Short Stay Surgeries for Urology Procedures
Saturday, January 16, 2010
The various procedures which can be done on the Short Stay basis for Urology are
Cystoscopy
This is a diagnostic procedure to check the Urethra and the Bladder. A small telescope ( Cystoscope ) is passed through the urinary pipe to have a look as well as carry out any procedures such as treating the Urethral Stricture, removal of small Bladder Tumours, removing any small stones in the Bladder. The insertion or removal of the Double 'J' stents can also be done during this procedure.
Lower Ureteric Stones:
The stones in the lower part of the Ureter can be treated on a Short stay basis. After passing the Ureteroscope, the stones can be broken by the Lithotripsy and extracted with the help of the Basket. A Double 'J' stent may be inserted after the procedure, which will be removed at the later date.
Varicocele:
The dilatation of the veins around the Testes is called Varicocele. It can cause pain and discomfort in the scrotum. The other significant effect of Varicocele is on the Male Infertility. The ligation of Varicocele is carried out as a Day-Case procedure involving two small cuts in the groins and carefully ligating the dilated veins with the help of a microscope.
Circumcision, Vasectomy
These are the other procedures ideally suitable on a short stay basis. There is minimum disturbance in the patient's routine and they can get back to work quickly.
Short Stay Procedures : Make your Hospital Stay Short
After a surgery, hospital stay often becomes a tedious task for the patient and his visitors. Not only does it take the patient time to adjust to his new surroundings, it is often noted as a discomfort. Every surgery has its own healing time and requires the patient to rest adequately before he can be sent home. However, there are some surgeries where the patient is operated and sent home that very same day!
Short Stay Surgery has been defined by the Royal College of Surgeons as when the surgical day case patient is admitted for investigation or operation on a planned non-resident basis and who nonetheless requires facilities for recovery.
This definition excludes upper and lower GI endoscopies, outpatient procedures such as flexible cystoscopy, and minor superficial surgery under local anaesthetic, none of which require full day case facilities for recovery. Currently the Short Stay Surgery has a specialized dedicated team, functioning only at Cunningham Road, Bangalore.
Some of the Short Stay Surgery Procedures
1. Orchidopexy
2. Circumcision
3. Inguinal hernia repair
4. Excision of breast lump
5. Anal fissure dilatation or excision
6. Haemorrhoidectomy
7. Laparoscopic cholecystectomy
8. Varicose vein stripping or ligation
9. Transurethral resection of bladder tumour
10. Excision of dupuytren's contracture
11. Carpal tunnel decompression
12. Excision of ganglion
13. Arthroscopy
14. Bunion operations
15. Removal of metalware
16. Extraction of cataract with/without implant
17. Correction of squint
18. Myringotomy
19. Tonsillectomy
20. Sub Mucous resection
21. Reduction of nasal fracture
22. Operation for bat ears
23. Dilatation and curettage/hysteroscopy
24. Laparoscopy
25. Termination of Pregnancy
Benefits of Short Stay Surgery
1. Pre-booked date and less likely to be cancelled
2. Shorter waiting lists and lesser uncertainty of a long wait
3. Easier domestic arrangements
4. Earlier mobilisation
5. Minimal disruption of patient's personal life
6. Earlier return to normal environment
7. Reduced risk of cross-infection
8. Avoidance of disruptive nights in hospital wards
9. Less loss of time at work
10. Less psychological disturbances in children
11. Lesser chances of cancellation due to pressures of emergency surgeries in a dedicated day care facility.
To find out if you are a candidate for short stay surgery, pls email enquiries@wockhardthospitals.net or sms short to 56767
32 year old Rwandan gets a new lease of life in India
Friday, January 8, 2010
~Martin undergoes a rare cardiac surgery at Wockhardt Hospitals Mulund-Now a network of Fortis~
A team of cardiac experts led by Dr. Ajay Chaughule, Consultant Cardiac Surgeon, Wockhardt Hospitals Mulund( Now a Network of Fortis Hospitals) performed a major tricuspid valve repair on 32 year old Martin from Republic of Rwanda.
Martin was suffering from breathlessness, swelling on face, extremities and abdomen since last 4 -5 years. Martin had history of Rheumatic fever at the age of 8yr. Doctors in Rwanda diagnosed as having Rheumatic fever and treated him with Injection -penicillin for several years (from age of 9 yrs to age of 15 yrs). However nothing gave relief to Martin of his fever. Soon Martin realized this was not getting him anywhere and he failed to receive the right kind of treatment he decided to venture out to the neighbouring countries in search of treatment. He went to Tanzania, Uganda showed to expert doctor, but there as well no one was able to give a proper diagnosis to his problem. They concluded that Martin was suffering from poor liver function and put him on medication. As a last hope Martin went to Nairobi (Kenya) where investigation revealed that he was suffering from Valvular heart diseases and was advised to undergo Valve Surgery.
“Martin had a very a rare and uncommon valve defect which is called the Rheumatic Isolated Predominant Tricuspid Stenosis of Heart" and required to undergo a valve repair surgery. The heart has four valves – Mitral, Aortic, Pulmonary and Tricuspid. In most common cases the mitral, aortic valves gets affected as the primary pathology and the patient needs to undergo a valve repair or replacement procedure. Tricuspid valve getting affected as isolated one is very rare. In Martin’s case this valve had defect and he needed immediate surgery to correct the problem” said Dr. Ajay Chaughule, Cardio-Thoracic & Vascular Surgeon.
Due to the defect in the Tricuspid wall his heart had formed thrombus or cloth which was of 6 cm in size on the right atrium for which the blood flow was restricted and the thickness of the right atrium became 3 cm whereas in normal condition the size is about 2 -3 mm. His heart condition led to many other issues in his system like his liver had enlarged up to the umbilicus and liver function was deranged. He had severe carditus (inflammation of the heart) which led to adhesion of his heart which means his heart was stuck to the surrounding tissue.
“The Echocardiography confirmed the diagnosis Tricuspid valve stenosis with osifice of 0.8cm normal being 5.8cm. Then we decided to go ahead with immediate surgery as his condition was deteriorating.”
“I had to travel from one place to another in search of the right kind of treatment for my problem. With years my condition worsened and it restricted my physical mobility as I was suffering from severe fatigue and breathlessness at slightest physical activity I used to conduct. My physical ill-health perturbed me to quite an extent and I used to feel terrible when all my friends of my age led a healthy life and could do anything they wanted” said Martin.
“But once my diagnosis was confirmed in Kenya I made up my mind to go ahead with the surgery as I definitely craved for a healthy life.
“But once my diagnosis was confirmed in Kenya I made up my mind to go ahead with the surgery as I definitely craved for a healthy life.
However the treatment cost there was too high and there were no expert cardiac surgeon available in Kenya. That’s when my elder brother who is a film director came to know from his colleague about treatment option available in India and the expertise at Wockhardt Hospitals Mulund in the cardiac space and he referred us to fly down to India for my surgery. This experience had given me a new meaning to life and I am extremely happy and consider my self to be fortunate enough to have received such marvelous treatment here. Dr. Ajay Chaugle has almost given me a new life and I would definitely like to make the most of it now. I thank Doctor and Wockhardt Hospitals for the phenomenal treatment offered to me” said Martin.
2 year old Nigerian baby with complex heart deformity undergoes Surgery without blood transfusion
Monday, January 4, 2010
A team of cardiac experts led by Dr. N S Devananda, Consultant Cardiac Surgeon, Wockhardt Hospitals,Bangalore (now a Fortis Hospitals Network ) has performed a major open heart surgery on a 2 year old baby from Nigeria. Baby Brendan was suffering from congenital heart defect called – Tetralogy of Fallot or complex blue baby syndrome.
“Baby Brendan was brought to us in a condition which was complicated and need surgical intervention to correct the anomaly. In this syndrome the pure and impure blood gets mixed in the heart and the amount of blood flow to the lungs is decreased. It is the most common complex heart defect, representing 55-70%, and the most common cause of blue baby syndrome. It can prove fatal if it is not treated in time,” said Dr. N S Devananda, Consultant Cardiac Surgeon, Wockhardt Hospitals.
The other bigger challenge which came before the surgery was the fact that the baby’s parents belonged to the Jehovah Witness community and as per their religious belief they oppose to any form of transfusion of blood and any blood products however they could accept other from of treatment. This made the case all the more complicated.
“Babies with Tetrology of Fallout have two treatment options – the first is palliative where no open heart surgery is done and the defect is treated with shunt operation. The second is complete repair – which is definitive treatment where the patient undergoes an open heart surgery with a heart lung machine. In the case of Baby Brendan we obviously chose the second option due to its curative value. But the problem we faced was that the heart lung machine requires 500 ml of blood by itself to drive away the air and still haemoglobin at acceptable level. The challenge was with the baby weighed only 11 kgs and his blood volume was 800 – 900 ml and to conduct an open heart proved difficult without additional usage of blood” said Dr. Devananda.
The team devised many things technically to make operative time shorter and do the best possible ways so that re-operation or re-exploration can be avoided and the ICU stay is reduced. The heart lung machine circuit was modified in such a way that total priming volume was reduced to the least possible; the haemo-filteration technique was used in such a way that excess water from the body is removed and it gives back the RBC’s to the body. We also had to reduce the sampling to the least possible for various tests.
“We did everything technically possible to reduce the requirement of blood. With all these modifications the baby underwent the open heart surgery and was out of ICU within 24 hours and is flying back to his native on the 7th post operative day. In an era where a lot of talking is happening around blood transfusion and adults have been undergoing surgery without blood transfusion, the same thing on a child is quite complicated. However with technical modification and surgical skills it is definitely possible and should be encouraged so that no child from the community remains untreated” said Dr. Devananda.
Brendan can live an active life like any other child of his age as this is a one time complete correction and his post op ECHO is satisfactory.
Brendan’s mother Ettieh’s faith in Jehovah has strengthened after this incident. She says, “Everybody should give proper attention to their child and keep monitoring the health of the baby time and again. Till one year when Brendan was not keeping too well and was not gaining weight we got very concerned and kept taking to the local physicians in Nigeria. However nobody could give us a proper answer to his continuous ill health until last year August, 09 Brendan complained of breathlessness and pain on his left chest.
A thorough examination indicated that my baby has some heart complication which needed to be treated immediately. Being a member of the Jehovah Witness community our challenge was to take Brendan to the right hands where surgery was possible without using blood transfusion. That’s when one of our friends at Nigeria who knew about Wockhardt Hospitals and their expertise in performing surgery without blood transfusion suggested us and we finally decided to fly Brendan down here for treatment. Initially when we decided to come to India for treatment I was engulfed with mixed feelings, but with the kind of care and response we received here I was quite confident that I have brought my baby to the right place.”
Wockhardt Hospitals in key geographies transits into Fortis Hospitals
Thursday, December 24, 2009
The transition of Wockhardt Hospitals in Mumbai, Bangalore and Kolkata to Fortis Healthcare network is the largest merger in the Indian healthcare delivery sector. With this transition the new entity named as Fortis Hospitals headed by Mr. Vishal Bali is all set to add significant scale and look at consolidation in the Indian healthcare space.
Addressing a press conference today Mr. Vishal Bali, Chief Executive Officer, Fortis Hospitals Group said “The transaction of the 10 Wockhardt Hospitals into the Fortis Healthcare network has been completed and these hospitals will now be rechristened as Fortis Hospitals. This deal is a landmark in the Indian Healthcare sector and the transition has been accomplished seamlessly”
With the addition of 10 hospitals of Wockhardt, Fortis Healthcare scales up its presence to a network of 39 hospitals and bed capacity from 3278 to 5180. It now extends its reach to 12 cities across the country and adds to its kitty 2 internationally accredited hospitals (Joint Commission International – JCI accreditation) located in Bangalore and Mumbai besides its own one in Mohali. The Fortis network has been strengthened by 3000 people including a team of accomplished clinicians and 15 member senior management team.
With this merger the Fortis Healthcare Network gets further strengthened to provide patient care in super specialty areas of Cardiac care, Neuro Sciences, Orthopedics, Minimal Access Surgery, Renal Sciences and Liver Transplants.
Talking about the growth plans for Fortis Hospitals in Bangalore, Mumbai and Kolkata Mr. Bali said, “We are looking at significant capacity additions in these three cities which will get completed in 2010”.
Fortis Hospitals will scale up its presence in Bangalore with the upcoming 120 bedded tertiary facility in Peenya which is likely to be commissioned by July 2010. The group has also opened a super specialty out-patient medical centre in Marathalli giving it a much needed foothold in East Bangalore. A hospital in East Bangalore is also being planned.
Mr. Bali also spoke about the significant growth in the Mumbai market with an addition of 300 beds which will happen in two phases. The first phase will see a capacity addition of 150 beds by December 2010. A full-fledged Oncology centre would be part of the phase 1 of the expansion. Apart from this, 2 super specialty out-patient clinics in Mumbai are also on the anvil.
Mr. Bali also spoke about consolidating the Eastern market with the launch of a 414 bedded Super specialty Hospital in Kolkata which will be commissioned in June 2010. With a network of 2 hospitals and 1 day care surgery centre Fortis Hospitals will become a major healthcare provider in Eastern India.
Strengthening India as a Healthcare Hub Fortis Hospitals will front end Tertiary Hospitals across key cities to the Medical value traveler from across the globe. The combined might of the new entity would enable Fortis to consolidate its position in the Medical value travel space. With Delhi, Bangalore, and the Mumbai facilities being front ended a wider choice would be offered to overseas patients across geographies.
“We have made significant progress in our International patient volumes particularly from the developed world. Our current international patient volume is growing by 35% and a major component of this growth is from the US. We have clearly established India as a key destination for the global medical value traveler” said Mr. Vishal Bali.
About Fortis Healthcare Limited
Fortis Healthcare Limited was incorporated in the year 1996 with its first hospital commencing in 2001 at Mohali. It was founded on the vision of creating an integrated healthcare delivery system. Headquartered in New Delhi, Fortis which acquired Escorts Heart Institute and Research Centre Limited in September 2005, has operations in Amritsar, Bangalore, Chennai, Faridabad, Jaipur, Kolkatta. Kota, Mauritius, Mohali, Noida,New Delhi, Raipur and Mumbai. With the recent additions of four hospitals in Mauritius, Bangalore, Kota and S.L. Raheja in Mumbai and ten Wockhardt hospitals Fortis is now a network of 39 hospitals with the capacity to increase inpatient beds to 5180 beds. These hospitals include multi specialty hospitals, as well as super-specialty centres providing tertiary and quaternary healthcare to patients in areas such as cardiac care, orthopedics, neurosciences, oncology, renal care, gastroenterology and mother and child care. The hospitals that Fortis operates include a “boutique” hospital for women - Fortis La Femme, its first foray into women’s health and maternity care.
Fortis Hospitals consists of 10 hospitals located in Bangalore, Mumbai and Kolkata out of which 8 are fully functional and 2 are upcoming projects. The hospital focuses on high end tertiary care around the specialties of cardiac care – adult and pediatric cardiology and cardiac surgery, neuro sciences, minimal access surgery and woman care. The entity consists of 2 JCI accredited hospitals located in Bangalore and Mumbai.
27 year old software engineer survives a massive cardiac arrest
Wednesday, December 23, 2009
In an extra ordinary medical feat Wockhardt Hospitals,Bangalore – "A Network Hospital of Fortis, has set yet another benchmark in the history of medical science by performing a very complicated cardiac surgery on a 27 year old who suffered a massive heart attack.
Rupesh Mathur, a 27 year old engineer hailing from Bihar, complained of breathing difficulty and chest pain on 15th of November 2009 while on his way back home. As the pain increased his friends took him to a city hospital where he was diagnosed with heart attack and was initially treated with clot dissolving medicines. His family later shifted him to Wockhardt Hospitals.
“An angiogram showed severe blockage in 3 arteries. His heart was severely damaged and weakened. His life was in danger. We had to put him on an Intra-Aortic- Balloon-Pump (IABP), but he still had breathing difficulty. So he was put on a ventilator and special medication to stop clots from forming again. Surgery was the only option to save his life as his chances for survival was minimal even after surgery”, said Dr. N S Devananda, Cardiac Surgeon, Wockhardt Hospitals,Bangalore – A Network of Fortis.
“It was a big decision for his family to make him undergo surgery with less than 5% chance of survival. But his parents decided to go ahead” he added.
Rupesh underwent bypass surgery with the assistance of heart and lung machine to maintain blood circulation. Post the surgery his heart was extremely weak (Pulmonary Adema) and was not coping and he was on the verge of death, hence the doctors could not take him off the heart and lung machine.
Later the doctors decided to place him on an extra carboniam membrane operation (ECMO) and he was shifted to the ICU for 24 hours. ECMO treatment provides oxygenation until the patients lung function has sufficiently recovered to maintain appropriate O2 saturation.
It is often a last resort. Rupesh’s lungs had weakened due to poor circulation of oxygen. Keeping him on ECMO was a major challenge as his chest had to be open and his blood needed to be thin, which lead to bleeding. After 24 hours doctors tried to take him off the bypass however they were forced to put him back on circulatory support after just 45 minutes as his heart could not cope. The situation was extremely grim and doctors had left with two options 1) to keep him on life support system for further 24 hours and hope that his heart strengthens 2) A heart transplant, which was next to impossible to get a donor heart on such short notice.
On 22nd of November 2009 Rupesh was taken off circulatory system for 4 hours with his chest still open, but his heart was still too weak. Doctors put him back on circulatory support for another 12 hours after which his heart started strengthening and he was removed from the machine. 4 days later he was removed from the IABB and 9 days later he was taken off the ventilator. His heart recovered well and was discharged after 2 weeks.
Dr. Devananda said “I have never come across such a difficult case in my entire career. This is miracle, where a patient who was on mechanical life support for survival for so long recovering to live a normal life. This is truly a victory for modern technology and the never say die attitude of this 27 year old”.
These days’ young people are not immune to heart diseases and when it happens in younger people it is sudden, severe and caused more damage to the heart. Of late there is an alarming increase in the number of youngsters with heart diseases.
Young Philippino who never had a hip socket since birth undergoes revision hip replacement surgery
Orthopedic team led by Dr. Kaushal Malhan, Consultant Orthopedic Surgeon, Wockhardt Hospitals,Mulund,Mumbai performed a revision hip replacement surgery on a 29 year old girl from Philippines.
29 year old Elvira was suffering from a congenital birth defect wherein her hip bone had not developed and her hip had no cup since birth. At the age of 21 she had her first hip replacement surgery in Philippines. However the surgery was not a successful one and after a month of her operation she had to undergo a second surgery on the same hip. The second surgery was also not a success and Alvira’s left leg was shortened nearly by 6 cms due to dislocation of her hip joint. Since then she continued to be in pain and had difficulty in walking and performing all the simple day to day chores. Her physical condition restricted her life to a great extent and she lived a compromised life without being able to enjoy the pleasures that one enjoyed at her age. This left Elvira in pain, frustrated, mentally depressed and she decided to sit back home and not interact with any one, for over 3 yrs.
To distract herself and get out of her agony Elvira decided to go for her graduation in 2005 and completed Pharmacy graduation in 2009. Meanwhile destiny gave her a second chance, having suffered for so long Elvira mustered the courage to rectify her problem and decided to come down to India and get operated upon her hip once again.
“Elvira’s problem was a complicated one as she had already undergone hip replacement before and both those operations were failures. The surgeries had damaged Elvira’s bone and now we had to be very careful while performing the revision replacement surgery so as to not damage her bones any further”, said Dr. Kaushal Malhan.
“Her surgery involved removing the previous cemented Hip Replacement, and implanting new specialized components after having reconstructed the bone socket, which was had never developed since child hood. We needed to make up for the loss of bone that occurred due to lack of development and damage in the previous 2 failed operations” he added.
The length of her shortened leg was also corrected and made equal. The implants used have been put in a manner that allows her to sit on the floor without the risk of dislocation, as is seen in conventional Total Hip Replacement (THR) surgery. Elvira is very comfortable post surgery and has already started sitting properly in a manner which she has not been able to do for years. Her pain is completely reduced and now she is hoping to study further to become a doctor.
“My parents consulted a Pediatric doctor at Philippines to sort my problem but we could never get the right direction and the Doctors were not able to offer any solution as mine was a birth defect. Since then I had a compromised gait and could not do all those regular activities which a child of my age used to. When both my surgeries failed I almost lost all hopes and the thought of living a challenged life devastated by morale. But like the saying goes every cloud has a silver lining! I too saw some hope after 8 years. My fiancé read about total hip replacement surgery in a magazine and we got curious and searched on the internet to know more about it. That’s when we read about the credentials of joint replacement surgeries at Wockhardt Hospitals and expertise of various joint replacement surgeons including Dr. Kaushal Malhan who has done some interesting and compelling replacement surgeries. Hence we contacted Wockhardt Hospitals and once everything was finalized we decided to fly down to India for my surgery” said Elvira.
“I no longer have to limp, I am no more in pain and most importantly I can now do everything I had dreamt of doing all these years. This has given a new meaning to my life and I would like to make the most of it now without losing a single opportunity!! All I want to say is there is a solution to every problem, only thing is we need to hunt out for the opportunity and everything else falls in place”, says Elvira with a comforting smile on her face.
Public Forum on Causes ,Prevention and Treatement of Knee and Hip pain
Sunday, December 13, 2009
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