdominal or vaginal. The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks. The vaginal hysterectomy can be done entirely through the vagina, or using a laparoscope (the laparoscopic-assisted vaginal hysterectomy, or LAVH).

Laparoscopic Management of Ovarian Teratoma

https://www.laparoscopyhospital.com This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.

Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch. Manipulating the gallbladder with the left-hand instrument is a key part of performing a laparoscopic cholecystectomy. In these case stone should be removed from hartmann pouch. If a stone is impacted in the Hartmann’s pouch, this manipulation can be difficult, and can cause cramp and exhaustion of the surgeon’s left hand or injury to the gallbladder if a toothed instrument is used to improve grip. For the experienced laparoscopic surgeon, this tip makes manoeuvrability of the thickened, impacted Hartmann’s pouch simpler. We have used it in the acute and elective setting to great effect. The tape provides gentle traction and can be resisted easily if there are any concerns about placement as dissection continues.

Laparoscopic Weston Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ The Weston slip knot was initially described in the obstetric and gynecology literature and is also used in arthroscopic surgery.The advantage of this knot is that it is relatively easy to tie outside, can then slip easily into place and be tightly secured. The post strand does not move throughout the knot; the loop strand is the longer strand which is moved to make the knot. The advantage of the Weston knot is that it locks readily and is not bulky.

Laparoscopic sleeve gastrectomy with endoscopic calibration

Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy. The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim is to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. Gastrointestinal complication after sleeve gastrectomy surgery may be summarized as follow: acute bleeding and/or anemia, staple-line complications such as anastomotic leaks, fistulae, and strictures, erosion and slippage, bezoars, and choledocholithiasis. An endoscopy is the preferred strategy, unless there is a suspicion of leaks or fistulae, in which case preliminary contrast radiography may be more appropriate. Endoscopic treatment plays an important role in the management of a variety of staple-line complications during and even after surgery, such as stomal stenosis and anastomotic leaks. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group is done in all the patients. In the endoscopic calibration the check with blue dye is much better in all cases.

Laparoscopic Anatomy of Pelvis by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate Laparoscopic Pelvic Anatomy by Dr R K Mishra. The abdominal cavity is traditionally divided into nine regions. Regardless of the quadrants chosen for laparoscopic access, thorough knowledge of the relevant surface anatomy increases patient safety during laparoscopic surgery. Laparoscopic surgery is a safe and effective option for many patients, provided the surgeon knows the relevant anatomic landmarks and variations created by obesity, prior surgery, and aberrant anatomy. pelvic anatomy visualized two-dimensionally under magnification during traditional laparoscopy can look very different than it does during conventional surgery, due to the effects of the pneumoperitoneum, steep Trendelenburg position, and/or the use of uterine manipulators.

IPOM Inguinal Hernia by Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This video demonstrate IPOM Inguinal Hernia by Dr. R. K. Mishra at World Laparoscopy Hospital. Inguinal Hernia Laparoscopic Surgery is commonly also called as Minimal Invasive Surgery is method of choice and IPOM technique is increasing. Laparoscopic Inguinal Hernia Surgery is one of the most common minimal access surgery performed in the world. This Inguinal Hernia Surgery is done under General Anesthesia and Laparoscopic Hernia Surgeon makes 3-4 keyholes of nearly 0.5 to 1 cm. near the groins to perform IPOM inguinal hernia surgery. With the help of Laparoscopic instruments Surgeons pushes the tissue back into abdomen and repair the hernia by Mesh. In IPOM Laparoscopic Hernia surgery special mesh made for intraperitoneal application is used. Tacker or suture then uses a Surgical Mesh to hold the tissues back to its normal position. A tackers is used to hold the mesh at its position. Patient is discharged the next day because there are no stitches and no cuts.

Laparoscopic Surgery for Hydatid Cyst Disease

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic lecture of treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. The laparoscopic approach is safe with acceptable mortality and morbidity for both conservative and radical resections in selected patients. Clinical outcomes are comparable to open surgery, albeit in a selected group of patients.

Laparoscopic Nissen fundoplication - Dr R K Mishra

Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.

Gastrointestinal Endoscopy Procedure Preparation & Risks

https://www.laparoscopyhospital.com/ This video is lecture of Gastrointestinal Endoscopy Procedure Preparation & Risks by Dr. R. K. Mishra at World Laparoscopy Hospital. Endoscopy has several names, depending on which portion of digestive tract by physician seeks to inspect. Upper GI endoscopy (EGD): This procedure enables the examination of the esophagus, stomach and the upper small bowel called duodenum. Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel. Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways: To diagnose and treat hidden GI bleeding To detect the cause for malabsorption To confirm problems of the small bowel seen on an X-ray During surgery, to locate and remove sores with little damage to healthy tissue

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

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Appendectomy - Lecture by Dr R K Mishra. Appendicitis is one of the most common surgical problems and appendectomy is one of the most common surgery. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall. ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY: Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are: Less postoperative pain May shorten hospital stay May result in a quicker return to bowel function Quicker return to normal activity Better cosmetic results

Laparoscopic Management of Ectopic Pregnancies Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This Video Lecture of Dr R K Mishra is to compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this lecture was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

Laparoscopic Sleeve Gastrectomy Surgery Video Explained Step by Step

This video demonstrate Laparoscopic Sleeve Gastrectomy which is a popular Bariatric Surgery for morbid obesity. Sleeve gastrectomy is a simpler bariatric operation than the gastric bypass procedure for morbid obesity because it does not involve rerouting of or reconnection of the intestines. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach. Laparoscopic Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Laparoscopic Mishra's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This is a video of Laparoscopic Mishra's Knot. Laparoscopic suturing and knotting is important for surgeons and gynecologist. Mishra's Knot is one of the important extracorporeal knot for any tubular structure. Configuration of Mishra's Knot is 1:1:1:1:1:1:1. This knot is secured upto 18mm of tubular structure.

Total Laparoscopic Hysterectomy with Bilateral Salpingo Oophorectomy

https://www.laparoscopyhospital.com/ This video demonstrate TLH with BSO by Dr R K Mishra at World Laparoscopy Hospital. The use of laparoscopic hysterectomy has recently been reported as an alternative to traditional abdominal hysterectomy and the utilization of a mini-endoscopic technique has also been recorded. This prospective randomized study has demonstrated that after laparoscopic hysterectomy, patients recovered more quickly and had less pain, and the incidence of complications was also low. One serious complication after laparoscopic hysterectomy is increased ureteric injury, but in our opinion it is possible to avoid major complications by paying particular attention to the surgical details.

Sleeve Gastrectomy

https://www.laparoscopyhospital.com/bariatric-surgery.html This video demonstrate laparoscopic sleeve gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital. The laparoscopic sleeve gastrectomy (SG) or gastric sleeve surgery, involves re-shaping the stomach from a pouch-like shape into a long tube, or “sleeve”. Pre-surgery the stomach looks like a kidney bean and can expand to the volume of several liter-size bottles of soda. With staples, the stomach is converted to look like a banana. This weight loss surgery reduces the capacity and prevents the stomach from expanding significantly. Before sleeve gastrectomy a regular stomach can hold about six cups of food. The new small stomach can hold about a half cup in volume, resulting in a ‘restrictive’ weight loss of the person. This type of laparoscopic sleeve gastrectomy bariatric surgery can be done as a stand-alone procedure or as part of a staged operation. The weight loss is projected to be in the range of 55 to 70 percent of excess body weight. There is no malabsorption created and no foreign body or implant involved. Long-term results are becoming available and the data suggest the weight loss is similar to gastric bypass.

Laparoscopic Repair of Inguinal Hernia Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstration is Laparoscopic Repair of Inguinal Hernia Lecture by Dr. R. K. Mishra at World Laparoscopy Hospital. A major benefit of the laparoscopic technique is for patients who present with bilateral inguinal hernias and recurrent hernia. Laparoscopy allows for both hernias to be repaired in a single operation without need for additional ports or incisions. As a result, recovery time is similar to unilateral laparoscopic hernia repair.

Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling in same patient by Dr R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows surgeon to see gallbladder on a HD monitor. Laparoscopic cholecystectomy is Gold standard for Gallstone disease.

Laparoscopic PCOD Management

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html This video demonstrate laparoscopic ovarian drilling for PCOS (Polycystic Ovary Syndrome) Treatment. The exact mechanism of Ovarian Drilling in PCOS is yet to be elucidated. The most plausible one is the destruction of ovarian follicles and stroma resulting in a decrease in androgen and inhibin levels and a secondary rise in follicle-stimulating hormone (FSH) levels. Production of inflammatory growth factors like insulin-like growth factor-1, in response to thermal injury is in Laparoscopic Ovarian Drilling to Treat PCOS Infertility, further potentiates the actions of FSH on folliculogenesis, while increased blood flow to the ovary provoked by surgery, facilitates increased delivery of gonadotropins. The number of punctures is empirically chosen depending on the ovarian size. In the original procedure, 3-8 diathermy punctures (each of 3 mm diameter and 2-4 mm depth) per ovary were applied, using power setting of 40W W for 2-4 s

Lecture on Laparoscopic Appendectomy for Acute Appendicitis

https://www.laparoscopyhospital.com/ This video is lecture of Dr R K Mishra on Laparoscopic Appendectomy. Laparoscopic Appendectomy can be performed by single incision, two port or three incisions, one umbilical and one suprapubic are made; permanent material used comprises: grasping forceps, hook, scissors, needle holders, three metal trocars and four other usual instruments, and a single strand of cotton. There is possibility of using endobag and in few cases no need to use of operative extractors bags, clips, endoloops, staples or bipolar or harmonic energy instruments. Allows triangulation and instrumentation in the conventional manner.

Laparoscopic Repair of Huge Incisional Hernia

Laparoscopic Repair of Huge Incisional Hernia performed by Dr R K Mishra at World Laparoscopy Hospital. Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy.

Laparoscopic Surgery for Pedunculated Myoma by Mishra's Knot

Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.

Appendectomy lecture New in Full HD - Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Appendectomy is one of the most frequently performed General Surgical Procedure. An appendectomy is the surgical removal of the appendix. It's a common emergency surgery that's performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It's located in the lower right side of your abdomen.Jan 5, 2016

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IPOM Inguinal Hernia by Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This video demonstrate IPOM Inguinal Hernia by Dr. R. K. Mishra at World Laparoscopy Hospital. Inguinal Hernia Laparoscopic Surgery is commonly also called as Minimal Invasive Surgery is method of choice and IPOM technique is increasing. Laparoscopic Inguinal Hernia Surgery is one of the most common minimal access surgery performed in the world. This Inguinal Hernia Surgery is done under General Anesthesia and Laparoscopic Hernia Surgeon makes 3-4 keyholes of nearly 0.5 to 1 cm. near the groins to perform IPOM inguinal hernia surgery. With the help of Laparoscopic instruments Surgeons pushes the tissue back into abdomen and repair the hernia by Mesh. In IPOM Laparoscopic Hernia surgery special mesh made for intraperitoneal application is used. Tacker or suture then uses a Surgical Mesh to hold the tissues back to its normal position. A tackers is used to hold the mesh at its position. Patient is discharged the next day because there are no stitches and no cuts.

Laparoscopic Surgery for Large Endometrioma

For most of the gynecologist Laparoscopic ovarian cystectomy remains a first-line choice for the surgical treatment of endometriotic cysts. Laparoscopy for endometrioma is performed through an umbilical incision and two or three lower abdominal incisions. This video demonstrate laparoscopic surgery for large right sided endometrioma performed for an unmarried girl by Dr R K Mishra at World Laparoscopy Hospital. Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

Laparoscopic Management of Ectopic Pregnancies Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This Video Lecture of Dr R K Mishra is to compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this lecture was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

Dundee Jamming Knot and Aberdeen Termination demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This Video demonstrate Dundee Jamming Knot Continuous Suturing and Aberdeen Termination. Continuous suturing is required in laparoscopic surgery to close delicate long suture line. It can be started with Dundee Jamming Knot. The final knot of a continuous suture can be accomplished in the traditional way of open surgery as Aberdeen Termination. Dundee Jamming Knot and Aberdeen Termination are two surgical knots in the same direction and a final one in the opposite direction, tying the final loop of the continuous suture with the end of the suture with the needle, or it is possible to recur to the “Aberdeen knot,”8 in which a final knot is accomplished by creating a new loop in the already existing one. The final loop of the suture is kept loosely; then, grasping the needle with the assistant needle holder, the needle holder is inserted into the loop, and the suture thread is grasped at its middle and retracted without the grasper dropping the needle. This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder. This procedure is repeated twice. Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. If, at the end of the suture, the thread were too short to accomplish one of the described procedures.

Laparoscopic Removal of Huge Ovarian Cyst

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html Laparoscopic surgery has been increasingly applied to different gynecologic ovaries surgical problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall. With proper patient selection, the size of an ovarian cyst should not constitute a contraindication to laparoscopic surgery. Experience in advanced laparoscopic surgery and the availability of a gynecologic oncologist should make the procedure safely applicable to a broader patient population.

Laparoscopic Nephrectomy Lecture by Dr R K Mishra

This video is of Laparoscopic Nephrectomy Lecture by Dr R K Mishra. A laparoscopic nephrectomy is minimally invasive operation to remove kidney. A laparoscopic nephrectomy involves removing an entire kidney through keyhole incisions in the flank, the side of the body between the ribs and the hip. A laparoscopic nephrectomy removes the kidney by using laparoscopic equipment. Long thin instruments are passed through up to five small incisions made in the flank, each about 1cm in length. The abdomen is first filled with carbon dioxide, which separates the tissues to allow for vision during the surgery. A camera is then passed, giving the urologist a detailed picture inside the abdomen. The other incisions are used to pass cutting and suturing instruments so the blood supply to the kidney can be isolated and tied off and the kidney removed either with or without its surrounding structures. A wound drain is then inserted to drain any wound ooze. This is usually stitched in place and stays in for 1 – 2 days. A nephrectomy is usually done for one of two reasons, either for cancer of the kidney or because of a non- functioning kidney. In the case of kidney cancer a radical laparoscopic nephrectomy is done. This is done in an attempt to rid the body of cancer by removing the entire kidney and adrenal gland, with its surrounding fat and attached vessels. In more advanced cases it may be done to stop continued bleeding from the effected kidney. For non-functioning kidneys, which are either caused by large stones, a lack of blood supply or abnormal kidney structure, a simple laparoscopic nephrectomy is done. This is where only the kidney itself is taken and the adrenal gland and other structures are left behind. A simple nephrectomy is usually done to avoid recurrent infection and pain and the possibility of severe illness because of infection.

Laparoscopic Tayside Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tayside Knot. This is an extracorporeal knot can be used to ligate tubular structure. The Tayside knot is suitable for use with all braided sutures (2/0 or stronger) as well as dacron. It is used with Dacron for ligation of vessels such as the azygous vein, splenic artery/vein or the inferior mesenteric artery/vein. A variety of slipknots are used by various professions and in certain leisure activities. Some of these have been adapted for use in endoscopic surgery. The holding strength of individual types of slipknots is influenced by a number of factors including the ligature material used and its caliber. Thus a slipknot may be secure when tied in catgut but unsafe with other materials. In addition, some slipknots are difficult to tie or jam lock too easily for reliable placement by push rod before locking.

Laparoscopic Repair of Epigastric Hernia by Two Ports

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Repair of Epigastric Hernia by Two Ports performed by Dr R K Mishra at World Laparoscopy Hospital. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It's above the belly button and just below the sternum of your rib cage. This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias.

Laparoscopic Myomectomy for Multiple Myoma

Laparoscopic myomectomy in multiple fibroids. Myomectomy is the surgery of choice for women who have symptomatic fibroids and who wish to retain their uterus. ... It is known that uterine fibroids are estrogen dependent. During pregnancy these fibroids increase in size, whereas in the puerperium and menopause they shrink. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console. Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic Tumble Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tumble Square Knot. Laparoscopic Tumble Square Knot is the only knots that can be used when the suture does not slide freely through the tissue and anchoring device. Laparoscopic Tumble Square Knot configurations also theoretically avoid suture damage from abrasion and tissue damage during sliding. The major disadvantage of static knots is the propensity of the loop to loosen before the second half-hitch is seated to the point that it provisionally “locks” the knot. One method of minimizing this effect is by using a maryland to push the square knot on which one limb is tumbled which holds the tissue loop tight as it advances sequential half-hitches.

Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Laparoscopic Repair of Huge Incisional Hernia

Laparoscopic Repair of Huge Incisional Hernia performed by Dr R K Mishra at World Laparoscopy Hospital. Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy.

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

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Appendectomy - Lecture by Dr R K Mishra. Appendicitis is one of the most common surgical problems and appendectomy is one of the most common surgery. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall. ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY: Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are: Less postoperative pain May shorten hospital stay May result in a quicker return to bowel function Quicker return to normal activity Better cosmetic results

Laparoscopic sleeve gastrectomy with endoscopic calibration

Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy. The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim is to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. Gastrointestinal complication after sleeve gastrectomy surgery may be summarized as follow: acute bleeding and/or anemia, staple-line complications such as anastomotic leaks, fistulae, and strictures, erosion and slippage, bezoars, and choledocholithiasis. An endoscopy is the preferred strategy, unless there is a suspicion of leaks or fistulae, in which case preliminary contrast radiography may be more appropriate. Endoscopic treatment plays an important role in the management of a variety of staple-line complications during and even after surgery, such as stomal stenosis and anastomotic leaks. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group is done in all the patients. In the endoscopic calibration the check with blue dye is much better in all cases.

Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstrate Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia. by Dr R K Mishra at World Laparoscopy Hospital. Recovery from laparoscopic repair of bilateral recurrent inguinal hernia repair is usually very quick. Patient will be mobile very soon after the laparoscopic procedure and will be encouraged to increase how much you walk around over the first few days post surgery. Many patients return to normal day to day activities within the first week.

Laparoscopic Ventral and Incisional Hernia Repair: Pros and Cons

https://www.laparoscopyhospital.com/ This video is lecture of Pros and Cons of Laparoscopic Ventral and Incisional Hernia Repair by Dr. R. K. Mishra at World Laparoscopy Hospital. The purpose of this lecture is to analyse the surgical techniques, perioperative complications, and recurrence rate of laparoscopic ventral hernia repair (LVHR) including incisional Hernia, in comparison with the open ventral hernia repair (OVHR), based on the international literature. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. The laparoscopic technique has numerous variations of the methodology used by surgeons, although several common steps are followed by all. The procedure starts with entering the peritoneal cavity by using a Veress needle, an open Hasson method, or an optical trocar allowing view of the abdominal wall layers during penetration. Palmer's point is the best place to access. This lecture indicates that LVHR is a safe and effective approach to abdominal wall hernias. The technique offers the advantages of the laparoscopic approach, ie, a short hospital stay, less postoperative pain, and early convalescence. The procedure carries an acceptable risk of complications compared to open surgery, a low risk of recurrence, and an excellent cosmetic result. It is considered a good alternative to its open counterpart, at least in experienced hands.

Laparoscopic Extracorporeal Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Extracorporeal Square Knot. Laparoscopic Square knot is used for any structure which is tough and under tension. It can be used for approximation of vaginal vault, Rectus Divarication, Myomectomy, Crural Approximation etc...

Laparoscopic Surgeon's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic knot-tying is an advanced skill. The traditional surgeon's knot is often used in laparoscopic surgery for every tissue. Surgeons knot is most versatile knot in laparoscopic surgery. It can be used in many situations like bowel anastomosis, pyeloplasty, tubal recanalization etc... Surgeons knot can be terminated at the end of a continuous suture line in laparoscopic surgery by again surgeons knot or square knot. The Aberdeen knot has been shown to be stronger and more secure than the surgeon's knot for ending a suture line but is rarely used in laparoscopic surgery. We have developed a new technique to make the surgeons knot laparoscopically. Any surgeon's concern about the ease and safety of laparoscopic knotting is natural, and knots performed laparoscopically must be as safe as those traditionally performed. A knot should secure proper tissue approximation, and be simple, easy, quick, and reliable.

Laparoscopic Weston Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ The Weston slip knot was initially described in the obstetric and gynecology literature and is also used in arthroscopic surgery.The advantage of this knot is that it is relatively easy to tie outside, can then slip easily into place and be tightly secured. The post strand does not move throughout the knot; the loop strand is the longer strand which is moved to make the knot. The advantage of the Weston knot is that it locks readily and is not bulky.

Laparoscopic Management of Ovarian Teratoma

https://www.laparoscopyhospital.com This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.

Hysterectomy by Laparoscopic Technique

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html A TLH or Total Laparoscopic Hysterectomy is defined by the laparoscopic dissection of the ovarian arteries and veins with the removal of the uterus vaginally or abdominally, along with laparoscopic closure of the vaginal cuff. This is in contrast to other methods of removing the uterus, fallopian tubes, and ovaries abdominal or vaginal. The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks. The vaginal hysterectomy can be done entirely through the vagina, or using a laparoscope (the laparoscopic-assisted vaginal hysterectomy, or LAVH).

Laparoscopic Sleeve Gastrectomy Surgery Video Explained Step by Step

This video demonstrate Laparoscopic Sleeve Gastrectomy which is a popular Bariatric Surgery for morbid obesity. Sleeve gastrectomy is a simpler bariatric operation than the gastric bypass procedure for morbid obesity because it does not involve rerouting of or reconnection of the intestines. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach. Laparoscopic Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Laparoscopic Surgery for Pedunculated Myoma by Mishra's Knot

Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.

Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test

https://www.laparoscopyhospital.com/international-patients.html Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test thus not only helps in regulating ovulation and enhancing conception rates but also provides an opportunity to assess the pelvis for other potential causes of subfertility which could be treated at the same time. We therefore believe that diagnostic hysteroscopy and laparoscopy should be offered quite high-up in the hierarchy of infertility investigations and treatment. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile.

Laparoscopic Surgery for Ectopic Pregnancy - Lecture by Dr R K Mishra

This video is lecture of Dr R K Mishra on laparoscopic management of ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity. Laparoscopic Salpingostomy or Salpingectomy is the method of choice for the management of ectopic pregnancy. In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth. An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss. According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths. Ectopic surgery The fallopian tubes can be repaired or removed with surgery. Keyhole surgery can be performed to remove the ectopic tissue. This is also known as a laparoscopy. In a laparoscopy, the surgeon makes a small incision in or near the navel and inserts a device called a laparoscope to view the area. Other surgical instruments are inserted into a tube, or through other small incisions, to remove the ectopic tissue. If the area is damaged, surgeons might be able to repair the fallopian tubes, but they will probably have to remove the affected tube as part of this procedure. If the other fallopian tube is still intact, a healthy pregnancy is still possible. If severe internal bleeding has occurred, a larger incision may be needed. This procedure would be called a laparotomy.

Unedited Laparoscopic Hysterectomy - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.

IPOM Inguinal Hernia Repair by Laparoscopy

https://www.laparoscopyhospital.com/SERV01.HTM Laparoscopic inguinal hernia repair originated in the early 1987 by GER as laparoscopy gained a foothold in general surgery. Inguinal hernias account for 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Although TAPP and TEP, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons IPOM inguinal hernia repair, produces excellent results comparable to those of TAPP or TEP repair.

Laparoscopic Surgery for Hydatid Cyst Disease

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic lecture of treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. The laparoscopic approach is safe with acceptable mortality and morbidity for both conservative and radical resections in selected patients. Clinical outcomes are comparable to open surgery, albeit in a selected group of patients.

Laparoscopic Nissen fundoplication - Dr R K Mishra

Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.

Sleeve Gastrectomy

https://www.laparoscopyhospital.com/bariatric-surgery.html This video demonstrate laparoscopic sleeve gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital. The laparoscopic sleeve gastrectomy (SG) or gastric sleeve surgery, involves re-shaping the stomach from a pouch-like shape into a long tube, or “sleeve”. Pre-surgery the stomach looks like a kidney bean and can expand to the volume of several liter-size bottles of soda. With staples, the stomach is converted to look like a banana. This weight loss surgery reduces the capacity and prevents the stomach from expanding significantly. Before sleeve gastrectomy a regular stomach can hold about six cups of food. The new small stomach can hold about a half cup in volume, resulting in a ‘restrictive’ weight loss of the person. This type of laparoscopic sleeve gastrectomy bariatric surgery can be done as a stand-alone procedure or as part of a staged operation. The weight loss is projected to be in the range of 55 to 70 percent of excess body weight. There is no malabsorption created and no foreign body or implant involved. Long-term results are becoming available and the data suggest the weight loss is similar to gastric bypass.

Total Laparoscopic Hysterectomy with Bilateral Salpingo Oophorectomy

https://www.laparoscopyhospital.com/ This video demonstrate TLH with BSO by Dr R K Mishra at World Laparoscopy Hospital. The use of laparoscopic hysterectomy has recently been reported as an alternative to traditional abdominal hysterectomy and the utilization of a mini-endoscopic technique has also been recorded. This prospective randomized study has demonstrated that after laparoscopic hysterectomy, patients recovered more quickly and had less pain, and the incidence of complications was also low. One serious complication after laparoscopic hysterectomy is increased ureteric injury, but in our opinion it is possible to avoid major complications by paying particular attention to the surgical details.

Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling in same patient by Dr R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows surgeon to see gallbladder on a HD monitor. Laparoscopic cholecystectomy is Gold standard for Gallstone disease.

Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra. Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be "open," meaning the surgeon has to make a larger cut, healing takes longer. In gastric sleeve surgery your surgeon creates a small stomach "sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%. This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above). There is no rearrangement of the bowel with a gastric sleeve surgery therefore dumping, which may occur to gastric bypass patients when their undigested stomach contents are “dumped” into their small intestine too quickly, should not a problem. Also a sleeve gastrectomy doesn’t affect the absorption of food, so nutritional deficiencies are less likely to occur.

Laparoscopic Mishra's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This is a video of Laparoscopic Mishra's Knot. Laparoscopic suturing and knotting is important for surgeons and gynecologist. Mishra's Knot is one of the important extracorporeal knot for any tubular structure. Configuration of Mishra's Knot is 1:1:1:1:1:1:1. This knot is secured upto 18mm of tubular structure.

Lecture PPH Stapler piles surgery Step by Step by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate PPH stapled Piles Surgery step by step by Dr R K Mishra. PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement. Haemorrhoidal disease is the most frequent and ancient proctological pathology. Haemorrhoidectomy is always feared for intensive post-operative pain and complications. Stapled hemorrhoidopexy is good procedure but may be followed by severe postoperative complications of which haemorrhage is one of the most serious early events. Surgical techniques have advanced more and more with the aim of reducing the post-surgical complications and to help a faster recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan procedure, has been the most used method in Europe, also in the “Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”, according to Ferguson procedure, has been the most used method in the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative method to conventional surgical procedures. It has many advantages such as less pain, faster recovery and a quicker return to normal activities. PPH stapler procedure for treatment of haemorrhoidal prolapse.

Laparoscopic Roeder's knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Roeder's knot is one of the oldest knot used in laparoscopic surgery. Laparoscopic Roeder's knot is one of the most popular extracorporeal knot. This technique of the extracorporeal knotting is simple, easy, and reproducible with good knot and loop security and can be used with multifilament suture material of 90cm. Laparoscopic extracorporeal knot is popular for appendectomy, cholecystectomy, and any tubular structure upto 8mm structure.

Laparoscopic PCOD Management

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html This video demonstrate laparoscopic ovarian drilling for PCOS (Polycystic Ovary Syndrome) Treatment. The exact mechanism of Ovarian Drilling in PCOS is yet to be elucidated. The most plausible one is the destruction of ovarian follicles and stroma resulting in a decrease in androgen and inhibin levels and a secondary rise in follicle-stimulating hormone (FSH) levels. Production of inflammatory growth factors like insulin-like growth factor-1, in response to thermal injury is in Laparoscopic Ovarian Drilling to Treat PCOS Infertility, further potentiates the actions of FSH on folliculogenesis, while increased blood flow to the ovary provoked by surgery, facilitates increased delivery of gonadotropins. The number of punctures is empirically chosen depending on the ovarian size. In the original procedure, 3-8 diathermy punctures (each of 3 mm diameter and 2-4 mm depth) per ovary were applied, using power setting of 40W W for 2-4 s

Gastrointestinal Endoscopy Procedure Preparation & Risks

https://www.laparoscopyhospital.com/ This video is lecture of Gastrointestinal Endoscopy Procedure Preparation & Risks by Dr. R. K. Mishra at World Laparoscopy Hospital. Endoscopy has several names, depending on which portion of digestive tract by physician seeks to inspect. Upper GI endoscopy (EGD): This procedure enables the examination of the esophagus, stomach and the upper small bowel called duodenum. Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel. Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways: To diagnose and treat hidden GI bleeding To detect the cause for malabsorption To confirm problems of the small bowel seen on an X-ray During surgery, to locate and remove sores with little damage to healthy tissue

Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch. Manipulating the gallbladder with the left-hand instrument is a key part of performing a laparoscopic cholecystectomy. In these case stone should be removed from hartmann pouch. If a stone is impacted in the Hartmann’s pouch, this manipulation can be difficult, and can cause cramp and exhaustion of the surgeon’s left hand or injury to the gallbladder if a toothed instrument is used to improve grip. For the experienced laparoscopic surgeon, this tip makes manoeuvrability of the thickened, impacted Hartmann’s pouch simpler. We have used it in the acute and elective setting to great effect. The tape provides gentle traction and can be resisted easily if there are any concerns about placement as dissection continues.

Laparoscopic Suturing Melzer's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic suturing and knot tying require a lot of patience and practice and can be difficult, time consuming, and frustrating in spite of the advances made in the fields of instrumentation, optics, and imaging. The new technique described here is an effort to make the procedure simpler by providing extracorporeal control of one limb of the suture. It involves percutaneous placement of the needle end of the suture in the abdomen and its removal using a modified 10 cm long cloth-sewing needle.

Laparoscopic Tubal Patency Test Hysteroscopy and Ovarian Drilling

This surgery was performed to evaluate the effectiveness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile

Laparoscopic Radical Hysterectomy

https://www.laparoscopyhospital.com/ This video is lecture of Laparoscopic Radical Hysterectomy by Dr R K Mishra. This procedure is used to treat stage I or IIA cervical cancer. Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. Laparoscopic radical hysterectomy is a feasible alternative to laparotomy for early stage cervical cancer. Similar surgical outcomes are achieved with significantly less morbidity.

Dangerous way of Performing Laparoscopic Cholecystectomy

https://www.laparoscopyhospital.com/ This Video demonstrate a dangerous way of Performing Laparoscopic Cholecystectomy by Harmonic Scalpel In Mass Shearing. Ideally a nice dissection of calot's triangle with critical view of safety should be done. World wide laparoscopic cholecystectomy (LC) has become the customary method for treating gallstones, some incidents and complications appear rather more frequently than with the open technique. Several aspects of these complications and their treatment possibilities are analysed and clipless cholecystectomy with Harmonic scalpel is one of them. During the past decade world wide laparoscopic cholecystectomy has become the procedure of choice in the surgical treatment of symptomatic gallstone. The operation is not completely risk-free, some incidents and complications being more frequent than with open cholecystectomy. The use of the Harmonic scalpel is deemed safe and comparable to clip placement at the discretion of the surgeon for cystic duct ligation. According to the article published by many author, harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. Further research with larger homogeneous studies and assessments of cost-effectiveness would further enhance the increasing use of the Harmonic scalpel in laparoscopic cholecystectomy.

Mishra's Knot - Ideal for Laparoscopic Cholecystectomy

This video demonstrate Mishra's Knot used in laparoscopic cholecystectomy. This is an Ideal for Laparoscopic Cholecystectomy. Tying extracorporeal knot to the cystic duct has many advantages. This knot is also can be used for in mass ligation and partial cholecystectomy.

Appendectomy lecture New in Full HD - Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Appendectomy is one of the most frequently performed General Surgical Procedure. An appendectomy is the surgical removal of the appendix. It's a common emergency surgery that's performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It's located in the lower right side of your abdomen.Jan 5, 2016

Laparoscopic Surgery for Peritoneal Inclusion cyst with Bilateral Endometrioma

This Video demonstrate Laparoscopic Management of Inclusion cyst with Bilateral Endometrioma. Peritoneal inclusion cyst (PIC) is defined as a fluid-filled mesothelial-lined cysts of the pelvis and it is most frequently encountered in women of reproductive age. The treatment options are observation, hormonal management, imaging-guided aspiration, image-guided sclerotherapy and surgical excision. Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in reproductive age group women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts.

Lecture on Laparoscopic Appendectomy for Acute Appendicitis

https://www.laparoscopyhospital.com/ This video is lecture of Dr R K Mishra on Laparoscopic Appendectomy. Laparoscopic Appendectomy can be performed by single incision, two port or three incisions, one umbilical and one suprapubic are made; permanent material used comprises: grasping forceps, hook, scissors, needle holders, three metal trocars and four other usual instruments, and a single strand of cotton. There is possibility of using endobag and in few cases no need to use of operative extractors bags, clips, endoloops, staples or bipolar or harmonic energy instruments. Allows triangulation and instrumentation in the conventional manner.

Laparoscopic Repair of Inguinal Hernia Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstration is Laparoscopic Repair of Inguinal Hernia Lecture by Dr. R. K. Mishra at World Laparoscopy Hospital. A major benefit of the laparoscopic technique is for patients who present with bilateral inguinal hernias and recurrent hernia. Laparoscopy allows for both hernias to be repaired in a single operation without need for additional ports or incisions. As a result, recovery time is similar to unilateral laparoscopic hernia repair.

Torted Ovarian Dermoid Cyst in Pregnant Patient

https://www.laparoscopyhospital.com/ This video is Laparoscopic management of Torted Ovarian Dermoid Cyst in Pregnant Patient. Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant in 5% of cases. The incidence of torsion in pregnant patients with ovarian cyst persisting during pregnancy is approximately 15%. Benign dermoid cysts/teratomas are the most frequent ovarian tumors, with an incidence ranging from 5% to 25% of all ovarian neoplasms [3]. They are of germ cell origin and composed of multiple types of tissue. Torsion of the cystic contents and ovary may occur in them, thus leading to vascular infarction and necrosis. Torsion of the pedicle has been reported to be the most frequent complication, occurring in 16.1% of cases [3]. Traditional risk factors for ovarian torsion are increased ovarian size, ovarian tumors, ovarian hyperstimulation, and pregnancy

Laparoscopic Anatomy of Pelvis by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate Laparoscopic Pelvic Anatomy by Dr R K Mishra. The abdominal cavity is traditionally divided into nine regions. Regardless of the quadrants chosen for laparoscopic access, thorough knowledge of the relevant surface anatomy increases patient safety during laparoscopic surgery. Laparoscopic surgery is a safe and effective option for many patients, provided the surgeon knows the relevant anatomic landmarks and variations created by obesity, prior surgery, and aberrant anatomy. pelvic anatomy visualized two-dimensionally under magnification during traditional laparoscopy can look very different than it does during conventional surgery, due to the effects of the pneumoperitoneum, steep Trendelenburg position, and/or the use of uterine manipulators.

https://www.laparoscopyhospital.com/

Laparoscopic Roeder's knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Roeder's knot is one of the oldest knot used in laparoscopic surgery. Laparoscopic Roeder's knot is one of the most popular extracorporeal knot. This technique of the extracorporeal knotting is simple, easy, and reproducible with good knot and loop security and can be used with multifilament suture material of 90cm. Laparoscopic extracorporeal knot is popular for appendectomy, cholecystectomy, and any tubular structure upto 8mm structure.

Laparoscopic Myomectomy for Multiple Myoma

Laparoscopic myomectomy in multiple fibroids. Myomectomy is the surgery of choice for women who have symptomatic fibroids and who wish to retain their uterus. ... It is known that uterine fibroids are estrogen dependent. During pregnancy these fibroids increase in size, whereas in the puerperium and menopause they shrink. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console. Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic Tayside Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tayside Knot. This is an extracorporeal knot can be used to ligate tubular structure. The Tayside knot is suitable for use with all braided sutures (2/0 or stronger) as well as dacron. It is used with Dacron for ligation of vessels such as the azygous vein, splenic artery/vein or the inferior mesenteric artery/vein. A variety of slipknots are used by various professions and in certain leisure activities. Some of these have been adapted for use in endoscopic surgery. The holding strength of individual types of slipknots is influenced by a number of factors including the ligature material used and its caliber. Thus a slipknot may be secure when tied in catgut but unsafe with other materials. In addition, some slipknots are difficult to tie or jam lock too easily for reliable placement by push rod before locking.

Laparoscopic Management of Ectopic Pregnancies Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This Video Lecture of Dr R K Mishra is to compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this lecture was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

Gastrointestinal Endoscopy Procedure Preparation & Risks

https://www.laparoscopyhospital.com/ This video is lecture of Gastrointestinal Endoscopy Procedure Preparation & Risks by Dr. R. K. Mishra at World Laparoscopy Hospital. Endoscopy has several names, depending on which portion of digestive tract by physician seeks to inspect. Upper GI endoscopy (EGD): This procedure enables the examination of the esophagus, stomach and the upper small bowel called duodenum. Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel. Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways: To diagnose and treat hidden GI bleeding To detect the cause for malabsorption To confirm problems of the small bowel seen on an X-ray During surgery, to locate and remove sores with little damage to healthy tissue

Laparoscopic Surgery for Peritoneal Inclusion cyst with Bilateral Endometrioma

This Video demonstrate Laparoscopic Management of Inclusion cyst with Bilateral Endometrioma. Peritoneal inclusion cyst (PIC) is defined as a fluid-filled mesothelial-lined cysts of the pelvis and it is most frequently encountered in women of reproductive age. The treatment options are observation, hormonal management, imaging-guided aspiration, image-guided sclerotherapy and surgical excision. Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in reproductive age group women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts.

Laparoscopic Repair of Huge Incisional Hernia

Laparoscopic Repair of Huge Incisional Hernia performed by Dr R K Mishra at World Laparoscopy Hospital. Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy.

Lecture on Laparoscopic Appendectomy for Acute Appendicitis

https://www.laparoscopyhospital.com/ This video is lecture of Dr R K Mishra on Laparoscopic Appendectomy. Laparoscopic Appendectomy can be performed by single incision, two port or three incisions, one umbilical and one suprapubic are made; permanent material used comprises: grasping forceps, hook, scissors, needle holders, three metal trocars and four other usual instruments, and a single strand of cotton. There is possibility of using endobag and in few cases no need to use of operative extractors bags, clips, endoloops, staples or bipolar or harmonic energy instruments. Allows triangulation and instrumentation in the conventional manner.

Laparoscopic Suturing Melzer's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic suturing and knot tying require a lot of patience and practice and can be difficult, time consuming, and frustrating in spite of the advances made in the fields of instrumentation, optics, and imaging. The new technique described here is an effort to make the procedure simpler by providing extracorporeal control of one limb of the suture. It involves percutaneous placement of the needle end of the suture in the abdomen and its removal using a modified 10 cm long cloth-sewing needle.

Laparoscopic Removal of Huge Ovarian Cyst

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html Laparoscopic surgery has been increasingly applied to different gynecologic ovaries surgical problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall. With proper patient selection, the size of an ovarian cyst should not constitute a contraindication to laparoscopic surgery. Experience in advanced laparoscopic surgery and the availability of a gynecologic oncologist should make the procedure safely applicable to a broader patient population.

Laparoscopic Surgeon's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic knot-tying is an advanced skill. The traditional surgeon's knot is often used in laparoscopic surgery for every tissue. Surgeons knot is most versatile knot in laparoscopic surgery. It can be used in many situations like bowel anastomosis, pyeloplasty, tubal recanalization etc... Surgeons knot can be terminated at the end of a continuous suture line in laparoscopic surgery by again surgeons knot or square knot. The Aberdeen knot has been shown to be stronger and more secure than the surgeon's knot for ending a suture line but is rarely used in laparoscopic surgery. We have developed a new technique to make the surgeons knot laparoscopically. Any surgeon's concern about the ease and safety of laparoscopic knotting is natural, and knots performed laparoscopically must be as safe as those traditionally performed. A knot should secure proper tissue approximation, and be simple, easy, quick, and reliable.

Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch. Manipulating the gallbladder with the left-hand instrument is a key part of performing a laparoscopic cholecystectomy. In these case stone should be removed from hartmann pouch. If a stone is impacted in the Hartmann’s pouch, this manipulation can be difficult, and can cause cramp and exhaustion of the surgeon’s left hand or injury to the gallbladder if a toothed instrument is used to improve grip. For the experienced laparoscopic surgeon, this tip makes manoeuvrability of the thickened, impacted Hartmann’s pouch simpler. We have used it in the acute and elective setting to great effect. The tape provides gentle traction and can be resisted easily if there are any concerns about placement as dissection continues.

Torted Ovarian Dermoid Cyst in Pregnant Patient

https://www.laparoscopyhospital.com/ This video is Laparoscopic management of Torted Ovarian Dermoid Cyst in Pregnant Patient. Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant in 5% of cases. The incidence of torsion in pregnant patients with ovarian cyst persisting during pregnancy is approximately 15%. Benign dermoid cysts/teratomas are the most frequent ovarian tumors, with an incidence ranging from 5% to 25% of all ovarian neoplasms [3]. They are of germ cell origin and composed of multiple types of tissue. Torsion of the cystic contents and ovary may occur in them, thus leading to vascular infarction and necrosis. Torsion of the pedicle has been reported to be the most frequent complication, occurring in 16.1% of cases [3]. Traditional risk factors for ovarian torsion are increased ovarian size, ovarian tumors, ovarian hyperstimulation, and pregnancy

Laparoscopic PCOD Management

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html This video demonstrate laparoscopic ovarian drilling for PCOS (Polycystic Ovary Syndrome) Treatment. The exact mechanism of Ovarian Drilling in PCOS is yet to be elucidated. The most plausible one is the destruction of ovarian follicles and stroma resulting in a decrease in androgen and inhibin levels and a secondary rise in follicle-stimulating hormone (FSH) levels. Production of inflammatory growth factors like insulin-like growth factor-1, in response to thermal injury is in Laparoscopic Ovarian Drilling to Treat PCOS Infertility, further potentiates the actions of FSH on folliculogenesis, while increased blood flow to the ovary provoked by surgery, facilitates increased delivery of gonadotropins. The number of punctures is empirically chosen depending on the ovarian size. In the original procedure, 3-8 diathermy punctures (each of 3 mm diameter and 2-4 mm depth) per ovary were applied, using power setting of 40W W for 2-4 s

Laparoscopic Sleeve Gastrectomy Surgery Video Explained Step by Step

This video demonstrate Laparoscopic Sleeve Gastrectomy which is a popular Bariatric Surgery for morbid obesity. Sleeve gastrectomy is a simpler bariatric operation than the gastric bypass procedure for morbid obesity because it does not involve rerouting of or reconnection of the intestines. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach. Laparoscopic Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Laparoscopic Tubal Patency Test Hysteroscopy and Ovarian Drilling

This surgery was performed to evaluate the effectiveness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile

Total Laparoscopic Hysterectomy with Bilateral Salpingo Oophorectomy

https://www.laparoscopyhospital.com/ This video demonstrate TLH with BSO by Dr R K Mishra at World Laparoscopy Hospital. The use of laparoscopic hysterectomy has recently been reported as an alternative to traditional abdominal hysterectomy and the utilization of a mini-endoscopic technique has also been recorded. This prospective randomized study has demonstrated that after laparoscopic hysterectomy, patients recovered more quickly and had less pain, and the incidence of complications was also low. One serious complication after laparoscopic hysterectomy is increased ureteric injury, but in our opinion it is possible to avoid major complications by paying particular attention to the surgical details.

Laparoscopic Anatomy of Pelvis by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate Laparoscopic Pelvic Anatomy by Dr R K Mishra. The abdominal cavity is traditionally divided into nine regions. Regardless of the quadrants chosen for laparoscopic access, thorough knowledge of the relevant surface anatomy increases patient safety during laparoscopic surgery. Laparoscopic surgery is a safe and effective option for many patients, provided the surgeon knows the relevant anatomic landmarks and variations created by obesity, prior surgery, and aberrant anatomy. pelvic anatomy visualized two-dimensionally under magnification during traditional laparoscopy can look very different than it does during conventional surgery, due to the effects of the pneumoperitoneum, steep Trendelenburg position, and/or the use of uterine manipulators.

Unedited Laparoscopic Hysterectomy - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.

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

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Appendectomy - Lecture by Dr R K Mishra. Appendicitis is one of the most common surgical problems and appendectomy is one of the most common surgery. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall. ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY: Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are: Less postoperative pain May shorten hospital stay May result in a quicker return to bowel function Quicker return to normal activity Better cosmetic results

Laparoscopic Nephrectomy Lecture by Dr R K Mishra

This video is of Laparoscopic Nephrectomy Lecture by Dr R K Mishra. A laparoscopic nephrectomy is minimally invasive operation to remove kidney. A laparoscopic nephrectomy involves removing an entire kidney through keyhole incisions in the flank, the side of the body between the ribs and the hip. A laparoscopic nephrectomy removes the kidney by using laparoscopic equipment. Long thin instruments are passed through up to five small incisions made in the flank, each about 1cm in length. The abdomen is first filled with carbon dioxide, which separates the tissues to allow for vision during the surgery. A camera is then passed, giving the urologist a detailed picture inside the abdomen. The other incisions are used to pass cutting and suturing instruments so the blood supply to the kidney can be isolated and tied off and the kidney removed either with or without its surrounding structures. A wound drain is then inserted to drain any wound ooze. This is usually stitched in place and stays in for 1 – 2 days. A nephrectomy is usually done for one of two reasons, either for cancer of the kidney or because of a non- functioning kidney. In the case of kidney cancer a radical laparoscopic nephrectomy is done. This is done in an attempt to rid the body of cancer by removing the entire kidney and adrenal gland, with its surrounding fat and attached vessels. In more advanced cases it may be done to stop continued bleeding from the effected kidney. For non-functioning kidneys, which are either caused by large stones, a lack of blood supply or abnormal kidney structure, a simple laparoscopic nephrectomy is done. This is where only the kidney itself is taken and the adrenal gland and other structures are left behind. A simple nephrectomy is usually done to avoid recurrent infection and pain and the possibility of severe illness because of infection.

Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstrate Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia. by Dr R K Mishra at World Laparoscopy Hospital. Recovery from laparoscopic repair of bilateral recurrent inguinal hernia repair is usually very quick. Patient will be mobile very soon after the laparoscopic procedure and will be encouraged to increase how much you walk around over the first few days post surgery. Many patients return to normal day to day activities within the first week.

Laparoscopic Repair of Epigastric Hernia by Two Ports

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Repair of Epigastric Hernia by Two Ports performed by Dr R K Mishra at World Laparoscopy Hospital. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It's above the belly button and just below the sternum of your rib cage. This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias.

Laparoscopic Weston Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ The Weston slip knot was initially described in the obstetric and gynecology literature and is also used in arthroscopic surgery.The advantage of this knot is that it is relatively easy to tie outside, can then slip easily into place and be tightly secured. The post strand does not move throughout the knot; the loop strand is the longer strand which is moved to make the knot. The advantage of the Weston knot is that it locks readily and is not bulky.

Laparoscopic Management of Ovarian Teratoma

https://www.laparoscopyhospital.com This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.

Hysterectomy by Laparoscopic Technique

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html A TLH or Total Laparoscopic Hysterectomy is defined by the laparoscopic dissection of the ovarian arteries and veins with the removal of the uterus vaginally or abdominally, along with laparoscopic closure of the vaginal cuff. This is in contrast to other methods of removing the uterus, fallopian tubes, and ovaries abdominal or vaginal. The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks. The vaginal hysterectomy can be done entirely through the vagina, or using a laparoscope (the laparoscopic-assisted vaginal hysterectomy, or LAVH).

IPOM Inguinal Hernia by Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This video demonstrate IPOM Inguinal Hernia by Dr. R. K. Mishra at World Laparoscopy Hospital. Inguinal Hernia Laparoscopic Surgery is commonly also called as Minimal Invasive Surgery is method of choice and IPOM technique is increasing. Laparoscopic Inguinal Hernia Surgery is one of the most common minimal access surgery performed in the world. This Inguinal Hernia Surgery is done under General Anesthesia and Laparoscopic Hernia Surgeon makes 3-4 keyholes of nearly 0.5 to 1 cm. near the groins to perform IPOM inguinal hernia surgery. With the help of Laparoscopic instruments Surgeons pushes the tissue back into abdomen and repair the hernia by Mesh. In IPOM Laparoscopic Hernia surgery special mesh made for intraperitoneal application is used. Tacker or suture then uses a Surgical Mesh to hold the tissues back to its normal position. A tackers is used to hold the mesh at its position. Patient is discharged the next day because there are no stitches and no cuts.

Laparoscopic Radical Hysterectomy

https://www.laparoscopyhospital.com/ This video is lecture of Laparoscopic Radical Hysterectomy by Dr R K Mishra. This procedure is used to treat stage I or IIA cervical cancer. Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. Laparoscopic radical hysterectomy is a feasible alternative to laparotomy for early stage cervical cancer. Similar surgical outcomes are achieved with significantly less morbidity.

Laparoscopic Extracorporeal Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Extracorporeal Square Knot. Laparoscopic Square knot is used for any structure which is tough and under tension. It can be used for approximation of vaginal vault, Rectus Divarication, Myomectomy, Crural Approximation etc...

Laparoscopic sleeve gastrectomy with endoscopic calibration

Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy. The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim is to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. Gastrointestinal complication after sleeve gastrectomy surgery may be summarized as follow: acute bleeding and/or anemia, staple-line complications such as anastomotic leaks, fistulae, and strictures, erosion and slippage, bezoars, and choledocholithiasis. An endoscopy is the preferred strategy, unless there is a suspicion of leaks or fistulae, in which case preliminary contrast radiography may be more appropriate. Endoscopic treatment plays an important role in the management of a variety of staple-line complications during and even after surgery, such as stomal stenosis and anastomotic leaks. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group is done in all the patients. In the endoscopic calibration the check with blue dye is much better in all cases.

Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test

https://www.laparoscopyhospital.com/international-patients.html Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test thus not only helps in regulating ovulation and enhancing conception rates but also provides an opportunity to assess the pelvis for other potential causes of subfertility which could be treated at the same time. We therefore believe that diagnostic hysteroscopy and laparoscopy should be offered quite high-up in the hierarchy of infertility investigations and treatment. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile.

Laparoscopic Nissen fundoplication - Dr R K Mishra

Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.

Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra. Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be "open," meaning the surgeon has to make a larger cut, healing takes longer. In gastric sleeve surgery your surgeon creates a small stomach "sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%. This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above). There is no rearrangement of the bowel with a gastric sleeve surgery therefore dumping, which may occur to gastric bypass patients when their undigested stomach contents are “dumped” into their small intestine too quickly, should not a problem. Also a sleeve gastrectomy doesn’t affect the absorption of food, so nutritional deficiencies are less likely to occur.

Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling in same patient by Dr R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows surgeon to see gallbladder on a HD monitor. Laparoscopic cholecystectomy is Gold standard for Gallstone disease.

Laparoscopic Surgery for Large Endometrioma

For most of the gynecologist Laparoscopic ovarian cystectomy remains a first-line choice for the surgical treatment of endometriotic cysts. Laparoscopy for endometrioma is performed through an umbilical incision and two or three lower abdominal incisions. This video demonstrate laparoscopic surgery for large right sided endometrioma performed for an unmarried girl by Dr R K Mishra at World Laparoscopy Hospital. Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

Dangerous way of Performing Laparoscopic Cholecystectomy

https://www.laparoscopyhospital.com/ This Video demonstrate a dangerous way of Performing Laparoscopic Cholecystectomy by Harmonic Scalpel In Mass Shearing. Ideally a nice dissection of calot's triangle with critical view of safety should be done. World wide laparoscopic cholecystectomy (LC) has become the customary method for treating gallstones, some incidents and complications appear rather more frequently than with the open technique. Several aspects of these complications and their treatment possibilities are analysed and clipless cholecystectomy with Harmonic scalpel is one of them. During the past decade world wide laparoscopic cholecystectomy has become the procedure of choice in the surgical treatment of symptomatic gallstone. The operation is not completely risk-free, some incidents and complications being more frequent than with open cholecystectomy. The use of the Harmonic scalpel is deemed safe and comparable to clip placement at the discretion of the surgeon for cystic duct ligation. According to the article published by many author, harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. Further research with larger homogeneous studies and assessments of cost-effectiveness would further enhance the increasing use of the Harmonic scalpel in laparoscopic cholecystectomy.

Laparoscopic Surgery for Ectopic Pregnancy - Lecture by Dr R K Mishra

This video is lecture of Dr R K Mishra on laparoscopic management of ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity. Laparoscopic Salpingostomy or Salpingectomy is the method of choice for the management of ectopic pregnancy. In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth. An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss. According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths. Ectopic surgery The fallopian tubes can be repaired or removed with surgery. Keyhole surgery can be performed to remove the ectopic tissue. This is also known as a laparoscopy. In a laparoscopy, the surgeon makes a small incision in or near the navel and inserts a device called a laparoscope to view the area. Other surgical instruments are inserted into a tube, or through other small incisions, to remove the ectopic tissue. If the area is damaged, surgeons might be able to repair the fallopian tubes, but they will probably have to remove the affected tube as part of this procedure. If the other fallopian tube is still intact, a healthy pregnancy is still possible. If severe internal bleeding has occurred, a larger incision may be needed. This procedure would be called a laparotomy.

Laparoscopic Surgery for Pedunculated Myoma by Mishra's Knot

Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.

IPOM Inguinal Hernia Repair by Laparoscopy

https://www.laparoscopyhospital.com/SERV01.HTM Laparoscopic inguinal hernia repair originated in the early 1987 by GER as laparoscopy gained a foothold in general surgery. Inguinal hernias account for 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Although TAPP and TEP, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons IPOM inguinal hernia repair, produces excellent results comparable to those of TAPP or TEP repair.

Laparoscopic Surgery for Hydatid Cyst Disease

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic lecture of treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. The laparoscopic approach is safe with acceptable mortality and morbidity for both conservative and radical resections in selected patients. Clinical outcomes are comparable to open surgery, albeit in a selected group of patients.

Dundee Jamming Knot and Aberdeen Termination demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This Video demonstrate Dundee Jamming Knot Continuous Suturing and Aberdeen Termination. Continuous suturing is required in laparoscopic surgery to close delicate long suture line. It can be started with Dundee Jamming Knot. The final knot of a continuous suture can be accomplished in the traditional way of open surgery as Aberdeen Termination. Dundee Jamming Knot and Aberdeen Termination are two surgical knots in the same direction and a final one in the opposite direction, tying the final loop of the continuous suture with the end of the suture with the needle, or it is possible to recur to the “Aberdeen knot,”8 in which a final knot is accomplished by creating a new loop in the already existing one. The final loop of the suture is kept loosely; then, grasping the needle with the assistant needle holder, the needle holder is inserted into the loop, and the suture thread is grasped at its middle and retracted without the grasper dropping the needle. This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder. This procedure is repeated twice. Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. If, at the end of the suture, the thread were too short to accomplish one of the described procedures.

Laparoscopic Repair of Inguinal Hernia Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstration is Laparoscopic Repair of Inguinal Hernia Lecture by Dr. R. K. Mishra at World Laparoscopy Hospital. A major benefit of the laparoscopic technique is for patients who present with bilateral inguinal hernias and recurrent hernia. Laparoscopy allows for both hernias to be repaired in a single operation without need for additional ports or incisions. As a result, recovery time is similar to unilateral laparoscopic hernia repair.

Lecture PPH Stapler piles surgery Step by Step by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate PPH stapled Piles Surgery step by step by Dr R K Mishra. PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement. Haemorrhoidal disease is the most frequent and ancient proctological pathology. Haemorrhoidectomy is always feared for intensive post-operative pain and complications. Stapled hemorrhoidopexy is good procedure but may be followed by severe postoperative complications of which haemorrhage is one of the most serious early events. Surgical techniques have advanced more and more with the aim of reducing the post-surgical complications and to help a faster recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan procedure, has been the most used method in Europe, also in the “Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”, according to Ferguson procedure, has been the most used method in the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative method to conventional surgical procedures. It has many advantages such as less pain, faster recovery and a quicker return to normal activities. PPH stapler procedure for treatment of haemorrhoidal prolapse.

Appendectomy lecture New in Full HD - Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Appendectomy is one of the most frequently performed General Surgical Procedure. An appendectomy is the surgical removal of the appendix. It's a common emergency surgery that's performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It's located in the lower right side of your abdomen.Jan 5, 2016

Laparoscopic Mishra's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This is a video of Laparoscopic Mishra's Knot. Laparoscopic suturing and knotting is important for surgeons and gynecologist. Mishra's Knot is one of the important extracorporeal knot for any tubular structure. Configuration of Mishra's Knot is 1:1:1:1:1:1:1. This knot is secured upto 18mm of tubular structure.

Mishra's Knot - Ideal for Laparoscopic Cholecystectomy

This video demonstrate Mishra's Knot used in laparoscopic cholecystectomy. This is an Ideal for Laparoscopic Cholecystectomy. Tying extracorporeal knot to the cystic duct has many advantages. This knot is also can be used for in mass ligation and partial cholecystectomy.

Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Sleeve Gastrectomy

https://www.laparoscopyhospital.com/bariatric-surgery.html This video demonstrate laparoscopic sleeve gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital. The laparoscopic sleeve gastrectomy (SG) or gastric sleeve surgery, involves re-shaping the stomach from a pouch-like shape into a long tube, or “sleeve”. Pre-surgery the stomach looks like a kidney bean and can expand to the volume of several liter-size bottles of soda. With staples, the stomach is converted to look like a banana. This weight loss surgery reduces the capacity and prevents the stomach from expanding significantly. Before sleeve gastrectomy a regular stomach can hold about six cups of food. The new small stomach can hold about a half cup in volume, resulting in a ‘restrictive’ weight loss of the person. This type of laparoscopic sleeve gastrectomy bariatric surgery can be done as a stand-alone procedure or as part of a staged operation. The weight loss is projected to be in the range of 55 to 70 percent of excess body weight. There is no malabsorption created and no foreign body or implant involved. Long-term results are becoming available and the data suggest the weight loss is similar to gastric bypass.

Laparoscopic Ventral and Incisional Hernia Repair: Pros and Cons

https://www.laparoscopyhospital.com/ This video is lecture of Pros and Cons of Laparoscopic Ventral and Incisional Hernia Repair by Dr. R. K. Mishra at World Laparoscopy Hospital. The purpose of this lecture is to analyse the surgical techniques, perioperative complications, and recurrence rate of laparoscopic ventral hernia repair (LVHR) including incisional Hernia, in comparison with the open ventral hernia repair (OVHR), based on the international literature. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. The laparoscopic technique has numerous variations of the methodology used by surgeons, although several common steps are followed by all. The procedure starts with entering the peritoneal cavity by using a Veress needle, an open Hasson method, or an optical trocar allowing view of the abdominal wall layers during penetration. Palmer's point is the best place to access. This lecture indicates that LVHR is a safe and effective approach to abdominal wall hernias. The technique offers the advantages of the laparoscopic approach, ie, a short hospital stay, less postoperative pain, and early convalescence. The procedure carries an acceptable risk of complications compared to open surgery, a low risk of recurrence, and an excellent cosmetic result. It is considered a good alternative to its open counterpart, at least in experienced hands.

Laparoscopic Tumble Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tumble Square Knot. Laparoscopic Tumble Square Knot is the only knots that can be used when the suture does not slide freely through the tissue and anchoring device. Laparoscopic Tumble Square Knot configurations also theoretically avoid suture damage from abrasion and tissue damage during sliding. The major disadvantage of static knots is the propensity of the loop to loosen before the second half-hitch is seated to the point that it provisionally “locks” the knot. One method of minimizing this effect is by using a maryland to push the square knot on which one limb is tumbled which holds the tissue loop tight as it advances sequential half-hitches.

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Mishra's Knot - Ideal for Laparoscopic Cholecystectomy

This video demonstrate Mishra's Knot used in laparoscopic cholecystectomy. This is an Ideal for Laparoscopic Cholecystectomy. Tying extracorporeal knot to the cystic duct has many advantages. This knot is also can be used for in mass ligation and partial cholecystectomy.

Laparoscopic Tumble Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tumble Square Knot. Laparoscopic Tumble Square Knot is the only knots that can be used when the suture does not slide freely through the tissue and anchoring device. Laparoscopic Tumble Square Knot configurations also theoretically avoid suture damage from abrasion and tissue damage during sliding. The major disadvantage of static knots is the propensity of the loop to loosen before the second half-hitch is seated to the point that it provisionally “locks” the knot. One method of minimizing this effect is by using a maryland to push the square knot on which one limb is tumbled which holds the tissue loop tight as it advances sequential half-hitches.

Laparoscopic Management of Ectopic Pregnancies Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This Video Lecture of Dr R K Mishra is to compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this lecture was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

Laparoscopic Surgery for Ectopic Pregnancy - Lecture by Dr R K Mishra

This video is lecture of Dr R K Mishra on laparoscopic management of ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity. Laparoscopic Salpingostomy or Salpingectomy is the method of choice for the management of ectopic pregnancy. In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth. An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss. According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths. Ectopic surgery The fallopian tubes can be repaired or removed with surgery. Keyhole surgery can be performed to remove the ectopic tissue. This is also known as a laparoscopy. In a laparoscopy, the surgeon makes a small incision in or near the navel and inserts a device called a laparoscope to view the area. Other surgical instruments are inserted into a tube, or through other small incisions, to remove the ectopic tissue. If the area is damaged, surgeons might be able to repair the fallopian tubes, but they will probably have to remove the affected tube as part of this procedure. If the other fallopian tube is still intact, a healthy pregnancy is still possible. If severe internal bleeding has occurred, a larger incision may be needed. This procedure would be called a laparotomy.

Laparoscopic Weston Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ The Weston slip knot was initially described in the obstetric and gynecology literature and is also used in arthroscopic surgery.The advantage of this knot is that it is relatively easy to tie outside, can then slip easily into place and be tightly secured. The post strand does not move throughout the knot; the loop strand is the longer strand which is moved to make the knot. The advantage of the Weston knot is that it locks readily and is not bulky.

Torted Ovarian Dermoid Cyst in Pregnant Patient

https://www.laparoscopyhospital.com/ This video is Laparoscopic management of Torted Ovarian Dermoid Cyst in Pregnant Patient. Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant in 5% of cases. The incidence of torsion in pregnant patients with ovarian cyst persisting during pregnancy is approximately 15%. Benign dermoid cysts/teratomas are the most frequent ovarian tumors, with an incidence ranging from 5% to 25% of all ovarian neoplasms [3]. They are of germ cell origin and composed of multiple types of tissue. Torsion of the cystic contents and ovary may occur in them, thus leading to vascular infarction and necrosis. Torsion of the pedicle has been reported to be the most frequent complication, occurring in 16.1% of cases [3]. Traditional risk factors for ovarian torsion are increased ovarian size, ovarian tumors, ovarian hyperstimulation, and pregnancy

Laparoscopic Surgery for Large Endometrioma

For most of the gynecologist Laparoscopic ovarian cystectomy remains a first-line choice for the surgical treatment of endometriotic cysts. Laparoscopy for endometrioma is performed through an umbilical incision and two or three lower abdominal incisions. This video demonstrate laparoscopic surgery for large right sided endometrioma performed for an unmarried girl by Dr R K Mishra at World Laparoscopy Hospital. Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

Laparoscopic PCOD Management

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html This video demonstrate laparoscopic ovarian drilling for PCOS (Polycystic Ovary Syndrome) Treatment. The exact mechanism of Ovarian Drilling in PCOS is yet to be elucidated. The most plausible one is the destruction of ovarian follicles and stroma resulting in a decrease in androgen and inhibin levels and a secondary rise in follicle-stimulating hormone (FSH) levels. Production of inflammatory growth factors like insulin-like growth factor-1, in response to thermal injury is in Laparoscopic Ovarian Drilling to Treat PCOS Infertility, further potentiates the actions of FSH on folliculogenesis, while increased blood flow to the ovary provoked by surgery, facilitates increased delivery of gonadotropins. The number of punctures is empirically chosen depending on the ovarian size. In the original procedure, 3-8 diathermy punctures (each of 3 mm diameter and 2-4 mm depth) per ovary were applied, using power setting of 40W W for 2-4 s

Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling in same patient by Dr R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows surgeon to see gallbladder on a HD monitor. Laparoscopic cholecystectomy is Gold standard for Gallstone disease.

Laparoscopic Roeder's knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Roeder's knot is one of the oldest knot used in laparoscopic surgery. Laparoscopic Roeder's knot is one of the most popular extracorporeal knot. This technique of the extracorporeal knotting is simple, easy, and reproducible with good knot and loop security and can be used with multifilament suture material of 90cm. Laparoscopic extracorporeal knot is popular for appendectomy, cholecystectomy, and any tubular structure upto 8mm structure.

Laparoscopic Nephrectomy Lecture by Dr R K Mishra

This video is of Laparoscopic Nephrectomy Lecture by Dr R K Mishra. A laparoscopic nephrectomy is minimally invasive operation to remove kidney. A laparoscopic nephrectomy involves removing an entire kidney through keyhole incisions in the flank, the side of the body between the ribs and the hip. A laparoscopic nephrectomy removes the kidney by using laparoscopic equipment. Long thin instruments are passed through up to five small incisions made in the flank, each about 1cm in length. The abdomen is first filled with carbon dioxide, which separates the tissues to allow for vision during the surgery. A camera is then passed, giving the urologist a detailed picture inside the abdomen. The other incisions are used to pass cutting and suturing instruments so the blood supply to the kidney can be isolated and tied off and the kidney removed either with or without its surrounding structures. A wound drain is then inserted to drain any wound ooze. This is usually stitched in place and stays in for 1 – 2 days. A nephrectomy is usually done for one of two reasons, either for cancer of the kidney or because of a non- functioning kidney. In the case of kidney cancer a radical laparoscopic nephrectomy is done. This is done in an attempt to rid the body of cancer by removing the entire kidney and adrenal gland, with its surrounding fat and attached vessels. In more advanced cases it may be done to stop continued bleeding from the effected kidney. For non-functioning kidneys, which are either caused by large stones, a lack of blood supply or abnormal kidney structure, a simple laparoscopic nephrectomy is done. This is where only the kidney itself is taken and the adrenal gland and other structures are left behind. A simple nephrectomy is usually done to avoid recurrent infection and pain and the possibility of severe illness because of infection.

Unedited Laparoscopic Hysterectomy - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.

Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch. Manipulating the gallbladder with the left-hand instrument is a key part of performing a laparoscopic cholecystectomy. In these case stone should be removed from hartmann pouch. If a stone is impacted in the Hartmann’s pouch, this manipulation can be difficult, and can cause cramp and exhaustion of the surgeon’s left hand or injury to the gallbladder if a toothed instrument is used to improve grip. For the experienced laparoscopic surgeon, this tip makes manoeuvrability of the thickened, impacted Hartmann’s pouch simpler. We have used it in the acute and elective setting to great effect. The tape provides gentle traction and can be resisted easily if there are any concerns about placement as dissection continues.

Laparoscopic Repair of Huge Incisional Hernia

Laparoscopic Repair of Huge Incisional Hernia performed by Dr R K Mishra at World Laparoscopy Hospital. Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy.

Lecture on Laparoscopic Appendectomy for Acute Appendicitis

https://www.laparoscopyhospital.com/ This video is lecture of Dr R K Mishra on Laparoscopic Appendectomy. Laparoscopic Appendectomy can be performed by single incision, two port or three incisions, one umbilical and one suprapubic are made; permanent material used comprises: grasping forceps, hook, scissors, needle holders, three metal trocars and four other usual instruments, and a single strand of cotton. There is possibility of using endobag and in few cases no need to use of operative extractors bags, clips, endoloops, staples or bipolar or harmonic energy instruments. Allows triangulation and instrumentation in the conventional manner.

Laparoscopic Sleeve Gastrectomy Surgery Video Explained Step by Step

This video demonstrate Laparoscopic Sleeve Gastrectomy which is a popular Bariatric Surgery for morbid obesity. Sleeve gastrectomy is a simpler bariatric operation than the gastric bypass procedure for morbid obesity because it does not involve rerouting of or reconnection of the intestines. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach. Laparoscopic Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Laparoscopic Ventral and Incisional Hernia Repair: Pros and Cons

https://www.laparoscopyhospital.com/ This video is lecture of Pros and Cons of Laparoscopic Ventral and Incisional Hernia Repair by Dr. R. K. Mishra at World Laparoscopy Hospital. The purpose of this lecture is to analyse the surgical techniques, perioperative complications, and recurrence rate of laparoscopic ventral hernia repair (LVHR) including incisional Hernia, in comparison with the open ventral hernia repair (OVHR), based on the international literature. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. The laparoscopic technique has numerous variations of the methodology used by surgeons, although several common steps are followed by all. The procedure starts with entering the peritoneal cavity by using a Veress needle, an open Hasson method, or an optical trocar allowing view of the abdominal wall layers during penetration. Palmer's point is the best place to access. This lecture indicates that LVHR is a safe and effective approach to abdominal wall hernias. The technique offers the advantages of the laparoscopic approach, ie, a short hospital stay, less postoperative pain, and early convalescence. The procedure carries an acceptable risk of complications compared to open surgery, a low risk of recurrence, and an excellent cosmetic result. It is considered a good alternative to its open counterpart, at least in experienced hands.

Laparoscopic Extracorporeal Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Extracorporeal Square Knot. Laparoscopic Square knot is used for any structure which is tough and under tension. It can be used for approximation of vaginal vault, Rectus Divarication, Myomectomy, Crural Approximation etc...

Laparoscopic Nissen fundoplication - Dr R K Mishra

Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.

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

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Appendectomy - Lecture by Dr R K Mishra. Appendicitis is one of the most common surgical problems and appendectomy is one of the most common surgery. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall. ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY: Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are: Less postoperative pain May shorten hospital stay May result in a quicker return to bowel function Quicker return to normal activity Better cosmetic results

Appendectomy lecture New in Full HD - Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Appendectomy is one of the most frequently performed General Surgical Procedure. An appendectomy is the surgical removal of the appendix. It's a common emergency surgery that's performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It's located in the lower right side of your abdomen.Jan 5, 2016

IPOM Inguinal Hernia by Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This video demonstrate IPOM Inguinal Hernia by Dr. R. K. Mishra at World Laparoscopy Hospital. Inguinal Hernia Laparoscopic Surgery is commonly also called as Minimal Invasive Surgery is method of choice and IPOM technique is increasing. Laparoscopic Inguinal Hernia Surgery is one of the most common minimal access surgery performed in the world. This Inguinal Hernia Surgery is done under General Anesthesia and Laparoscopic Hernia Surgeon makes 3-4 keyholes of nearly 0.5 to 1 cm. near the groins to perform IPOM inguinal hernia surgery. With the help of Laparoscopic instruments Surgeons pushes the tissue back into abdomen and repair the hernia by Mesh. In IPOM Laparoscopic Hernia surgery special mesh made for intraperitoneal application is used. Tacker or suture then uses a Surgical Mesh to hold the tissues back to its normal position. A tackers is used to hold the mesh at its position. Patient is discharged the next day because there are no stitches and no cuts.

Laparoscopic Radical Hysterectomy

https://www.laparoscopyhospital.com/ This video is lecture of Laparoscopic Radical Hysterectomy by Dr R K Mishra. This procedure is used to treat stage I or IIA cervical cancer. Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. Laparoscopic radical hysterectomy is a feasible alternative to laparotomy for early stage cervical cancer. Similar surgical outcomes are achieved with significantly less morbidity.

Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstrate Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia. by Dr R K Mishra at World Laparoscopy Hospital. Recovery from laparoscopic repair of bilateral recurrent inguinal hernia repair is usually very quick. Patient will be mobile very soon after the laparoscopic procedure and will be encouraged to increase how much you walk around over the first few days post surgery. Many patients return to normal day to day activities within the first week.

Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test

https://www.laparoscopyhospital.com/international-patients.html Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test thus not only helps in regulating ovulation and enhancing conception rates but also provides an opportunity to assess the pelvis for other potential causes of subfertility which could be treated at the same time. We therefore believe that diagnostic hysteroscopy and laparoscopy should be offered quite high-up in the hierarchy of infertility investigations and treatment. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile.

Lecture PPH Stapler piles surgery Step by Step by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate PPH stapled Piles Surgery step by step by Dr R K Mishra. PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement. Haemorrhoidal disease is the most frequent and ancient proctological pathology. Haemorrhoidectomy is always feared for intensive post-operative pain and complications. Stapled hemorrhoidopexy is good procedure but may be followed by severe postoperative complications of which haemorrhage is one of the most serious early events. Surgical techniques have advanced more and more with the aim of reducing the post-surgical complications and to help a faster recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan procedure, has been the most used method in Europe, also in the “Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”, according to Ferguson procedure, has been the most used method in the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative method to conventional surgical procedures. It has many advantages such as less pain, faster recovery and a quicker return to normal activities. PPH stapler procedure for treatment of haemorrhoidal prolapse.

Laparoscopic Anatomy of Pelvis by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate Laparoscopic Pelvic Anatomy by Dr R K Mishra. The abdominal cavity is traditionally divided into nine regions. Regardless of the quadrants chosen for laparoscopic access, thorough knowledge of the relevant surface anatomy increases patient safety during laparoscopic surgery. Laparoscopic surgery is a safe and effective option for many patients, provided the surgeon knows the relevant anatomic landmarks and variations created by obesity, prior surgery, and aberrant anatomy. pelvic anatomy visualized two-dimensionally under magnification during traditional laparoscopy can look very different than it does during conventional surgery, due to the effects of the pneumoperitoneum, steep Trendelenburg position, and/or the use of uterine manipulators.

Laparoscopic Mishra's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This is a video of Laparoscopic Mishra's Knot. Laparoscopic suturing and knotting is important for surgeons and gynecologist. Mishra's Knot is one of the important extracorporeal knot for any tubular structure. Configuration of Mishra's Knot is 1:1:1:1:1:1:1. This knot is secured upto 18mm of tubular structure.

Total Laparoscopic Hysterectomy with Bilateral Salpingo Oophorectomy

https://www.laparoscopyhospital.com/ This video demonstrate TLH with BSO by Dr R K Mishra at World Laparoscopy Hospital. The use of laparoscopic hysterectomy has recently been reported as an alternative to traditional abdominal hysterectomy and the utilization of a mini-endoscopic technique has also been recorded. This prospective randomized study has demonstrated that after laparoscopic hysterectomy, patients recovered more quickly and had less pain, and the incidence of complications was also low. One serious complication after laparoscopic hysterectomy is increased ureteric injury, but in our opinion it is possible to avoid major complications by paying particular attention to the surgical details.

Laparoscopic Myomectomy for Multiple Myoma

Laparoscopic myomectomy in multiple fibroids. Myomectomy is the surgery of choice for women who have symptomatic fibroids and who wish to retain their uterus. ... It is known that uterine fibroids are estrogen dependent. During pregnancy these fibroids increase in size, whereas in the puerperium and menopause they shrink. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console. Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic Surgery for Peritoneal Inclusion cyst with Bilateral Endometrioma

This Video demonstrate Laparoscopic Management of Inclusion cyst with Bilateral Endometrioma. Peritoneal inclusion cyst (PIC) is defined as a fluid-filled mesothelial-lined cysts of the pelvis and it is most frequently encountered in women of reproductive age. The treatment options are observation, hormonal management, imaging-guided aspiration, image-guided sclerotherapy and surgical excision. Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in reproductive age group women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts.

Laparoscopic Surgery for Pedunculated Myoma by Mishra's Knot

Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.

Laparoscopic Removal of Huge Ovarian Cyst

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html Laparoscopic surgery has been increasingly applied to different gynecologic ovaries surgical problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall. With proper patient selection, the size of an ovarian cyst should not constitute a contraindication to laparoscopic surgery. Experience in advanced laparoscopic surgery and the availability of a gynecologic oncologist should make the procedure safely applicable to a broader patient population.

Laparoscopic Tayside Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tayside Knot. This is an extracorporeal knot can be used to ligate tubular structure. The Tayside knot is suitable for use with all braided sutures (2/0 or stronger) as well as dacron. It is used with Dacron for ligation of vessels such as the azygous vein, splenic artery/vein or the inferior mesenteric artery/vein. A variety of slipknots are used by various professions and in certain leisure activities. Some of these have been adapted for use in endoscopic surgery. The holding strength of individual types of slipknots is influenced by a number of factors including the ligature material used and its caliber. Thus a slipknot may be secure when tied in catgut but unsafe with other materials. In addition, some slipknots are difficult to tie or jam lock too easily for reliable placement by push rod before locking.

Dundee Jamming Knot and Aberdeen Termination demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This Video demonstrate Dundee Jamming Knot Continuous Suturing and Aberdeen Termination. Continuous suturing is required in laparoscopic surgery to close delicate long suture line. It can be started with Dundee Jamming Knot. The final knot of a continuous suture can be accomplished in the traditional way of open surgery as Aberdeen Termination. Dundee Jamming Knot and Aberdeen Termination are two surgical knots in the same direction and a final one in the opposite direction, tying the final loop of the continuous suture with the end of the suture with the needle, or it is possible to recur to the “Aberdeen knot,”8 in which a final knot is accomplished by creating a new loop in the already existing one. The final loop of the suture is kept loosely; then, grasping the needle with the assistant needle holder, the needle holder is inserted into the loop, and the suture thread is grasped at its middle and retracted without the grasper dropping the needle. This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder. This procedure is repeated twice. Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. If, at the end of the suture, the thread were too short to accomplish one of the described procedures.

Gastrointestinal Endoscopy Procedure Preparation & Risks

https://www.laparoscopyhospital.com/ This video is lecture of Gastrointestinal Endoscopy Procedure Preparation & Risks by Dr. R. K. Mishra at World Laparoscopy Hospital. Endoscopy has several names, depending on which portion of digestive tract by physician seeks to inspect. Upper GI endoscopy (EGD): This procedure enables the examination of the esophagus, stomach and the upper small bowel called duodenum. Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel. Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways: To diagnose and treat hidden GI bleeding To detect the cause for malabsorption To confirm problems of the small bowel seen on an X-ray During surgery, to locate and remove sores with little damage to healthy tissue

Laparoscopic Repair of Inguinal Hernia Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstration is Laparoscopic Repair of Inguinal Hernia Lecture by Dr. R. K. Mishra at World Laparoscopy Hospital. A major benefit of the laparoscopic technique is for patients who present with bilateral inguinal hernias and recurrent hernia. Laparoscopy allows for both hernias to be repaired in a single operation without need for additional ports or incisions. As a result, recovery time is similar to unilateral laparoscopic hernia repair.

Laparoscopic Suturing Melzer's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic suturing and knot tying require a lot of patience and practice and can be difficult, time consuming, and frustrating in spite of the advances made in the fields of instrumentation, optics, and imaging. The new technique described here is an effort to make the procedure simpler by providing extracorporeal control of one limb of the suture. It involves percutaneous placement of the needle end of the suture in the abdomen and its removal using a modified 10 cm long cloth-sewing needle.

Hysterectomy by Laparoscopic Technique

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html A TLH or Total Laparoscopic Hysterectomy is defined by the laparoscopic dissection of the ovarian arteries and veins with the removal of the uterus vaginally or abdominally, along with laparoscopic closure of the vaginal cuff. This is in contrast to other methods of removing the uterus, fallopian tubes, and ovaries abdominal or vaginal. The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks. The vaginal hysterectomy can be done entirely through the vagina, or using a laparoscope (the laparoscopic-assisted vaginal hysterectomy, or LAVH).

Laparoscopic sleeve gastrectomy with endoscopic calibration

Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy. The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim is to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. Gastrointestinal complication after sleeve gastrectomy surgery may be summarized as follow: acute bleeding and/or anemia, staple-line complications such as anastomotic leaks, fistulae, and strictures, erosion and slippage, bezoars, and choledocholithiasis. An endoscopy is the preferred strategy, unless there is a suspicion of leaks or fistulae, in which case preliminary contrast radiography may be more appropriate. Endoscopic treatment plays an important role in the management of a variety of staple-line complications during and even after surgery, such as stomal stenosis and anastomotic leaks. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group is done in all the patients. In the endoscopic calibration the check with blue dye is much better in all cases.

Laparoscopic Repair of Epigastric Hernia by Two Ports

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Repair of Epigastric Hernia by Two Ports performed by Dr R K Mishra at World Laparoscopy Hospital. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It's above the belly button and just below the sternum of your rib cage. This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias.

IPOM Inguinal Hernia Repair by Laparoscopy

https://www.laparoscopyhospital.com/SERV01.HTM Laparoscopic inguinal hernia repair originated in the early 1987 by GER as laparoscopy gained a foothold in general surgery. Inguinal hernias account for 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Although TAPP and TEP, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons IPOM inguinal hernia repair, produces excellent results comparable to those of TAPP or TEP repair.

Laparoscopic Management of Ovarian Teratoma

https://www.laparoscopyhospital.com This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.

Laparoscopic Tubal Patency Test Hysteroscopy and Ovarian Drilling

This surgery was performed to evaluate the effectiveness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile

Sleeve Gastrectomy

https://www.laparoscopyhospital.com/bariatric-surgery.html This video demonstrate laparoscopic sleeve gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital. The laparoscopic sleeve gastrectomy (SG) or gastric sleeve surgery, involves re-shaping the stomach from a pouch-like shape into a long tube, or “sleeve”. Pre-surgery the stomach looks like a kidney bean and can expand to the volume of several liter-size bottles of soda. With staples, the stomach is converted to look like a banana. This weight loss surgery reduces the capacity and prevents the stomach from expanding significantly. Before sleeve gastrectomy a regular stomach can hold about six cups of food. The new small stomach can hold about a half cup in volume, resulting in a ‘restrictive’ weight loss of the person. This type of laparoscopic sleeve gastrectomy bariatric surgery can be done as a stand-alone procedure or as part of a staged operation. The weight loss is projected to be in the range of 55 to 70 percent of excess body weight. There is no malabsorption created and no foreign body or implant involved. Long-term results are becoming available and the data suggest the weight loss is similar to gastric bypass.

Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra. Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be "open," meaning the surgeon has to make a larger cut, healing takes longer. In gastric sleeve surgery your surgeon creates a small stomach "sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%. This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above). There is no rearrangement of the bowel with a gastric sleeve surgery therefore dumping, which may occur to gastric bypass patients when their undigested stomach contents are “dumped” into their small intestine too quickly, should not a problem. Also a sleeve gastrectomy doesn’t affect the absorption of food, so nutritional deficiencies are less likely to occur.

Laparoscopic Surgery for Hydatid Cyst Disease

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic lecture of treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. The laparoscopic approach is safe with acceptable mortality and morbidity for both conservative and radical resections in selected patients. Clinical outcomes are comparable to open surgery, albeit in a selected group of patients.

Laparoscopic Surgeon's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic knot-tying is an advanced skill. The traditional surgeon's knot is often used in laparoscopic surgery for every tissue. Surgeons knot is most versatile knot in laparoscopic surgery. It can be used in many situations like bowel anastomosis, pyeloplasty, tubal recanalization etc... Surgeons knot can be terminated at the end of a continuous suture line in laparoscopic surgery by again surgeons knot or square knot. The Aberdeen knot has been shown to be stronger and more secure than the surgeon's knot for ending a suture line but is rarely used in laparoscopic surgery. We have developed a new technique to make the surgeons knot laparoscopically. Any surgeon's concern about the ease and safety of laparoscopic knotting is natural, and knots performed laparoscopically must be as safe as those traditionally performed. A knot should secure proper tissue approximation, and be simple, easy, quick, and reliable.

Dangerous way of Performing Laparoscopic Cholecystectomy

https://www.laparoscopyhospital.com/ This Video demonstrate a dangerous way of Performing Laparoscopic Cholecystectomy by Harmonic Scalpel In Mass Shearing. Ideally a nice dissection of calot's triangle with critical view of safety should be done. World wide laparoscopic cholecystectomy (LC) has become the customary method for treating gallstones, some incidents and complications appear rather more frequently than with the open technique. Several aspects of these complications and their treatment possibilities are analysed and clipless cholecystectomy with Harmonic scalpel is one of them. During the past decade world wide laparoscopic cholecystectomy has become the procedure of choice in the surgical treatment of symptomatic gallstone. The operation is not completely risk-free, some incidents and complications being more frequent than with open cholecystectomy. The use of the Harmonic scalpel is deemed safe and comparable to clip placement at the discretion of the surgeon for cystic duct ligation. According to the article published by many author, harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. Further research with larger homogeneous studies and assessments of cost-effectiveness would further enhance the increasing use of the Harmonic scalpel in laparoscopic cholecystectomy.

https://www.laparoscopyhospital.com/

Laparoscopic Repair of Inguinal Hernia Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstration is Laparoscopic Repair of Inguinal Hernia Lecture by Dr. R. K. Mishra at World Laparoscopy Hospital. A major benefit of the laparoscopic technique is for patients who present with bilateral inguinal hernias and recurrent hernia. Laparoscopy allows for both hernias to be repaired in a single operation without need for additional ports or incisions. As a result, recovery time is similar to unilateral laparoscopic hernia repair.

Unedited Laparoscopic Hysterectomy - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ Minimal Access Laparoscopic Hysterectomy is becoming a very common procedure, although significant concerns about the procedure voiced by many gynecologists are twofold: The ability to confidently close the vaginal cuff laparoscopically and the fear of cuff dehiscence and ureteric injury. This has resulted in many practitioners securing the uterine artery vaginally and closing the cuff vaginally, which increases operating time, or converting to LAVH or LSH. We have developed a nice desiccation technique of uterine artery during Total Laparoscopic Hysterectomy and vaginal cuff closure technique following TLH that incorporates the same surgical principles as closure for an abdominal hysterectomy. It is easy to learn and simple continuous suturing is required intracorporeally to close the vault. Mean surgical time is half an hour. This video demonstrates the use of a vessel sealing device to perform a laparoscopic hysterectomy with an obliterated posterior cul-de-sac. This technique demonstrates how to dissect the anterior compartment first. Then we controlled the large uterine vessels.

Laparoscopic Tubal Patency Test Hysteroscopy and Ovarian Drilling

This surgery was performed to evaluate the effectiveness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile

Laparoscopic Extracorporeal Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Extracorporeal Square Knot. Laparoscopic Square knot is used for any structure which is tough and under tension. It can be used for approximation of vaginal vault, Rectus Divarication, Myomectomy, Crural Approximation etc...

Total Laparoscopic Hysterectomy with Bilateral Salpingo Oophorectomy

https://www.laparoscopyhospital.com/ This video demonstrate TLH with BSO by Dr R K Mishra at World Laparoscopy Hospital. The use of laparoscopic hysterectomy has recently been reported as an alternative to traditional abdominal hysterectomy and the utilization of a mini-endoscopic technique has also been recorded. This prospective randomized study has demonstrated that after laparoscopic hysterectomy, patients recovered more quickly and had less pain, and the incidence of complications was also low. One serious complication after laparoscopic hysterectomy is increased ureteric injury, but in our opinion it is possible to avoid major complications by paying particular attention to the surgical details.

Laparoscopic Tumble Square Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tumble Square Knot. Laparoscopic Tumble Square Knot is the only knots that can be used when the suture does not slide freely through the tissue and anchoring device. Laparoscopic Tumble Square Knot configurations also theoretically avoid suture damage from abrasion and tissue damage during sliding. The major disadvantage of static knots is the propensity of the loop to loosen before the second half-hitch is seated to the point that it provisionally “locks” the knot. One method of minimizing this effect is by using a maryland to push the square knot on which one limb is tumbled which holds the tissue loop tight as it advances sequential half-hitches.

Sleeve Gastrectomy

https://www.laparoscopyhospital.com/bariatric-surgery.html This video demonstrate laparoscopic sleeve gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital. The laparoscopic sleeve gastrectomy (SG) or gastric sleeve surgery, involves re-shaping the stomach from a pouch-like shape into a long tube, or “sleeve”. Pre-surgery the stomach looks like a kidney bean and can expand to the volume of several liter-size bottles of soda. With staples, the stomach is converted to look like a banana. This weight loss surgery reduces the capacity and prevents the stomach from expanding significantly. Before sleeve gastrectomy a regular stomach can hold about six cups of food. The new small stomach can hold about a half cup in volume, resulting in a ‘restrictive’ weight loss of the person. This type of laparoscopic sleeve gastrectomy bariatric surgery can be done as a stand-alone procedure or as part of a staged operation. The weight loss is projected to be in the range of 55 to 70 percent of excess body weight. There is no malabsorption created and no foreign body or implant involved. Long-term results are becoming available and the data suggest the weight loss is similar to gastric bypass.

Laparoscopic PCOD Management

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html This video demonstrate laparoscopic ovarian drilling for PCOS (Polycystic Ovary Syndrome) Treatment. The exact mechanism of Ovarian Drilling in PCOS is yet to be elucidated. The most plausible one is the destruction of ovarian follicles and stroma resulting in a decrease in androgen and inhibin levels and a secondary rise in follicle-stimulating hormone (FSH) levels. Production of inflammatory growth factors like insulin-like growth factor-1, in response to thermal injury is in Laparoscopic Ovarian Drilling to Treat PCOS Infertility, further potentiates the actions of FSH on folliculogenesis, while increased blood flow to the ovary provoked by surgery, facilitates increased delivery of gonadotropins. The number of punctures is empirically chosen depending on the ovarian size. In the original procedure, 3-8 diathermy punctures (each of 3 mm diameter and 2-4 mm depth) per ovary were applied, using power setting of 40W W for 2-4 s

Torted Ovarian Dermoid Cyst in Pregnant Patient

https://www.laparoscopyhospital.com/ This video is Laparoscopic management of Torted Ovarian Dermoid Cyst in Pregnant Patient. Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant in 5% of cases. The incidence of torsion in pregnant patients with ovarian cyst persisting during pregnancy is approximately 15%. Benign dermoid cysts/teratomas are the most frequent ovarian tumors, with an incidence ranging from 5% to 25% of all ovarian neoplasms [3]. They are of germ cell origin and composed of multiple types of tissue. Torsion of the cystic contents and ovary may occur in them, thus leading to vascular infarction and necrosis. Torsion of the pedicle has been reported to be the most frequent complication, occurring in 16.1% of cases [3]. Traditional risk factors for ovarian torsion are increased ovarian size, ovarian tumors, ovarian hyperstimulation, and pregnancy

Laparoscopic Nephrectomy Lecture by Dr R K Mishra

This video is of Laparoscopic Nephrectomy Lecture by Dr R K Mishra. A laparoscopic nephrectomy is minimally invasive operation to remove kidney. A laparoscopic nephrectomy involves removing an entire kidney through keyhole incisions in the flank, the side of the body between the ribs and the hip. A laparoscopic nephrectomy removes the kidney by using laparoscopic equipment. Long thin instruments are passed through up to five small incisions made in the flank, each about 1cm in length. The abdomen is first filled with carbon dioxide, which separates the tissues to allow for vision during the surgery. A camera is then passed, giving the urologist a detailed picture inside the abdomen. The other incisions are used to pass cutting and suturing instruments so the blood supply to the kidney can be isolated and tied off and the kidney removed either with or without its surrounding structures. A wound drain is then inserted to drain any wound ooze. This is usually stitched in place and stays in for 1 – 2 days. A nephrectomy is usually done for one of two reasons, either for cancer of the kidney or because of a non- functioning kidney. In the case of kidney cancer a radical laparoscopic nephrectomy is done. This is done in an attempt to rid the body of cancer by removing the entire kidney and adrenal gland, with its surrounding fat and attached vessels. In more advanced cases it may be done to stop continued bleeding from the effected kidney. For non-functioning kidneys, which are either caused by large stones, a lack of blood supply or abnormal kidney structure, a simple laparoscopic nephrectomy is done. This is where only the kidney itself is taken and the adrenal gland and other structures are left behind. A simple nephrectomy is usually done to avoid recurrent infection and pain and the possibility of severe illness because of infection.

Laparoscopic Radical Hysterectomy

https://www.laparoscopyhospital.com/ This video is lecture of Laparoscopic Radical Hysterectomy by Dr R K Mishra. This procedure is used to treat stage I or IIA cervical cancer. Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. Laparoscopic radical hysterectomy is a feasible alternative to laparotomy for early stage cervical cancer. Similar surgical outcomes are achieved with significantly less morbidity.

Laparoscopic Management of Ovarian Teratoma

https://www.laparoscopyhospital.com This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.

Appendectomy lecture New in Full HD - Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Appendectomy is one of the most frequently performed General Surgical Procedure. An appendectomy is the surgical removal of the appendix. It's a common emergency surgery that's performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It's located in the lower right side of your abdomen.Jan 5, 2016

Laparoscopic sleeve gastrectomy with endoscopic calibration

Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy. The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim is to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. Gastrointestinal complication after sleeve gastrectomy surgery may be summarized as follow: acute bleeding and/or anemia, staple-line complications such as anastomotic leaks, fistulae, and strictures, erosion and slippage, bezoars, and choledocholithiasis. An endoscopy is the preferred strategy, unless there is a suspicion of leaks or fistulae, in which case preliminary contrast radiography may be more appropriate. Endoscopic treatment plays an important role in the management of a variety of staple-line complications during and even after surgery, such as stomal stenosis and anastomotic leaks. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group is done in all the patients. In the endoscopic calibration the check with blue dye is much better in all cases.

Gastrointestinal Endoscopy Procedure Preparation & Risks

https://www.laparoscopyhospital.com/ This video is lecture of Gastrointestinal Endoscopy Procedure Preparation & Risks by Dr. R. K. Mishra at World Laparoscopy Hospital. Endoscopy has several names, depending on which portion of digestive tract by physician seeks to inspect. Upper GI endoscopy (EGD): This procedure enables the examination of the esophagus, stomach and the upper small bowel called duodenum. Colonoscopy: This procedure enables the doctor to see ulcers, inflamed mucous lining of your intestine, abnormal growths and bleeding in your colon, or large bowel. Enteroscopy: Enteroscopy is a recent diagnostic tool that allows a doctor to see your small bowel. The procedure may be used in the following ways: To diagnose and treat hidden GI bleeding To detect the cause for malabsorption To confirm problems of the small bowel seen on an X-ray During surgery, to locate and remove sores with little damage to healthy tissue

Lecture PPH Stapler piles surgery Step by Step by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate PPH stapled Piles Surgery step by step by Dr R K Mishra. PPH-stapler procedure for treatment of haemorrhoidal prolapse is an important improvement. Haemorrhoidal disease is the most frequent and ancient proctological pathology. Haemorrhoidectomy is always feared for intensive post-operative pain and complications. Stapled hemorrhoidopexy is good procedure but may be followed by severe postoperative complications of which haemorrhage is one of the most serious early events. Surgical techniques have advanced more and more with the aim of reducing the post-surgical complications and to help a faster recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan procedure, has been the most used method in Europe, also in the “Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”, according to Ferguson procedure, has been the most used method in the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative method to conventional surgical procedures. It has many advantages such as less pain, faster recovery and a quicker return to normal activities. PPH stapler procedure for treatment of haemorrhoidal prolapse.

Laparoscopic Nissen fundoplication - Dr R K Mishra

Laparoscopic Nissen fundoplication is a surgical procedure that alleviates gastroesophageal reflux disease (GERD) symptoms when lifestyle changes or anti-reflux medications have not controlled symptoms. The procedure was first performed in 1951 as an open-surgical procedure. Patients were hospitalized for 7 to 10 days after the procedure. Today, the Nissen fundoplication is performed in approximately 90 minutes. A majority of the time the patient is in the hospital overnight and is discharged the morning after surgery. Laparoscopic Nissen fundoplication is one of the popular surgery performed by general surgeon. Almost 90% of all the fundoplication in whole world is now performed via laparoscopic surgery. It is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure. The Nissen fundoplication is total (360°), but partial fundoplications known as Thal (270° anterior), Belsey (270° anterior transthoracic), Dor (anterior 180–200°), Lind (300° posterior), and Toupet fundoplications (posterior 270°) are alternative procedures with somewhat different indications and outcomes. In this procedure, the top part of the stomach (approximately 5 percent) is wrapped around the esophagus to form an additional valve to keep stomach contents from flowing up into the esophagus. The patient has five or six incisions, about ¼-inch each, in the abdomen. Post-operation, after arousing from the anesthesia, the patient is given liquids to drink, advancing then to a soft diet. It is a successful treatment in about 95 percent of the patients who have surgery.

Laparoscopic Management of Ectopic Pregnancies Lecture - Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This Video Lecture of Dr R K Mishra is to compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this lecture was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test

https://www.laparoscopyhospital.com/international-patients.html Diagnostic Laparoscopy Ovarian Drilling for PCOD and Tubal Patency Test thus not only helps in regulating ovulation and enhancing conception rates but also provides an opportunity to assess the pelvis for other potential causes of subfertility which could be treated at the same time. We therefore believe that diagnostic hysteroscopy and laparoscopy should be offered quite high-up in the hierarchy of infertility investigations and treatment. PCOS is characterized by presence of the hyperandrogenism, oligo- or anovulation. It is one of the most common reproductive endocrine disorders in the adolescent women. Females with PCOS present with a dysregulation in the menstrual cycle, hirsutism, anovulation, acne, and obesity. An approximately 5-10% of women in Poland suffer from PCOS and 10-15% of them are infertile.

Laparoscopic Tayside Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Tayside Knot. This is an extracorporeal knot can be used to ligate tubular structure. The Tayside knot is suitable for use with all braided sutures (2/0 or stronger) as well as dacron. It is used with Dacron for ligation of vessels such as the azygous vein, splenic artery/vein or the inferior mesenteric artery/vein. A variety of slipknots are used by various professions and in certain leisure activities. Some of these have been adapted for use in endoscopic surgery. The holding strength of individual types of slipknots is influenced by a number of factors including the ligature material used and its caliber. Thus a slipknot may be secure when tied in catgut but unsafe with other materials. In addition, some slipknots are difficult to tie or jam lock too easily for reliable placement by push rod before locking.

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

https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Appendectomy - Lecture by Dr R K Mishra. Appendicitis is one of the most common surgical problems and appendectomy is one of the most common surgery. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right lower abdominal wall. ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY: Results may vary depending upon the type of procedure and patient’s overall condition. Common advantages are: Less postoperative pain May shorten hospital stay May result in a quicker return to bowel function Quicker return to normal activity Better cosmetic results

Laparoscopic Surgery for Hydatid Cyst Disease

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic lecture of treatment of hydatid disease of the liver is an alternative to open surgery in well-selected patients. Important steps are the evacuation of the cyst contents without spillage, sterilization of the cyst cavity with scolicidal agents and cavity management using classical surgical techniques. The laparoscopic approach is safe with acceptable mortality and morbidity for both conservative and radical resections in selected patients. Clinical outcomes are comparable to open surgery, albeit in a selected group of patients.

Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra

https://www.laparoscopyhospital.com/ This video demonstrate Bariatric Surgery Laparoscopic sleeve Gastrectomy Step by Step Video by Dr R K Mishra. Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The result is a sleeve or tube like structure. Most gastric bypass surgery is laparoscopic, which means the surgeon makes small cuts. That makes for shorter recovery time. Most people stay in the hospital 2 to 3 days, and get back to normal activities in 3 to 5 weeks. If the surgery must be "open," meaning the surgeon has to make a larger cut, healing takes longer. In gastric sleeve surgery your surgeon creates a small stomach "sleeve” using a stapling device and the rest of your stomach is permanently removed. Your stomach’s size will be reduced by approx 75%. This procedure may be recommended if you have a body mass index (BMI) of 40 or more as this indicates you are at least 100 pounds over your recommended weight. It may also be advised for you if you have a BMI of 35 or more and also a serious medical condition that might improve with weight loss. Some of these conditions are sleep apnoea, type 2 diabetes, and heart disease. A gastric sleeve surgery may also be used to treat extremely morbidly obese people (with a BMI of 60 or above). There is no rearrangement of the bowel with a gastric sleeve surgery therefore dumping, which may occur to gastric bypass patients when their undigested stomach contents are “dumped” into their small intestine too quickly, should not a problem. Also a sleeve gastrectomy doesn’t affect the absorption of food, so nutritional deficiencies are less likely to occur.

Laparoscopic Weston Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ The Weston slip knot was initially described in the obstetric and gynecology literature and is also used in arthroscopic surgery.The advantage of this knot is that it is relatively easy to tie outside, can then slip easily into place and be tightly secured. The post strand does not move throughout the knot; the loop strand is the longer strand which is moved to make the knot. The advantage of the Weston knot is that it locks readily and is not bulky.

Laparoscopic Surgery for Pedunculated Myoma by Mishra's Knot

Not all laparoscopic surgeons are trained in laparoscopic myomectomy surgery. Laparoscopic myomectomy is Gold Standard because of the small size of the incisions, removing uterine fibroids with laparoscopic myomectomy requires special training of knotting and suturing. Fibroids that are attached to the outside of the uterus by a stalk (pedunculated fibroids) are the easiest to remove laparoscopically my Mishra's Knot.

Dundee Jamming Knot and Aberdeen Termination demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This Video demonstrate Dundee Jamming Knot Continuous Suturing and Aberdeen Termination. Continuous suturing is required in laparoscopic surgery to close delicate long suture line. It can be started with Dundee Jamming Knot. The final knot of a continuous suture can be accomplished in the traditional way of open surgery as Aberdeen Termination. Dundee Jamming Knot and Aberdeen Termination are two surgical knots in the same direction and a final one in the opposite direction, tying the final loop of the continuous suture with the end of the suture with the needle, or it is possible to recur to the “Aberdeen knot,”8 in which a final knot is accomplished by creating a new loop in the already existing one. The final loop of the suture is kept loosely; then, grasping the needle with the assistant needle holder, the needle holder is inserted into the loop, and the suture thread is grasped at its middle and retracted without the grasper dropping the needle. This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder. This procedure is repeated twice. Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. If, at the end of the suture, the thread were too short to accomplish one of the described procedures.

Hysterectomy by Laparoscopic Technique

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html A TLH or Total Laparoscopic Hysterectomy is defined by the laparoscopic dissection of the ovarian arteries and veins with the removal of the uterus vaginally or abdominally, along with laparoscopic closure of the vaginal cuff. This is in contrast to other methods of removing the uterus, fallopian tubes, and ovaries abdominal or vaginal. The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six weeks. The vaginal hysterectomy can be done entirely through the vagina, or using a laparoscope (the laparoscopic-assisted vaginal hysterectomy, or LAVH).

Mishra's Knot - Ideal for Laparoscopic Cholecystectomy

This video demonstrate Mishra's Knot used in laparoscopic cholecystectomy. This is an Ideal for Laparoscopic Cholecystectomy. Tying extracorporeal knot to the cystic duct has many advantages. This knot is also can be used for in mass ligation and partial cholecystectomy.

IPOM Inguinal Hernia by Dr. R. K. Mishra

https://www.laparoscopyhospital.com/ This video demonstrate IPOM Inguinal Hernia by Dr. R. K. Mishra at World Laparoscopy Hospital. Inguinal Hernia Laparoscopic Surgery is commonly also called as Minimal Invasive Surgery is method of choice and IPOM technique is increasing. Laparoscopic Inguinal Hernia Surgery is one of the most common minimal access surgery performed in the world. This Inguinal Hernia Surgery is done under General Anesthesia and Laparoscopic Hernia Surgeon makes 3-4 keyholes of nearly 0.5 to 1 cm. near the groins to perform IPOM inguinal hernia surgery. With the help of Laparoscopic instruments Surgeons pushes the tissue back into abdomen and repair the hernia by Mesh. In IPOM Laparoscopic Hernia surgery special mesh made for intraperitoneal application is used. Tacker or suture then uses a Surgical Mesh to hold the tissues back to its normal position. A tackers is used to hold the mesh at its position. Patient is discharged the next day because there are no stitches and no cuts.

Laparoscopic Anatomy of Pelvis by Dr R K Mishra

https://www.laparoscopyhospital.com/dubai.html This video demonstrate Laparoscopic Pelvic Anatomy by Dr R K Mishra. The abdominal cavity is traditionally divided into nine regions. Regardless of the quadrants chosen for laparoscopic access, thorough knowledge of the relevant surface anatomy increases patient safety during laparoscopic surgery. Laparoscopic surgery is a safe and effective option for many patients, provided the surgeon knows the relevant anatomic landmarks and variations created by obesity, prior surgery, and aberrant anatomy. pelvic anatomy visualized two-dimensionally under magnification during traditional laparoscopy can look very different than it does during conventional surgery, due to the effects of the pneumoperitoneum, steep Trendelenburg position, and/or the use of uterine manipulators.

Laparoscopic Myomectomy for Multiple Myoma

Laparoscopic myomectomy in multiple fibroids. Myomectomy is the surgery of choice for women who have symptomatic fibroids and who wish to retain their uterus. ... It is known that uterine fibroids are estrogen dependent. During pregnancy these fibroids increase in size, whereas in the puerperium and menopause they shrink. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope ― a narrow tube fitted with a camera ― into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. Robotic myomectomy. Instruments are inserted through small incisions similar to those in a laparoscopic myomectomy, and the surgeon controls movement of instruments from a separate console. Sometimes, the fibroid is cut into pieces and removed through a small incision in the abdominal wall. Other times the fibroid is removed through a bigger incision in your abdomen so it can be removed without being cut into pieces. Rarely, the fibroid may be removed through an incision in your vagina (colpotomy).

Laparoscopic Surgeon's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic knot-tying is an advanced skill. The traditional surgeon's knot is often used in laparoscopic surgery for every tissue. Surgeons knot is most versatile knot in laparoscopic surgery. It can be used in many situations like bowel anastomosis, pyeloplasty, tubal recanalization etc... Surgeons knot can be terminated at the end of a continuous suture line in laparoscopic surgery by again surgeons knot or square knot. The Aberdeen knot has been shown to be stronger and more secure than the surgeon's knot for ending a suture line but is rarely used in laparoscopic surgery. We have developed a new technique to make the surgeons knot laparoscopically. Any surgeon's concern about the ease and safety of laparoscopic knotting is natural, and knots performed laparoscopically must be as safe as those traditionally performed. A knot should secure proper tissue approximation, and be simple, easy, quick, and reliable.

Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy for Stone impacted at Hartmann's pouch. Manipulating the gallbladder with the left-hand instrument is a key part of performing a laparoscopic cholecystectomy. In these case stone should be removed from hartmann pouch. If a stone is impacted in the Hartmann’s pouch, this manipulation can be difficult, and can cause cramp and exhaustion of the surgeon’s left hand or injury to the gallbladder if a toothed instrument is used to improve grip. For the experienced laparoscopic surgeon, this tip makes manoeuvrability of the thickened, impacted Hartmann’s pouch simpler. We have used it in the acute and elective setting to great effect. The tape provides gentle traction and can be resisted easily if there are any concerns about placement as dissection continues.

Laparoscopic Surgery for Ectopic Pregnancy - Lecture by Dr R K Mishra

This video is lecture of Dr R K Mishra on laparoscopic management of ectopic pregnancy. Most ectopic pregnancies occur in the fallopian tube, but they can also happen in the neck of the womb, in the ovary, or in the abdominal cavity. Laparoscopic Salpingostomy or Salpingectomy is the method of choice for the management of ectopic pregnancy. In a normal pregnancy, fertilization occurs in the fallopian tubes, where an egg, or ovum, meets a sperm cell. The fertilized egg then travels into the uterus and becomes implanted in the womb lining. The embryo develops into a fetus and remains in the uterus until birth. An ectopic pregnancy can be fatal without prompt treatment. For example, the fallopian tube can burst, causing internal abdominal bleeding, shock, and serious blood loss. According to the Centers for Disease Control and Prevention, between 1 and 2 percent of all pregnancies are ectopic. However, ectopic pregnancy is the cause of 3 to 4 percent of pregnancy-related deaths. Ectopic surgery The fallopian tubes can be repaired or removed with surgery. Keyhole surgery can be performed to remove the ectopic tissue. This is also known as a laparoscopy. In a laparoscopy, the surgeon makes a small incision in or near the navel and inserts a device called a laparoscope to view the area. Other surgical instruments are inserted into a tube, or through other small incisions, to remove the ectopic tissue. If the area is damaged, surgeons might be able to repair the fallopian tubes, but they will probably have to remove the affected tube as part of this procedure. If the other fallopian tube is still intact, a healthy pregnancy is still possible. If severe internal bleeding has occurred, a larger incision may be needed. This procedure would be called a laparotomy.

Laparoscopic Repair of Huge Incisional Hernia

Laparoscopic Repair of Huge Incisional Hernia performed by Dr R K Mishra at World Laparoscopy Hospital. Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy.

Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Cholecystectomy with Laparoscopic Ovarian Drilling in same patient by Dr R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women who have polycystic ovary syndrome (PCOS). Electrocautery or a laser is used to destroy parts of the ovaries. A laparoscopic cholecystectomy is a surgery during which the doctor removes your gallbladder. This procedure uses several small cuts instead of one large one. A laparoscope, a narrow tube with a camera, is inserted through one incision. This allows surgeon to see gallbladder on a HD monitor. Laparoscopic cholecystectomy is Gold standard for Gallstone disease.

Laparoscopic Sleeve Gastrectomy Surgery Video Explained Step by Step

This video demonstrate Laparoscopic Sleeve Gastrectomy which is a popular Bariatric Surgery for morbid obesity. Sleeve gastrectomy is a simpler bariatric operation than the gastric bypass procedure for morbid obesity because it does not involve rerouting of or reconnection of the intestines. The sleeve gastrectomy, unlike the Lap-band, does not require the use of a banding device to be implanted around a portion of the stomach. Laparoscopic Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The sleeve gastrectomy, by reducing the size of the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.

Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh

https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Laparoscopic Mishra's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ This is a video of Laparoscopic Mishra's Knot. Laparoscopic suturing and knotting is important for surgeons and gynecologist. Mishra's Knot is one of the important extracorporeal knot for any tubular structure. Configuration of Mishra's Knot is 1:1:1:1:1:1:1. This knot is secured upto 18mm of tubular structure.

Laparoscopic Surgery for Large Endometrioma

For most of the gynecologist Laparoscopic ovarian cystectomy remains a first-line choice for the surgical treatment of endometriotic cysts. Laparoscopy for endometrioma is performed through an umbilical incision and two or three lower abdominal incisions. This video demonstrate laparoscopic surgery for large right sided endometrioma performed for an unmarried girl by Dr R K Mishra at World Laparoscopy Hospital. Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed. Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous.

Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia

https://www.laparoscopyhospital.com/SERV02.HTM This video demonstrate Laparoscopic Repair of Bilateral Recurrent Inguinal Hernia. by Dr R K Mishra at World Laparoscopy Hospital. Recovery from laparoscopic repair of bilateral recurrent inguinal hernia repair is usually very quick. Patient will be mobile very soon after the laparoscopic procedure and will be encouraged to increase how much you walk around over the first few days post surgery. Many patients return to normal day to day activities within the first week.

IPOM Inguinal Hernia Repair by Laparoscopy

https://www.laparoscopyhospital.com/SERV01.HTM Laparoscopic inguinal hernia repair originated in the early 1987 by GER as laparoscopy gained a foothold in general surgery. Inguinal hernias account for 75% of all abdominal wall hernias, and with a lifetime risk of 27% in men and 3% in women. Although TAPP and TEP, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons IPOM inguinal hernia repair, produces excellent results comparable to those of TAPP or TEP repair.

Lecture on Laparoscopic Appendectomy for Acute Appendicitis

https://www.laparoscopyhospital.com/ This video is lecture of Dr R K Mishra on Laparoscopic Appendectomy. Laparoscopic Appendectomy can be performed by single incision, two port or three incisions, one umbilical and one suprapubic are made; permanent material used comprises: grasping forceps, hook, scissors, needle holders, three metal trocars and four other usual instruments, and a single strand of cotton. There is possibility of using endobag and in few cases no need to use of operative extractors bags, clips, endoloops, staples or bipolar or harmonic energy instruments. Allows triangulation and instrumentation in the conventional manner.

Laparoscopic Removal of Huge Ovarian Cyst

https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html Laparoscopic surgery has been increasingly applied to different gynecologic ovaries surgical problems with excellent surgical outcome and rapid recovery. Large ovarian cysts, a relatively common gynecologic problem, pose certain challenges to laparoscopic management. Laparoscopy is a safe technique for managing patients with large ovarian cysts and is associated with low conversion and complication rates. The chance of finding unexpected ovarian cancer varies according to the patients’ selection criteria but is low overall. With proper patient selection, the size of an ovarian cyst should not constitute a contraindication to laparoscopic surgery. Experience in advanced laparoscopic surgery and the availability of a gynecologic oncologist should make the procedure safely applicable to a broader patient population.

Dangerous way of Performing Laparoscopic Cholecystectomy

https://www.laparoscopyhospital.com/ This Video demonstrate a dangerous way of Performing Laparoscopic Cholecystectomy by Harmonic Scalpel In Mass Shearing. Ideally a nice dissection of calot's triangle with critical view of safety should be done. World wide laparoscopic cholecystectomy (LC) has become the customary method for treating gallstones, some incidents and complications appear rather more frequently than with the open technique. Several aspects of these complications and their treatment possibilities are analysed and clipless cholecystectomy with Harmonic scalpel is one of them. During the past decade world wide laparoscopic cholecystectomy has become the procedure of choice in the surgical treatment of symptomatic gallstone. The operation is not completely risk-free, some incidents and complications being more frequent than with open cholecystectomy. The use of the Harmonic scalpel is deemed safe and comparable to clip placement at the discretion of the surgeon for cystic duct ligation. According to the article published by many author, harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. Further research with larger homogeneous studies and assessments of cost-effectiveness would further enhance the increasing use of the Harmonic scalpel in laparoscopic cholecystectomy.

Laparoscopic Surgery for Peritoneal Inclusion cyst with Bilateral Endometrioma

This Video demonstrate Laparoscopic Management of Inclusion cyst with Bilateral Endometrioma. Peritoneal inclusion cyst (PIC) is defined as a fluid-filled mesothelial-lined cysts of the pelvis and it is most frequently encountered in women of reproductive age. The treatment options are observation, hormonal management, imaging-guided aspiration, image-guided sclerotherapy and surgical excision. Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in reproductive age group women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts.

Laparoscopic Repair of Epigastric Hernia by Two Ports

https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Repair of Epigastric Hernia by Two Ports performed by Dr R K Mishra at World Laparoscopy Hospital. An epigastric hernia is a type of hernia in the epigastric region of the abdominal wall. It's above the belly button and just below the sternum of your rib cage. This type of hernia is a somewhat common condition in both adults and children. About 2 to 3 percent of all abdominal hernias are epigastric hernias.

Laparoscopic Roeder's knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic Roeder's knot is one of the oldest knot used in laparoscopic surgery. Laparoscopic Roeder's knot is one of the most popular extracorporeal knot. This technique of the extracorporeal knotting is simple, easy, and reproducible with good knot and loop security and can be used with multifilament suture material of 90cm. Laparoscopic extracorporeal knot is popular for appendectomy, cholecystectomy, and any tubular structure upto 8mm structure.

Laparoscopic Suturing Melzer's Knot demonstration by Dr R K Mishra

https://www.laparoscopyhospital.com/ Laparoscopic suturing and knot tying require a lot of patience and practice and can be difficult, time consuming, and frustrating in spite of the advances made in the fields of instrumentation, optics, and imaging. The new technique described here is an effort to make the procedure simpler by providing extracorporeal control of one limb of the suture. It involves percutaneous placement of the needle end of the suture in the abdomen and its removal using a modified 10 cm long cloth-sewing needle.

Laparoscopic Ventral and Incisional Hernia Repair: Pros and Cons

https://www.laparoscopyhospital.com/ This video is lecture of Pros and Cons of Laparoscopic Ventral and Incisional Hernia Repair by Dr. R. K. Mishra at World Laparoscopy Hospital. The purpose of this lecture is to analyse the surgical techniques, perioperative complications, and recurrence rate of laparoscopic ventral hernia repair (LVHR) including incisional Hernia, in comparison with the open ventral hernia repair (OVHR), based on the international literature. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. The laparoscopic technique has numerous variations of the methodology used by surgeons, although several common steps are followed by all. The procedure starts with entering the peritoneal cavity by using a Veress needle, an open Hasson method, or an optical trocar allowing view of the abdominal wall layers during penetration. Palmer's point is the best place to access. This lecture indicates that LVHR is a safe and effective approach to abdominal wall hernias. The technique offers the advantages of the laparoscopic approach, ie, a short hospital stay, less postoperative pain, and early convalescence. The procedure carries an acceptable risk of complications compared to open surgery, a low risk of recurrence, and an excellent cosmetic result. It is considered a good alternative to its open counterpart, at least in experienced hands.

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