Most Advanced Laparoscopic Varicocelectomy at World Best Hospitals in India

A varicocele is an enlarged or dilated group of veins in the scrotum (the sac that holds the testicles). Varicoceles are located along the vas deferens, a blood vessel-rich cord that connects the epididymis, which is the area where sperm are stored, to the prostate gland, a walnut-shaped gland below the bladder that supplies part of a man's seminal fluid. Varicoceles occur when scrotal vein valves malfunction and blood pools, causing the veins to become varicose (swollen). In most men the resulting varicocele is on the left side of the scrotum.

Varicoceles are serious because they can cause infertility. Approximately 40 percent of all men evaluated for primary infertility (meaning they are unable to father a child) have a varicocele; 80 percent of all men with secondary infertility (meaning they have fathered at least one child, but are not currently able to do so) have a varicocele. Despite this fact, physicians aren't entirely certain why varicoceles cause infertility. One theory is that increased blood in the veins because of varicoceles increases the temperature of the scrotal environment, which in turn raises the temperature of the testicles so that sperm production decreases. This sperm damage can occur in both testicles even if a varicocele is on one side of the scrotum because the varicocele transfers blood to the whole scrotum and both testicles.

Varicoceles usually develop slowly during adolescence when the testes grow dramatically and more blood flows to them, which may pool on return to the heart if a vein valve malfunctions. Approximately 16 percent of adolescent boys have a varicocele, a percentage that is repeated among adult men.

What are the signs of varicocele?

In some men, varicocele does not cause any symptoms. If the sperm number and quality are normal treatment may not be required in such cases. In some however, varicocele may cause important problems including infertility. The most common symptoms of varicocele are as follows:

1. Pain: In patients with varicocele, pain may occur because of the increased blood pressure in the veins around the testicle.

2. Infertility: The blood accumulated in the testicular veins may increase the temperature in the testicle. This may decrease the sperm count and mobility and cause sperm deformation by time. In one study, about 40% of the infertile men were found to have varicocele. In 50-70% of such cases, correction of the varicocele with embolization or surgery may result in improvement of sperm parameters.

3. Atrophy: In varicocele, retention of the deoxygenated venous blood in the testicular veins may impair the blood circulation and cause testicular atrophy (shrinkage). If the patient is diagnosed at an early stage and treated properly, the testicle may regrow and reach its normal size.

4. Bad appearance: Some varicoceles may be large enough to be readily seen when the patient is standing. This may disturb some patients and cause psycological problems.

5. Leg varicosities: In some patients, varicocele may be accompanied by leg varicosities. Likewise, in patients with leg varicosities a varicocele may be detected just by coincidence. In such patients, both the varicocele and leg varicosities may be caused by the insufficiency of the main testicular vein, and the occlusion of this vein may not only treat the varicocele but also be beneficial for the leg varicosities.

What are the causes of veicoceles?

The valves in the veins that go along the spermatic cord do not work properly, a similar process as varicose veins in the legs. A defect in the valves leads to a backflow of blood into the pampiniform plexus, raising pressure there and causing the veins to dilate, and eventually damaging testicular tissue. Most varicoceles occur on the left side, where the left-testicular vein is.

How is a varicocele diagnosed?

It is best to catch a varicocele before it can cause major problems, such as infertility. Self-exam of the scrotum is the best way to diagnose a varicocele early. A varicocele can feel like a "bag of worms", and is usually found in the left testicle. The majority of varicoceles are detected by a doctor during a health checkup.

Treatment Options for Varicocelectomy in India

Laparoscopic varicocelectomy

Laparoscopic varicocelectomy is one of three main treatment options for varicoceles. The other two options are varicocele embolization (non-invasive) and traditional varicocelectomy (open surgery). Laparoscopic varicocele surgery is very similar to open surgery but is less invasive. It is a relatively new procedure often used as an alternative to testicular varicocele surgery with varicolectomy. Men with varicoceles associated with significant pain or those who have fertility problems often seek treatment.

Laparoscopic varicocelectomy is performed by surgeons who specialize in urologic surgery. The patient is put under general anesthesia while three surgical cuts, each approximately 5 millimeters in length, are made in the patient’s abdomen. Using tools inserted though these small incisions, including a tool to magnify the area, the surgeon can sever the enlarged veins from the healthy ones. Then veins that direct blood into an already enlarged varicocele can be tied off so that the varicocele will eventually disappear. During a traditional varicocelectomy, one long incision is made near the top of the penis. Advantages of laparoscopy over this type of open surgery include a lower risk of damage to vital testicular arteries and reduced post-operative pain. Patients typically need to stay home for up to three days after the procedure in order to recover. They may experience bruising and pain where incisions were made.

Open surgery to find and preserve the tiny artery that brings blood to the testes. Magnification allows identification and preservation of the testicular arteries and lymphatics, reducing the risk of complications after surgery. Microsurgery contributes to higher success rates and fewer complications.

Varicocele Embolization

Varicocele embolization is an outpatient, image-guided procedure that uses a catheter to place a tiny coil and/or drugs into the problem blood vessel to divert blood flow away from the varicocele. Unlike varicocele surgery, embolization requires no incision, stitches, or general anesthesia. Several studies have shown that embolization is just as effective as surgery and recovery is significantly less. Embolization patients can return to full activities in a day or two, but varicocele surgery patients may need to avoid strenuous activity for several days or even weeks

Advantages of laparoscopic varicocele surgery over other techniques:

1. Accurate identification of all the veins and avoiding injury to the artery and lymphatic vessels as the surgery is done under magnification during laparoscopy

2. Varicoceles from both sides of the body can be corrected at the same time without needs for further surgical incisions

3. Rapid recovery from surgery with minimal pain as the small 5mm wounds causes minimal trauma to tissue

Surgery is completed within 45 minutes, even in the case of varicoceles occurring on both sides. Patient can be discharged a few hours after surgery and return to work is within 48 to 72 hours.

World Most Advanced Radical Prostatectomy Surgery in India

Radical Prostatectomy

If you have been diagnosed with prostate cancer, your doctor will discuss different options for treatment. If your cancer is only inside the prostate gland and has not spread to surrounding tissue, your doctor may recommend a surgery called a radical prostatectomy.

In a radical prostatectomy, a surgeon removes your entire prostate gland. The prostate is a small organ that wraps around your urethra, the tube that moves urine from your bladder to your penis. The seminal vesicles (small glands that produce a liquid that is part of semen) and the vas deferens (a muscular cord that moves sperm from your testicles to your urethra) may also be removed in this surgery. The surgery is called a “radical” prostatectomy because the entire prostate gland is removed. In other prostate surgeries (i.e., a “simple” prostatectomy), only part of the gland is removed.

Different Types of Radical Prostatectomy

Open surgery

In open surgery, the surgeon uses a large incision to reach the prostate gland. Depending on the case, the incision is made either in the lower belly or in the groin between the anus and the penis. When the incision is made in the lower belly, it is called the retropubic approach. A radical prostatectomy using the retropubic approach is the most common treatment for prostate cancer. In this procedure, the surgeon may also remove lymph nodes in the area so that they can be tested for cancer.1 When the incision is made in the groin, it is called the perineal approach. The recovery time after this surgery may be shorter than with the retropubic approach. If the surgeon wants to remove lymph nodes for testing, he or she must make a separate incision. If the lymph nodes are believed to be free of cancer based on the grade of the cancer and results of the PSA test, the surgeon may skip the lymph node removal.

Laparoscopic surgery

In laparoscopic surgery, the surgeon makes several small incisions in the belly. A lighted viewing instrument called a laparoscope is inserted into one of the incisions. The surgeon uses special instruments to reach and remove the prostate through the other incisions. Men who have laparoscopic surgery tend to lose less blood during the operation and to recover faster than men who have open surgery.2 Laparoscopic prostatectomy is not yet widely available, and because it is a relatively new technique, no results from long-term follow-up after treatment are available.The main goal of either type of surgery is to remove all the cancer. Sometimes that means removing the prostate as well as the tissues around it, including a set of nerves to the penis that affect the man's ability to have an erection. Some tumors can be removed using a nerve-sparing technique, which means carefully cutting around those nerves to leave them intact. Nerve-sparing surgery sometimes preserves the man's ability to have an erection.

In laparoscopic surgery, the surgeon makes several small incisions in the belly. A lighted viewing instrument called a laparoscope is inserted into one of the incisions. The surgeon uses special instruments to reach and remove the prostate through the other incisions. Men who have laparoscopic surgery tend to lose less blood during the operation and to recover faster than men who have open surgery.2 Laparoscopic prostatectomy is not yet widely available, and because it is a relatively new technique, no results from long-term follow-up after treatment are available.The main goal of either type of surgery is to remove all the cancer. Sometimes that means removing the prostate as well as the tissues around it, including a set of nerves to the penis that affect the man's ability to have an erection. Some tumors can be removed using a nerve-sparing technique, which means carefully cutting around those nerves to leave them intact. Nerve-sparing surgery sometimes preserves the man's ability to have an erection.

Robotic-assisted radical prostatectomy

Another form of keyhole surgery is robotic-assisted surgery (robotic-assisted radical prostatectomy for RARP). A robotic-assisted device allows the surgeon to see a three dimensional picture and also to use instruments more advanced than those used for conventional laparoscopic surgery.

This method is becoming more widely available in Australia. Compared with open radical prostatectomy, robotic-assisted surgery leads to a shorter hospital stay, less blood loss, a smaller scar and faster healing.

Keyhole surgery is not suitable for all men. Also, robotic-assisted surgery is more expensive than a conventional prostatectomy, although it is now available in a number of public hospitals.

There is currently no long-term evidence to show if keyhole surgery leads to fewer side effects, such as incontinence and sexual function, than conventional prostatectomy.

Benefits of Radical Prostatectomy Surgery in India

By electing to have radical prostatectomy in India, you will be able to appreciate many benefits over having the surgery in your home country. Some of these benefits are:

• The cost of radical prostatectomy in India is a fraction of the cost in the US and other western countries. Free quotes are available online to see just how affordable it can be.

• In addition to techniques like the Da Vinci prostatectomy in India, which uses robotics, other minimally invasive procedures are available. You can choose to have a laparoscopic prostatectomy in India instead, which is a more traditional minimally invasive procedure that is carried out without the use of a machine.

• In India, you can expect to receive care from doctors who have handled a large number of cases and are very experienced.

• It’s recommended that after prostate removal surgery you begin to walk leisurely as soon as possible to help your body recover. Having your prostate removal surgery in India means you can take in a unique and beautiful culture during your recovery.

Most Advanced Male Hypospadias Treatment at World Best Hospitals in India

What is Hypospadias?

Hypospadias is a male birth defect in which the opening of the tube that carries urine from the body (urethra) develops abnormally, usually on the underside of the penis. The opening can occur anywhere from just below the end of the penis to the scrotum. In most cases, the cause of this birth defect is not fully understood. Treatment with hormones such

as progesterone during pregnancy may increase the risk of hypospadias. Certain hormonal fluctuations, such as failure of the fetal testes to produce enough testosterone or the failure of the body to respond to testosterone, increase the risk of hypospadias and other genetic problems.

Mild hypospadias usually does not cause symptoms, especially in newborns and young children. If it's more severe, a male may have problems such as spraying urine, having difficulty directing the urine stream, and having erections that are not straight. In some cases, this defect may make it impossible to urinate while standing.

Diagnosis

Hypospadias is usually diagnosed in males at birth. Upon examination, the foreskin is usually incomplete and the urethral opening is misplaced. Mild hypospadias may not be diagnosed unless removal of the foreskin (circumcision) is performed.

Some pediatricians perform ‘partial circumcisions’. In this situation the pediatrician begins the circumcision procedure, and, after exposure of the glans, identifies a hypospadias.

Due to swelling after the procedure, the consequences of a partial circumcision may look bothersome at first, but after several days or weeks the inflammation reduces and the penis appears much better over time.

Treatment for Male Hypospadias in India

Male hypospadias is treated for several reasons and is conducted in full term or healthy boys, who are in between 3 months to 18 months. However, the repair can be performed also in childhood and sometimes possibly in the adulthood. Sometimes treatment for testosterone hormone is done before the surgery in case the opening is proximal.

The surgery is done to make the penis to straight to normal position having urinary channel at the head tip ends of the penis. The surgery is performed in four steps.

• Straightening the shaft

• Creation of the urinary channel

• Positioning the opening of the urethral in the head

• Reconstruction or circumcision of the foreskin

The surgery for hypospadias repair takes 90 minutes to 3 hours. It is done usually in stages. The surgery is usually performed with spinal anesthesia or general anesthesia. Urologists perform certain tasks during the surgery. They straighten the shaft separately before the urinary channel is constructed.

Hypospadias is done in first degree, second degree or third degree. First degree is a mere cosmetic defect, in which there is hardly any effect on the function. However, in certain cases, like the direction of the stream of the urine is the exceptional condition in the first degree. If it is not corrected the following second degree or third degree will make the urination to become messy, and may create the problems related to the fertility. Sometimes it may interfere with the erections. In some countries, especially in the developed countries, most of the hypospadias repair surgery is performed during the infancy itself. Most of the time, first degree and second degree surgical repair is successful, when performed in one procedure itself. The same procedure is usually done by plastic surgeon or pediatric urologists during the year of individual’s life.

Before the surgery is performed, sometimes it would be necessary to give human chorionic gonadotropin injection or testosterone injections, in case the penis is found very small. If the hypospadias is severe, multiple procedures may be required and sometimes mucosal grafting is also required. It is important to avoid circumcision before the repair is performed.

For the hypospadias repair, many of the surgeons prefer the fresh repair to be not used immediately, by the patient. After the surgery, for the first few days it is connected with a small catheter, which directly connects to the diaper. So, the patient does not need to urinate through the fresh repair. While the catheter has been connected, antibiotics and also antispasmodics for bladder are given.

After the surgery is performed, the schedule for the follow up visits is usually dependent upon the urologists.

MyMedOpinion - World’s Most Advanced Robotic Surgery for Prostate Cancer Surgery in India

MyMedOpinion affiliated Super Specialty hospitals in India, which are amongst globally the most advanced hospitals in terms of Technology and Clinical Expertise have launched a program to help prostate patients the Robotic Prostate Surgery Service -  where a minimally invasive robot assisted radical prostatectomy technique eradicates prostate cancer with minimal post surgery complications 

The mission of “Minimally Invasive Robotic Prostate Surgery Program” is to leverage latest technology to and treat prostate  disease through small incision and great precision resulting in:

• Shorter hospital stay, Faster recovery and return to normal activities
• Less pain and scarring , Reduced blood loss and need for blood transfusion
• Reduction in the use of pain medicines, Decreased postoperative pain

Usually in conventional approach surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave some cancer behind.  Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence

Highly trained Indian surgeons who have worked for decades at some of the global centres of excellence now use  Advanced Robotic technique gives surgeon a sophisticated master slave robot that seamlessly translates the surgeon's movements at the computer console into precise, real-time movements of the surgical instruments inside the patient. This ensures that the Prostate is removed excellent outcomes and minimal chances of cancer left behind after the surgery. 

Prostate Surgery at MyMedOpinion affiliated hospital in India is also used for and many other advanced surgeries with excellent outcomes  like Radical prostatectomy for prostate cancer, Pyeloplasty, where  the obstruction of the pelviureteric junction is removed and renal pelvis is joined back to healthy ureter,  Partial Nephrectomy, Radical Cystectomy, Pediatric Robotic-Assisted Antireflux Surgery, Adrenalectomy , Ureteroneocystostomy, Nephroureterectomy, Ureterolysis In Retroperitoneal Fibrosis,  Ureteroureterostomy, Sacropexy, Anterior And Posterior Colpopexy 

WORLD’s LOWEST COST SURGERY PACKAGES - This most modern treatment for Prostate Cancer comes at a very attractive cost which is a fraction of the cost of similar services anywhere in the world. Robotic Prostate is made available by  MyMedOpinion  at World class hospitals in India for about   5500 US Dollars and that includes stay in a private  room where a companion can stay with the patient, surgeon fee, medicines and consumables, nursing care, patient's food and airport pick up & drop etc.

Advanced Robotic Prostate Surgery in India - Prostate Surgery Hospital India

A boon for Prostate Cancer patients - Advanced Robotic Prostate Surgery is now preferred choice for Prostate Cancer patients due to following Unmatched advantages

• Minimal Bleeding
• Much quicker recovery
• Reduced hospital stay
• Lesser pain killer requirements
• Lower blood transfusion rates
• Improved preservation of physical appearance
• Three (3) D vision enables surgeon to perform Prostate excision with Cancer
• Control without risk of Post Surgery Continence (control over urinary and
• fecal discharge) and causing Impotency

What is Da Vinci master slave Robotic System?

Da Vinci master slave robotic system is used to completely eradicate cancer with minimal side effects for treating Prostate Cancer. Through this system a minimally invasive robot assisted radical prostatectomy technique has been developed in which doctors evolved a unique sequence of surgical steps.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualisation, scaling of movement, and wristed instrumentation.

The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

Unbeatable Advantages of RoboticProstate Surgery over the
Conventional Prostate Cancer Surgery

1) Usually in conventional approach, surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave cancer behind. In the Advanced Robotic Technique (ART) surgeons uses a sophisticated mastr slave robot that incorporates 3-D high definition vision, scaling of movement and wristed instrumentation that gives him the ability to perform Prostate excision with minimal risk of leaving the cancer behind and also minimal bleeding and post operative risk of incontinence and impotence.

2) Neither clinical nor imaging tests are sensitive enough to capture a tumour at T3 stage where it has become locally advanced and a risk for spreading to other body parts. Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence Da vinci robot system minimizes side effects thereby greater control for the patient over urinary discharge i.e. continence and return to normal sexual function after the surgery.

About MyMedOpinion

MyMedOpinion  affiliated   Best hospitals in India provide an medical opinion from experienced surgeons and the treatment cost includes companion stay  , surgeon fee, medicines and consumables, nursing care, patient's food and airport pick up & drop etc. etc. We offer free, no obligation assistance to international patients to find world class medical treatment in India. We offer support and services to facilitate the care you require. We can help you find the best hospital in India

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Laser Prostate (TURP) Surgery in India

Minimally Invasive Laser Prostrate surgery, also known as Laser Prostatectomy or TURP surgery or Transurethral Resection of Prostrate, is a procedure used to remove the enlarged portion of prostate gland. The procedure involves removal of the section of the prostate that is blocking urine flow.

TURP is one of the most effective options for treating an enlarged prostate, a condition also known as benign prostatic hyperplasia (BPH).

Conventional vs Laser Prostatectomy / TURP:

The Laser TURP procedure is much more advanced & beneficial than the conventional procedure. The differences in the two are:

•    For the conventional TURP, the resectoscope, a combined visual and surgical instrument is used, whereas the Laser procedure involves use of advanced laser energy to cut excess gland, thus there is no loss of blood & shorter hospitalization is required
• 
   
  
  Blood thinning agents have to be stopped a week to 10 days before the procedure for conventional TURP, which puts the heart at risk, whereas the laser TURP is done with the blood thinning agents on board, which is highly beneficial for cardiac patients.
• 
   Conventional TURP allows tissue removal at only 1gram/min, whereas laser can vaporize tissue as fast as 3-4 grams/ min.
•   
  For prostates larger than 100gm, open surgery is required in case of conventional TURP, whereas lasers can effectively perform surgery in such large prostate cases

Advantages of Laser TURP:

1. Safer & Faster
2. No blood loss
3. Shorter hospital stay & faster recovery

• Highly beneficial for
•    Patients on blood thinning agents like heparin, aspirin, clopidegrol etc.
•    Patients with kidney dysfunction
•    Patients whose prostate gland size more than 60 gm
•    Patients who are at poor risk for anesthesia
•    Patients with cardiac complications or who have undergone joint replacement surgery

Most Advanced Robotic Prostate Cancer Surgery in India

Most Advanced Robotic Surgery for Prostate Cancer in India

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Advantages of Robotic prostatectomy

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• Minimal Bleeding Faster return to normal daily activities .

• Reduced hospital stay Significantly less pain and scarring

• Lower blood transfusion rates

• Improved preservation of physical appearance.

• Three (3) D vision enables surgeon to perform Prostate excision with Cancer.

• Lower blood transfusion rates

• Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

Scope of Robotic assisted Laparoscopic surgery in Urology

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• Prostate Cancer- Robotic Radical Prostatectomy

• Pelvi-Ureteric Junction (PUJ) Obstruction- Robotic Pyeloplasty

• Kidney Tumors- Robotic Partial Nephrectomy

• Bladder Cancer- Radical Cystectomy

• Ureteric Reimplantation

• Pelvic Tumor Excision

Robotic surgery involves use of the da Vinci robotic surgical unit in performing complex surgical procedures such as prostatectomy (removal of the prostate gland for cancer). Originally developed for space and military uses, this advanced technology allows the operating surgeon to sit behind a console and control the robot that is next to the patient to perform surgery.

This technology allows the surgeon to operate with very small and precise instruments under a 3 dimensional (3-D) vision, which is magnified up to 10 times. This is achieved by inserting the camera and the instruments into the patient’s body through small cuts (incisions) ranging from 5 – 12 mm in size.

Da Vinci Master Slave Robotic System

The surgical application of robotic systems is one of the most exciting and significant technological developments of this century; its future implications are incalculable.Huge strides have been made in the field of closed operations in the past 10 years and the use of robotic systems has emerged as the principle solution to technical limitations

The use of robotic surgical systems has numerous advantages. Whereas modern laparoscopic systems give only

 a two-dimensional vision, robotic systems give the surgeon a three-dimensional field of vision and depth, provide arms that, unlike the human hand, never tire and permit an unprecedented continuityin operations. Since robotic systemsexceed even the human hand’s freedom and facility of movement, far greater delicacy and dexterity is achieved. Modern robotic systems fall into three categories; active, semi-active and master-slave.But the most commonly used are master-slave systems distinguished by the surgeon’s absolute control of the robot via a remote control console.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation. The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen