MAJOR
PROCEDURES
Partial Nephrectomy
Renal preservation is the call of the day. For smaller tumours (<4cm) and in some patients with bigger tumours having diabetes /hypertension/single kidney/diseased opposite kidney, the whole of the affected kidney is not removed - only the tumour along with a margin of normal tissue is removed. Partial nephrectomy has almost equal cure rates as radical nephrectomy; moreover it significantly decreases the chance of developing renal failure in the long run.
Laparoscopic Radical Nephrectomy
This life saving operation is done in patients having relatively big tumours of the kidney. The affected kidney along with the tumour is taken out. Mostly the operation is done laparoscopically through 4 small holes in the abdomen. This has cure rates equal to open surgery, along with the advantage of short hospital stay (4-5 days) and early return to normal life.
Trans-Urethral Resection of the Prostate (TURP)
More than half of men above 60 years have prostatic enlargement with associated symptoms of difficulties starting urination/ frequent need to urinate/ difficulty emptying the bladder fully. Patients who do not improve with medical treatment needs surgery. TURP, popularly known as the KEY HOLE SURGERY/ MICROSURGERY of Prostate, is basically a NO HOLE surgery. A special instrument called Resectoscope along with a telescope is introduced into the urinary bladder through patient's urethra (Urinary passage). The prostate is cut into small- small pieces and is taken out of the body through the same passage. During this operation the patient is usually fully awake and can enjoy the whole operation in the monitor. The patient is discharged home after 3-4 days. Mostly the patients are fit for normal daily activities within a month.
Radical Prostatectomy
This operation is done in males having localised prostate cancer. The whole of the prostate along with its capsule is removed. If done in properly selected cases the patient is cured for life. Mostly the patients have good urinary control and they are sexually active too!
Buccal Mucosal Graft Urethroplasty
This operation is done in patients who has urethral stricture (blockade in the urethra) because of infection / inflammation of the urethra. The diseased portion of the urethra is either incised or excised and is replaced by buccal mucosa taken from the inner side of the cheek. It is a very complex reconstructive operation, but if done properly it gives excellent and long lasting result.
Per Cutaneous Nephro Lithotomy (PCNL)
Gone are the days when all the kidney stones had to be taken out by open surgery with long scars and prolonged convalescence. We urologists are treating most kidney stones by a KEY HOLE Surgery called PERCUTANEOUS NEPHRO LITHOTOMY (PCNL). A small hole of a centimetre diameter is made on the kidney through the back, a nephroscope is passed into the kidney and stones are broken into pieces with a lithotripter and taken out. Recently we are doing MINI PCNL with a smaller nephroscope, resulting in a hole in the kidney of the size of a pencil! The stone clearance is as good as open surgery and sometimes even better! The patient goes home after 3-4 days and is fit for normal activities within 3-4 weeks.
Trans-Urethral Resection of Bladder Tumor (TURBT)
This operation is done for early stage urinary bladder tumours. This operation is done through the urethra (as in TURP) without making any cut/hole in patient's body. Patient is discharged home after 2-3 days. If done properly in the early stage the patient is fully curable. But the patient has to be under strict follow-up of the Urologist withperiodic cystoscopic check-up depending on the tumour pathology.
Urethral Sling Surgery for Urinary Incontinence
About four million women around the world are affected by Stress Urinary Incontinence. Coughing, sneezing, laughing, exercise or heavy lifting is accompanied by involuntary leakage of urine. It is commonly associated with aging but can also affect women of all ages. Tension free Vaginal Tape- Obturator (TVT-O) is the newest and safest minimally invasive procedure with an 85%- 90% success rate in treating SUI. A small incision is made in the vagina and the permanent tape is introduced via the vagina to sit under the urethra. The tape is positioned without tension under the urethra and acts as a 'backboard' to support the urethral continence mechanism (sphincter) when coughing. Most women are able to be as active as they like after the placement of a trans-obturator tape.
Radical Cystectomy with
Neo-Bladder Formation
Some patients have urinary bladder cancer that has invaded the bladder wall, having propensity for rapid spread outside the bladder. In these patients the whole of the bladder along with the prostate is removed. A new urinary bladder (Neobladder) is made using patients intestine and the patient passes urine through his native urethra like before. It is a long and complex operation but with good cure rate if done in the right time.
Uretero Renoscopy with lithotripsy (URSL)
This microsurgery is done in patients having a stone lodged in the Ureter (the urine pipe connecting the kidney and urinary bladder). A fine ureteroscope is passed into the ureter through the urethra, stones are broken with a lithotripter. Patient can go home on the same day or the next day, and is fit for normal daily activity within a couple of days
Flexible URSL with
Laser Lithotripsy
This is done in patients having small stones in the peripheral calyces of kidney. A flexible (bendable) URS is passed into the desired calyx through the ureter and stone is pulverised using LASER energy. With this technique multiple small stones in multiple calyces can be cleared in a single operation without making any hole in the kidney!
Pyeloplasty
This reconstructive surgery is done in patients who have obstruction at the pelvi-uereteric junction (junction between the kidney and ureter). This condition is usually congenital but can manifest at any age. The diseased part is removed and kidney pelvis is anastomosed to the ureter creating an unobstructed passage. This can be done both by open surgery and laparoscopically with excellent results.