Laparoscopic Videos from World Laparoscopy Hospital

Robotic Reversal of Tubal Sterilization

This video demonstrates Robotic Reversal of Tubal Sterilization surgery performed by Dr R K Mishra at World Laparoscopy Hospital. Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalization) are not infrequent. The reversal procedure can be done either by open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). Patients going through tubal reversal will go to the outpatient surgery center and have a small incision made through which your surgeon will repair your fallopian tubes. The surgery usually takes 1 hour to complete.

How to Use Hysteroscopy Instruments?

This video demonstrate how to use various hysteroscopic instruments. Hysteroscopy is a procedure that allows us to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. The procedure can be either diagnostic or operative. Hysteroscopy is a procedure that allows gynecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Intraperitoneal Onlay Mesh Repair of Inguinal Hernia

This video demonstrates Intraperitoneal Onlay Mesh Repair of Inguinal Hernia. Our study at World Laparoscopy hospital 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 recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However, the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Uterine Manipulators

The uterine manipulators in use for various gynecological laparoscopic surgeries including laparoscopic hysterectomy or laparoscopic pelvic endometriosis have to achieve many different tasks in order to arrive at a safe and successful outcome in gynecological and pelvic surgery. The most obvious function of Uterine Manipulators is to suitably mobilize the uterus.

Robotic Myomectomy

Robotic myomectomy is a minimally invasive way for ROBOTIC surgeons to remove uterine fibroids. The DAVINCI ROBOT provides 7 degrees of freedom: 3 degrees provided by the robotic arms (insertion, pitch, yaw) and 4 degrees from the “wristed” instruments (pitch, yaw, roll, and grip). This improves dexterity and enables the DaVinci robotic surgeon to manipulate and dissect tissue in a delicate, controlled fashion. Robotic surgical technology used in uterine myoma improves efficiency, accuracy, ease, and comfort associated with the performance. Advantages of robotic myomectomy over conventional laparoscopy include the absence of tremor, a 3-dimensional image, superior instrument articulation, downscaling of movements, and comfort for the surgeon.

Laparoscopic Ovarian Cystectomy - Aspiration with Transparent Needle

This video demonstrates laparoscopic ovarian cystectomy. An ovarian cystectomy is a laparoscopic surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgical technique that only uses a few small incisions in your lower abdomen. https://www.laparoscopyhospital.com/mmas.htm

Safest Way to Perform Total Laparoscopic Hysterectomy with Bilateral Salpingo-oophorectomy

Risk-Reducing Bilateral Salpingo-oophorectomy: Surgery to remove both healthy fallopian tubes and both healthy ovaries. The surgery is done to reduce the risk of cancer. Salpingectomy: Surgery to remove one or both of the fallopian tubes. the side effects of laparoscopic hysterectomy? These risks include major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots. infection. anesthesia side effects. bowel blockage. The side effects of laparoscopic hysterectomy are major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots...

Laparoscopic IPOM Inguinal Hernia Repair - Skin to Skin

This education video of IPOM is demonstrated in order to assess the feasibility of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair as an alternative method for inguinal hernia repair. All medical records were reviewed retrospectively. Mean operative time was 45 minutes, and mean postoperative hospital stay was 1 days. There were two cases of postoperative swelling at the groin area due to entrapment of CO2 and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. Even though laparoscopic Intraperitoneal Onlay Mesh Repair of Hernia which is popularly called as IPOM repair is not a preferred method for inguinal hernia, it can be applied as an alternative method in specific cases.

Basic Demonstration of Da Vinci Robot - How Surgical Robot Works?

This video demonstrates the Basic Demonstration of Da Vinci Robot - How Surgical Robot Works? Compared to traditional techniques of open surgery and laparoscopic surgery, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

Sleeve Gastrectomy Tips and Tricks

Laparoscopic sleeve gastrectomy (LSG) is becoming popular as a stand alone bariatric procedure for morbid obesity. The laparoscopic sleeve gastrectomy technique has evolved over the years towards standardization. Better standardization has minimized complications as leaks, stricture, and weight regain. Adequate posterior dissection up to the hiatus and the linear sleeve without a torque can be safely performed. The video presentation refers to the international consensus document on LSG as well as the expert panel consensus where our centre’s technique is shared. The video demonstrates step by step approach to a safe, standardized technique of LSG. https://www.laparoscopyhospital.com/bariatric-surgery.html

Laparoscopic Heller's Myotomy with Appendectomy

The Laparoscopic Heller myotomy is a laparoscopic (minimally invasive) surgical procedure used to treat achalasia. Achalasia is a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach. The Laparoscopic Heller myotomy is essentially an esophagomyotomy, the cutting the esophageal sphincter muscle, performed laparoscopically. The Laparoscopic Heller myotomy operation's success rate is very high and usually permanent. In the procedure of Laparoscopic Heller myotomy, several tiny incisions are made and a small scope inserted, through which miniature surgical instruments are passed. The scope is connected to a video camera which then sends a magnified image to a monitor, allowing the surgeon to envision the anatomy and manipulate the instruments. For more information https://www.laparoscopyhospital.com/SERV02.HTM

Difficult Laparoscopic Cholecystectomy performed by Pledget Dissection of Calot's triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gall bladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.

Laparoscopic Hysterectomy By Ligation of Uterine Artery and Simultaneous Appendectomy

This video demonstrates Laparoscopic Hysterectomy By Ligation of Uterine Artery by Mishra's Knot and Vault Closure by Weston Knot. In this procedure, Appendectomy was also performed. Today, lap hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort, shorter hospital stay, rapid convalescence, and early return to the activities of daily living. Considerable technical advances in this procedure have occurred during the last few years. One of the best practice of performing laparoscopic hysterectomy is to ligate the uterine artery. The vascular supply of the uterus is mainly derived from the uterine and ovarian arteries. Because most blood enters the uterus through the uterine arteries, transient uterine ischemia occurs after uterine artery ligation. Bilateral uterine vessel ligation is an efficient method to obliterate the blood flow to the uterus.

Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh

This video demonstrates Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh. For large incisional hernia repair, IPOM-Plus seems to be more effective than sIPOM in terms of reducing mesh bulging. Laparoscopic repair of hernia is the method of choice for all type of hernia. The laparoscopic repair of incarcerated incisional hernias is still debated in the literature. The recent EAES/EHS guidelines state that laparoscopic surgery is not contraindicated in most of the hernia and may be considered in selected patients with an incarcerated hernia. For more information: https://www.laparoscopyhospital.com/admission.php

Robotic Cerclage for Cervical insufficiency

Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We have demonstrated in this video Robotic abdomina cerclage to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Laparoscopic abdominal cerclage during pregnancy has been shown to be advantageous over laparotomy when comparing success rates and recognizing the well-known benefits of minimally invasive surgery, such as decreased blood loss, shorter hospital stay, decreased pain, and faster recovery time. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that facilitates less invasive procedures when compared to the open approach, and it has the advantages of 3-dimensional visualization and endowristed instrumentation when compared to traditional laparoscopy. Since the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, USA) was approved by the FDA for gynecologic procedures in 2005, there have been only a few robotic abdominal cerclages performed; the first robotic cerclage in India was performed by us at World Laparoscopy Hospital was in 2010.

Laparoscopic Hysterectomy And Appendectomy Using Illuminated Ureteral Stent Step Step Demonstration

This video demonstrate Total Laparoscopic Hysterectomy step by step using infrared ureter stent together with appendectomy. Combination procedure is very easy to perform by laparoscopy. Laparoscopic Hysterectomy remains a reasonable substitute for abdominal hysterectomy. Laparoscopic hysterectomy together with appendectomy is a cost-effective procedure when done with reusable instruments. Laparoscopic hysterectomy with ureteric stenting with infrared catheter is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and its adoption can decrease abdominal incision hysterectomies.

Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy

This Video demonstrates right sided Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy. Prophylactic removal of the appendix during a benign gynecologic procedure is known as an elective incidental laparoscopic appendectomy. Incidental appendectomy at the time of cesarean delivery was reported initially in 1959. Subsequent studies of removal of a normal-appearing appendix at the time of gynecologic surgery have met with considerable debate. Proponents argue that the removal of the appendix at the time of abdominal hysterectomy does not increase operative time or postoperative morbidity. More important, it does prevent future appendicitis. Advantages of incidental appendectomy include technical ease, low patient morbidity and mortality, and significant diagnostic and protective value. It also prevents conflicting diagnoses, especially in patients who have chronic pelvic pain, a ruptured ovarian cyst, or endometriosis. Other patients likely to benefit from elective incidental appendectomy are those who are undergoing abdominal radiation or chemotherapy, women unable to communicate health complaints, and those who are planning to undergo complex abdominal or pelvic procedures that are likely to cause extensive adhesions.

Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy

This video demonstrates Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy performed by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic inguinal hernia repair is performed with general anesthesia. Two 5mm and one 10mm incision are made in the lower part of the abdomen. In laparoscopic inguinal hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The inguinal hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia that can cause chronic pain if injured, blood vessels that can bleed, or the vas deferens. The small incisions are closed with suturing that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you. The hernia is repaired by a different technique like TAPP, TEP or IPOM. The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Laparoscopic Removal of Posterior Cervical Fibroid

This video demonstrate Laparoscopic Myomectomy for Posterior Cervical Fibroid. Fibroid or Myomas are benign tumours composed partly of muscle and fibrous tissue. They seldom develop in the cervix, the lower part of the uterus as in this video. When posterior cervical fibroid grow, they are usually obliterating entire cul de sac. Cervical fibroids grow in the wall of the cervix and are difficult to remove without damaging the surrounding area. Most cervical myomas eventually cause symptoms of GIT or ureteric obstruction. The most common symptom may be irregular or heavy menstrual bleeding . Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility. Cervical myomas can block the flow of urine; women may have a hesitant start when urinating; dribble at the end of urination, and retain urine. Urinary tract infections are also more likely to develop. If cervical fibroids cause symptoms, they are surgically removed in a procedure called a Laparoscopic Myomectomy. After removal of fibroid suturing of the raw area is required. Depending upon the size of fibroid a long time is spend in morcellation of myoma. For more information log on to https://www.laparoscopyhospital.com/

How Harmonic Scalpel Works?

This video demonstrate Harmonic Scalpel presented by Dr R K Mishra. The Harmonic scalpel is basically an ultrasonic generator. Harmonic Scalpel is a surgical instrument used to simultaneously cut and coagulate tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue. Benefits of the Harmonic Scalpel. The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral thermal tissue damage in comparison to other operating devices. A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation.

Davinci Robotic Adhesiolysis Surgery with Application of Interceed

This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.

Laparoscopic Repair of Common bile duct (CBD) injury

Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury. In this video, We have demonstrated a method of repair on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this video with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques or by ICG.

Ruptured Ectopic Pregnancy

This video demonstrates Laparoscopic management of Ruptured Ectopic Pregnancy. A ruptured ectopic pregnancy or tubal pregnancy is a surgical emergency in which a fertilized egg implants itself outside the uterus. Usually, an ectopic pregnancy is situated in one of the fallopian tubes. As it grows, it can cause the tube to tear or burst. This results in dangerous internal bleeding which may be fatal if immediate surgery is not being performed. Laparoscopic Surgery Offer a very good treatment of ruptured ectopic pregnancy. Salpingectomy can be performed to cure this ectopic pregnancy.

Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis (4 K Video)

This video demonstrates Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection. For more detail https://www.laparoscopyhospital.com/SERV01.HTM

How Ligasure Works?

This video demonstrate how Ligasure works presented by Dr R K Mishra. Ligasure is a tissue responce generator. Across the range of products and procedures, LigaSure also called as vessel sealer is a technology which delivers a unique combination of pressure and energy to create a consistent seal with each application. Ligasure provides a combination of pressure and energy to create vessel fusion. Permanently fuses vessels up to and including 7 mm in diameter and tissue bundles without dissection or isolation Average seal cycle is 2 to 4 seconds. Ligasure seals withstand three times normal systolic blood pressure. Feedback-controlled response system automatically discontinues energy delivery when the seal cycle is complete, eliminating the guesswork.

Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Near Infrared Cholangiography

This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. 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 because of difficulties of doing it. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used in for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.

Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent

This video demonstrate Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent performed by Dr R K Mishra at World Laparoscopy Hospital. This is a must watch video for every one to see how nicely illuminated stent look. Despite the skepticism, potential advantages afforded by this minimal access technique motivated the development and evaluation of the laparoscope in an expanding number of surgical applications. Numerous technologic advances were critical to this evolution. During the first half of this century, the development of various lens systems and endoscopes was there. Recently use of Infrared imaging system in laparoscopy has revolutionized the way how we were looking at ureter in past. The infrared lighted ureteral stent or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm.

Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator

This video demonstrates Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. In this technique, the uterus was bound from the uterine corpus and fundus like a bridle with Myoma Screw, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 90% of cases. The mean application time was 30 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. For more information https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic Repair of Recurrent Umbilical Hernia

This video demonstrates laparoscopic repair of Umbilical recurrent hernia. An umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised by the laparoscopic technique. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. We are performing at World Laparoscopy Hospital for more than 20 years. Laparoscopic umbilical hernia repair has been practiced at World Laparoscopy Hospital since the late 1990s. Newer bilayer prosthetic devices are designed for open intraperitoneal inlay placement. They have two sides, one is polypropylene and the other side is a non-adherent material to face viscera. Bilayer polypropylene or partially reabsorbable meshes have also been used for umbilical hernias. They comprised one sublay and one overlay patch with a connector to eliminate migration. However, clinical outcomes after repairs with these devices have not been widely documented.

Laparoscopic Surgery for Left Ovarian Dermoid Cyst

This video demonstrates Laparoscopic Surgery for Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.

TAPP Hernia Repair by Ipsilateral Port

This video demonstrate TAPP (Transabdominal Preperitoneal Inguinal Hernia) Repair by Ipsilateral Port. The indications for laparoscopic inguinal hernia repair, TAPP or TEP, are the same for open inguinal hernia repair. They may be ideal for bilateral inguinal hernias and recurrences from anterior approaches but is also appropriate with unilateral primary hernias when the surgeon is comfortable with the technique. For young, active males with primary hernias, it may ofter decrease pain and an earlier return to activity. Prior to lower abdominal surgery or pelvic radiation is strong relative contraindications, as these may make access to the preperitoneal space difficult. The hernia is visualized, and the peritoneum overlying it incised sharply. Blunt dissection can be used to peel the peritoneal flaps inferiorly, exposing the inferior epigastric vessels, the pubic symphysis and the Cooper’s ligament, and the iliopubic tract. A direct hernia should be reduced if seen, and an indirect dissected from the cord structures. Femoral and obturator hernias can also be visualized and reduced. Care is taken to avoid the “Triangle of Doom” containing the external iliac vessels bordered by the vas deferens medially and the gonadal vessels laterally. A mesh ranging from 10 to 15 cm in diameter of polypropylene or polyester is introduced through the optical trocar and positioned anterior along the pelvic wall with the center over of the primary hernia defect. For more detail log on to https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient

This video demonstrate Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children. The laparoscopic approach is most frequently used, except for young children. Superficial surgical site infections are more frequent after open surgery only in patients with complicated appendicitis. The normal appendix rate is low, most likely because of routine preoperative imaging.

Safe Way of Performing Laparoscopic Cholecystectomy

CBD injury is one of the most common injuries during laparoscopic cholecystectomy. It is very important to minimize CBD injury for a laparoscopic surgeon. This video demonstrates Safe Way of Performing Laparoscopic Cholecystectomy. The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. A safe cholecystectomy is one that is “safe for both the patient no bile duct/hollow viscus/vascular injury and for the operating surgeon no or minimal scope for litigation. In addition, a surgeon should be able to anticipate the operative difficulty based on various preoperative predictors, should adhere to basic principles of surgery including safe use of energy devices and use of fluorescence cholangiography using ICG. https://www.laparoscopyhospital.com/SERV01.HTM

Sleeve Gastrectomy with Hernia Repair

This video demonstrates laparoscopic sleeve gastrectomy together with hernia repair inpatient of morbid obesity. In morbidly obese patients with any hernia with or without GERD undergoing LSG, repair of the hernia helps in amelioration of morbidity due to hernia and prevents any new onset improving quality of life. Obesity is associated with multiple comorbidities including diabetes mellitus, hypertension, obstructive sleep apnoea and gastro-oesophageal reflux disease (GERD). Thus, the presence of any ventral hernia should not be considered as a contraindication for laparoscopic sleeve gastrectomy surgery and both the procedure can effectively be performed together.

Da Vinci Robotic Hysterectomy

This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.

Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina

This video demonstrate Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina. The average surgical time was 45 min for laparoscopic cholecystectomy and 15 min for hysterectomy and 30 min for hysterectomy. Total blood loss was approximately less than 50ml. Lesson for both, gynecologists and the surgeons, is to combine these two when required and possible. This provides maximum advantages through minimizing risk of anesthesia and time duration, hospital stay, cost-effectiveness.

Para-umbilical Hernia IPOM Repair

This video demonstrates laparoscopic repair of a paraumbilical hernia. 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. A paraumbilical or umbilical hernia is a common type of abdominal hernia. Paraumbilical hernias usually develop later in life and are often caused by acquired abdomen openings linked to intra-abdominal pressure from carrying excess body weight, ascites, cancer or other intra-abdominal malignancy, or multiple pregnancies. Hernias don't go away on their own. Only surgery can repair a hernia. Many people are able to delay surgery for months or even years but there is always a chance of incarceration. For more information: https://www.laparoscopyhospital.com/SERV01.HTM

Robotic Sleeve Gastrectomy Surgery

This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

Laparoscopic Port Closure or Fascial Closure Needles

This video demonstrates Laparoscopic Port Closure Needles explained by Dr. R K Mishra at World Laparoscopy Hospital. Fascial closure of port sites represents a challenging issue in laparoscopic surgery. We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation. New technical challenges have emerged since the introduction of the laparoscopic approach in surgery. One of these is fascial closure at port sites, which is necessary especially when large trocars are used or after dilation of a port site for organ extraction. New developments, such as single-port laparoscopic surgery, and the need for small esthetic incisions render fascial closure a current issue

Easiest Way of Performing Laparoscopic Inguinal Hernia Repair Using Less Expensive Mesh

This video demonstrates Laparoscopic Inguinal Hernia Repair with Cheaper Mesh. It has been clearly demonstrated in developed countries that the modern standard of care for inguinal hernia is mesh repair, either through an open repair, namely the Lichtenstein procedure. Compared to non-mesh repairs, the use of a mesh in inguinal hernia surgery provides better results in terms of recurrence and decreased early and late postoperative pain. However, the fact that mesh repairs are the modern standard procedures for inguinal hernia poses several issues in developing countries.

Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury

This video demonstrates Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury. Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of a female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a robotic adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. For more detail log on to: https://www.laparoscopyhospital.com/robotic-surgery.html

First in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder & Appendix removed by Laparoscopy

This Video demonstrates First time in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder and Appendix removed by Laparoscopy in the Same Patient. The patient has torsion of Myoma giving severe pain, She had multiple episodes of appendicitis in the past. She had Cholelithiasis and one paraovarian cyst. All were removed by laparoscopy. The surgery took 6 hour time. Only 4 ports were used to remove all these pathologies. She was also having hydronephrosis due to the pressure of fibroid on the ureter.

Laparoscopic Hysterectomy with Ureteral Stent Placement

Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility

This video demonstrates Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility. A laparoscopy, Hysteroscopy, and dye test is an operation to help find out why any female is having difficulty becoming pregnant. The dye test will show if your fallopian tubes are blocked. The laparoscopy will help find out if a patient has endometriosis, pelvic infection, adhesions, ovarian cysts or fibroids. Some minor treatments can be performed at the same time. A laparoscopy and dye test is usually performed under a general anesthetic. The operation usually takes about fifteen minutes. The gynecologist will make only two small cuts on the abdomen. Surgical instruments, along with a telescope will be introduced inside the abdomen to perform the operation. A gynecologist will inject a dye, which passes down the fallopian tubes. For more information: https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Skin to Skin Laparoscopic Cholecystectomy in 4K

This video demonstrates Skin to Skin Laparoscopic Cholecystectomy using 4K Camera to improve vision. This year a '4K' laparoscopic system has become commercially available, so-named as it provides a high-resolution 2D image with four times the number of pixels of 2D full high definition. The improved visualization is likely to provide additional depth cues. It is currently unclear to what degree improving the resolution of 2D systems can compensate for binocular depth cues however in coming days 4K laparoscopy will be very popular. 4K UHD enables rich color reproducibility and provides suitable colors for each clinical discipline which uses the laparoscopic camera. Ultra High Definition camera system provides four times more information than conventional Full HD imaging systems.

Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction

This Video demonstrates Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction. The prevalence of incisional hernia after laparotomy is reported to be between 11% and 20%,3,4 and incisional hernia recurrence after surgical repair is as high as 45%. Incisional hernias cause pain and other more serious problems, such as bowel obstruction, incarceration, and strangulation. After Laparoscopic Surgery these recurrences are very less.

Total Laparoscopic Hysterectomy for Very Large Uterus With Multiple Fibroid

In this video, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uterus weighing more than 9500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform an efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number, and location of the myomas. Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Laparoscopic Myomectomy and Ovarian Cystectomy for Multiple Myomas and Paraovarian Cyst

Laparoscopic Ovarian cystectomy and Laparoscopic myomectomy are the two most frequently performed gynecologic operations in reproductive-age women. Benign ovarian cysts mostly occur in reproductive-age women, for whom it is important to have the majority of the ovarian tissue preserved after laparoscopic surgery. In order to preserve the maximum ovarian reserve, laparoscopic ovarian cystectomy is generally preferred. The lifetime incidence of uterine myoma is approximately 20% to 25%, and it is the most common benign tumor in reproductive-age women. Laparoscopic Surgery is performed on women who suffer from menorrhagia, dysmenorrhea, or increase in the size of the fibroid. The utility of laparoscopic myomectomy has been well established among symptomatic reproductive-age women with myoma, and previous studies have found no difference in the duration of surgery, the amount of blood loss during surgery, or the incidence of postoperative adhesion in comparison with open surgery. Likewise, no difference was found between laparoscopic myomectomy or open myomectomy in the rate of postoperative uterine rupture. In infertile patients, myomectomy has been shown to lead to a significant improvement in the pregnancy rate. Currently, single-port access (SPA) laparoscopic myomectomy is performed as a minimally invasive surgical technique. SPA laparoscopic surgery is superior to multi-port laparoscopic surgery in terms of cosmetic outcomes and postoperative pain relief and recovery, but due to the difficulty in the suture technique, hemostasis is more challenging and it generally is more time-consuming.

Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac

This video demonstrates Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac and application of interceed which act as a mechanical adhesive barrier. Ablation/fulguration of ovarian tissue during laparoscopy isn't recommended. Surgical excision is the most common and effective treatment for endometriosis of the ovary (endometrioma cyst). Surgical removal at the time of laparoscopy has been shown to improve pain without damaging the ovaries. A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis. By laparoscopic surgery, it is also possible to remove cysts, implants, and scar tissue caused by endometriosis. Laparoscopy for endometriosis is a low-risk and minimally invasive procedure.

Laparoscopic Inguinal Hernia Repair in Female

A groin hernia is relatively uncommon in females. The laparoscopic surgery is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia. TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.

https://www.laparoscopyhospital.com/

Laparoscopic Hysterectomy By Ligation of Uterine Artery and Simultaneous Appendectomy

This video demonstrates Laparoscopic Hysterectomy By Ligation of Uterine Artery by Mishra's Knot and Vault Closure by Weston Knot. In this procedure, Appendectomy was also performed. Today, lap hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort, shorter hospital stay, rapid convalescence, and early return to the activities of daily living. Considerable technical advances in this procedure have occurred during the last few years. One of the best practice of performing laparoscopic hysterectomy is to ligate the uterine artery. The vascular supply of the uterus is mainly derived from the uterine and ovarian arteries. Because most blood enters the uterus through the uterine arteries, transient uterine ischemia occurs after uterine artery ligation. Bilateral uterine vessel ligation is an efficient method to obliterate the blood flow to the uterus.

How to Use Hysteroscopy Instruments?

This video demonstrate how to use various hysteroscopic instruments. Hysteroscopy is a procedure that allows us to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. The procedure can be either diagnostic or operative. Hysteroscopy is a procedure that allows gynecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina

This video demonstrate Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina. The average surgical time was 45 min for laparoscopic cholecystectomy and 15 min for hysterectomy and 30 min for hysterectomy. Total blood loss was approximately less than 50ml. Lesson for both, gynecologists and the surgeons, is to combine these two when required and possible. This provides maximum advantages through minimizing risk of anesthesia and time duration, hospital stay, cost-effectiveness.

Laparoscopic Ovarian Cystectomy - Aspiration with Transparent Needle

This video demonstrates laparoscopic ovarian cystectomy. An ovarian cystectomy is a laparoscopic surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgical technique that only uses a few small incisions in your lower abdomen. https://www.laparoscopyhospital.com/mmas.htm

Laparoscopic Hysterectomy with Ureteral Stent Placement

Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Para-umbilical Hernia IPOM Repair

This video demonstrates laparoscopic repair of a paraumbilical hernia. 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. A paraumbilical or umbilical hernia is a common type of abdominal hernia. Paraumbilical hernias usually develop later in life and are often caused by acquired abdomen openings linked to intra-abdominal pressure from carrying excess body weight, ascites, cancer or other intra-abdominal malignancy, or multiple pregnancies. Hernias don't go away on their own. Only surgery can repair a hernia. Many people are able to delay surgery for months or even years but there is always a chance of incarceration. For more information: https://www.laparoscopyhospital.com/SERV01.HTM

Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac

This video demonstrates Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac and application of interceed which act as a mechanical adhesive barrier. Ablation/fulguration of ovarian tissue during laparoscopy isn't recommended. Surgical excision is the most common and effective treatment for endometriosis of the ovary (endometrioma cyst). Surgical removal at the time of laparoscopy has been shown to improve pain without damaging the ovaries. A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis. By laparoscopic surgery, it is also possible to remove cysts, implants, and scar tissue caused by endometriosis. Laparoscopy for endometriosis is a low-risk and minimally invasive procedure.

Laparoscopic Repair of Common bile duct (CBD) injury

Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury. In this video, We have demonstrated a method of repair on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this video with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques or by ICG.

TAPP Hernia Repair by Ipsilateral Port

This video demonstrate TAPP (Transabdominal Preperitoneal Inguinal Hernia) Repair by Ipsilateral Port. The indications for laparoscopic inguinal hernia repair, TAPP or TEP, are the same for open inguinal hernia repair. They may be ideal for bilateral inguinal hernias and recurrences from anterior approaches but is also appropriate with unilateral primary hernias when the surgeon is comfortable with the technique. For young, active males with primary hernias, it may ofter decrease pain and an earlier return to activity. Prior to lower abdominal surgery or pelvic radiation is strong relative contraindications, as these may make access to the preperitoneal space difficult. The hernia is visualized, and the peritoneum overlying it incised sharply. Blunt dissection can be used to peel the peritoneal flaps inferiorly, exposing the inferior epigastric vessels, the pubic symphysis and the Cooper’s ligament, and the iliopubic tract. A direct hernia should be reduced if seen, and an indirect dissected from the cord structures. Femoral and obturator hernias can also be visualized and reduced. Care is taken to avoid the “Triangle of Doom” containing the external iliac vessels bordered by the vas deferens medially and the gonadal vessels laterally. A mesh ranging from 10 to 15 cm in diameter of polypropylene or polyester is introduced through the optical trocar and positioned anterior along the pelvic wall with the center over of the primary hernia defect. For more detail log on to https://www.laparoscopyhospital.com/youtube/preview.php

Da Vinci Robotic Hysterectomy

This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.

Safe Way of Performing Laparoscopic Cholecystectomy

CBD injury is one of the most common injuries during laparoscopic cholecystectomy. It is very important to minimize CBD injury for a laparoscopic surgeon. This video demonstrates Safe Way of Performing Laparoscopic Cholecystectomy. The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. A safe cholecystectomy is one that is “safe for both the patient no bile duct/hollow viscus/vascular injury and for the operating surgeon no or minimal scope for litigation. In addition, a surgeon should be able to anticipate the operative difficulty based on various preoperative predictors, should adhere to basic principles of surgery including safe use of energy devices and use of fluorescence cholangiography using ICG. https://www.laparoscopyhospital.com/SERV01.HTM

Laparoscopic IPOM Inguinal Hernia Repair - Skin to Skin

This education video of IPOM is demonstrated in order to assess the feasibility of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair as an alternative method for inguinal hernia repair. All medical records were reviewed retrospectively. Mean operative time was 45 minutes, and mean postoperative hospital stay was 1 days. There were two cases of postoperative swelling at the groin area due to entrapment of CO2 and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. Even though laparoscopic Intraperitoneal Onlay Mesh Repair of Hernia which is popularly called as IPOM repair is not a preferred method for inguinal hernia, it can be applied as an alternative method in specific cases.

Laparoscopic Myomectomy and Ovarian Cystectomy for Multiple Myomas and Paraovarian Cyst

Laparoscopic Ovarian cystectomy and Laparoscopic myomectomy are the two most frequently performed gynecologic operations in reproductive-age women. Benign ovarian cysts mostly occur in reproductive-age women, for whom it is important to have the majority of the ovarian tissue preserved after laparoscopic surgery. In order to preserve the maximum ovarian reserve, laparoscopic ovarian cystectomy is generally preferred. The lifetime incidence of uterine myoma is approximately 20% to 25%, and it is the most common benign tumor in reproductive-age women. Laparoscopic Surgery is performed on women who suffer from menorrhagia, dysmenorrhea, or increase in the size of the fibroid. The utility of laparoscopic myomectomy has been well established among symptomatic reproductive-age women with myoma, and previous studies have found no difference in the duration of surgery, the amount of blood loss during surgery, or the incidence of postoperative adhesion in comparison with open surgery. Likewise, no difference was found between laparoscopic myomectomy or open myomectomy in the rate of postoperative uterine rupture. In infertile patients, myomectomy has been shown to lead to a significant improvement in the pregnancy rate. Currently, single-port access (SPA) laparoscopic myomectomy is performed as a minimally invasive surgical technique. SPA laparoscopic surgery is superior to multi-port laparoscopic surgery in terms of cosmetic outcomes and postoperative pain relief and recovery, but due to the difficulty in the suture technique, hemostasis is more challenging and it generally is more time-consuming.

How Ligasure Works?

This video demonstrate how Ligasure works presented by Dr R K Mishra. Ligasure is a tissue responce generator. Across the range of products and procedures, LigaSure also called as vessel sealer is a technology which delivers a unique combination of pressure and energy to create a consistent seal with each application. Ligasure provides a combination of pressure and energy to create vessel fusion. Permanently fuses vessels up to and including 7 mm in diameter and tissue bundles without dissection or isolation Average seal cycle is 2 to 4 seconds. Ligasure seals withstand three times normal systolic blood pressure. Feedback-controlled response system automatically discontinues energy delivery when the seal cycle is complete, eliminating the guesswork.

Laparoscopic Repair of Recurrent Umbilical Hernia

This video demonstrates laparoscopic repair of Umbilical recurrent hernia. An umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised by the laparoscopic technique. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. We are performing at World Laparoscopy Hospital for more than 20 years. Laparoscopic umbilical hernia repair has been practiced at World Laparoscopy Hospital since the late 1990s. Newer bilayer prosthetic devices are designed for open intraperitoneal inlay placement. They have two sides, one is polypropylene and the other side is a non-adherent material to face viscera. Bilayer polypropylene or partially reabsorbable meshes have also been used for umbilical hernias. They comprised one sublay and one overlay patch with a connector to eliminate migration. However, clinical outcomes after repairs with these devices have not been widely documented.

Robotic Cerclage for Cervical insufficiency

Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We have demonstrated in this video Robotic abdomina cerclage to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Laparoscopic abdominal cerclage during pregnancy has been shown to be advantageous over laparotomy when comparing success rates and recognizing the well-known benefits of minimally invasive surgery, such as decreased blood loss, shorter hospital stay, decreased pain, and faster recovery time. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that facilitates less invasive procedures when compared to the open approach, and it has the advantages of 3-dimensional visualization and endowristed instrumentation when compared to traditional laparoscopy. Since the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, USA) was approved by the FDA for gynecologic procedures in 2005, there have been only a few robotic abdominal cerclages performed; the first robotic cerclage in India was performed by us at World Laparoscopy Hospital was in 2010.

Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy

This video demonstrates Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy performed by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic inguinal hernia repair is performed with general anesthesia. Two 5mm and one 10mm incision are made in the lower part of the abdomen. In laparoscopic inguinal hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The inguinal hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia that can cause chronic pain if injured, blood vessels that can bleed, or the vas deferens. The small incisions are closed with suturing that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you. The hernia is repaired by a different technique like TAPP, TEP or IPOM. The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Sleeve Gastrectomy Tips and Tricks

Laparoscopic sleeve gastrectomy (LSG) is becoming popular as a stand alone bariatric procedure for morbid obesity. The laparoscopic sleeve gastrectomy technique has evolved over the years towards standardization. Better standardization has minimized complications as leaks, stricture, and weight regain. Adequate posterior dissection up to the hiatus and the linear sleeve without a torque can be safely performed. The video presentation refers to the international consensus document on LSG as well as the expert panel consensus where our centre’s technique is shared. The video demonstrates step by step approach to a safe, standardized technique of LSG. https://www.laparoscopyhospital.com/bariatric-surgery.html

Safest Way to Perform Total Laparoscopic Hysterectomy with Bilateral Salpingo-oophorectomy

Risk-Reducing Bilateral Salpingo-oophorectomy: Surgery to remove both healthy fallopian tubes and both healthy ovaries. The surgery is done to reduce the risk of cancer. Salpingectomy: Surgery to remove one or both of the fallopian tubes. the side effects of laparoscopic hysterectomy? These risks include major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots. infection. anesthesia side effects. bowel blockage. The side effects of laparoscopic hysterectomy are major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots...

Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis (4 K Video)

This video demonstrates Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection. For more detail https://www.laparoscopyhospital.com/SERV01.HTM

Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent

This video demonstrate Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent performed by Dr R K Mishra at World Laparoscopy Hospital. This is a must watch video for every one to see how nicely illuminated stent look. Despite the skepticism, potential advantages afforded by this minimal access technique motivated the development and evaluation of the laparoscope in an expanding number of surgical applications. Numerous technologic advances were critical to this evolution. During the first half of this century, the development of various lens systems and endoscopes was there. Recently use of Infrared imaging system in laparoscopy has revolutionized the way how we were looking at ureter in past. The infrared lighted ureteral stent or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm.

Basic Demonstration of Da Vinci Robot - How Surgical Robot Works?

This video demonstrates the Basic Demonstration of Da Vinci Robot - How Surgical Robot Works? Compared to traditional techniques of open surgery and laparoscopic surgery, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

Robotic Sleeve Gastrectomy Surgery

This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

Uterine Manipulators

The uterine manipulators in use for various gynecological laparoscopic surgeries including laparoscopic hysterectomy or laparoscopic pelvic endometriosis have to achieve many different tasks in order to arrive at a safe and successful outcome in gynecological and pelvic surgery. The most obvious function of Uterine Manipulators is to suitably mobilize the uterus.

Difficult Laparoscopic Cholecystectomy performed by Pledget Dissection of Calot's triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gall bladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.

Laparoscopic Removal of Posterior Cervical Fibroid

This video demonstrate Laparoscopic Myomectomy for Posterior Cervical Fibroid. Fibroid or Myomas are benign tumours composed partly of muscle and fibrous tissue. They seldom develop in the cervix, the lower part of the uterus as in this video. When posterior cervical fibroid grow, they are usually obliterating entire cul de sac. Cervical fibroids grow in the wall of the cervix and are difficult to remove without damaging the surrounding area. Most cervical myomas eventually cause symptoms of GIT or ureteric obstruction. The most common symptom may be irregular or heavy menstrual bleeding . Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility. Cervical myomas can block the flow of urine; women may have a hesitant start when urinating; dribble at the end of urination, and retain urine. Urinary tract infections are also more likely to develop. If cervical fibroids cause symptoms, they are surgically removed in a procedure called a Laparoscopic Myomectomy. After removal of fibroid suturing of the raw area is required. Depending upon the size of fibroid a long time is spend in morcellation of myoma. For more information log on to https://www.laparoscopyhospital.com/

Total Laparoscopic Hysterectomy for Very Large Uterus With Multiple Fibroid

In this video, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uterus weighing more than 9500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform an efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number, and location of the myomas. Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient

This video demonstrate Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children. The laparoscopic approach is most frequently used, except for young children. Superficial surgical site infections are more frequent after open surgery only in patients with complicated appendicitis. The normal appendix rate is low, most likely because of routine preoperative imaging.

Davinci Robotic Adhesiolysis Surgery with Application of Interceed

This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.

Laparoscopic Surgery for Left Ovarian Dermoid Cyst

This video demonstrates Laparoscopic Surgery for Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.

Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Near Infrared Cholangiography

This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. 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 because of difficulties of doing it. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used in for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.

Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury

This video demonstrates Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury. Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of a female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a robotic adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. For more detail log on to: https://www.laparoscopyhospital.com/robotic-surgery.html

Intraperitoneal Onlay Mesh Repair of Inguinal Hernia

This video demonstrates Intraperitoneal Onlay Mesh Repair of Inguinal Hernia. Our study at World Laparoscopy hospital 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 recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However, the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Sleeve Gastrectomy with Hernia Repair

This video demonstrates laparoscopic sleeve gastrectomy together with hernia repair inpatient of morbid obesity. In morbidly obese patients with any hernia with or without GERD undergoing LSG, repair of the hernia helps in amelioration of morbidity due to hernia and prevents any new onset improving quality of life. Obesity is associated with multiple comorbidities including diabetes mellitus, hypertension, obstructive sleep apnoea and gastro-oesophageal reflux disease (GERD). Thus, the presence of any ventral hernia should not be considered as a contraindication for laparoscopic sleeve gastrectomy surgery and both the procedure can effectively be performed together.

Laparoscopic Inguinal Hernia Repair in Female

A groin hernia is relatively uncommon in females. The laparoscopic surgery is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia. TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.

Robotic Myomectomy

Robotic myomectomy is a minimally invasive way for ROBOTIC surgeons to remove uterine fibroids. The DAVINCI ROBOT provides 7 degrees of freedom: 3 degrees provided by the robotic arms (insertion, pitch, yaw) and 4 degrees from the “wristed” instruments (pitch, yaw, roll, and grip). This improves dexterity and enables the DaVinci robotic surgeon to manipulate and dissect tissue in a delicate, controlled fashion. Robotic surgical technology used in uterine myoma improves efficiency, accuracy, ease, and comfort associated with the performance. Advantages of robotic myomectomy over conventional laparoscopy include the absence of tremor, a 3-dimensional image, superior instrument articulation, downscaling of movements, and comfort for the surgeon.

Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction

This Video demonstrates Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction. The prevalence of incisional hernia after laparotomy is reported to be between 11% and 20%,3,4 and incisional hernia recurrence after surgical repair is as high as 45%. Incisional hernias cause pain and other more serious problems, such as bowel obstruction, incarceration, and strangulation. After Laparoscopic Surgery these recurrences are very less.

Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator

This video demonstrates Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. In this technique, the uterus was bound from the uterine corpus and fundus like a bridle with Myoma Screw, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 90% of cases. The mean application time was 30 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. For more information https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic Heller's Myotomy with Appendectomy

The Laparoscopic Heller myotomy is a laparoscopic (minimally invasive) surgical procedure used to treat achalasia. Achalasia is a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach. The Laparoscopic Heller myotomy is essentially an esophagomyotomy, the cutting the esophageal sphincter muscle, performed laparoscopically. The Laparoscopic Heller myotomy operation's success rate is very high and usually permanent. In the procedure of Laparoscopic Heller myotomy, several tiny incisions are made and a small scope inserted, through which miniature surgical instruments are passed. The scope is connected to a video camera which then sends a magnified image to a monitor, allowing the surgeon to envision the anatomy and manipulate the instruments. For more information https://www.laparoscopyhospital.com/SERV02.HTM

Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh

This video demonstrates Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh. For large incisional hernia repair, IPOM-Plus seems to be more effective than sIPOM in terms of reducing mesh bulging. Laparoscopic repair of hernia is the method of choice for all type of hernia. The laparoscopic repair of incarcerated incisional hernias is still debated in the literature. The recent EAES/EHS guidelines state that laparoscopic surgery is not contraindicated in most of the hernia and may be considered in selected patients with an incarcerated hernia. For more information: https://www.laparoscopyhospital.com/admission.php

Easiest Way of Performing Laparoscopic Inguinal Hernia Repair Using Less Expensive Mesh

This video demonstrates Laparoscopic Inguinal Hernia Repair with Cheaper Mesh. It has been clearly demonstrated in developed countries that the modern standard of care for inguinal hernia is mesh repair, either through an open repair, namely the Lichtenstein procedure. Compared to non-mesh repairs, the use of a mesh in inguinal hernia surgery provides better results in terms of recurrence and decreased early and late postoperative pain. However, the fact that mesh repairs are the modern standard procedures for inguinal hernia poses several issues in developing countries.

Robotic Reversal of Tubal Sterilization

This video demonstrates Robotic Reversal of Tubal Sterilization surgery performed by Dr R K Mishra at World Laparoscopy Hospital. Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalization) are not infrequent. The reversal procedure can be done either by open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). Patients going through tubal reversal will go to the outpatient surgery center and have a small incision made through which your surgeon will repair your fallopian tubes. The surgery usually takes 1 hour to complete.

First in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder & Appendix removed by Laparoscopy

This Video demonstrates First time in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder and Appendix removed by Laparoscopy in the Same Patient. The patient has torsion of Myoma giving severe pain, She had multiple episodes of appendicitis in the past. She had Cholelithiasis and one paraovarian cyst. All were removed by laparoscopy. The surgery took 6 hour time. Only 4 ports were used to remove all these pathologies. She was also having hydronephrosis due to the pressure of fibroid on the ureter.

Skin to Skin Laparoscopic Cholecystectomy in 4K

This video demonstrates Skin to Skin Laparoscopic Cholecystectomy using 4K Camera to improve vision. This year a '4K' laparoscopic system has become commercially available, so-named as it provides a high-resolution 2D image with four times the number of pixels of 2D full high definition. The improved visualization is likely to provide additional depth cues. It is currently unclear to what degree improving the resolution of 2D systems can compensate for binocular depth cues however in coming days 4K laparoscopy will be very popular. 4K UHD enables rich color reproducibility and provides suitable colors for each clinical discipline which uses the laparoscopic camera. Ultra High Definition camera system provides four times more information than conventional Full HD imaging systems.

Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy

This Video demonstrates right sided Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy. Prophylactic removal of the appendix during a benign gynecologic procedure is known as an elective incidental laparoscopic appendectomy. Incidental appendectomy at the time of cesarean delivery was reported initially in 1959. Subsequent studies of removal of a normal-appearing appendix at the time of gynecologic surgery have met with considerable debate. Proponents argue that the removal of the appendix at the time of abdominal hysterectomy does not increase operative time or postoperative morbidity. More important, it does prevent future appendicitis. Advantages of incidental appendectomy include technical ease, low patient morbidity and mortality, and significant diagnostic and protective value. It also prevents conflicting diagnoses, especially in patients who have chronic pelvic pain, a ruptured ovarian cyst, or endometriosis. Other patients likely to benefit from elective incidental appendectomy are those who are undergoing abdominal radiation or chemotherapy, women unable to communicate health complaints, and those who are planning to undergo complex abdominal or pelvic procedures that are likely to cause extensive adhesions.

Laparoscopic Hysterectomy And Appendectomy Using Illuminated Ureteral Stent Step Step Demonstration

This video demonstrate Total Laparoscopic Hysterectomy step by step using infrared ureter stent together with appendectomy. Combination procedure is very easy to perform by laparoscopy. Laparoscopic Hysterectomy remains a reasonable substitute for abdominal hysterectomy. Laparoscopic hysterectomy together with appendectomy is a cost-effective procedure when done with reusable instruments. Laparoscopic hysterectomy with ureteric stenting with infrared catheter is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and its adoption can decrease abdominal incision hysterectomies.

Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility

This video demonstrates Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility. A laparoscopy, Hysteroscopy, and dye test is an operation to help find out why any female is having difficulty becoming pregnant. The dye test will show if your fallopian tubes are blocked. The laparoscopy will help find out if a patient has endometriosis, pelvic infection, adhesions, ovarian cysts or fibroids. Some minor treatments can be performed at the same time. A laparoscopy and dye test is usually performed under a general anesthetic. The operation usually takes about fifteen minutes. The gynecologist will make only two small cuts on the abdomen. Surgical instruments, along with a telescope will be introduced inside the abdomen to perform the operation. A gynecologist will inject a dye, which passes down the fallopian tubes. For more information: https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

How Harmonic Scalpel Works?

This video demonstrate Harmonic Scalpel presented by Dr R K Mishra. The Harmonic scalpel is basically an ultrasonic generator. Harmonic Scalpel is a surgical instrument used to simultaneously cut and coagulate tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue. Benefits of the Harmonic Scalpel. The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral thermal tissue damage in comparison to other operating devices. A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation.

Laparoscopic Port Closure or Fascial Closure Needles

This video demonstrates Laparoscopic Port Closure Needles explained by Dr. R K Mishra at World Laparoscopy Hospital. Fascial closure of port sites represents a challenging issue in laparoscopic surgery. We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation. New technical challenges have emerged since the introduction of the laparoscopic approach in surgery. One of these is fascial closure at port sites, which is necessary especially when large trocars are used or after dilation of a port site for organ extraction. New developments, such as single-port laparoscopic surgery, and the need for small esthetic incisions render fascial closure a current issue

Ruptured Ectopic Pregnancy

This video demonstrates Laparoscopic management of Ruptured Ectopic Pregnancy. A ruptured ectopic pregnancy or tubal pregnancy is a surgical emergency in which a fertilized egg implants itself outside the uterus. Usually, an ectopic pregnancy is situated in one of the fallopian tubes. As it grows, it can cause the tube to tear or burst. This results in dangerous internal bleeding which may be fatal if immediate surgery is not being performed. Laparoscopic Surgery Offer a very good treatment of ruptured ectopic pregnancy. Salpingectomy can be performed to cure this ectopic pregnancy.

https://www.laparoscopyhospital.com/

Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis (4 K Video)

This video demonstrates Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection. For more detail https://www.laparoscopyhospital.com/SERV01.HTM

Laparoscopic Hysterectomy By Ligation of Uterine Artery and Simultaneous Appendectomy

This video demonstrates Laparoscopic Hysterectomy By Ligation of Uterine Artery by Mishra's Knot and Vault Closure by Weston Knot. In this procedure, Appendectomy was also performed. Today, lap hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort, shorter hospital stay, rapid convalescence, and early return to the activities of daily living. Considerable technical advances in this procedure have occurred during the last few years. One of the best practice of performing laparoscopic hysterectomy is to ligate the uterine artery. The vascular supply of the uterus is mainly derived from the uterine and ovarian arteries. Because most blood enters the uterus through the uterine arteries, transient uterine ischemia occurs after uterine artery ligation. Bilateral uterine vessel ligation is an efficient method to obliterate the blood flow to the uterus.

Difficult Laparoscopic Cholecystectomy performed by Pledget Dissection of Calot's triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gall bladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.

Davinci Robotic Adhesiolysis Surgery with Application of Interceed

This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.

Laparoscopic Repair of Common bile duct (CBD) injury

Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury. In this video, We have demonstrated a method of repair on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this video with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques or by ICG.

Easiest Way of Performing Laparoscopic Inguinal Hernia Repair Using Less Expensive Mesh

This video demonstrates Laparoscopic Inguinal Hernia Repair with Cheaper Mesh. It has been clearly demonstrated in developed countries that the modern standard of care for inguinal hernia is mesh repair, either through an open repair, namely the Lichtenstein procedure. Compared to non-mesh repairs, the use of a mesh in inguinal hernia surgery provides better results in terms of recurrence and decreased early and late postoperative pain. However, the fact that mesh repairs are the modern standard procedures for inguinal hernia poses several issues in developing countries.

Laparoscopic Ovarian Cystectomy - Aspiration with Transparent Needle

This video demonstrates laparoscopic ovarian cystectomy. An ovarian cystectomy is a laparoscopic surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgical technique that only uses a few small incisions in your lower abdomen. https://www.laparoscopyhospital.com/mmas.htm

How Harmonic Scalpel Works?

This video demonstrate Harmonic Scalpel presented by Dr R K Mishra. The Harmonic scalpel is basically an ultrasonic generator. Harmonic Scalpel is a surgical instrument used to simultaneously cut and coagulate tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue. Benefits of the Harmonic Scalpel. The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral thermal tissue damage in comparison to other operating devices. A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation.

Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury

This video demonstrates Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury. Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of a female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a robotic adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. For more detail log on to: https://www.laparoscopyhospital.com/robotic-surgery.html

Laparoscopic IPOM Inguinal Hernia Repair - Skin to Skin

This education video of IPOM is demonstrated in order to assess the feasibility of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair as an alternative method for inguinal hernia repair. All medical records were reviewed retrospectively. Mean operative time was 45 minutes, and mean postoperative hospital stay was 1 days. There were two cases of postoperative swelling at the groin area due to entrapment of CO2 and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. Even though laparoscopic Intraperitoneal Onlay Mesh Repair of Hernia which is popularly called as IPOM repair is not a preferred method for inguinal hernia, it can be applied as an alternative method in specific cases.

Safe Way of Performing Laparoscopic Cholecystectomy

CBD injury is one of the most common injuries during laparoscopic cholecystectomy. It is very important to minimize CBD injury for a laparoscopic surgeon. This video demonstrates Safe Way of Performing Laparoscopic Cholecystectomy. The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. A safe cholecystectomy is one that is “safe for both the patient no bile duct/hollow viscus/vascular injury and for the operating surgeon no or minimal scope for litigation. In addition, a surgeon should be able to anticipate the operative difficulty based on various preoperative predictors, should adhere to basic principles of surgery including safe use of energy devices and use of fluorescence cholangiography using ICG. https://www.laparoscopyhospital.com/SERV01.HTM

Robotic Cerclage for Cervical insufficiency

Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We have demonstrated in this video Robotic abdomina cerclage to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Laparoscopic abdominal cerclage during pregnancy has been shown to be advantageous over laparotomy when comparing success rates and recognizing the well-known benefits of minimally invasive surgery, such as decreased blood loss, shorter hospital stay, decreased pain, and faster recovery time. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that facilitates less invasive procedures when compared to the open approach, and it has the advantages of 3-dimensional visualization and endowristed instrumentation when compared to traditional laparoscopy. Since the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, USA) was approved by the FDA for gynecologic procedures in 2005, there have been only a few robotic abdominal cerclages performed; the first robotic cerclage in India was performed by us at World Laparoscopy Hospital was in 2010.

Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator

This video demonstrates Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. In this technique, the uterus was bound from the uterine corpus and fundus like a bridle with Myoma Screw, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 90% of cases. The mean application time was 30 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. For more information https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic Removal of Posterior Cervical Fibroid

This video demonstrate Laparoscopic Myomectomy for Posterior Cervical Fibroid. Fibroid or Myomas are benign tumours composed partly of muscle and fibrous tissue. They seldom develop in the cervix, the lower part of the uterus as in this video. When posterior cervical fibroid grow, they are usually obliterating entire cul de sac. Cervical fibroids grow in the wall of the cervix and are difficult to remove without damaging the surrounding area. Most cervical myomas eventually cause symptoms of GIT or ureteric obstruction. The most common symptom may be irregular or heavy menstrual bleeding . Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility. Cervical myomas can block the flow of urine; women may have a hesitant start when urinating; dribble at the end of urination, and retain urine. Urinary tract infections are also more likely to develop. If cervical fibroids cause symptoms, they are surgically removed in a procedure called a Laparoscopic Myomectomy. After removal of fibroid suturing of the raw area is required. Depending upon the size of fibroid a long time is spend in morcellation of myoma. For more information log on to https://www.laparoscopyhospital.com/

Intraperitoneal Onlay Mesh Repair of Inguinal Hernia

This video demonstrates Intraperitoneal Onlay Mesh Repair of Inguinal Hernia. Our study at World Laparoscopy hospital 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 recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However, the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Robotic Myomectomy

Robotic myomectomy is a minimally invasive way for ROBOTIC surgeons to remove uterine fibroids. The DAVINCI ROBOT provides 7 degrees of freedom: 3 degrees provided by the robotic arms (insertion, pitch, yaw) and 4 degrees from the “wristed” instruments (pitch, yaw, roll, and grip). This improves dexterity and enables the DaVinci robotic surgeon to manipulate and dissect tissue in a delicate, controlled fashion. Robotic surgical technology used in uterine myoma improves efficiency, accuracy, ease, and comfort associated with the performance. Advantages of robotic myomectomy over conventional laparoscopy include the absence of tremor, a 3-dimensional image, superior instrument articulation, downscaling of movements, and comfort for the surgeon.

Laparoscopic Repair of Recurrent Umbilical Hernia

This video demonstrates laparoscopic repair of Umbilical recurrent hernia. An umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised by the laparoscopic technique. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. We are performing at World Laparoscopy Hospital for more than 20 years. Laparoscopic umbilical hernia repair has been practiced at World Laparoscopy Hospital since the late 1990s. Newer bilayer prosthetic devices are designed for open intraperitoneal inlay placement. They have two sides, one is polypropylene and the other side is a non-adherent material to face viscera. Bilayer polypropylene or partially reabsorbable meshes have also been used for umbilical hernias. They comprised one sublay and one overlay patch with a connector to eliminate migration. However, clinical outcomes after repairs with these devices have not been widely documented.

Ruptured Ectopic Pregnancy

This video demonstrates Laparoscopic management of Ruptured Ectopic Pregnancy. A ruptured ectopic pregnancy or tubal pregnancy is a surgical emergency in which a fertilized egg implants itself outside the uterus. Usually, an ectopic pregnancy is situated in one of the fallopian tubes. As it grows, it can cause the tube to tear or burst. This results in dangerous internal bleeding which may be fatal if immediate surgery is not being performed. Laparoscopic Surgery Offer a very good treatment of ruptured ectopic pregnancy. Salpingectomy can be performed to cure this ectopic pregnancy.

Laparoscopic Inguinal Hernia Repair in Female

A groin hernia is relatively uncommon in females. The laparoscopic surgery is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia. TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.

Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy

This video demonstrates Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy performed by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic inguinal hernia repair is performed with general anesthesia. Two 5mm and one 10mm incision are made in the lower part of the abdomen. In laparoscopic inguinal hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The inguinal hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia that can cause chronic pain if injured, blood vessels that can bleed, or the vas deferens. The small incisions are closed with suturing that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you. The hernia is repaired by a different technique like TAPP, TEP or IPOM. The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Sleeve Gastrectomy with Hernia Repair

This video demonstrates laparoscopic sleeve gastrectomy together with hernia repair inpatient of morbid obesity. In morbidly obese patients with any hernia with or without GERD undergoing LSG, repair of the hernia helps in amelioration of morbidity due to hernia and prevents any new onset improving quality of life. Obesity is associated with multiple comorbidities including diabetes mellitus, hypertension, obstructive sleep apnoea and gastro-oesophageal reflux disease (GERD). Thus, the presence of any ventral hernia should not be considered as a contraindication for laparoscopic sleeve gastrectomy surgery and both the procedure can effectively be performed together.

TAPP Hernia Repair by Ipsilateral Port

This video demonstrate TAPP (Transabdominal Preperitoneal Inguinal Hernia) Repair by Ipsilateral Port. The indications for laparoscopic inguinal hernia repair, TAPP or TEP, are the same for open inguinal hernia repair. They may be ideal for bilateral inguinal hernias and recurrences from anterior approaches but is also appropriate with unilateral primary hernias when the surgeon is comfortable with the technique. For young, active males with primary hernias, it may ofter decrease pain and an earlier return to activity. Prior to lower abdominal surgery or pelvic radiation is strong relative contraindications, as these may make access to the preperitoneal space difficult. The hernia is visualized, and the peritoneum overlying it incised sharply. Blunt dissection can be used to peel the peritoneal flaps inferiorly, exposing the inferior epigastric vessels, the pubic symphysis and the Cooper’s ligament, and the iliopubic tract. A direct hernia should be reduced if seen, and an indirect dissected from the cord structures. Femoral and obturator hernias can also be visualized and reduced. Care is taken to avoid the “Triangle of Doom” containing the external iliac vessels bordered by the vas deferens medially and the gonadal vessels laterally. A mesh ranging from 10 to 15 cm in diameter of polypropylene or polyester is introduced through the optical trocar and positioned anterior along the pelvic wall with the center over of the primary hernia defect. For more detail log on to https://www.laparoscopyhospital.com/youtube/preview.php

Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility

This video demonstrates Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility. A laparoscopy, Hysteroscopy, and dye test is an operation to help find out why any female is having difficulty becoming pregnant. The dye test will show if your fallopian tubes are blocked. The laparoscopy will help find out if a patient has endometriosis, pelvic infection, adhesions, ovarian cysts or fibroids. Some minor treatments can be performed at the same time. A laparoscopy and dye test is usually performed under a general anesthetic. The operation usually takes about fifteen minutes. The gynecologist will make only two small cuts on the abdomen. Surgical instruments, along with a telescope will be introduced inside the abdomen to perform the operation. A gynecologist will inject a dye, which passes down the fallopian tubes. For more information: https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

How Ligasure Works?

This video demonstrate how Ligasure works presented by Dr R K Mishra. Ligasure is a tissue responce generator. Across the range of products and procedures, LigaSure also called as vessel sealer is a technology which delivers a unique combination of pressure and energy to create a consistent seal with each application. Ligasure provides a combination of pressure and energy to create vessel fusion. Permanently fuses vessels up to and including 7 mm in diameter and tissue bundles without dissection or isolation Average seal cycle is 2 to 4 seconds. Ligasure seals withstand three times normal systolic blood pressure. Feedback-controlled response system automatically discontinues energy delivery when the seal cycle is complete, eliminating the guesswork.

Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy

This Video demonstrates right sided Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy. Prophylactic removal of the appendix during a benign gynecologic procedure is known as an elective incidental laparoscopic appendectomy. Incidental appendectomy at the time of cesarean delivery was reported initially in 1959. Subsequent studies of removal of a normal-appearing appendix at the time of gynecologic surgery have met with considerable debate. Proponents argue that the removal of the appendix at the time of abdominal hysterectomy does not increase operative time or postoperative morbidity. More important, it does prevent future appendicitis. Advantages of incidental appendectomy include technical ease, low patient morbidity and mortality, and significant diagnostic and protective value. It also prevents conflicting diagnoses, especially in patients who have chronic pelvic pain, a ruptured ovarian cyst, or endometriosis. Other patients likely to benefit from elective incidental appendectomy are those who are undergoing abdominal radiation or chemotherapy, women unable to communicate health complaints, and those who are planning to undergo complex abdominal or pelvic procedures that are likely to cause extensive adhesions.

Laparoscopic Surgery for Left Ovarian Dermoid Cyst

This video demonstrates Laparoscopic Surgery for Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.

Robotic Sleeve Gastrectomy Surgery

This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

Laparoscopic Hysterectomy And Appendectomy Using Illuminated Ureteral Stent Step Step Demonstration

This video demonstrate Total Laparoscopic Hysterectomy step by step using infrared ureter stent together with appendectomy. Combination procedure is very easy to perform by laparoscopy. Laparoscopic Hysterectomy remains a reasonable substitute for abdominal hysterectomy. Laparoscopic hysterectomy together with appendectomy is a cost-effective procedure when done with reusable instruments. Laparoscopic hysterectomy with ureteric stenting with infrared catheter is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and its adoption can decrease abdominal incision hysterectomies.

Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent

This video demonstrate Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent performed by Dr R K Mishra at World Laparoscopy Hospital. This is a must watch video for every one to see how nicely illuminated stent look. Despite the skepticism, potential advantages afforded by this minimal access technique motivated the development and evaluation of the laparoscope in an expanding number of surgical applications. Numerous technologic advances were critical to this evolution. During the first half of this century, the development of various lens systems and endoscopes was there. Recently use of Infrared imaging system in laparoscopy has revolutionized the way how we were looking at ureter in past. The infrared lighted ureteral stent or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm.

Total Laparoscopic Hysterectomy for Very Large Uterus With Multiple Fibroid

In this video, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uterus weighing more than 9500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform an efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number, and location of the myomas. Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Para-umbilical Hernia IPOM Repair

This video demonstrates laparoscopic repair of a paraumbilical hernia. 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. A paraumbilical or umbilical hernia is a common type of abdominal hernia. Paraumbilical hernias usually develop later in life and are often caused by acquired abdomen openings linked to intra-abdominal pressure from carrying excess body weight, ascites, cancer or other intra-abdominal malignancy, or multiple pregnancies. Hernias don't go away on their own. Only surgery can repair a hernia. Many people are able to delay surgery for months or even years but there is always a chance of incarceration. For more information: https://www.laparoscopyhospital.com/SERV01.HTM

Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient

This video demonstrate Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children. The laparoscopic approach is most frequently used, except for young children. Superficial surgical site infections are more frequent after open surgery only in patients with complicated appendicitis. The normal appendix rate is low, most likely because of routine preoperative imaging.

Uterine Manipulators

The uterine manipulators in use for various gynecological laparoscopic surgeries including laparoscopic hysterectomy or laparoscopic pelvic endometriosis have to achieve many different tasks in order to arrive at a safe and successful outcome in gynecological and pelvic surgery. The most obvious function of Uterine Manipulators is to suitably mobilize the uterus.

Laparoscopic Myomectomy and Ovarian Cystectomy for Multiple Myomas and Paraovarian Cyst

Laparoscopic Ovarian cystectomy and Laparoscopic myomectomy are the two most frequently performed gynecologic operations in reproductive-age women. Benign ovarian cysts mostly occur in reproductive-age women, for whom it is important to have the majority of the ovarian tissue preserved after laparoscopic surgery. In order to preserve the maximum ovarian reserve, laparoscopic ovarian cystectomy is generally preferred. The lifetime incidence of uterine myoma is approximately 20% to 25%, and it is the most common benign tumor in reproductive-age women. Laparoscopic Surgery is performed on women who suffer from menorrhagia, dysmenorrhea, or increase in the size of the fibroid. The utility of laparoscopic myomectomy has been well established among symptomatic reproductive-age women with myoma, and previous studies have found no difference in the duration of surgery, the amount of blood loss during surgery, or the incidence of postoperative adhesion in comparison with open surgery. Likewise, no difference was found between laparoscopic myomectomy or open myomectomy in the rate of postoperative uterine rupture. In infertile patients, myomectomy has been shown to lead to a significant improvement in the pregnancy rate. Currently, single-port access (SPA) laparoscopic myomectomy is performed as a minimally invasive surgical technique. SPA laparoscopic surgery is superior to multi-port laparoscopic surgery in terms of cosmetic outcomes and postoperative pain relief and recovery, but due to the difficulty in the suture technique, hemostasis is more challenging and it generally is more time-consuming.

Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac

This video demonstrates Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac and application of interceed which act as a mechanical adhesive barrier. Ablation/fulguration of ovarian tissue during laparoscopy isn't recommended. Surgical excision is the most common and effective treatment for endometriosis of the ovary (endometrioma cyst). Surgical removal at the time of laparoscopy has been shown to improve pain without damaging the ovaries. A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis. By laparoscopic surgery, it is also possible to remove cysts, implants, and scar tissue caused by endometriosis. Laparoscopy for endometriosis is a low-risk and minimally invasive procedure.

Da Vinci Robotic Hysterectomy

This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.

Safest Way to Perform Total Laparoscopic Hysterectomy with Bilateral Salpingo-oophorectomy

Risk-Reducing Bilateral Salpingo-oophorectomy: Surgery to remove both healthy fallopian tubes and both healthy ovaries. The surgery is done to reduce the risk of cancer. Salpingectomy: Surgery to remove one or both of the fallopian tubes. the side effects of laparoscopic hysterectomy? These risks include major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots. infection. anesthesia side effects. bowel blockage. The side effects of laparoscopic hysterectomy are major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots...

Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction

This Video demonstrates Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction. The prevalence of incisional hernia after laparotomy is reported to be between 11% and 20%,3,4 and incisional hernia recurrence after surgical repair is as high as 45%. Incisional hernias cause pain and other more serious problems, such as bowel obstruction, incarceration, and strangulation. After Laparoscopic Surgery these recurrences are very less.

Sleeve Gastrectomy Tips and Tricks

Laparoscopic sleeve gastrectomy (LSG) is becoming popular as a stand alone bariatric procedure for morbid obesity. The laparoscopic sleeve gastrectomy technique has evolved over the years towards standardization. Better standardization has minimized complications as leaks, stricture, and weight regain. Adequate posterior dissection up to the hiatus and the linear sleeve without a torque can be safely performed. The video presentation refers to the international consensus document on LSG as well as the expert panel consensus where our centre’s technique is shared. The video demonstrates step by step approach to a safe, standardized technique of LSG. https://www.laparoscopyhospital.com/bariatric-surgery.html

Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh

This video demonstrates Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh. For large incisional hernia repair, IPOM-Plus seems to be more effective than sIPOM in terms of reducing mesh bulging. Laparoscopic repair of hernia is the method of choice for all type of hernia. The laparoscopic repair of incarcerated incisional hernias is still debated in the literature. The recent EAES/EHS guidelines state that laparoscopic surgery is not contraindicated in most of the hernia and may be considered in selected patients with an incarcerated hernia. For more information: https://www.laparoscopyhospital.com/admission.php

Robotic Reversal of Tubal Sterilization

This video demonstrates Robotic Reversal of Tubal Sterilization surgery performed by Dr R K Mishra at World Laparoscopy Hospital. Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalization) are not infrequent. The reversal procedure can be done either by open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). Patients going through tubal reversal will go to the outpatient surgery center and have a small incision made through which your surgeon will repair your fallopian tubes. The surgery usually takes 1 hour to complete.

Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina

This video demonstrate Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina. The average surgical time was 45 min for laparoscopic cholecystectomy and 15 min for hysterectomy and 30 min for hysterectomy. Total blood loss was approximately less than 50ml. Lesson for both, gynecologists and the surgeons, is to combine these two when required and possible. This provides maximum advantages through minimizing risk of anesthesia and time duration, hospital stay, cost-effectiveness.

Laparoscopic Hysterectomy with Ureteral Stent Placement

Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Basic Demonstration of Da Vinci Robot - How Surgical Robot Works?

This video demonstrates the Basic Demonstration of Da Vinci Robot - How Surgical Robot Works? Compared to traditional techniques of open surgery and laparoscopic surgery, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

First in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder & Appendix removed by Laparoscopy

This Video demonstrates First time in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder and Appendix removed by Laparoscopy in the Same Patient. The patient has torsion of Myoma giving severe pain, She had multiple episodes of appendicitis in the past. She had Cholelithiasis and one paraovarian cyst. All were removed by laparoscopy. The surgery took 6 hour time. Only 4 ports were used to remove all these pathologies. She was also having hydronephrosis due to the pressure of fibroid on the ureter.

Laparoscopic Port Closure or Fascial Closure Needles

This video demonstrates Laparoscopic Port Closure Needles explained by Dr. R K Mishra at World Laparoscopy Hospital. Fascial closure of port sites represents a challenging issue in laparoscopic surgery. We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation. New technical challenges have emerged since the introduction of the laparoscopic approach in surgery. One of these is fascial closure at port sites, which is necessary especially when large trocars are used or after dilation of a port site for organ extraction. New developments, such as single-port laparoscopic surgery, and the need for small esthetic incisions render fascial closure a current issue

Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Near Infrared Cholangiography

This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. 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 because of difficulties of doing it. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used in for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.

Laparoscopic Heller's Myotomy with Appendectomy

The Laparoscopic Heller myotomy is a laparoscopic (minimally invasive) surgical procedure used to treat achalasia. Achalasia is a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach. The Laparoscopic Heller myotomy is essentially an esophagomyotomy, the cutting the esophageal sphincter muscle, performed laparoscopically. The Laparoscopic Heller myotomy operation's success rate is very high and usually permanent. In the procedure of Laparoscopic Heller myotomy, several tiny incisions are made and a small scope inserted, through which miniature surgical instruments are passed. The scope is connected to a video camera which then sends a magnified image to a monitor, allowing the surgeon to envision the anatomy and manipulate the instruments. For more information https://www.laparoscopyhospital.com/SERV02.HTM

Skin to Skin Laparoscopic Cholecystectomy in 4K

This video demonstrates Skin to Skin Laparoscopic Cholecystectomy using 4K Camera to improve vision. This year a '4K' laparoscopic system has become commercially available, so-named as it provides a high-resolution 2D image with four times the number of pixels of 2D full high definition. The improved visualization is likely to provide additional depth cues. It is currently unclear to what degree improving the resolution of 2D systems can compensate for binocular depth cues however in coming days 4K laparoscopy will be very popular. 4K UHD enables rich color reproducibility and provides suitable colors for each clinical discipline which uses the laparoscopic camera. Ultra High Definition camera system provides four times more information than conventional Full HD imaging systems.

How to Use Hysteroscopy Instruments?

This video demonstrate how to use various hysteroscopic instruments. Hysteroscopy is a procedure that allows us to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. The procedure can be either diagnostic or operative. Hysteroscopy is a procedure that allows gynecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

https://www.laparoscopyhospital.com/

Basic Demonstration of Da Vinci Robot - How Surgical Robot Works?

This video demonstrates the Basic Demonstration of Da Vinci Robot - How Surgical Robot Works? Compared to traditional techniques of open surgery and laparoscopic surgery, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

Laparoscopic Hysterectomy By Ligation of Uterine Artery and Simultaneous Appendectomy

This video demonstrates Laparoscopic Hysterectomy By Ligation of Uterine Artery by Mishra's Knot and Vault Closure by Weston Knot. In this procedure, Appendectomy was also performed. Today, lap hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort, shorter hospital stay, rapid convalescence, and early return to the activities of daily living. Considerable technical advances in this procedure have occurred during the last few years. One of the best practice of performing laparoscopic hysterectomy is to ligate the uterine artery. The vascular supply of the uterus is mainly derived from the uterine and ovarian arteries. Because most blood enters the uterus through the uterine arteries, transient uterine ischemia occurs after uterine artery ligation. Bilateral uterine vessel ligation is an efficient method to obliterate the blood flow to the uterus.

Laparoscopic Hysterectomy with Ureteral Stent Placement

Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina

This video demonstrate Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina. The average surgical time was 45 min for laparoscopic cholecystectomy and 15 min for hysterectomy and 30 min for hysterectomy. Total blood loss was approximately less than 50ml. Lesson for both, gynecologists and the surgeons, is to combine these two when required and possible. This provides maximum advantages through minimizing risk of anesthesia and time duration, hospital stay, cost-effectiveness.

Sleeve Gastrectomy with Hernia Repair

This video demonstrates laparoscopic sleeve gastrectomy together with hernia repair inpatient of morbid obesity. In morbidly obese patients with any hernia with or without GERD undergoing LSG, repair of the hernia helps in amelioration of morbidity due to hernia and prevents any new onset improving quality of life. Obesity is associated with multiple comorbidities including diabetes mellitus, hypertension, obstructive sleep apnoea and gastro-oesophageal reflux disease (GERD). Thus, the presence of any ventral hernia should not be considered as a contraindication for laparoscopic sleeve gastrectomy surgery and both the procedure can effectively be performed together.

Robotic Reversal of Tubal Sterilization

This video demonstrates Robotic Reversal of Tubal Sterilization surgery performed by Dr R K Mishra at World Laparoscopy Hospital. Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalization) are not infrequent. The reversal procedure can be done either by open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). Patients going through tubal reversal will go to the outpatient surgery center and have a small incision made through which your surgeon will repair your fallopian tubes. The surgery usually takes 1 hour to complete.

How Harmonic Scalpel Works?

This video demonstrate Harmonic Scalpel presented by Dr R K Mishra. The Harmonic scalpel is basically an ultrasonic generator. Harmonic Scalpel is a surgical instrument used to simultaneously cut and coagulate tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue. Benefits of the Harmonic Scalpel. The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral thermal tissue damage in comparison to other operating devices. A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation.

Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Near Infrared Cholangiography

This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. 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 because of difficulties of doing it. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used in for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.

Laparoscopic Removal of Posterior Cervical Fibroid

This video demonstrate Laparoscopic Myomectomy for Posterior Cervical Fibroid. Fibroid or Myomas are benign tumours composed partly of muscle and fibrous tissue. They seldom develop in the cervix, the lower part of the uterus as in this video. When posterior cervical fibroid grow, they are usually obliterating entire cul de sac. Cervical fibroids grow in the wall of the cervix and are difficult to remove without damaging the surrounding area. Most cervical myomas eventually cause symptoms of GIT or ureteric obstruction. The most common symptom may be irregular or heavy menstrual bleeding . Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility. Cervical myomas can block the flow of urine; women may have a hesitant start when urinating; dribble at the end of urination, and retain urine. Urinary tract infections are also more likely to develop. If cervical fibroids cause symptoms, they are surgically removed in a procedure called a Laparoscopic Myomectomy. After removal of fibroid suturing of the raw area is required. Depending upon the size of fibroid a long time is spend in morcellation of myoma. For more information log on to https://www.laparoscopyhospital.com/

Easiest Way of Performing Laparoscopic Inguinal Hernia Repair Using Less Expensive Mesh

This video demonstrates Laparoscopic Inguinal Hernia Repair with Cheaper Mesh. It has been clearly demonstrated in developed countries that the modern standard of care for inguinal hernia is mesh repair, either through an open repair, namely the Lichtenstein procedure. Compared to non-mesh repairs, the use of a mesh in inguinal hernia surgery provides better results in terms of recurrence and decreased early and late postoperative pain. However, the fact that mesh repairs are the modern standard procedures for inguinal hernia poses several issues in developing countries.

First in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder & Appendix removed by Laparoscopy

This Video demonstrates First time in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder and Appendix removed by Laparoscopy in the Same Patient. The patient has torsion of Myoma giving severe pain, She had multiple episodes of appendicitis in the past. She had Cholelithiasis and one paraovarian cyst. All were removed by laparoscopy. The surgery took 6 hour time. Only 4 ports were used to remove all these pathologies. She was also having hydronephrosis due to the pressure of fibroid on the ureter.

Safest Way to Perform Total Laparoscopic Hysterectomy with Bilateral Salpingo-oophorectomy

Risk-Reducing Bilateral Salpingo-oophorectomy: Surgery to remove both healthy fallopian tubes and both healthy ovaries. The surgery is done to reduce the risk of cancer. Salpingectomy: Surgery to remove one or both of the fallopian tubes. the side effects of laparoscopic hysterectomy? These risks include major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots. infection. anesthesia side effects. bowel blockage. The side effects of laparoscopic hysterectomy are major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots...

Davinci Robotic Adhesiolysis Surgery with Application of Interceed

This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.

Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh

This video demonstrates Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh. For large incisional hernia repair, IPOM-Plus seems to be more effective than sIPOM in terms of reducing mesh bulging. Laparoscopic repair of hernia is the method of choice for all type of hernia. The laparoscopic repair of incarcerated incisional hernias is still debated in the literature. The recent EAES/EHS guidelines state that laparoscopic surgery is not contraindicated in most of the hernia and may be considered in selected patients with an incarcerated hernia. For more information: https://www.laparoscopyhospital.com/admission.php

Laparoscopic Ovarian Cystectomy - Aspiration with Transparent Needle

This video demonstrates laparoscopic ovarian cystectomy. An ovarian cystectomy is a laparoscopic surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgical technique that only uses a few small incisions in your lower abdomen. https://www.laparoscopyhospital.com/mmas.htm

Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient

This video demonstrate Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children. The laparoscopic approach is most frequently used, except for young children. Superficial surgical site infections are more frequent after open surgery only in patients with complicated appendicitis. The normal appendix rate is low, most likely because of routine preoperative imaging.

Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator

This video demonstrates Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. In this technique, the uterus was bound from the uterine corpus and fundus like a bridle with Myoma Screw, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 90% of cases. The mean application time was 30 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. For more information https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic Myomectomy and Ovarian Cystectomy for Multiple Myomas and Paraovarian Cyst

Laparoscopic Ovarian cystectomy and Laparoscopic myomectomy are the two most frequently performed gynecologic operations in reproductive-age women. Benign ovarian cysts mostly occur in reproductive-age women, for whom it is important to have the majority of the ovarian tissue preserved after laparoscopic surgery. In order to preserve the maximum ovarian reserve, laparoscopic ovarian cystectomy is generally preferred. The lifetime incidence of uterine myoma is approximately 20% to 25%, and it is the most common benign tumor in reproductive-age women. Laparoscopic Surgery is performed on women who suffer from menorrhagia, dysmenorrhea, or increase in the size of the fibroid. The utility of laparoscopic myomectomy has been well established among symptomatic reproductive-age women with myoma, and previous studies have found no difference in the duration of surgery, the amount of blood loss during surgery, or the incidence of postoperative adhesion in comparison with open surgery. Likewise, no difference was found between laparoscopic myomectomy or open myomectomy in the rate of postoperative uterine rupture. In infertile patients, myomectomy has been shown to lead to a significant improvement in the pregnancy rate. Currently, single-port access (SPA) laparoscopic myomectomy is performed as a minimally invasive surgical technique. SPA laparoscopic surgery is superior to multi-port laparoscopic surgery in terms of cosmetic outcomes and postoperative pain relief and recovery, but due to the difficulty in the suture technique, hemostasis is more challenging and it generally is more time-consuming.

Laparoscopic Inguinal Hernia Repair in Female

A groin hernia is relatively uncommon in females. The laparoscopic surgery is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia. TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.

Laparoscopic Heller's Myotomy with Appendectomy

The Laparoscopic Heller myotomy is a laparoscopic (minimally invasive) surgical procedure used to treat achalasia. Achalasia is a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach. The Laparoscopic Heller myotomy is essentially an esophagomyotomy, the cutting the esophageal sphincter muscle, performed laparoscopically. The Laparoscopic Heller myotomy operation's success rate is very high and usually permanent. In the procedure of Laparoscopic Heller myotomy, several tiny incisions are made and a small scope inserted, through which miniature surgical instruments are passed. The scope is connected to a video camera which then sends a magnified image to a monitor, allowing the surgeon to envision the anatomy and manipulate the instruments. For more information https://www.laparoscopyhospital.com/SERV02.HTM

Laparoscopic Port Closure or Fascial Closure Needles

This video demonstrates Laparoscopic Port Closure Needles explained by Dr. R K Mishra at World Laparoscopy Hospital. Fascial closure of port sites represents a challenging issue in laparoscopic surgery. We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation. New technical challenges have emerged since the introduction of the laparoscopic approach in surgery. One of these is fascial closure at port sites, which is necessary especially when large trocars are used or after dilation of a port site for organ extraction. New developments, such as single-port laparoscopic surgery, and the need for small esthetic incisions render fascial closure a current issue

Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy

This video demonstrates Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy performed by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic inguinal hernia repair is performed with general anesthesia. Two 5mm and one 10mm incision are made in the lower part of the abdomen. In laparoscopic inguinal hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The inguinal hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia that can cause chronic pain if injured, blood vessels that can bleed, or the vas deferens. The small incisions are closed with suturing that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you. The hernia is repaired by a different technique like TAPP, TEP or IPOM. The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Laparoscopic Surgery for Left Ovarian Dermoid Cyst

This video demonstrates Laparoscopic Surgery for Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.

Laparoscopic Hysterectomy And Appendectomy Using Illuminated Ureteral Stent Step Step Demonstration

This video demonstrate Total Laparoscopic Hysterectomy step by step using infrared ureter stent together with appendectomy. Combination procedure is very easy to perform by laparoscopy. Laparoscopic Hysterectomy remains a reasonable substitute for abdominal hysterectomy. Laparoscopic hysterectomy together with appendectomy is a cost-effective procedure when done with reusable instruments. Laparoscopic hysterectomy with ureteric stenting with infrared catheter is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and its adoption can decrease abdominal incision hysterectomies.

Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis (4 K Video)

This video demonstrates Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection. For more detail https://www.laparoscopyhospital.com/SERV01.HTM

Robotic Sleeve Gastrectomy Surgery

This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

How Ligasure Works?

This video demonstrate how Ligasure works presented by Dr R K Mishra. Ligasure is a tissue responce generator. Across the range of products and procedures, LigaSure also called as vessel sealer is a technology which delivers a unique combination of pressure and energy to create a consistent seal with each application. Ligasure provides a combination of pressure and energy to create vessel fusion. Permanently fuses vessels up to and including 7 mm in diameter and tissue bundles without dissection or isolation Average seal cycle is 2 to 4 seconds. Ligasure seals withstand three times normal systolic blood pressure. Feedback-controlled response system automatically discontinues energy delivery when the seal cycle is complete, eliminating the guesswork.

How to Use Hysteroscopy Instruments?

This video demonstrate how to use various hysteroscopic instruments. Hysteroscopy is a procedure that allows us to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. The procedure can be either diagnostic or operative. Hysteroscopy is a procedure that allows gynecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

TAPP Hernia Repair by Ipsilateral Port

This video demonstrate TAPP (Transabdominal Preperitoneal Inguinal Hernia) Repair by Ipsilateral Port. The indications for laparoscopic inguinal hernia repair, TAPP or TEP, are the same for open inguinal hernia repair. They may be ideal for bilateral inguinal hernias and recurrences from anterior approaches but is also appropriate with unilateral primary hernias when the surgeon is comfortable with the technique. For young, active males with primary hernias, it may ofter decrease pain and an earlier return to activity. Prior to lower abdominal surgery or pelvic radiation is strong relative contraindications, as these may make access to the preperitoneal space difficult. The hernia is visualized, and the peritoneum overlying it incised sharply. Blunt dissection can be used to peel the peritoneal flaps inferiorly, exposing the inferior epigastric vessels, the pubic symphysis and the Cooper’s ligament, and the iliopubic tract. A direct hernia should be reduced if seen, and an indirect dissected from the cord structures. Femoral and obturator hernias can also be visualized and reduced. Care is taken to avoid the “Triangle of Doom” containing the external iliac vessels bordered by the vas deferens medially and the gonadal vessels laterally. A mesh ranging from 10 to 15 cm in diameter of polypropylene or polyester is introduced through the optical trocar and positioned anterior along the pelvic wall with the center over of the primary hernia defect. For more detail log on to https://www.laparoscopyhospital.com/youtube/preview.php

Laparoscopic IPOM Inguinal Hernia Repair - Skin to Skin

This education video of IPOM is demonstrated in order to assess the feasibility of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair as an alternative method for inguinal hernia repair. All medical records were reviewed retrospectively. Mean operative time was 45 minutes, and mean postoperative hospital stay was 1 days. There were two cases of postoperative swelling at the groin area due to entrapment of CO2 and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. Even though laparoscopic Intraperitoneal Onlay Mesh Repair of Hernia which is popularly called as IPOM repair is not a preferred method for inguinal hernia, it can be applied as an alternative method in specific cases.

Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy

This Video demonstrates right sided Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy. Prophylactic removal of the appendix during a benign gynecologic procedure is known as an elective incidental laparoscopic appendectomy. Incidental appendectomy at the time of cesarean delivery was reported initially in 1959. Subsequent studies of removal of a normal-appearing appendix at the time of gynecologic surgery have met with considerable debate. Proponents argue that the removal of the appendix at the time of abdominal hysterectomy does not increase operative time or postoperative morbidity. More important, it does prevent future appendicitis. Advantages of incidental appendectomy include technical ease, low patient morbidity and mortality, and significant diagnostic and protective value. It also prevents conflicting diagnoses, especially in patients who have chronic pelvic pain, a ruptured ovarian cyst, or endometriosis. Other patients likely to benefit from elective incidental appendectomy are those who are undergoing abdominal radiation or chemotherapy, women unable to communicate health complaints, and those who are planning to undergo complex abdominal or pelvic procedures that are likely to cause extensive adhesions.

Skin to Skin Laparoscopic Cholecystectomy in 4K

This video demonstrates Skin to Skin Laparoscopic Cholecystectomy using 4K Camera to improve vision. This year a '4K' laparoscopic system has become commercially available, so-named as it provides a high-resolution 2D image with four times the number of pixels of 2D full high definition. The improved visualization is likely to provide additional depth cues. It is currently unclear to what degree improving the resolution of 2D systems can compensate for binocular depth cues however in coming days 4K laparoscopy will be very popular. 4K UHD enables rich color reproducibility and provides suitable colors for each clinical discipline which uses the laparoscopic camera. Ultra High Definition camera system provides four times more information than conventional Full HD imaging systems.

Uterine Manipulators

The uterine manipulators in use for various gynecological laparoscopic surgeries including laparoscopic hysterectomy or laparoscopic pelvic endometriosis have to achieve many different tasks in order to arrive at a safe and successful outcome in gynecological and pelvic surgery. The most obvious function of Uterine Manipulators is to suitably mobilize the uterus.

Difficult Laparoscopic Cholecystectomy performed by Pledget Dissection of Calot's triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gall bladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.

Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent

This video demonstrate Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent performed by Dr R K Mishra at World Laparoscopy Hospital. This is a must watch video for every one to see how nicely illuminated stent look. Despite the skepticism, potential advantages afforded by this minimal access technique motivated the development and evaluation of the laparoscope in an expanding number of surgical applications. Numerous technologic advances were critical to this evolution. During the first half of this century, the development of various lens systems and endoscopes was there. Recently use of Infrared imaging system in laparoscopy has revolutionized the way how we were looking at ureter in past. The infrared lighted ureteral stent or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm.

Da Vinci Robotic Hysterectomy

This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.

Total Laparoscopic Hysterectomy for Very Large Uterus With Multiple Fibroid

In this video, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uterus weighing more than 9500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform an efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number, and location of the myomas. Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Robotic Cerclage for Cervical insufficiency

Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We have demonstrated in this video Robotic abdomina cerclage to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Laparoscopic abdominal cerclage during pregnancy has been shown to be advantageous over laparotomy when comparing success rates and recognizing the well-known benefits of minimally invasive surgery, such as decreased blood loss, shorter hospital stay, decreased pain, and faster recovery time. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that facilitates less invasive procedures when compared to the open approach, and it has the advantages of 3-dimensional visualization and endowristed instrumentation when compared to traditional laparoscopy. Since the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, USA) was approved by the FDA for gynecologic procedures in 2005, there have been only a few robotic abdominal cerclages performed; the first robotic cerclage in India was performed by us at World Laparoscopy Hospital was in 2010.

Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac

This video demonstrates Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac and application of interceed which act as a mechanical adhesive barrier. Ablation/fulguration of ovarian tissue during laparoscopy isn't recommended. Surgical excision is the most common and effective treatment for endometriosis of the ovary (endometrioma cyst). Surgical removal at the time of laparoscopy has been shown to improve pain without damaging the ovaries. A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis. By laparoscopic surgery, it is also possible to remove cysts, implants, and scar tissue caused by endometriosis. Laparoscopy for endometriosis is a low-risk and minimally invasive procedure.

Intraperitoneal Onlay Mesh Repair of Inguinal Hernia

This video demonstrates Intraperitoneal Onlay Mesh Repair of Inguinal Hernia. Our study at World Laparoscopy hospital 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 recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However, the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Safe Way of Performing Laparoscopic Cholecystectomy

CBD injury is one of the most common injuries during laparoscopic cholecystectomy. It is very important to minimize CBD injury for a laparoscopic surgeon. This video demonstrates Safe Way of Performing Laparoscopic Cholecystectomy. The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. A safe cholecystectomy is one that is “safe for both the patient no bile duct/hollow viscus/vascular injury and for the operating surgeon no or minimal scope for litigation. In addition, a surgeon should be able to anticipate the operative difficulty based on various preoperative predictors, should adhere to basic principles of surgery including safe use of energy devices and use of fluorescence cholangiography using ICG. https://www.laparoscopyhospital.com/SERV01.HTM

Para-umbilical Hernia IPOM Repair

This video demonstrates laparoscopic repair of a paraumbilical hernia. 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. A paraumbilical or umbilical hernia is a common type of abdominal hernia. Paraumbilical hernias usually develop later in life and are often caused by acquired abdomen openings linked to intra-abdominal pressure from carrying excess body weight, ascites, cancer or other intra-abdominal malignancy, or multiple pregnancies. Hernias don't go away on their own. Only surgery can repair a hernia. Many people are able to delay surgery for months or even years but there is always a chance of incarceration. For more information: https://www.laparoscopyhospital.com/SERV01.HTM

Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility

This video demonstrates Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility. A laparoscopy, Hysteroscopy, and dye test is an operation to help find out why any female is having difficulty becoming pregnant. The dye test will show if your fallopian tubes are blocked. The laparoscopy will help find out if a patient has endometriosis, pelvic infection, adhesions, ovarian cysts or fibroids. Some minor treatments can be performed at the same time. A laparoscopy and dye test is usually performed under a general anesthetic. The operation usually takes about fifteen minutes. The gynecologist will make only two small cuts on the abdomen. Surgical instruments, along with a telescope will be introduced inside the abdomen to perform the operation. A gynecologist will inject a dye, which passes down the fallopian tubes. For more information: https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction

This Video demonstrates Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction. The prevalence of incisional hernia after laparotomy is reported to be between 11% and 20%,3,4 and incisional hernia recurrence after surgical repair is as high as 45%. Incisional hernias cause pain and other more serious problems, such as bowel obstruction, incarceration, and strangulation. After Laparoscopic Surgery these recurrences are very less.

Laparoscopic Repair of Recurrent Umbilical Hernia

This video demonstrates laparoscopic repair of Umbilical recurrent hernia. An umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised by the laparoscopic technique. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. We are performing at World Laparoscopy Hospital for more than 20 years. Laparoscopic umbilical hernia repair has been practiced at World Laparoscopy Hospital since the late 1990s. Newer bilayer prosthetic devices are designed for open intraperitoneal inlay placement. They have two sides, one is polypropylene and the other side is a non-adherent material to face viscera. Bilayer polypropylene or partially reabsorbable meshes have also been used for umbilical hernias. They comprised one sublay and one overlay patch with a connector to eliminate migration. However, clinical outcomes after repairs with these devices have not been widely documented.

Sleeve Gastrectomy Tips and Tricks

Laparoscopic sleeve gastrectomy (LSG) is becoming popular as a stand alone bariatric procedure for morbid obesity. The laparoscopic sleeve gastrectomy technique has evolved over the years towards standardization. Better standardization has minimized complications as leaks, stricture, and weight regain. Adequate posterior dissection up to the hiatus and the linear sleeve without a torque can be safely performed. The video presentation refers to the international consensus document on LSG as well as the expert panel consensus where our centre’s technique is shared. The video demonstrates step by step approach to a safe, standardized technique of LSG. https://www.laparoscopyhospital.com/bariatric-surgery.html

Ruptured Ectopic Pregnancy

This video demonstrates Laparoscopic management of Ruptured Ectopic Pregnancy. A ruptured ectopic pregnancy or tubal pregnancy is a surgical emergency in which a fertilized egg implants itself outside the uterus. Usually, an ectopic pregnancy is situated in one of the fallopian tubes. As it grows, it can cause the tube to tear or burst. This results in dangerous internal bleeding which may be fatal if immediate surgery is not being performed. Laparoscopic Surgery Offer a very good treatment of ruptured ectopic pregnancy. Salpingectomy can be performed to cure this ectopic pregnancy.

Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury

This video demonstrates Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury. Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of a female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a robotic adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. For more detail log on to: https://www.laparoscopyhospital.com/robotic-surgery.html

Robotic Myomectomy

Robotic myomectomy is a minimally invasive way for ROBOTIC surgeons to remove uterine fibroids. The DAVINCI ROBOT provides 7 degrees of freedom: 3 degrees provided by the robotic arms (insertion, pitch, yaw) and 4 degrees from the “wristed” instruments (pitch, yaw, roll, and grip). This improves dexterity and enables the DaVinci robotic surgeon to manipulate and dissect tissue in a delicate, controlled fashion. Robotic surgical technology used in uterine myoma improves efficiency, accuracy, ease, and comfort associated with the performance. Advantages of robotic myomectomy over conventional laparoscopy include the absence of tremor, a 3-dimensional image, superior instrument articulation, downscaling of movements, and comfort for the surgeon.

Laparoscopic Repair of Common bile duct (CBD) injury

Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury. In this video, We have demonstrated a method of repair on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this video with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques or by ICG.

https://www.laparoscopyhospital.com/

Intraperitoneal Onlay Mesh Repair of Inguinal Hernia

This video demonstrates Intraperitoneal Onlay Mesh Repair of Inguinal Hernia. Our study at World Laparoscopy hospital 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 recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However, the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Laparoscopic IPOM Inguinal Hernia Repair - Skin to Skin

This education video of IPOM is demonstrated in order to assess the feasibility of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair as an alternative method for inguinal hernia repair. All medical records were reviewed retrospectively. Mean operative time was 45 minutes, and mean postoperative hospital stay was 1 days. There were two cases of postoperative swelling at the groin area due to entrapment of CO2 and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. Even though laparoscopic Intraperitoneal Onlay Mesh Repair of Hernia which is popularly called as IPOM repair is not a preferred method for inguinal hernia, it can be applied as an alternative method in specific cases.

Uterine Manipulators

The uterine manipulators in use for various gynecological laparoscopic surgeries including laparoscopic hysterectomy or laparoscopic pelvic endometriosis have to achieve many different tasks in order to arrive at a safe and successful outcome in gynecological and pelvic surgery. The most obvious function of Uterine Manipulators is to suitably mobilize the uterus.

Da Vinci Robotic Hysterectomy

This video demonstrates Da Vinci Robotic Hysterectomy performed by Dr R K Mishra at World Laparoscopy Hospital. Vaginal hysterectomy removes the uterus through an incision in your vagina. Doctors perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision near the belly button. Recovery after robotic hysterectomy is shorter and less painful than after an abdominal hysterectomy. Full recovery might take three to four weeks. During robotic surgery, your doctor performs the hysterectomy with instruments that are passed through small abdominal cuts (incisions). The magnified, 3D view makes possible great precision, flexibility, and control.

Total Laparoscopic Hysterectomy for Very Large Uterus With Multiple Fibroid

In this video, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uterus weighing more than 9500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform an efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number, and location of the myomas. Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

First in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder & Appendix removed by Laparoscopy

This Video demonstrates First time in the World 3.5 Kg Fibroid, Ovarian Cyst, Gallbladder and Appendix removed by Laparoscopy in the Same Patient. The patient has torsion of Myoma giving severe pain, She had multiple episodes of appendicitis in the past. She had Cholelithiasis and one paraovarian cyst. All were removed by laparoscopy. The surgery took 6 hour time. Only 4 ports were used to remove all these pathologies. She was also having hydronephrosis due to the pressure of fibroid on the ureter.

Easiest Way of Performing Laparoscopic Inguinal Hernia Repair Using Less Expensive Mesh

This video demonstrates Laparoscopic Inguinal Hernia Repair with Cheaper Mesh. It has been clearly demonstrated in developed countries that the modern standard of care for inguinal hernia is mesh repair, either through an open repair, namely the Lichtenstein procedure. Compared to non-mesh repairs, the use of a mesh in inguinal hernia surgery provides better results in terms of recurrence and decreased early and late postoperative pain. However, the fact that mesh repairs are the modern standard procedures for inguinal hernia poses several issues in developing countries.

Safest Way to Perform Total Laparoscopic Hysterectomy with Bilateral Salpingo-oophorectomy

Risk-Reducing Bilateral Salpingo-oophorectomy: Surgery to remove both healthy fallopian tubes and both healthy ovaries. The surgery is done to reduce the risk of cancer. Salpingectomy: Surgery to remove one or both of the fallopian tubes. the side effects of laparoscopic hysterectomy? These risks include major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots. infection. anesthesia side effects. bowel blockage. The side effects of laparoscopic hysterectomy are major blood loss. damage to surrounding tissues, including the bladder, urethra, blood vessels, and nerves. blood clots...

Difficult Laparoscopic Cholecystectomy performed by Pledget Dissection of Calot's triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gall bladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.

Basic Demonstration of Da Vinci Robot - How Surgical Robot Works?

This video demonstrates the Basic Demonstration of Da Vinci Robot - How Surgical Robot Works? Compared to traditional techniques of open surgery and laparoscopic surgery, the very small incisions created by robotic surgery drastically reduce patients' time in the hospital and their risk of infections. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren't able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments.

Laparoscopic Hysterectomy By Ligation of Uterine Artery and Simultaneous Appendectomy

This video demonstrates Laparoscopic Hysterectomy By Ligation of Uterine Artery by Mishra's Knot and Vault Closure by Weston Knot. In this procedure, Appendectomy was also performed. Today, lap hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort, shorter hospital stay, rapid convalescence, and early return to the activities of daily living. Considerable technical advances in this procedure have occurred during the last few years. One of the best practice of performing laparoscopic hysterectomy is to ligate the uterine artery. The vascular supply of the uterus is mainly derived from the uterine and ovarian arteries. Because most blood enters the uterus through the uterine arteries, transient uterine ischemia occurs after uterine artery ligation. Bilateral uterine vessel ligation is an efficient method to obliterate the blood flow to the uterus.

Skin to Skin Laparoscopic Cholecystectomy in 4K

This video demonstrates Skin to Skin Laparoscopic Cholecystectomy using 4K Camera to improve vision. This year a '4K' laparoscopic system has become commercially available, so-named as it provides a high-resolution 2D image with four times the number of pixels of 2D full high definition. The improved visualization is likely to provide additional depth cues. It is currently unclear to what degree improving the resolution of 2D systems can compensate for binocular depth cues however in coming days 4K laparoscopy will be very popular. 4K UHD enables rich color reproducibility and provides suitable colors for each clinical discipline which uses the laparoscopic camera. Ultra High Definition camera system provides four times more information than conventional Full HD imaging systems.

Laparoscopic Removal of Posterior Cervical Fibroid

This video demonstrate Laparoscopic Myomectomy for Posterior Cervical Fibroid. Fibroid or Myomas are benign tumours composed partly of muscle and fibrous tissue. They seldom develop in the cervix, the lower part of the uterus as in this video. When posterior cervical fibroid grow, they are usually obliterating entire cul de sac. Cervical fibroids grow in the wall of the cervix and are difficult to remove without damaging the surrounding area. Most cervical myomas eventually cause symptoms of GIT or ureteric obstruction. The most common symptom may be irregular or heavy menstrual bleeding . Other symptoms include abdominal pain or pressure, changes in bladder and bowel patterns and, in some cases, infertility. Cervical myomas can block the flow of urine; women may have a hesitant start when urinating; dribble at the end of urination, and retain urine. Urinary tract infections are also more likely to develop. If cervical fibroids cause symptoms, they are surgically removed in a procedure called a Laparoscopic Myomectomy. After removal of fibroid suturing of the raw area is required. Depending upon the size of fibroid a long time is spend in morcellation of myoma. For more information log on to https://www.laparoscopyhospital.com/

Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Near Infrared Cholangiography

This video demonstrate Laparoscopic Cholecystectomy Full Length Skin to Skin Video with Infrared Cholangiography performed by Dr R K Mishra at World Laparoscopy Hospital. Infrared Cholegiography is performed by using Indocyanine Green during laparoscopic cholecystectomy surgery for gallbladder removal. 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 because of difficulties of doing it. Near Infrared Fluorescence Cholangiography (NIRF-C) is a novel non-invasive method for real-time, radiation free, intra-operative biliary mapping during laparoscopic cholecystectomy. We have experienced that NIRF-C is a safe and effective method for identifying biliary anatomy during laparoscopic cholecystectomy. Indocyanine green is a cyanine dye is very popular and used in for many years in medical diagnostics. It is used for determining cardiac output, hepatic function, liver and gastric blood flow, and for ophthalmic angiography. Now the use of this dye in lap chole has improved the safety of this surgery by NEAR INFRARED FLUORESCENT CHOLANGIOGRAPHY.

Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility

This video demonstrates Diagnostic Laparoscopy, Hysteroscopy and Dye Test for Infertility. A laparoscopy, Hysteroscopy, and dye test is an operation to help find out why any female is having difficulty becoming pregnant. The dye test will show if your fallopian tubes are blocked. The laparoscopy will help find out if a patient has endometriosis, pelvic infection, adhesions, ovarian cysts or fibroids. Some minor treatments can be performed at the same time. A laparoscopy and dye test is usually performed under a general anesthetic. The operation usually takes about fifteen minutes. The gynecologist will make only two small cuts on the abdomen. Surgical instruments, along with a telescope will be introduced inside the abdomen to perform the operation. A gynecologist will inject a dye, which passes down the fallopian tubes. For more information: https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Laparoscopic Ovarian Cystectomy - Aspiration with Transparent Needle

This video demonstrates laparoscopic ovarian cystectomy. An ovarian cystectomy is a laparoscopic surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgical technique that only uses a few small incisions in your lower abdomen. https://www.laparoscopyhospital.com/mmas.htm

Laparoscopic Surgery for Left Ovarian Dermoid Cyst

This video demonstrates Laparoscopic Surgery for Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.

Robotic Cerclage for Cervical insufficiency

Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We have demonstrated in this video Robotic abdomina cerclage to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Laparoscopic abdominal cerclage during pregnancy has been shown to be advantageous over laparotomy when comparing success rates and recognizing the well-known benefits of minimally invasive surgery, such as decreased blood loss, shorter hospital stay, decreased pain, and faster recovery time. Robot-assisted abdominal cerclage is a relatively new minimally invasive technique that facilitates less invasive procedures when compared to the open approach, and it has the advantages of 3-dimensional visualization and endowristed instrumentation when compared to traditional laparoscopy. Since the da Vinci surgical system (Intuitive Surgical, Sunnyvale, California, USA) was approved by the FDA for gynecologic procedures in 2005, there have been only a few robotic abdominal cerclages performed; the first robotic cerclage in India was performed by us at World Laparoscopy Hospital was in 2010.

Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh

This video demonstrates Laparoscopic Incisional Hernia Repair by IPOM Plus Technique and Titanized Mesh. For large incisional hernia repair, IPOM-Plus seems to be more effective than sIPOM in terms of reducing mesh bulging. Laparoscopic repair of hernia is the method of choice for all type of hernia. The laparoscopic repair of incarcerated incisional hernias is still debated in the literature. The recent EAES/EHS guidelines state that laparoscopic surgery is not contraindicated in most of the hernia and may be considered in selected patients with an incarcerated hernia. For more information: https://www.laparoscopyhospital.com/admission.php

Laparoscopic Repair of Recurrent Umbilical Hernia

This video demonstrates laparoscopic repair of Umbilical recurrent hernia. An umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised by the laparoscopic technique. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. We are performing at World Laparoscopy Hospital for more than 20 years. Laparoscopic umbilical hernia repair has been practiced at World Laparoscopy Hospital since the late 1990s. Newer bilayer prosthetic devices are designed for open intraperitoneal inlay placement. They have two sides, one is polypropylene and the other side is a non-adherent material to face viscera. Bilayer polypropylene or partially reabsorbable meshes have also been used for umbilical hernias. They comprised one sublay and one overlay patch with a connector to eliminate migration. However, clinical outcomes after repairs with these devices have not been widely documented.

How to Use Hysteroscopy Instruments?

This video demonstrate how to use various hysteroscopic instruments. Hysteroscopy is a procedure that allows us to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. The procedure can be either diagnostic or operative. Hysteroscopy is a procedure that allows gynecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent

This video demonstrate Skin to Skin Total Laparoscopic Hysterectomy with Infrared Ureteric Stent performed by Dr R K Mishra at World Laparoscopy Hospital. This is a must watch video for every one to see how nicely illuminated stent look. Despite the skepticism, potential advantages afforded by this minimal access technique motivated the development and evaluation of the laparoscope in an expanding number of surgical applications. Numerous technologic advances were critical to this evolution. During the first half of this century, the development of various lens systems and endoscopes was there. Recently use of Infrared imaging system in laparoscopy has revolutionized the way how we were looking at ureter in past. The infrared lighted ureteral stent or ureteric stent, is a thin tube inserted into the ureter to prevent or treat obstruction of the urine flow from the kidney. The length of the stents used in adult patients varies between 24 and 30 cm.

Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient

This video demonstrate Laparoscopic Appendectomy for Acute Appendicitis in Pediatric Patient. Laparoscopic technique seems to be safer than open appendectomy for acute appendicitis in children. The laparoscopic approach is most frequently used, except for young children. Superficial surgical site infections are more frequent after open surgery only in patients with complicated appendicitis. The normal appendix rate is low, most likely because of routine preoperative imaging.

Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy

This video demonstrates Step by Step demonstration of Inguinal Hernia Surgery by Laparoscopy performed by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic inguinal hernia repair is performed with general anesthesia. Two 5mm and one 10mm incision are made in the lower part of the abdomen. In laparoscopic inguinal hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the surgeon’s movements. The inguinal hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. While doing this, surgeons are careful to avoid injuring the nerves that are near the hernia that can cause chronic pain if injured, blood vessels that can bleed, or the vas deferens. The small incisions are closed with suturing that dissolve on their own over time. You should discuss all hernia repair options with your surgeon to determine which approach is best for you. The hernia is repaired by a different technique like TAPP, TEP or IPOM. The majority of patients undergoing elective or nonemergent groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.

Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury

This video demonstrates Robotic Roux-en-Y Hepaticojejunostomy in a Post-cholecystectomy Bile Duct Injury. Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of a female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a robotic adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. For more detail log on to: https://www.laparoscopyhospital.com/robotic-surgery.html

Ruptured Ectopic Pregnancy

This video demonstrates Laparoscopic management of Ruptured Ectopic Pregnancy. A ruptured ectopic pregnancy or tubal pregnancy is a surgical emergency in which a fertilized egg implants itself outside the uterus. Usually, an ectopic pregnancy is situated in one of the fallopian tubes. As it grows, it can cause the tube to tear or burst. This results in dangerous internal bleeding which may be fatal if immediate surgery is not being performed. Laparoscopic Surgery Offer a very good treatment of ruptured ectopic pregnancy. Salpingectomy can be performed to cure this ectopic pregnancy.

Robotic Reversal of Tubal Sterilization

This video demonstrates Robotic Reversal of Tubal Sterilization surgery performed by Dr R K Mishra at World Laparoscopy Hospital. Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalization) are not infrequent. The reversal procedure can be done either by open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach). Patients going through tubal reversal will go to the outpatient surgery center and have a small incision made through which your surgeon will repair your fallopian tubes. The surgery usually takes 1 hour to complete.

Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis (4 K Video)

This video demonstrates Laparoscopic Myomectomy for Posterior Wall Fibroid Uterus with Endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection. For more detail https://www.laparoscopyhospital.com/SERV01.HTM

Para-umbilical Hernia IPOM Repair

This video demonstrates laparoscopic repair of a paraumbilical hernia. 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. A paraumbilical or umbilical hernia is a common type of abdominal hernia. Paraumbilical hernias usually develop later in life and are often caused by acquired abdomen openings linked to intra-abdominal pressure from carrying excess body weight, ascites, cancer or other intra-abdominal malignancy, or multiple pregnancies. Hernias don't go away on their own. Only surgery can repair a hernia. Many people are able to delay surgery for months or even years but there is always a chance of incarceration. For more information: https://www.laparoscopyhospital.com/SERV01.HTM

Davinci Robotic Adhesiolysis Surgery with Application of Interceed

This video demonstrates Davinci Robotic Adhesiolysis Surgery with Application of Interceed performed by Dr R K Mishra at World Laparoscopy Hospital. Interceed(TC7) is a fabric mechanical adhesive barriar composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. Use of Interceed is evaluated Interceed(TC7) in a randomized, multicenter clinical study and proved to be effective. Peritoneal adhesions following pelvic and abdominal surgery are a frequent cause of intestinal obstruction, reduced fertility, and pelvic pain. In gynecology, adhesion formation at the vaginal cuff and pelvic sidewall frequently involves bowel, omentum, and adnexa. Davinci robotic surgery is very effective method of doing adhesiolysis.

Laparoscopic Port Closure or Fascial Closure Needles

This video demonstrates Laparoscopic Port Closure Needles explained by Dr. R K Mishra at World Laparoscopy Hospital. Fascial closure of port sites represents a challenging issue in laparoscopic surgery. We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation. New technical challenges have emerged since the introduction of the laparoscopic approach in surgery. One of these is fascial closure at port sites, which is necessary especially when large trocars are used or after dilation of a port site for organ extraction. New developments, such as single-port laparoscopic surgery, and the need for small esthetic incisions render fascial closure a current issue

Laparoscopic Hysterectomy with Ureteral Stent Placement

Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%. https://www.laparoscopyhospital.com/gynaecological-laparoscopy.html

Sleeve Gastrectomy with Hernia Repair

This video demonstrates laparoscopic sleeve gastrectomy together with hernia repair inpatient of morbid obesity. In morbidly obese patients with any hernia with or without GERD undergoing LSG, repair of the hernia helps in amelioration of morbidity due to hernia and prevents any new onset improving quality of life. Obesity is associated with multiple comorbidities including diabetes mellitus, hypertension, obstructive sleep apnoea and gastro-oesophageal reflux disease (GERD). Thus, the presence of any ventral hernia should not be considered as a contraindication for laparoscopic sleeve gastrectomy surgery and both the procedure can effectively be performed together.

How Harmonic Scalpel Works?

This video demonstrate Harmonic Scalpel presented by Dr R K Mishra. The Harmonic scalpel is basically an ultrasonic generator. Harmonic Scalpel is a surgical instrument used to simultaneously cut and coagulate tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue. Benefits of the Harmonic Scalpel. The Harmonic Scalpel's biggest advantage is the reduced bleeding and recovery time for the patient. Other advantages include the ability for a surgeon to make more precise cuts, and an overall reduction of lateral thermal tissue damage in comparison to other operating devices. A Harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation.

Safe Way of Performing Laparoscopic Cholecystectomy

CBD injury is one of the most common injuries during laparoscopic cholecystectomy. It is very important to minimize CBD injury for a laparoscopic surgeon. This video demonstrates Safe Way of Performing Laparoscopic Cholecystectomy. The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. A safe cholecystectomy is one that is “safe for both the patient no bile duct/hollow viscus/vascular injury and for the operating surgeon no or minimal scope for litigation. In addition, a surgeon should be able to anticipate the operative difficulty based on various preoperative predictors, should adhere to basic principles of surgery including safe use of energy devices and use of fluorescence cholangiography using ICG. https://www.laparoscopyhospital.com/SERV01.HTM

Laparoscopic Heller's Myotomy with Appendectomy

The Laparoscopic Heller myotomy is a laparoscopic (minimally invasive) surgical procedure used to treat achalasia. Achalasia is a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach. The Laparoscopic Heller myotomy is essentially an esophagomyotomy, the cutting the esophageal sphincter muscle, performed laparoscopically. The Laparoscopic Heller myotomy operation's success rate is very high and usually permanent. In the procedure of Laparoscopic Heller myotomy, several tiny incisions are made and a small scope inserted, through which miniature surgical instruments are passed. The scope is connected to a video camera which then sends a magnified image to a monitor, allowing the surgeon to envision the anatomy and manipulate the instruments. For more information https://www.laparoscopyhospital.com/SERV02.HTM

Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina

This video demonstrate Laparoscopic Hysterectomy and Cholecystectomy together with Removal of Gallbladder though Vagina. The average surgical time was 45 min for laparoscopic cholecystectomy and 15 min for hysterectomy and 30 min for hysterectomy. Total blood loss was approximately less than 50ml. Lesson for both, gynecologists and the surgeons, is to combine these two when required and possible. This provides maximum advantages through minimizing risk of anesthesia and time duration, hospital stay, cost-effectiveness.

Laparoscopic Hysterectomy And Appendectomy Using Illuminated Ureteral Stent Step Step Demonstration

This video demonstrate Total Laparoscopic Hysterectomy step by step using infrared ureter stent together with appendectomy. Combination procedure is very easy to perform by laparoscopy. Laparoscopic Hysterectomy remains a reasonable substitute for abdominal hysterectomy. Laparoscopic hysterectomy together with appendectomy is a cost-effective procedure when done with reusable instruments. Laparoscopic hysterectomy with ureteric stenting with infrared catheter is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and its adoption can decrease abdominal incision hysterectomies.

Robotic Myomectomy

Robotic myomectomy is a minimally invasive way for ROBOTIC surgeons to remove uterine fibroids. The DAVINCI ROBOT provides 7 degrees of freedom: 3 degrees provided by the robotic arms (insertion, pitch, yaw) and 4 degrees from the “wristed” instruments (pitch, yaw, roll, and grip). This improves dexterity and enables the DaVinci robotic surgeon to manipulate and dissect tissue in a delicate, controlled fashion. Robotic surgical technology used in uterine myoma improves efficiency, accuracy, ease, and comfort associated with the performance. Advantages of robotic myomectomy over conventional laparoscopy include the absence of tremor, a 3-dimensional image, superior instrument articulation, downscaling of movements, and comfort for the surgeon.

How Ligasure Works?

This video demonstrate how Ligasure works presented by Dr R K Mishra. Ligasure is a tissue responce generator. Across the range of products and procedures, LigaSure also called as vessel sealer is a technology which delivers a unique combination of pressure and energy to create a consistent seal with each application. Ligasure provides a combination of pressure and energy to create vessel fusion. Permanently fuses vessels up to and including 7 mm in diameter and tissue bundles without dissection or isolation Average seal cycle is 2 to 4 seconds. Ligasure seals withstand three times normal systolic blood pressure. Feedback-controlled response system automatically discontinues energy delivery when the seal cycle is complete, eliminating the guesswork.

Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac

This video demonstrates Laparoscopic Ablation and Fulguration of Endometriosis of Cul-De-Sac and application of interceed which act as a mechanical adhesive barrier. Ablation/fulguration of ovarian tissue during laparoscopy isn't recommended. Surgical excision is the most common and effective treatment for endometriosis of the ovary (endometrioma cyst). Surgical removal at the time of laparoscopy has been shown to improve pain without damaging the ovaries. A laparoscopy is a surgical procedure that may be used to diagnose and treat various conditions, including endometriosis. By laparoscopic surgery, it is also possible to remove cysts, implants, and scar tissue caused by endometriosis. Laparoscopy for endometriosis is a low-risk and minimally invasive procedure.

Laparoscopic Repair of Common bile duct (CBD) injury

Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury. In this video, We have demonstrated a method of repair on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this video with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries. Intraoperatively, CBD injury can be prevented in the case of short cystic duct with the use of a loop ligature or transfixing suture, and it can be diagnosed using intraoperative cholangiography or other visualization techniques or by ICG.

Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator

This video demonstrates Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. In this technique, the uterus was bound from the uterine corpus and fundus like a bridle with Myoma Screw, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 90% of cases. The mean application time was 30 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. For more information https://www.laparoscopyhospital.com/youtube/preview.php

TAPP Hernia Repair by Ipsilateral Port

This video demonstrate TAPP (Transabdominal Preperitoneal Inguinal Hernia) Repair by Ipsilateral Port. The indications for laparoscopic inguinal hernia repair, TAPP or TEP, are the same for open inguinal hernia repair. They may be ideal for bilateral inguinal hernias and recurrences from anterior approaches but is also appropriate with unilateral primary hernias when the surgeon is comfortable with the technique. For young, active males with primary hernias, it may ofter decrease pain and an earlier return to activity. Prior to lower abdominal surgery or pelvic radiation is strong relative contraindications, as these may make access to the preperitoneal space difficult. The hernia is visualized, and the peritoneum overlying it incised sharply. Blunt dissection can be used to peel the peritoneal flaps inferiorly, exposing the inferior epigastric vessels, the pubic symphysis and the Cooper’s ligament, and the iliopubic tract. A direct hernia should be reduced if seen, and an indirect dissected from the cord structures. Femoral and obturator hernias can also be visualized and reduced. Care is taken to avoid the “Triangle of Doom” containing the external iliac vessels bordered by the vas deferens medially and the gonadal vessels laterally. A mesh ranging from 10 to 15 cm in diameter of polypropylene or polyester is introduced through the optical trocar and positioned anterior along the pelvic wall with the center over of the primary hernia defect. For more detail log on to https://www.laparoscopyhospital.com/youtube/preview.php

Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy

This Video demonstrates right sided Salpingo Oophorectomy with Appendectomy and Extraction Through Colpotomy. Prophylactic removal of the appendix during a benign gynecologic procedure is known as an elective incidental laparoscopic appendectomy. Incidental appendectomy at the time of cesarean delivery was reported initially in 1959. Subsequent studies of removal of a normal-appearing appendix at the time of gynecologic surgery have met with considerable debate. Proponents argue that the removal of the appendix at the time of abdominal hysterectomy does not increase operative time or postoperative morbidity. More important, it does prevent future appendicitis. Advantages of incidental appendectomy include technical ease, low patient morbidity and mortality, and significant diagnostic and protective value. It also prevents conflicting diagnoses, especially in patients who have chronic pelvic pain, a ruptured ovarian cyst, or endometriosis. Other patients likely to benefit from elective incidental appendectomy are those who are undergoing abdominal radiation or chemotherapy, women unable to communicate health complaints, and those who are planning to undergo complex abdominal or pelvic procedures that are likely to cause extensive adhesions.

Robotic Sleeve Gastrectomy Surgery

This Video demonstrate Robotic Sleeve Gastrectomy performed by Dr R K Mishra at World Laparoscopy Hospital for a 43 BMI morbid obese patient. World Laparoscopy Hospital is first private hospital of India to start robotic surgery. Robotic Sleeve Gastrectomy also called RSG is very popular surgery all over World. Open sleeve gastrectomy surgery took significantly longer than the laparoscopic technique; whereas robotic sleeves elicited fewer complications. There was no significant difference in hospital length of stay between laparoscopic or robotic techniques.

Sleeve Gastrectomy Tips and Tricks

Laparoscopic sleeve gastrectomy (LSG) is becoming popular as a stand alone bariatric procedure for morbid obesity. The laparoscopic sleeve gastrectomy technique has evolved over the years towards standardization. Better standardization has minimized complications as leaks, stricture, and weight regain. Adequate posterior dissection up to the hiatus and the linear sleeve without a torque can be safely performed. The video presentation refers to the international consensus document on LSG as well as the expert panel consensus where our centre’s technique is shared. The video demonstrates step by step approach to a safe, standardized technique of LSG. https://www.laparoscopyhospital.com/bariatric-surgery.html

Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction

This Video demonstrates Recurrent Incisional Hernia with Severe Small Bowel Adhesion with Subacute Obstruction. The prevalence of incisional hernia after laparotomy is reported to be between 11% and 20%,3,4 and incisional hernia recurrence after surgical repair is as high as 45%. Incisional hernias cause pain and other more serious problems, such as bowel obstruction, incarceration, and strangulation. After Laparoscopic Surgery these recurrences are very less.

Laparoscopic Inguinal Hernia Repair in Female

A groin hernia is relatively uncommon in females. The laparoscopic surgery is an attractive approach in female groin hernia repair as it offers reduced surgical trauma, faster recovery and it has the added advantage of intra-operative diagnosis and treatment of incidental synchronous hernia which are mostly femoral hernia. TAPP approach can be identified as the preferred surgical modality for groin hernia repair in females due to low complication rate and recurrence and concurrently help in diagnoses of missed hernia.

Laparoscopic Myomectomy and Ovarian Cystectomy for Multiple Myomas and Paraovarian Cyst

Laparoscopic Ovarian cystectomy and Laparoscopic myomectomy are the two most frequently performed gynecologic operations in reproductive-age women. Benign ovarian cysts mostly occur in reproductive-age women, for whom it is important to have the majority of the ovarian tissue preserved after laparoscopic surgery. In order to preserve the maximum ovarian reserve, laparoscopic ovarian cystectomy is generally preferred. The lifetime incidence of uterine myoma is approximately 20% to 25%, and it is the most common benign tumor in reproductive-age women. Laparoscopic Surgery is performed on women who suffer from menorrhagia, dysmenorrhea, or increase in the size of the fibroid. The utility of laparoscopic myomectomy has been well established among symptomatic reproductive-age women with myoma, and previous studies have found no difference in the duration of surgery, the amount of blood loss during surgery, or the incidence of postoperative adhesion in comparison with open surgery. Likewise, no difference was found between laparoscopic myomectomy or open myomectomy in the rate of postoperative uterine rupture. In infertile patients, myomectomy has been shown to lead to a significant improvement in the pregnancy rate. Currently, single-port access (SPA) laparoscopic myomectomy is performed as a minimally invasive surgical technique. SPA laparoscopic surgery is superior to multi-port laparoscopic surgery in terms of cosmetic outcomes and postoperative pain relief and recovery, but due to the difficulty in the suture technique, hemostasis is more challenging and it generally is more time-consuming.

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