Procedures

CARDIOLOGY

Angiography
Angiography is a Diagnostic Test done under Fluoroscopy to determine the blockage in the Coronary or Peripheral Arteries. A radio-opaque agent is injected an the body and fluoroscope takes running images of the flow of that agent to determine the blockages. It is a 5-10 minute procedure done under Local Anesthesia.

Balloon Angioplasty
Balloon angioplasty of the coronary artery, or PercutaneousTransluminal coronary angioplasty (PTCA), was introduced in the late 1970’s. PTCA is a non-surgical procedure that relieves narrowing and obstruction of the arteries to the muscle of the heart (coronary arteries). This allows more blood and oxygen to be delivered to the heart muscle. Percutaneous coronary intervention is accomplished with a small balloon catheter inserted into an artery in the groin or arm, and advanced to the narrowing in the coronary artery. The balloon is then inflated to enlarge the narrowing in the artery. A stent is also now inserted the same way as the Balloon Catheter and expanded to the walls of the artery. Percutaneous Coronary Intervention (PCI or PTCA) can relieve chest pain of angina, improve the prognosis of individuals with unstable angina, and minimize or stop a heart attack without having the patient undergo Open Heart coronary artery bypass graft (CABG) surgery.

Time Taken : 1-2 hours or more depending on condition and number of arteries to be opened.
Duration of Hospital Stay: 1-3 days after procedure.

HEART VALVE SURGERY

There are four valves in your heart:

  • Aortic valve
  • Mitral valve
  • Tricuspid valve
  • Pulmonary valve
Heart valve surgery is used to repair or replace diseased heart valves.Blood that flows between different chambers of your heart must flow through a heart valve.Blood that flows out of your heart into large arteries must flow through a heart valve.These valves open up enough so that blood can flow through.
They then close, keeping blood from flowing backward.
Time Taken: 3-4 hours
Duration of Hospital Stay: 1 week.

PACE MAKER IMPLANTATION (PPI)
A Pace Maker is implanted on the upper portion of the chest with its leads going in various chambers of heart. This is done to correct various kinds of Arrhythmias such as Brady (Slow Heart Rate) and Tachy (Very High Heart Rate) Arrhythmias.A Cardiac Pace Maker is a battery operated programmable electronic device, which is designed to deliver pulse to the heart at a programmed rate, thereby maintaining a healthy heart rhythm on those occasions when the heart rate is too low or too high.
Time Taken: 1-3 hours depending on kind of device implanted
Duration of Hospital Stay: Normally 2-4 days post implant.

HEART TRANSPLANT
A Heart Transplant is done a patient with end stage heart failure or very severe Coronary Artery Disease. A brain dead donor or recently deceased person’s heart is removed and implanted in to the patient after doing several blood and tissue matching to ensure least rejections.There is a large waiting period for the Heart Transplants and the donors are very few. The concept of organ donation after death (cadaver donor) is picking up in India and will still take some more years that the relatives of the deceased would voluntarily come forward for donation to save many lives.
Time Taken: Not fixed,
Duration of Hospital Stay: Not Fixed

Partial Knee replacement and Total Knee replacement
When you have a total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a man-made surface of metal and plastic. In a partial knee replacement, the surgeon only replaces one part of your knee joint. The surgery can cause scarring, blood clots and, rarely, infections and in Total Knee Replacement, the whole joint is replaced.

Both the knees can also be replaced simultaneously, the process thus known as Bilateral Knee Replacement.

Total Hip Replacement
Total hip replacement surgery replaces the upper end of the thighbone (femur) with a metal ball and resurfaces the hip socket in the pelvic bone with a metal shell and plastic liner. Total hip replacement surgery replaces damaged cartilage with new joint material in a step-by-step process.

The Hip Resurfacing

In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement Spinal Disc Replacement

Spinal Disc Replacement
The use of an artificial disc to replace a damaged spinal disc that is generating chronic back pain. There are a wide variety of new products, procedures and techniques currently in development to enhance spine surgery, and many spine surgeons believe that artificial disc technology holds real promise for significantly improving the standard of care for many patients.

Spinal Fusion
Spinal fusion is surgery to join together two bones (vertebrae) in the spine. Fusion permanently joins two bones together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Other Orthopedic Treatments

  • Abnormal curvature of the spine (Scoliosis)
  • Injury to spinal vertebrae
  • Slipped disc
  • Weak or unstable spine caused by Infections or tumors
  • Spinal stenosis
  • Spinal Tumors
  • Herniated Disc

ORGAN TRANSPLANT

Kidney Transplant Specialist India

A Kidney Transplant is required by a patient who is suffering from End Stage Renal Disease. End-stage renal disease is the name for kidney failure so advanced that it cannot be reversed . The kidneys in irreversible renal failure function so poorly that they can no longer perform their function and keep the patient alive.

End-stage renal disease cannot be treated with conventional medical treatments such as drugs. There are only two kinds of treatments possible, Dialysis and Kidney Transplant.

  • Dialysis is the method of artificially filtering the blood. People who require dialysis are required to take it periodically and regularly and are generally confined to the home because of their dialysis schedule, fragile health, or both.
  • Kidney transplantation means replacement of at least one of the the failed kidneys with a working kidney from another person, called a donor. Many people who receive a kidney transplant are able to live a similar quality of life as they did before they reached end stage renal disease.
A donor is carefully chosen by the surgeons by matching Tissue and Blood so that the chances of acceptance are higher and the risk to the donor’s life is minimal.Various hospitals now do Kidney Transplants. Removal of the donors kidney is also now done with Robotic Arm in the few hospitals that have this facility.

Liver Transplant Specialist India
Liver transplantation is the replacement of a diseased liver with a healthy liver allograft, in which the native liver is removed and replaced by the donor organ in the same anatomic location as the original liver.Liver Transplant is often recommended as an option when other modes of treatment are not successful. The purpose is to replace your diseased liver with a healthy liver. Ideally, after a transplant the patient will be free from disease, and lead a fairly normal life as long as the transplant functions.Liver transplantation nowadays is a well-accepted treatment option for end-stage liver disease and acute liver failure. Typically three surgeons and one anesthesiologist are involved, with up to four supporting nurses. The surgical procedure is very demanding and ranges from 4 to 18 hours depending on outcome. Numerous anastomoses and sutures, and many disconnections and reconnections of abdominal and hepatic tissue, must be made for the transplant to succeed, requiring an eligible recipient and a well-calibrated liver or cadaveric donor match.There are three options for liver transplantation:

  • Cadaver donor transplantation.
  • Living donor transplantation
  • Auxiliary transplantation.
Cadaver donor:
The donor liver is obtained from a person who is diagnosed as brain dead, whose family volunteers to donate the organ for transplantation. People who receive cadaver donors wait on the institutional / regional list until a suitable donor becomes available. The waiting times vary.Living donor: A healthy family member, usually a parent, sibling, or child, or someone emotionally close to you, such as a spouse, volunteers to donate part of their liver for transplantation. The donor is carefully evaluated by the team to ensure that no harm comes to the donor or recipient.

Auxiliary transplantation:
Part of the liver of a healthy adult donor (living or cadaver) is transplanted into the recipient. The patient’s diseased liver remains intact until the auxiliary piece regenerates and assumes function. The diseased liver may then be removed. This technique is rarely used now.

Cornea Transplant Specialist India
The cornea is the clear layer on the front of the eye. A corneal transplant is surgery to replace the cornea with tissue from a donor. It is one of the most common transplants done.Injury, infection, genetic diseases and malnutrition can affect the functioning of the cornea. The cornea becomes cloudy or warped due to disease, injury or infection. A damaged cornea distorts light as it enters the eye causing decreased vision. This kind of visual impairment is called corneal blindness. This is the only type of visual impairment that can be treated by corneal transplantation.Corneal transplantation or corneal grafting, is a surgical procedure where the damaged cornea is replaced by donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft is taken from a recently deceased individual with no known diseases or other factors that may affect the viability of the donated tissue or the health of the recipient.The surgical procedure is performed by ophthalmologist, medical doctors who specialize in eyes, and is often done on an outpatient basis.

Bone Marrow Transplants Specialist India
Bone Marrow Transplantation is a form of intensive treatment used to treat certain cancers like leukemia, lymphomas and some non-cancerous diseases like thalassaemia.Bone marrow is found inside our bones, and is the ‘factory’ that makes blood. It is responsible for producing white blood cells (to protect against infection), red blood cells (to carry oxygen around the body) and platelets (to prevent bleeding). Stem cells are blood cells at their earliest stage of development in the bone marrow, before they have become committed to developing into white cells, red cells or platelets. It is these ‘mother’ cells, which are the key factors in transplantation.There are two main types of transplants – Autologous and Allogenic.
  • Autologous Transplants: This means that the bone marrow or stem cells used for the transplant are one’s own. A little bit of the patient’s bone marrow or stem cells is taken and stored before high dose treatment. When the treatment is over, the bone marrow or stem cells are given back through a vein.
  • Allogeneic Transplants: In this type of transplant, bone marrow donated by someone else is used. It is essential that the donor’s tissue match. The most suitable donor is usually a close relative, most commonly a brother or sister. It is possible to get a good match from an unrelated donor, but this facility does not exist in India.
Heart Transplant Specialist India
A Heart Transplant is done a patient with end stage heart failure or very severe Coronary Artery Disease. A brain dead donor or recently deceased person’s heart is removed and implanted in to the patient after doing several blood and tissue matching to ensure least rejections.There is a large waiting period for the Heart Transplants and the donors are very few. The concept of organ donation after death (cadaver donor) is picking up in India and will still take some more years that the relatives of the deceased would voluntarily come forward for donation to save many lives.

CANCER TREATMENTS

Radio Therapy
Radio Therapy or Radiation Therapy refers to the treatment of cancer through Ionizing Radiation to kill or contain the malignant cancer cells. It is generally useful in containing the growth of malignant cells and may also be used as curative treatment of Cancer.The Hospitals are equipped with latest machines and equipments to impart radiation therapy. The equipments such as Linear Accelerators and various kinds of CT and MRI machines are used to impart Radiation.The various machines that are used as of now for radiation therapy are.
  • Conventional Linear Accelerators
  • Gamma Knife
  • Cyber Knife
  • Novalis
All of these above equipments have their own advantages n terms of treating various Cancers.

Chemotherapy
t is a kind of Cancer treatment, which by injecting certain Antineoplastic drugs in the body, can kill cancer cells. An Oncologist would decide the kind of drug to be used for Chemotherapy and its duration. It is a useful treatment and is used in treating various kinds of Cancers.The conventional Chemotherapy has known side effects and now there are newer drugs, which directly act against the abnormal proteins in the cancer cells. This is called Targeted Chemotherapy Treatment.

Bone Marrow Transplants
Bone Marrow Transplantation is a form of intensive treatment used to treat certain cancers like leukemia, lymphomas and some non-cancerous diseases like thalassaemia.Bone marrow is found inside our bones, and is the ‘factory’ that makes blood. It is responsible for producing white blood cells (to protect against infection), red blood cells (to carry oxygen around the body) and platelets (to prevent bleeding). Stem cells are blood cells at their earliest stage of development in the bone marrow, before they have become committed to developing into white cells, red cells or platelets. It is these ‘mother’ cells, which are the key factors in transplantation.There are two main types of transplants – Autologous and Allogenic.

  • Autologous Transplants: This means that the bone marrow or stem cells used for the transplant are one’s own. A little bit of the patient’s bone marrow or stem cells is taken and stored before high dose treatment. When the treatment is over, the bone marrow or stem cells are given back through a vein.
  • Allogeneic Transplants: In this type of transplant, bone marrow donated by someone else is used. It is essential that the donor’s tissue match. The most suitable donor is usually a close relative, most commonly a brother or sister. It is possible to get a good match from an unrelated donor, but this facility does not exist in India.

BARIATRIC SURGERY

Bariatric surgery commonly known as weight-loss surgery is done on patients who are extremely obese and would not achieve weight loss through conventional diet plans or exercise.

In this surgery, a Gastric Band is implanted on the stomach to reduce its size or a portion of stomach is removed surgically or by resecting and re-routing the small intestines to a small stomach pouch (Gastric Bye Pass Surgery).

Bariatric surgery is usually considered for patients who have BMI of over 40kg/m2 and have not responded to the diet and exercise plan and are also suffering from other cardio vascular risk factors.

The long term results have shown these kind of surgeries to be helpful in weight loss and recovery from diabetes and other such cardiovascular risks.

These surgeries are now very simple surgeries and usually done laproscopically.

COSMETIC SURGERY

Cosmetic Surgeries
Cosmetic surgery itself is a huge subject and a lot of surgeries come under its purview.The following corrections or surgeries are performed.
  • Hair Transplant
  • Laser Hair Removal
  • Nose Correction
  • Brow Lift Eyelid Correction
  • Face Lift
  • Lips Correction
  • Breast Augmentation
  • Breast Upliftment
  • Breast Reduction
  • Liposuction

ROBOTIC SURGERIES

As the name suggests, Robotic surgeries are Computer-Assisted Surgeries that are performed by a computer assisted robotic arm and are generally perceived to be having much more precision than the normal surgeries and are definitely less invasive.This technology thrived on the fact that it overcame the limitations of otherwise minimally invasive surgeries and enhance the capability of surgeon. In the case of robotically assisted minimally invasive surgery, instead of directly moving the instruments, the surgeon uses a computer assisted remote manipulator that allows the surgeon to perform the normal movements associated with the surgery whilst the robotic arm carry out those movements. One advantage of using the computerized method is that the surgeon does not have to be present, indeed the surgeon could be anywhere in the world, leading to the possibility for remote surgeries.Below are mentioned a few kinds of surgeries where Robotic surgeries have found to be very useful.

Robotic Heart Surgeries
Heart surgeons perform minimally invasive robotic heart surgery, using state-of-the-art technology. The da Vinci® Surgical System uses robotic instrumentation and a second technology called port access, leading to greater benefits for patients, compared to those offered by open heart surgery.These benefits have been stated previously but include:

  • Shorter hospital stay
  • Less pain and scarring
  • Less risk of wound infections
  • Less blood loss and fewer transfusions
  • Faster recovery
  • Quicker return to normal activities and lifestyles
The reason that these minimally invasive procedures and techniques are so attractive to our heart surgeons and patients is that these surgeries do not require an opening of the chest with an eight to twelve inch incision. These minimally invasive procedures can be used to treat a variety of heart conditions, including mitral valve prolapse, atrialseptal defect, atrialmyxoma and thrombi, coronary artery disease, and cardiac and thoracic tumors.

Robotic Radical Prostectomy

Robotic assisted laparoscopic radical prostatectomy is a minimally invasive form of surgery to remove the prostate. This operation is performed as a local treatment for men with prostate cancer.The surgery is performed through several small incisions in the front of the abdominal wall. This allows access to the prostate which is located deep in the pelvis, below the bladder and on top of the pelvic floor. Through these small incisions ports (or thin tubes) are inserted through which specialised instruments are placed. These instruments are then controlled in a delicate fashion by the surgeon who sits at a consol adjacent to the operating table.

Robotic Organ Transplantation
A Da-Vinci robot was used to perform the surgery with doctors stating that the robot is usually used in kidney, heart and gynecological operationsRobotic surgery can be defined as a minimally invasive and unmanned surgery where a robot performs the surgery and the system is controlled by a surgeon. In this surgery, the system is controlled from a console by a surgeon who sits comfortably and operates while viewing an image of the patient’s body interior through a highly magnified 3D system. The surgeon with the help of master controls that functions like forceps conducts operations, as well as controls some parts of the instruments by using one or two methods.

COCHLEAR IMPLANT

In few patients who have almost lost their hearing ability or are profoundly deaf, an electronic device can be surgically implanted that provides a sense of sound. This device implant is called Cochlear Implant (CI) or also known as Bionic Ear.

The deafness or severe loss of hearing which is generally caused by some accident or damage to the sensory hair cells in cochlea can be improved by Cochlear Implants In those patients, they can often enable sufficient hearing to allow better understanding of speech.

The quality of sound is different from natural hearing, with less sound information being received and processed by the brain. However, many patients are able to hear and understand speech and environmental sounds.

Over the last few years the devices have improved a lot and the newer devices and processing algorithms and software strategies have produced better quality of sound specially in noise and patients can now even enjoy music, and even use their implant processors while swimming.

The high cost of the implant and post implant therapy is a detriment in the extensive usage of such procedures. But we can see a few patients who have also bilateral Cochlear Implants suggesting implants in both the ears. The ENT specialist after doing series of test on the profound deaf patients identify the right candidate for such implants.

IVF TREATMENT

IVF Treatment/ Surrogacy
IVF or In Vitro Fertilization is a process in which an egg is fertilized by a sperm outside the body. This treatment option is for those in whom all other methods of assistive reproductive techniques have failed.

Woman’s natural cycle is monitored to collect eggs for fertilization. The eggs are fertilized with human sperms in a controlled environment and the fertilized egg is planted in the patient’s uterus to obtain a successful pregnancy.

If the first cycle of IVF does not succeed there could be a few more IVF cycles performed to achieve sustainable pregnancy. At times, the patient’s body does not retain pregnancy then a surrogate mother could be sought, who bears the egg of the patient fertilized by her partner’s sperm.

Surrogacy is an arrangement between a woman and a couple or individual to carry and deliver a baby. Women or couples who choose surrogacy often do so because they are unable to conceive due to a missing or abnormal uterus, have experienced multiple pregnancy losses, or have had multiple in vitro fertilization attempts that have failed. The advantage of gestational surrogacy to the parents is that the embryo is created from the woman’s egg and the man’s sperm, so it is biologically theirs.

The patient’s family along with them can bring a surrogate mother OR more popularly a surrogate is taken from the place of treatment. The success rate of IVF treatment usually varies between 40-60%, however these are just estimates. The doctor can only give a closer estimate after physical examination.

The IVF for Gay Couples/ single mothers is also gaining popularity and such options can also be looked into.