Obesity Surgery - Vertical Sleeve Gastrectomy
https://www.laparoscopyhospital.com How does the Vertical Sleeve Gastrectomy compare to the other surgeries? Simple operation with low mortality risk. Technically easy to perform with low peri-operative risks. Minimal short-term and long-term complication rates. Short-term risks of staple line bleeding or leakage are very rare. The only long-term risk is GERD in some patients. Weight loss comparable with the gastric bypass. Gastric sleeve is not reversible. Part of the stomach is permanently removed. It is important to understand that reversing any weight loss operation (such as gastric band or gastric bypass) will result in weight regain back to original weight. You should not have any weight loss operation if you intend to ever reverse it. Though gastric sleeve is not reversible, it can be changed to gastric bypass if there was any need. Most illnesses that are related to obesity can be improved or even cured by weight loss surgery. These include: sleep apnoea, diabetes, high cholesterol, hypertension, stress incontinence, depression, acid reflux, joint pain, as well as osteoarthritis. Losing weight for obese patients also means greater outcomes from pregnancy, increased fertility, and a lower risk of cancer. The surgery increases life expectancy, on the whole.
https://www.laparoscopyhospital.com/ Anecdotal reports of splenectomy date back to the 16th century and by 1920 the Mayo Clinic had reported on splenectomy with operative mortality rates of about 10%. Deletaire originally described laparoscopic splenectomy, in 1991. The laparoscopic approach should be considered as a therapeutic option for all patients undergoing elective splenectomy. A few important contraindications to the laparoscopic approach are patients with liver failure with portal hypertension, ascities or unmanageable coagulopathy. In addition, while laparoscopic management of splenic trauma has been reported in the literature, it is not standard of care, and should not be considered in a patient with hemodynamic instability. It is very important to understand the vascular anatomy of the spleen when planning a splenectomy. The majority of the arterial supply is from the splenic artery, which is one of three major branches off the celiac axis of the aorta. The splenic artery has a serpentine course that crowns the superior boarder of the pancreas. It generally gives off a few pancreatic branches and a branch to the superior pole of the spleen prior to diving into the splenic hilum.
https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Laparoscopic Varicocelectomy by Dr R K Mishra at World Laparoscopy Hospital. Indications for surgery was subfertility in patients. All varicoceles were confirmed on Doppler ultrasound. A three-puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and secured and divided by Ligasure were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 30 Minute. Varicocelectomy is surgery to repair a varicocele. A varicocele is swelling of veins in the scrotum. This swelling is due to blood backing up in the veins. A varicocele can cause pain or a heavy feeling in the scrotum but is usually painless. It can also cause problems with fertility. During the surgery, the swollen veins are cut and the ends are closed off. Other veins in the groin area then take over carrying the blood supply. The surgery may be done with a method called laparoscopy or through open surgery. During laparoscopy, a thin, lighted tube or scope (called a laparoscope) is used. The scope allows the doctor to work through a few small incisions.
TLH - Ligasure is better than Enseal
https://www.laparoscopyhospital.com/ Which vessel sealing device is more effective in Laparoscopic Hysterectomy. The articulating advanced bipolar device was shown to have a statistically significant increase in surgeon-perceived workload and rate of device failure when used in TLH; however, clinical and surgical outcomes were not equivalent. To compare 2 laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device ENSEAL and an electrothermal bipolar vessel sealer LigaSure were analyzed for differences in surgeon perception of ease of instrument. For TLH Ligasure is better than Enseal
Hysterectomy Procedure Video
https://www.laparoscopyhospital.com/ A hysterectomy is a surgical procedure whereby the uterus (womb) is removed. This surgery for women is the most common non-obstetrical surgical procedure. The most common reason hysterectomy is performed is for uterine fibroids. Other common reasons are abnormal uterine bleeding (vaginal bleeding), cervical dysplasia (pre-cancerous conditions of the cervix), endometriosis, and uterine prolapse (including pelvic relaxation).
Laparoscopic Mesh Repair of Giant Hiatus hernia
https://www.laparoscopyhospital.com/international-patients.html Laparoscopic repair of giant hiatus hernia and antireflux surgery with a prosthetic mesh in cases of giant hiatal hernia is an effective and safe procedure, reducing the rate of postoperative hernia recurrence during long-term follow-up. The incidence of mesh-related complications is very low. he use of mesh in the repair of large hiatal hernias is promising with respect to the reduction of anatomical recurrences. However, many different kinds and configurations of mesh are available. The use of mesh is becoming more popular for large hiatal hernia (type II-IV) repair to reduce the recurrence rate
Torted Ovarian Dermoid Cyst in 7 Year Old Girl
Ovarian torsion in children is an uncommon cause of acute abdominal pain but mandates early surgical management to prevent further adnexal damage. The clinical presentation mimics other pathologies, such as appendicitis. Ovarian torsion should be considered in any female child with acute onset lower abdominal pain accompanied by vomiting. Pain can be characterized as constant or colicky, but unlike with appendicitis, does not typically migrate. Sterile pyuria is found in a substantial proportion of cases. Ultrasound is the most useful initial diagnostic modality, but the absence of flow on Doppler imaging is not always present. Conservative management with detorsion and oophoropexy is recommended.
Laparoscopic Management of Chronic Ectopic and Myomectomy in same patient
https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Management of Chronic Ectopic and Myomectomy in same patient at same session. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. Ectopic pregnancy presents diagnostic dilemmas in the absence of classical symptoms. MRI and laparoscopy are important tools in such cases. If patient has fibroid uterus it can be operated at same session.
Laparoscopic Management of Chronic Ectopic Pregnancy
https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Management of Chronic Ectopic Pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. A pregnancy test may or may not be positive. CULDOCENTESIS is the confirmatory test for rupture of a chronic ectopic pregnancy, The early diagnosis and minimally invasive management of ectopic pregnancy are usually possible because of the development of highly sensitive urine pregnancy tests and ultrasonography. We herein report a rare case of chronic ectopic pregnancy which was difficult to diagnose before laparoscopic surgery.
Basic Steps of Hysterectomy
https://www.laparoscopyhospital.com/ This video demonstrate step by step total laparoscopic hysterectomy. Hysterectomy is the removal of the uterus with surgery. There are many reasons a hysterectomy can be performed such as fibroids, heavy or irregular menstrual bleeding, prolapse, chronic uterine pain, pelvic inflammatory disease, pre-cancerous conditions, cancer and endometriosis. hysterectomy depending on the clinical circumstances. A hysterectomy can be performed using a laparoscope, which is a thin keyhole camera that allows the surgeon to see the pelvic organs. The laparoscope and other instruments are inserted through small incisions in the skin and then used by the surgeon to remove the uterus. hysterectomy depending on the clinical circumstances. A hysterectomy can be performed using a laparoscope, which is a thin keyhole camera that allows the surgeon to see the pelvic organs. The laparoscope and other instruments are inserted through small incisions in the skin and then used by the surgeon to remove the uterus.
Umbilical and Paraumbilical Hernia Surgery
https://www.laparoscopyhospital.com/ A paraumbilical (or umbilical) hernia is a protrusion of the abdominal contents, including mesenteric fat or bowel, through a weak point of the muscles or ligaments near the navel. It can lead to discomfort when fatty tissue gets trapped and a lump can be felt or seen. Whilst they are not usually life-threatening, routine surgical treatment is usually advised to prevent enlargement or strangulation or obstruction of the gut. Women are more frequently affected than men. A paraumbilical hernia is an area of weakness around your umbilicus that adults are more likely to develop. An umbilical hernia is an area of weakness in your umbilicus (naval) that often develops in children.
How to Perform Safe Sterilization and Reversal of Sterilization - Lecture by Dr R K Mishra
https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Laparoscopic Tubal Sterilization and also about Laparoscopic Reversal of Tubal Sterilization - Lecture by Dr R K Mishra. Female Tubal sterilisation can be reversed by laparoscopy called as laparoscopic recanalization, but it is a very difficult process that involves removing the blocked part of the fallopian tube and rejoining the ends. There is no guarantee that it will be fertile again after a sterilisation reversal but the main advantages of female sterilization are its high degree of effectiveness if performed by skilled surgeon, convenience, and the fact that routine follow-up medical care.
Sacrocolpopexy with hysterectomy using mesh for uterine prolapse repair
https://www.laparoscopyhospital.com/laparoscopic-urology.html Sacrocolpopexy with hysterectomy using mesh for uterine prolapse is performed with the patient under general anaesthesia. Laparoscopic approach is used, following on from a concomitant hysterectomy. Mesh is attached to the apex of the vagina and may also be attached to the anterior and/or posterior vaginal wall, with the aim of preventing future vaginal vault prolapse. Several different types of synthetic and biological mesh are available, which vary in structure and in their physical properties such as absorbability.
Laparoscopic Salpingotomy for Ectopic Pregnancy
This video demonstrate Laparoscopic Salpingotomy for ectopic pregnancy. Linear incision is made on antimesenteric side of ampullary portion of fallopian tube. At this time, the pregnancy usually protrudes out of the incision and may slip out of the tube. Laparoscopic picture of ampullary ectopic pregnancy protruding after linear salpingostomy was performed. In selective cases operative laparoscopic salpingectomy is an alternative to laparotomy in the surgical treatment of ectopic pregnancy. The obvious advantages of this procedure are decreased morbidity and surgical pain, lower cost, shorter hospitalization and convalescence, and less disability, as well as a cosmetic surgical scar. Because the procedure is so cost-effective, and since the tools are familiar to most gynecologists, we hope it will gain wider utilization. Laparoscopic salpingectomy is not a difficult procedure when the basic principles of surgery are followed. Depending on the fertility desires of the patient and the condition of the opposite tube, this procedure may be preferable to laparotomy. If a complication such as bleeding does occur and fails to respond to cauterization, laparotomy can be done as usual for an ectopic pregnancy.
Robotic Surgery - DaVinci and TransEnterix
https://www.laparoscopyhospital.com/roboticsurgerytraining.html The World Laparoscopy Hospital offers the newest generation of robotic surgery that allows doctors to perform major surgical procedures through the smallest of incisions. A surgical robot is a self-powered, computer-controlled device that can be programmed to aid in the positioning and manipulation of surgical instruments, enabling the surgeon to carry out more complex tasks. Although still in its infancy, robotic surgery is a cutting-edge development in surgery that will have far-reaching implications. While improving precision and dexterity, this emerging technology allows surgeons to perform operations that were traditionally not amenable to minimal access techniques. As a result, the benefits of minimal access surgery may be applicable to a wider range of procedures. Safety has been well established, and many series of cases have reported favorable outcomes. Robotic surgery has successfully addressed the limitations of traditional laparoscopic and thoracoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, 2-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a 3-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon via voice-activated or manual master controls. Also, manipulation of robotic arm instruments improves range of motion compared with traditional laparoscopic instruments, thus allowing the surgeon to perform more complex surgical movements
Incisional Hernia IPOM Repair with Dual Mesh
https://www.laparoscopyhospital.com/drrkmishra.htm This video demonstrate Laparoscopic Incisional Hernia IPOM Repair with Dual Mesh (Polyurathane Mesh) by Dr R K Mishra at World Laparoscopy Hospital. The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair. This document has been written to assist surgeons utilizing a laparoscopic approach to ventral hernia repair in terms of patient selection, operative technique, and postoperative care. It is not intended to debate the merits of prosthetic use and specific types of prosthetics. It is important to consider the size of the hernia defect when contemplating a laparoscopic approach, as larger defects generally increase the difficulty of the procedure. A recently published guideline by an Italian Consensus Conference recommended caution for defects greater than 10cm but did not consider such defects as absolute contraindication. Currently, there are two main categories of fixation methods available for use in the operating room – tacks and sutures, both of which are available in absorbable or permanent varieties. Sutures are commonly anchored to the mesh with conventional instruments in combination with a suture-passing device. Tacks are usually deployed via a mechanical device typically referred to as a “tacker” (deploys a variety of anchoring devices collectively known as “tacks”). There are human and laboratory reports utilizing fibrin-based sealant for fixation during LVHR, but the available evidence is limited. Proponents of tacks-only fixation have cited the shorter operating time, fewer skin incisions, improved cosmesis, and less acute and chronic pain as the main advantages of this approach.
Laparoscopic management of Peritoneal Inclusion Cyst
https://www.laparoscopyhospital.com/ `Peritoneal inclusion cysts are complex cystic adnexal masses consisting of a normal ovary entrapped in multiple fluid-filled adhesions. The cysts usually develop in women of reproductive age who have a history of previous pelvic surgery or pelvic infection. This unusual but benign mass, which has a distinct sonographic appearance, has also been referred to as benign encysted fluid, inflammatory cyst of the peritoneum, peritoneal pseudocyst, entrapped ovarian cyst, multilocular peritoneal cyst, and postoperative peritoneal cyst. The development of peritoneal inclusion cysts depends on the presence of peritoneal adhesions and active ovaries. During the reproductive years, ovaries are the main source of peritoneal fluid. Fluid normally produced by the ovaries during ovulation is absorbed by the peritoneum. However, if the peritoneum has been disrupted by previous surgery, inflammation, or infection, its absorptive properties diminish, thus trapping this physiologic fluid. Also, inflammation of the peritoneum can contribute to production of a more exudative fluid, which is less adequately absorbed by the peritoneum. Previous surgery, infection, or inflammation often leads to the development of adhesions within the abdomen and pelvis. With extensive peritoneal adhesions, the fluid produced by normal ovaries is trapped by the scarred peritoneum. As the normal ovary continues to produce fluid and the fluid becomes entrapped by surrounding adhesions, a complex cystic pelvic mass develops. Other causes of peritoneal inclusion cysts include trauma, pelvic inflammatory disease, and endometriosis.
https://www.laparoscopyhospital.com/SERV02.HTM Illustration of Stapled hemorrhoidopexy. Stapled hemorrhoidectomy, also known as stapled hemorrhoidopexy, is a surgical procedure that involves the removal of abnormally enlarged hemorrhoidal tissue, followed by the repositioning of the remaining hemorrhoidal tissue back to its normal anatomic position. Severe cases of hemorrhoidal prolapse will normally require surgery. Newer surgical procedures include stapled transanal rectal resection (STARR) and procedure for prolapse and hemorrhoids (PPH). Both STARR and PPH are contraindicated in persons with either enterocele or anismus. PPH is generally indicated for the more severe cases of internal hemorrhoidal prolapse (3rd and 4th degree) where surgery would normally be indicated. It may also be indicated for patients with minor degree haemorrhoids who have failed to respond to conservative treatments. The procedure may be contraindicated when only one cushion is prolapsed or in severe cases of fibrotic piles which cannot be physically repositioned.
Retroperitoneoscopic Nephrectomy and Ureterolithotomy
https://www.laparoscopyhospital.com/ This video demonstrate Retroperitoneoscopic Nephrectomy and Ureterolithotomy. The emergence of minimally invasive surgery about 20 years ago revolutionized urological surgery. Advances in retroperitoneoscopy allowed the widespread use of minimally invasive techniques in almost the entire range of urology. In this context, laparoscopy and later retroperitoneoscopy were developed and applied in a wide spectrum of urological diseases. Both approaches have since presented benefits and disadvantages that have been documented in various series. However, few comparative studies have been conducted. Retroperitoneoscopy can be accomplished placing the patient in lateral or prone position. This technique requires experience to find the way to the retroperitoneum. The main landmark during surgery is the psoas muscle. The prone approach is very versatile because it gives the surgeon the chance to reach the adrenal gland and the upper and lower urinary tract, and also allows a bilateral procedure to be achieved. Furthermore, this access leaves the kidney in place and has the advantage of a direct approach to the vessels. On the other hand, it is not the best option when mobilization of the lower ureter and urgent conversion are needed.
How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra
https://www.laparoscopyhospital.com/ This video demonstrate How to Perform Safe Pyeloplasty - Lecture by Dr R K Mishra. Pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney. Most commonly it is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate. No medical therapy is available for the treatment of ureteropelvic junction (UPJ) obstruction. ... Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows.
https://www.laparoscopyhospital.com/ This video demonstrate Laparoscopic Fundoplication Surgery for GERD. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease and hiatal hernia. The fundoplication operation is usually carried out using keyhole surgery (laparoscopy). The surgeon uses a telescope, with a miniature video camera mounted on it, inserted through a small incision (cut) to see inside the abdomen. Carbon dioxide gas is used to inflate the abdomen to create space in which the surgeon can operate using specialised instruments that are also passed through other smaller incisions (cuts) in the abdomen. The operation itself has two parts. Firstly the surgeon will examine the diaphragm to check the size of the opening around the oesophagus. If it too loose, the surgeon will tighten this. The second part of the operation involves wrapping the upper part of the stomach (fundus) around the base of the oesophagus and loosely stitching it in place. This tightens the sphincter enough to reduce reflux but not so tight as to affect swallowing.
Laparoscopic Appendectomy - Immediate Laparoscopy is Ideal for Acute Appendicitis
Acute appendicitis is inflammation of the appendix, the narrow, finger-shaped organ that branches off the first part of the large intestine on the right side of the abdomen. This video demonstrate laparoscopic appendectomy performed for acute appendicitis by Dr R K Mishra. Although the appendix is a vestigial organ with no known function, it can become diseased. Acute appendicitis remains the most common surgical emergency. The lifetime risk of developing an appendicitis is reported to be 6.7% in females and 8.7% in males. The peak incidence occurs in the first and second decade of life, while it is uncommon to face appendicitis in children younger than 5 years of age. The clinical presentation may be varied and often is similar to other medical conditions, so a misdiagnosis can be frequent and the most common one is usually gastroenteritis. Our diagnostic and therapeutic protocol from about ten years was the following: if the patient was thought to have an acute appendicitis preoperatively diagnosed by physical, laboratory findings and ultrasound examination, antibiotic treatment was started immediately with laparoscopic appendectomy. Laparoscopy is now demonstrated to be the optimal approach also to treat complicated appendicitis, but this standardized operation is not always easy to perform for new surgeons.
Sling Surgery for Incontinence
https://www.laparoscopyhospital.com/laparoscopic-urology.html Urinary incontinence - vaginal sling procedures. Vaginal sling procedures are types of surgeries that help control stress urinary incontinence. This is urine leakage that happens when you laugh, cough, sneeze, lift things, or exercise. The procedure helps close your urethra and bladder neck. Recovery time for tension-free sling surgery varies. Your doctor may recommend two to four weeks of healing before returning to activities that include heavy lifting or strenuous exercise. It may be up to six weeks before you're able to resume sexual activity.
Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography
This video demonstrate Laparoscopic Cholecystectomy with Real-time Near-Infrared Fluorescent Cholangiography by Dr R K Mishra at World Laparoscopy Hospital. Indocyanine green (icg) fluorescent cholangiography also called Fluorescent cholangiography can be considered as a useful tool for intra-operative visualization of the biliary tree during laparoscopic cholecystectomies. Bile duct injury remains the most feared complication of laparoscopic cholecystectomy. Intraoperative cholangiography (IOC) is the current gold standard for biliary imaging and may reduce injury, but is not widely used. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping. NIRF-C is a safe and effective alternative to IOC for imaging extrahepatic biliary structures during laparoscopic cholecystectomy. Significantly less time was required to perform NIRF-C than IOC and it is significantly cheaper to use compared to IOC. NIRF-C has the potential to decrease bile duct injury at a significantly lower cost than the use of routine IOC during laparoscopic cholecystectomy.
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.
Infrared Ureteral Stenting in Gynecological Laparoscopy
https://www.laparoscopyhospital.com/ This video demonstrate Infrared Ureteral Stenting by Dr R K Mishra at World Laparoscopy Hospital. The infrared ureteral stent decreases the operative time of laparoscopic gynecological surgery and makes it a safer and more acceptable treatment option. The insertion of prophylactic ureteral stents in traditional gynecological surgery has been debated for a long time but use of lighted infrared stent is a new innovative technique.
Laparoscopic 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.
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
IPOM Inguinal Hernia Surgery
https://www.laparoscopyhospital.com/ This Video Demonstrate IPOM Inguinal Hernia Surgery by Suturing. This is a personal technique where we do suturing of inferior edge of mesh. The laparoscopic intraperitoneal onlay mesh (IPOM) technique for the repair of inguinal hernias has increasingly gained popularity since its first description in 1993. The main advantage in comparison with the open approach is the reduced incidence of wound complications and the recurrence rate also seems to be lower. The laparoscopic technique is based on dissection of the complete abdominal wall. The whole original scar must be covered with a broad overlap of at least 5 cm. Structures like prevesical space must be opened to allow adequate fixation and incorporation of the mesh. Meshes used for laparoscopic approaches must induce strong and rapid incorporation on the parietal side and they should also prevent adhesions on the visceral side. The material should allow an overlap of two or more meshes to treat major defects. Isolated technical details are not supported by high evidence-based clinical data and can only be interpreted as summaries of personal preferences. However with respect of three basic aspects, coverage of the whole original scar, broad overlap of 5 cm and more and the use of adequate mesh material, very good clinical results can be obtained by the laparoscopic IPOM technique.
Sleeve Gastrectomy Full Length Step by Step Video
https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic sleeve gastrectomy full length video step by step performed by Dr R K Mishra at World Laparoscopy Hospital. The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or Gastric Sleeve, is a newer restrictive procedure where the majority of the stomach is removed, leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass because it does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract. The recovery time after sleeve gastrectomy surgery resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.
TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy May Reduce Cancer Risk
https://www.laparoscopyhospital.com/ This video demonstrate TLH with Bilateral Salpingectomy - Salpingectomy With Hysterectomy by Dr R K Mishra at World Laparoscopy Hospital. During Laparoscopic Hysterectomy doing Salpingectomy may Reduce Cancer Risk. Salpingectomy refers to the surgical removal of a Fallopian tube. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of ectopic pregnancies. During hysterectomy also we routinely perform salpingectomy. Bilateral salpingectomy at the time of ovarian-preserving hysterectomy results in no increased morbidity and is becoming more accepted by patients and surgeons as a risk-reducing strategy for both serous carcinoma and adnexal masses, new research suggests. "Emerging data that point to the fallopian tube as the site of origin for serous pelvic tumors led us and others to hypothesize that salpingectomy at the time of hysterectomy could have a real impact on the roughly 600,000 hysterectomies performed each year.
https://www.laparoscopyhospital.com This video demonstrate rudimentary uterus with absence of both ovaries and 46 ,XX normal karyotype. Genetic investigation revealed a 46,XX karyotype without any mosaicism. Diagnostic laparoscopy was performed. During laparoscopic pelvic exploration, a rudimentary uterus without ovaries and normal bilateral fallopian tubes were observed. If gonadal agenesis is thought to be the cause of primary amenorrhea in patients with normal secondary sexual characteristics, we believe that laparoscopic evaluation is the gold standard in diagnosis.
Endoscopy - Upper GI Endoscopy and Colonoscopy
https://www.laparoscopyhospital.com/ This video demonstrate basics of Upper and Lower GI Endoscopy. Several types of endoscopes have been developed to examine different parts of the body. Different procedures which use endoscopes that are inserted through a natural opening in the body include: Gastroscopy or upper endoscopy: a gastroscope is inserted into the mouth and used to examine the upper parts of the digestive tract e.g. the oesophagus (food pipe), stomach and first part of the small intestine. Colonoscopy: endoscope is inserted into the anus and used to examine lower parts of the digestive tract e.g. the rectum and colon. Sometimes, a shorter tube is used to examine just the lower part of the colon (the sigmoid colon). This procedure is called a sigmoidoscopy. Complications from an endoscopy are very uncommon. Some people may feel soreness or tenderness after the procedure, but this usually settles quickly. Complications may include: Piercing a hole or tearing in the area being examined. Excessive bleeding. Infection. People who have been sedated may occasionally have some side effects, for example they may feel sick or vomit, feel a burning sensation at the site of the injection, have trouble breathing, or develop low blood pressure or an irregular heartbeat.
https://www.laparoscopyhospital.com/ Laparoscopic gastric banding is surgery to help with weight loss. The surgeon places a band around the upper part of your stomach to create a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food. A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter. In this way, the band can be tightened or loosened as needed to reduce side effects and improve weight loss.
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.
Transthoracic Heller Myotomy for Esophageal Achalasia
https://www.laparoscopyhospital.com Surgical treatment of achalasia is still now controversial. In the last thirty years two main antithetic surgical trends developed. These differ in several technical points, particularly regarding the myotomy extends upward to the level of left inferior pulmonary vein. An adequate length of the abdominal esophagus is an important factor in maintaining gastroesophageal competence. We do not believe better functional results could be obtained by a shorter myotomy on the thoracic esophagus. On the contrary, a shorter myotomy is potentially inadequate in those intermediate motor disorders between achalasia and diffuse spasm, which are not always discriminated even by preoperative manometry. addition or not of an antireflux procedure after the myotomy.
Indocyanine green (ICG) Cholecystectomy
https://www.laparoscopyhospital.com/research/preview.php?id=18&p=#ontitle This video demonstrate Indocyanine green (ICG) Cholecystectomy by Dr R K Mishra at World Laparoscopy Hospital. Fluorescent cholangiography using intravenous injection of ICG may become the optimal tools to confirm the biliary tract anatomy during LC because it has potential advantages over radiographic cholangiography in that it does not require irradiation or dissection of triangle of Calot. NIR fluorescence-assisted LC has the potential to become a standard surgical procedure. Early visualization of the cystic duct and additional imaging of the CBD may increase safety in LC and might offer an alternative to the intraoperative cholangiogram in patients with an increased risk of CBD injury. In contrast to the ease and efficiency of CD and CBD detection by fluorescent imaging in uncomplicated cases, gallbladder pathology appears to create a much more challenging and complex situation.
Robotic Dermoid Ovarian Cystectomy
This video demonstrate Robotic Dermoid Ovarian Cystectomy by Dr R K Mishra at World Laparoscopy Hospital. Robotic excision of ovarian dermoid cysts in an endoscopic pouch: fostering the practice of contained tissue extraction in gynecologic davinci robotic surgery. The da Vinci robotic system with its 3-D High Definition Camera allows for precise removal of cysts using robotic ovarian cyst surgery at World Laparoscopy Hospital. The da Vinci system can be utilized for robotic Ovarian Cystectomy removal of an ovarian cyst. Using state of the art technology, a da Vinci robotic Cystectomy or Oophorectomy requires only a few incisions so patient can get back to your life faster. With traditional open surgery, recovery time is often 6 weeks with patients' remaining in the hospital for 2-3 days. In contrast, after ovarian cyst surgery utilizing the da Vinci Robot, a patient only goes home the same day. If your doctor recommends an Ovarian Cystectomy or Oophorectomy to treat your condition, you may be a candidate for da Vinci Surgery. Common types of cysts removed utilizing the da Vinci robotic surgery system include Endometriomas, Dermoids, Serous/Mucinous Cystadenomas, as well as many others. The da Vinci robotic ovarian cystectomy or oophorectomy offers women many potential benefits over traditional surgery, including: Less Pain Fewer complications Less Blood loss Shorter hospital stay Low risk of wound infection Quicker recovery and return to normal activities
Cholecystectomy and Appendectomy together by Mishra's knot.
https://www.laparoscopyhospital.com/SERV02.HTM Combined laparoscopic appendectomy and cholecystectomy produces good outcomes than either procedure performed independently, with a not increased incidence of wound complications and morbidity. Overall, however, patients who undergo simultaneous procedures appear much faster recovery. Further investigation is needed to define appropriate indications for these concomitant procedures as well as to identify the key factors that determine outcomes. An operative experience of three patients who underwent incidental laparoscopic appendectomy during laparoscopic cholecystectomy is presented. The technique and indications is shown in this video. We conclude with our experience that incidental laparoscopic appendectomy is possible and safe with existing incisions performed in gallbladder surgery. However, well-controlled prospective studies should be performed prior to wide application of this technique.
Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent
https://www.laparoscopyhospital.com/SERV01.HTM This video demonstrate Total Laparoscopic Hysterectomy (TLH) with Infrared Ureteral Stent by Dr R K Mishra at World Laparoscopy Hospital. IRIS U-Kits of stryker has Lighted ureteral stents which can be used in gynecological procedures. This Visualization technology built into the L10 Light Source is designed to help identify the ureters in lower pelvic procedures and reduce the risk of ureteral injury.
Laparoscopic Repair of Lumber Incisional Hernia
https://www.laparoscopyhospital.com Lumbar incisional hernias are often diffuse with fascial defects that are usually hard to appreciate. Computed tomography scan is the diagnostic modality of choice and allows differentiating them from abdominal wall musculature denervation atrophy complicating flank incisions. Repairing these hernias is difficult due to the surrounding structures. Principles of laparoscopic repair include lateral decubitus positioning with table flexed, adhesiolysis, and reduction of hernia contents, securing ePTFE mesh with spiral tacks and transfascial sutures to an intercostal space superiorly, iliac crest periosteum inferiorly, and rectus muscle anteriorly. Posteriorly, the mesh is secured to psoas major fascia with intracorporeal sutures to avoid nerve injury. Lumbar incisional hernia must be differentiated from muscle atrophy with no fascial defect. The laparoscopic approach provides an attractive option for this often challenging problem.
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.
Hysterectomy for Large Uterus
https://www.laparoscopyhospital.com This video demonstrate Total Laparoscopic Hysterectomy for Large Uterus. Hysterectomy is the most common gynecologic surgical procedure performed, accounting for 1600,000 procedures per year. The most common indication for a hysterectomy is abnormal uterine bleeding, which is frequently caused by uterine leiomyoma, which is present in 25-50% of reproductive-aged women. Total Laparoscopic Hysterectomy is method of choice for large uterus if surgeon has sufficient experience.
Sleeve Gastrectomy in Patient Previously operated for Ventral Hernia
Generally it should not be a problem to have a sleeve after incisional hernia repair, even with mesh. You do not need to worry about the insufflation of the abdomen stretching the mesh if you go through palmer's point. All laparoscopic incisions are small and do not disrupt the integrity of the mesh. The only incision that is a little larger is the one that the resected stomach is removed through. Ideally you want to do the sleeve laparoscopically. Yes, there will be a lot of adhesions, but an experienced laparoscopic bariatric surgeon can get it done with the laparoscope. The mesh can be re-sewn and it will heal fine. It is hard to say for sure without knowing where on your abdominal wall the mesh was placed, but I have operated on numerous patients with prior hernia repairs and it isn't a challenge that can't be overcome. If the hernia was from a prior C-section, meaning lower on your abdominal wall, then the laparoscopic port sites for a VSG should not interfere.
https://www.laparoscopyhospital.com/ Endoscopic thoracic sympathectomy (ETS) is surgery to treat sweating that is much heavier than normal. This condition is called hyperhidrosis. Usually the surgery is used to treat sweating in the palms or face. The sympathetic nerves control sweating. The surgery cuts these nerves to the part of the body that sweats too much. If blushing fails to respond to conservative medical treatment or behavioural therapy, then surgical sympathectomy is an option: this can be done either by open or endoscopic approaches. Video Assisted Thoracic Sympathectomy is now usually the preferred technique.
Laparoscopic Surgery for Subacute Small Bowel Obstruction
https://www.laparoscopyhospital.com/ This video demonstrate laparoscopic surgery for Small Bowel Obstruction Performed by Dr R K Mishra at World Laparoscopy Hospital. Subacute small bowel obstruction (Subacute Intestinal Obstruction) is an surgical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical intervention is required. Laparoscopy in small bowel obstruction does have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere the outcome. With regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach, including a reduced rate of complications, shorter hospitalisation period or lower consumption of analgesics. However, despite the fact that it is so commonly used and technically advanced, Subacute Intestinal Obstruction is still a condition where the use of laparoscopy is limited in everyday practice mainly to selected cases such as adhesive SBO caused by single adhesions or foreign bodies in the gastrointestinal tract. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.
Laparoscopic Removal of Intramural and Broad Ligament Myoma
https://www.laparoscopyhospital.com This video demonstrate Laparoscopic Removal of Intramural and Broad Ligament Myoma by Dr R K Mishra at World Laparoscopy Hospital. We describe a patient with three fibroids; the largest was a broad ligament fibroid, which was managed successfully with laparoscopic myomectomy. It is well known that myomectomy of a large broad ligament fibroid presents a challenge to the surgeon with intraoperative complications such as excessive bleeding and ureteric injury or later complications such as pelvic hematoma and infection. The aim of presenting this case was to demonstrate that in patients with a large broad ligament fibroid, who want to preserve their reproductive potential, laparoscopic myomectomy is feasible and safe. Trans-vaginal US plays an important role in determining the degree of attachment, location and vascularity between the uterus and the broad ligament fibroid, which in turn helps in the choice of surgical procedure and technique.
Recurrent Hernia Laparoscopic Repair
https://www.laparoscopyhospital.com/ Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.
Laparoscopic Surgery Training in Dubai
https://www.laparoscopyhospital.com/dubai.html The laparoscopy training institute of World Laparoscopy Hospital in Dubai provides exposure in live operational and surgical procedures. The training also includes practical and theoretical sessions. Free hands-on training in the latest of da vinci laparoscopic robots is also included in the course structure. The world laparoscopy hospital provides a modern facility for micro laparoscopic surgery as they incorporate the application of state of the art HD laparoscopic lab and surgical instruments. At World Laparoscopy Hospital we recognize the value of every psurgeon and are guided by our commitment to excellence and leadership to train them. We demonstrate this by providing exemplary physical, emotional and spiritual care for each of our trainees. We have Fellowship Program in Minimal Access Surgery for Surgeons and Gynecologists.
How to do Laparoscopic Video Editing by Davinci Resolve?
https://www.laparoscopyhospital.com/ This video demonstrate How to do Laparoscopic Video Editing by Davinci Resolve? DaVinci Resolve 15 is the world’s first solution that combines professional offline and online editing which can be used to edit laparoscopic videos, color correction, audio post production and now visual effects all in one software tool! You get unlimited creative flexibility because DaVinci Resolve 15 makes it easy for laparoscopic surgeons to explore different toolsets. It also lets you collaborate and bring surgeon with different creative talents together. With a single click, you can instantly move between editing, color, effects, and audio. Plus, you never have to export or translate files between separate software tools because, with DaVinci Resolve 15, everything is in the same software application! DaVinci Resolve 15 is the only post production software designed for true collaboration. Multiple editors, assistants, colorists, VFX artists and sound designers can all work on the same project at the same time! Whether you’re an individual artist, or part of a larger collaborative team, it’s easy to see why DaVinci Resolve 15 is the standard for high end post production and is used for finishing more laparoscopic surgery.