- Minimally Invasive Spine Treatment
- Spine Surgery and Treatment
- Brain Tumor Surgery Treatment
- Knee Replacement Treatment
- Heart Valve Replacement Surgery Treatment
- Paediatric Heart Treatment
Minimally Invasive Spine Surgery (MISS) does not involve long incisions, open manipulation of the muscles and tissue surrounding the spine is avoided, therefore, leading to shorter operative time. In general, reducing intraoperative (during surgery) manipulation of soft tissues results in less postoperative pain and a faster recovery.
Common Back Pain Conditions
- Back Pain
- Degenerative Disc Disease
- Herniated Disc
- Lower Back Pain
- Neck Pain
- Spinal Stenosis
Lumbar Decompression Back Surgery
Decompression is a surgical procedure that is performed to alleviate pain caused by pinched nerves. During a lumbar decompression back surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to give the nerve root more space and provide a better healing environment.
There are two common types of spine surgery decompression procedures:
A microdiscectomy (a microdecompression) is typically performed for pain from a lumbar herniated disc. The surgery is considered reliable for leg pain caused by the herniated disc, most commonly called sciatica by patients, and most commonly referred to by medical practitioners as a radiculopathy.
A lumbar laminectomy (open decompression) is typically performed for pain from lumbar spinal stenosis. The goal of the surgery is to allow more room for the nerve root, thus reducing pain (and potentially any leg weakness or neurological symptoms) and restoring the patient’s ability to participate in everyday activities.
Slipped Disc Surgery - Percutaneous Endoscopic Lumbar Discectomy (PELD)
An advanced minimal invasive technique, Percutaneous endoscopic lumbar discectomy (PELD) is performed for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. In addition to decompression surgery, the technique has been found effective in management of spinal tumors and structural deformities.Surgery is done under local anesthesia with conscious sedation.No muscle, ligament or normal tissue damage and minimal blood loss.Patient can be discharged in 24 hrs. No prolonged bed rest required after surgery. Early return to work.
Transforaminal Lumbar Fusion (TLIF) is a surgical technique that is performed from a posterior approach to stabilize the spinal vertebrae and disc between. By going through the transforaminal direction there is less bone removed so thus less disturbance to the site. By fusing the vertebrae to eliminate any movement between the bones, the spine is stabilized and a reduction of pain and nerve irritation is accomplished.
Vertebroplasty & Kyphoplasty
Vertebroplasty and kyphoplasty are used to treat painful vertebral compression fractures in the spinal column, which are a common result of osteoporosis. Your doctor may use imaging guidance to inject a cement mixture into the fractured bone (vertebroplasty) or insert a balloon into the fractured bone to create a space and then fill it with cement (kyphoplasty).
Posterior Lumbar Interbody Fusion (PLIF)
Posterior Lumbar Interbody Fusion (PLIF) is a surgical technique for placing bone graft between adjacent vertebrae (interbody). Using various instruments, the disc is removed through the right and left sides of the spinal canal and the intervertebral space, which has been cleared, is then packed with bone graft and a bone block or cage implant. Instrumentation, such as pedicle screws, are used to provide support for the fused vertebrae. Doing a pure PLIF surgery has the advantage that it can provide anterior fusion of the disc space without having a second incision.
Total Knee Replacement
Total Knee Replacement (TKR), also referred to as Total Knee Arthroplasty (TKA), is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces. It is a common surgical procedure most often performed to relieve the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis of knee, cartilage defects, and ligament tears.
The most common cause for knee pain which needs Knee Replacement Surgery is osteoarthritis of knee. In Total Knee Replacement, the orthopedic surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a prosthesis/implant of metal and plastic. Total knee replacement can help put an end to arthritic pain in your knee and enable you to resume a functional and active lifestyle.
Partial Knee Replacement
In case of larger number of patients have arthritis limited to one part of the joint alone, Orthopedic surgeons may recommend partial knee replacement if the arthritis is confined to a single part (compartment) of the knee
Replacing the whole joint in these patients is overkill and unnecessary. Many middle aged men and women develop osteoarthritis of the knee. Osteoarthritis of the knee affects the inner half or medial compartment to start with and then proceeds to affect the outer half or lateral compartment. In this operation only that part of the knee, which is unhealthy, is replaced. The normal surfaces are left alone. This operation has several advantages over total knee replacement surgery like small incision, longer life of implant and post operative hospitalization is reduced and return to normal is much faster than total knee replacement surgery.
Bilateral Knee Replacement | Both Knee Replacement Surgery
Orthopedic surgeons may recommend simultaneous procedure when both knees are required to be replaced. A simultaneous procedure means that both knees are replaced at the same surgery, in one day. The benefit of simultaneous knee replacement is that both problems are taken care of at one time. The overall stay and rehabilitation can be done in a shorter time, and there is only one hospitalization. Patients also only require one anaesthesia.
Revision Knee Replacement
Total Knee Replacements that need to be revised after 15-20 years (post primary surgery) are also done at the world class best orthopedic hospitals in India. The most advanced prosthesis and Computer Assisted Surgery (CAS) is also used for Revision Knee Replacements.
Knee Arthroscopic Surgery
Knee arthroscopic surgery is a procedure performed through small incisions in the skin to repair injuries to tissues such as ligaments, cartilage, or bone within the knee joint area. The surgery is conducted by an orthopedic surgeon with the aid of an arthroscope, which is a very small instrument guided by a lighted scope attached to a television monitor.
Knee arthroscopy has in many cases replaced the classic arthrotomy that was performed in the past. Today knee arthroscopy is commonly performed for treating meniscus injury, reconstruction of the anterior cruciate ligament and for cartilage microfracturing. Many knee joint problems are amenable to arthroscopic surgery like
- Trimming a torn meniscus of the knee
- Repairing a torn meniscus of the knee
- Treatment of cartilage damage in the knee
Arthroscopic surgery is a "less invasive" procedure and being a surgical procedure involves risks, but when performed for the right problem it is often very successful.
ACL Reconstruction: The Anterior Cruciate Ligament (ACL) keeps the shin bone (tibia) in place. A tear of this ligament can cause your Knee & Hip to give way during physical activity. ACL reconstruction surgery is done to replace the ligament in the center of your Knee & Hip with a new ligament.
Arthroscopic Menisectomy: Meniscectomy is the surgical removal of all or part of a torn meniscus (rupturing of one or more of the fibrocartilage strips in the Knee & Hip called menisci). A meniscus tear is a common Knee & Hip joint injury and can lead to pain and/or swelling of the Knee & Hip joint.. Menisci can also be torn during innocuous activities such as walking or squattig. Depending on the location of the tear, a repair may be possible. n the outer third of the meniscus, an adequate blood supply exists and a repair will likely heal. Usually younger patients are more resilient and respond well to this treatment, while older, more sedentary patients do not have a favourable outcome after a repair.
Meniscal repair: Doctors use arthroscopic surgery to repair the meniscus. The surgeon inserts a thin tube (arthroscope) containing a camera and a light through small incisions near the Knee & Hip and is able to see inside the Knee & Hip without making a large incision. Surgical instruments can be inserted through other small incisions. The surgeon repairs the meniscus using dissolvable sutures (stitches) or anchors.
The most advanced technology for minimally invasive heart surgery is now available in India. Robotic da Vinci Surgical System combines superior 3D visualization along with greatly enhanced dexterity, precision and control in an intuitive, ergonomic interface with breakthrough surgical capabilities. By enhancing surgical capabilities, robotic surgery helps to improve clinical outcomes and redefine standards of care.
Types of Minimally Invasive Cardiac Surgery
Coronary Artery Bypass Graft (CABG) – A less invasive alternative for treating severe blockage that is restricting blood flow and oxygen to the heart, also known as coronary artery disease. A healthy blood vessel is taken from another area of the body and used to divert the flow of blood around a section of blocked artery, restoring normal blood flow to the heart muscle. The least invasive approach to this procedure is known as a minimally invasive direct coronary artery bypass (MIDCAB).
Aortic Valve Replacement (AVR) – A procedure used to replace the aortic valve if it has thickened and narrowed, preventing adequate blood flow, or if the valve isn't fully closing, causing blood to leak back into the heart.
Mitral Valve Replacement/Repair (MVR) – Surgery to either replace or repair the mitral valve in the heart, one of four main valves that help pass blood through the heart while preventing blood from flowing backwards.
Atrial Fibrillation – Surgery to correct an abnormal heart rhythm in the two upper chambers of the heart (the atria) that is causing poor blood flow to the body. Known as the “mini Maze” procedure, this less invasive approach creates scar tissue on the heart to block the abnormal electrical impulses that are disrupting the heart's normal rhythm.
Hybrid Procedures – Procedures that combine minimally invasive cardiac surgery with catheter-based interventions, most commonly stents. These tailored treatment strategies use the least-invasive approach to achieve the best possible outcome.
Advantages of Minimally Invasive Cardiac Surgery
- Less pain.
- Less risk of infection.
- Reduced ICE and shorter hospital stay.
- Improved postoperative pulmonary function.
- Improved cosmetic results.
- Improved quality of life.
- Shorter hospital stay, faster recovery and quicker return to normal activities.
Quality World Class Pediatric Cardiac Surgery from Top Hospitals and Best Cardiac Specialists in India
A successful cardiac surgery in children requires an expert medical team - doctors, nurses, and other support staff - who are experienced in such surgeries, can promptly recognize problems and emerging side effects, and know how to react swiftly and properly if problems do arise. A cardiac surgery program will also recognize the importance of providing patients and their families with emotional and psychological support before, during and after the surgery, and will make personal and other support systems readily available to families for this purpose. We make this difficult journey easy for the patient and his relatives.
Paediatric surgeries deal with the correction of abnormalities present in the heart of new-borns, infants or children. Most of the defects are present since birth (congenital). They all come under the category of congenital heart defects. Some are present since birth but cause symptoms after a few years and some cause symptoms immediately after birth.
Types of Cardiac Defects in Children
Any defect in the septum or valves or position of arteries causes mixing of pure and impure blood or reduced blood supply to the body. If the defect is severe it is incompatible with life and requires immediate surgical intervention. Circulation of impure blood in the body results in bluish discoloration of the body called cyanosis. The tissues do not receive adequate amount of oxygen and hence cannot function.
The major cardiac defects include
- Atrial Septal Defect
- Ventricular Septal Defect,
- Fallot's Tetralogy
- Valvular defects
Atrial Septal Defect (ASD)
ASD- Atrial Septal Defect refers to a hole in the septum that separates the right and left atrium. This results in mixing of pure and impure blood. Depending on the size of the defect, the symptoms may range from no symptoms to bluish discoloration of the body, increase pulmonary blood pressure and irregular cardiac contractions (arrhythmias). It is corrected by open heart surgery. The sternum is split in the midline. Arterial and double venous (superior vena cava and inferior vena cava) vessels are clamped. By applying cardiopulmonary bypass (heart lung machine), the aorta is clamped, and the heart is temporarily paralyzed by a solution. The right atrium is opened and the defect is sutured.
At our world class best hospitals in India, minimally invasive approaches to the repair of ASD have now been developed. In most cases, the size of the incision is simply decreased with different approaches to cardiopulmonary bypass. Examples include partial or full submammary skin incision, hemisternotomy, and limited thoracotomy. The goal is to improve cosmetic results because these approaches are not associated with decreased morbidity or mortality.
In recent times, ASD have been closed by using a variety of catheter-implanted occlusion devices rather than by direct surgical closure with cardiopulmonary bypass. These devices are placed through a femoral venous approach and are deployed like an umbrella to seal the septal defect. These devices work best for centrally located secundum defects. Our cardiologist with congenital experience will continue patient care to monitor for recurrence of the shunt and to ensure that the patient has returned to normal activities and cardiac function.
Ventricular Septal Defect (VSD)
Ventricular Septal Defect - is a hole in the wall between the right and left ventricles of the heart. This abnormality usually develops before birth and is found most often in infants. A ventricular septal defect can allow newly oxygenated blood to flow from the left ventricle, where the pressures are higher, to the right ventricle, where the pressures are lower, and mix with un-oxygenated blood. The mixed blood in the right ventricle flows back or recirculates into the lungs. This means that the right and left ventricles are working harder, pumping a greater volume of blood than they normally would. Eventually, the left ventricle can work so hard that it starts to fail. It can no longer pump blood as well as it did. Blood returning to the heart from the blood vessels backs up into the lungs, causing pulmonary congestion, and further backup into the body, causing weight gain and fluid retention. If the VSD is large and surgically uncorrected, pressure can build excessively in the lungs, resulting in pulmonary hypertension. The higher the pulmonary pressure, greater the chances of blood flowing from the right ventricle to the left ventricle, backwards, causing un-oxygenated blood to be pumped to the body resulting in cyanosis (blue skin). The risk for these problems depends on the size of the hole in the septum and how well the infant's lungs function.
Small VSDs' are symptomless and closed spontaneously as the child grows. The large VSDs' cause symptoms like difficulty in breathing and feeding, poor growth and pallor. The symptoms occur due to the increase in size of the right ventricle (right ventricular hypertrophy) and increase in pressure inside the lungs (pulmonary hypertension).
Surgeries Types options available are -
- Intra-Cardiac Technique - the patient is attached to an external heart-lung machine (which performs circulatory and respiratory function during surgery). It is an open heart surgery in which the patient is placed under general anaesthesia. The rib cage is cut open in the midline. The heart is directly accessed and the defect is sutured.
- Trans- Catheter Technique - Surgical instruments are passed through the catheter which is inserted in the femoral artery at the groin. The catheter is slowly guided up towards the point of defect to close it. It is a successful surgery. With the separation of ventricles normal circulation resumes. The enlarged heart comes back to normal size. Pulmonary artery pressure reduces. The child's growth fastens. The prognosis is excellent.
Fallot's Tetralogy (TOF)
It is the most common congenital heart defect in children. The defect results in mixing of pure and impure blood. It comprises a combination of four defects- right ventricular hypertrophy (increase in the size of right lower chamber), ventricular septal defect (whole in the wall between the two ventricles), abnormal position of aorta (aorta is on right side of heart instead of the left) and pulmonary stenosis (narrowing of pulmonary valve opening which prevents outflow of blood from right ventricle).
The Surgery options are:
Blalock- Taussig's operation is a palliative procedure performed in smaller infants to increase blood flow to lungs and to allow the child to grow big enough to withstand the corrective surgery. A connection is made between right subclavian artery and pulmonary artery to pass more oxygenated blood to the latter. This relieves the cyanosis to a great extent.
The total corrective surgery is performed in children within 2 years of age. VSD is closed with a patch and the narrowed pulmonary valve is opened. The outcome of surgery is favourable and most children lead a healthy life after the surgery with minimum restrictions.
Double valve repair and replacement
Valves are openings between two chambers and also between a chamber and artery which allows unidirectional flow of blood. The patency of these valves is very important for normal flow of blood. The function of mitral valve (between left atrium and left ventricle) and the aortic valve (between left ventricle and aorta) is very important. If these valves get narrowed, the amount of blood passing from left atrium to left ventricle (mitral valve) or from left ventricle to aorta (aortic valve) is drastically reduced. In this case the heart will pump blood harder to push it through the narrowed valves. But the blood will tend to go upwards back into the pulmonary vein and finally to the lungs. This will cause excess blood in the lungs leading to congestion. At the same time very less blood will come out into the aorta from the left ventricle which will result in reduced blood and oxygen supply to all the body parts.
Double valve repair and replacement procedure aims at correcting or replacing these both these damaged valves (aortic & mitral together) with new functional valves. This is done through the open heart surgery. The patient is put under general anaesthesia and connected to the heart lung machine. This machine takes over the pumping, circulatory, and respiratory functions of the heart and lung till the surgical procedure is going on. The valves are accessed by cutting open the rib cage and accessing the heart directly. The old valves are sliced from their attachments and new valves are put in their place. The new valves may be obtained from a cadaveric donor, or an animal (pig) or it may be made of a nonreactive inert material. The patient needs to be given anticoagulants or immunosuppressive to clotting of blood or rejection of organ. The prognosis of this surgery is good. It is many a time a life-saving and life extending surgery.
Cardiac Valve Replacement Surgery from leading superspecialty best hospitals in India
At leading and best heart super specialty hospitals in India, Cardiac surgeons now use most advanced minimally invasive heart valve replacement or repair surgery techniques for eligible patients.
The heart has four valves that control the flow of blood through the heart:
By enhancing surgical capabilities, robotic surgery helps to improve clinical outcomes and redefine standards of care.
- Mitral Valve
- Aortic Valve
- Tricuspid Valve
- Pulmonary Valve
Minimally Invasive Valve Surgery in India
Minimal incision valve surgery does not require a large incision or cutting through the entire breastbone. The surgeon gains access to the heart through one to three smaller, less visible incisions (sometimes called “ports”) that can be made between the ribs or a smaller breastbone incision, as well as one small incision in the groin.
The diseased valve can be repaired or replaced through one or more of the ports between the ribs, with the surgeon looking at the heart directly through a small tube-shaped camera.
Heart Valve Repair | Replacement Surgery:
Heart valve specialists and surgeons agree that whenever possible a heart valve should be repaired rather than replaced. Heart valve repair leaves you with a normally functioning tissue, which resists infection more effectively, and you don't need to take blood-thinning medications after the surgery.
If you have mild to moderate heart valve disease, your surgeon often performs heart valve repair. If your heart valve isn't closing properly (regurgitation), your surgeon may treat your condition using one of three surgeries.
- Annuloplasty - In this procedure, your surgeon tightens the ring of tissue around the valve to help the valve flaps (leaflets) come together. Sometimes your surgeon will implant a ring where the leaflets meet to make the valve opening smaller so the leaflets can come together.
- Repair of structural support - In this procedure, your surgeon replaces or shortens the cords that support the valves (chordae tendinae and papillary muscles) to repair the structural support. When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
- Valve leaflet repair - In valve leaflet repair, your surgeon surgically separates, cuts or pleats a valve flap (leaflet) to repair a floppy or prolapsed valve leaflet.
TAVI (Transcatheter Aortic Valve Implantation)
Aortic stenosis, the narrowing of the aortic valve, which affects the supply of blood from the heart to the rest of the body, is one of the most frequently acquired heart valve diseases.
With the steady increase in the population of the elderly as well as their improved life expectancy, the proportion of those developing severe aortic stenosis due to degeneration and calcification of the aortic valve has been on the rise. For a significant number of high-risk, in-operable elderly, a new minimally invasive procedure, transcatheter aortic valve implantation (TAVI), has emerged as a safe and viable option.
Heart Valve Replacement Surgery
If your heart valve can't be repaired, your surgeon will remove your damaged valve and replace it with an artificial (prosthetic) valve You may need heart valve replacement if you have valve narrowing (stenosis) or severely damaged valves affected by calcium buildup in the valves (calcification) or rheumatic disease. Surgeons perform procedures often to replace mitral or aortic valves, but your surgeon can replace any heartvalve.
Heart valve replacements include:
- Mechanical valve - It is made totally of mechanical parts that are tolerated well by the body. The bi-leaflet valve is used most often. It consists of two carbon leaflets in a ring covered with polyester knit fabric.
- Biological valve - Tissue valves (also called biologic or bioprosthetic valves) are made of human or animal tissue. Animal tissue heart valves may come from pig tissue (porcine) or cow tissue (bovine). Tissue valves may have some artificial parts to help give the valve support and to aid placement.
- Homograft valve (also called allograft) - It is an aortic or pulmonary human valve that has been removed from a donated human heart, preserved, and frozen under sterile conditions. A homograft may be used to replace a diseased aortic or pulmonary valve.
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
In general, tumors occur when cells divide excessively in the body. Typically, cell division is strictly controlled. New cells are created to replace older ones or to perform new functions. Cells that are damaged or no longer needed die to make room for healthy replacements. If the balance of cell division and death is disturbed, a tumor may form.
- Malignant, cancerous
- Benign, noncancerous
- Brain Tumor, Adult
- Bronchial Tumors, Childhood
- Carcinoid Tumor, Childhood
- Embryonal Tumors
- Germ Cell Tumor
- Islet Cell Tumors
- Ovarian Low Malignant Potential Tumor
- Pineal Parenchymal Tumors
- Pituitary Tumor
- Supratentorial Primitive Neuroectodermal Tumors
- Trophoblastic Tumor
- Wilms Tumor
Symptoms depend on the type and location of the tumor.
- Loss of appetite
- Swelling of head
- Swelling of Eyes
- Weight loss
- Yellowing of skin or eyes
Major treatment types to treat BRAIN TUMORS available in India with our best hospitals are
Radiation therapy (also called radiotherapy, x-ray therapy, or irradiation) is a treatment approach that uses radiation to destroy cancer cells. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly. The goal of radiation therapy is to damage as many cancer cells as possible, while limiting harm to nearby healthy tissue. Unfortunately, rapidly dividing healthy cells can also be killed by this process. Skin and hair are some of the tissues affected by radiation treatment, resulting in skin lesions, burning, hair loss, etc.
The doctor needs to decide if surgery should be done at all. Because cancers spread (metastasize) to normal tissues, sometimes at the other end of the body, the ability of surgery to cure must be addressed at the outset. As long as the cancer is localized, the initial presumption is that cure should be attempted by removing it as soon as possible. Once surgical removal has been decided, an oncologic surgeon will remove the tumor whole, taking with it a large section of the surrounding normal tissue. The healthy tissue is removed to minimize the risk of possible seeding.