Robotic Surgery is the latest technique used to operate on cancer patients, where the patient benefits with a very quick recovery after a major surgery performed more precisely, small scars and early discharge from the Hospital. It gives more precision and a 3D view to the surgeon thus making surgery in limited spaces like pelvis more accurate.
In laparoscopic surgery, the surgeon makes several small cuts, not more than a half-inch long. (That’s why it’s also called keyhole surgery.) They insert a tube through each opening, and the camera and surgical instruments go through those. Then the surgeon does the operation.
Repair of Obstetric injuries
Childbirth injuries result in varied degrees of loss of control over passage of stools or gas. This is because of prolonged labour, forceps delivery or episiotomy related anal sphincter injury. The defect in the sphincter needs to be identified and repaired
Sphincter Saving Surgeries for Rectal Cancer
Cancer in the lower rectum means that the tumour is very near the anal sphincter muscles, which make us continent. In cancer surgery of the lower rectum, one can aim to save the anal sphincter by doing low or ultra low anterior resection and use of circular staplers. Thus we can save the sphincters and avoid having a permanent stoma.
Colonic Cancer Surgeries
Colon also known as large intestine is about 100 cm long and lies across the abdominal cavity. Surgery is the best treatment for colon cancer. Surgery depends on the location, size as well as stage of the cancer. It could be open or key hole surgery. Laparoscopic surgery is the most commonly performed surgery, if the stage is early and there is no surrounding organs involved or obstruction.
Surgery for Cancer of the Uterus
Endometrial or uterine cancer requires removal of the uterus along with surrounding tissues including ovaries and draining lymph nodes. Surgery can be done by open method or key hole surgery including laparoscopic or robotic surgery. Type of surgery depends on many oncologic factors.
Surgery for Ovarian Cancer
Carcinoma of the Ovary can present in various stages. Surgery is the first line of treatment for earlier stages of cancer of the ovary. In stage 3 or 4, surgery is done after initial chemotherapy. Key hole surgery is the mainstay for stage 1 or 2. Open surgery as debulking surgery is done for advanced stages. It is an extensive surgery but helps in keeping cancer in control for many years.
Cervical Cancer Surgery
Cervical cancer is one of the commonest cancer in females in India. If discovered early, Wertheims Radicle Hysterectomy is the classical surgery. This can be done by keyhole or open surgery. It involves removal of uterus, cervix, surrounding parametrical tissues and all the lymph nodes in the pelvis.
Vulvar Cancer Surgery
Vulvar cancer needs surgery if the tumour is resectable. This surgery requires precision as the space is very limited and reconstruction is required, especially in complete vulvectomy. If the lymph nodes are palpable, then unilateral or bilateral block dissection is also done.
Abdominal Sarcoma Surgery
Soft tissue sarcomas of the abdomen including the retroperitoneum and the pelvis could be very large. Surgical excision gives the best results if the sarcoma is resectable and not spread. The aim of surgery is to remove the entire tumour along with at least 1 to 2 cm (less than an inch) of the normal tissue around it and without harming surrounding structures. It is a high risk surgery because of the bleeding potential of sarcomas.
Laparoscopic cholecystectomy is the gold standard for gallstones. Open cholecystectomy is reserved for complicated gall bladder stone disease and required in less than 5% of patients with gallstones.
Inguinal Hernia Repair
Inguinal Hernia Repair is necessary for all inguinal hernias. Herniotomy is done for toddlers. TEP or TAP are two Laparoscopic Surgeries offered for all adult inguinal hernia. Open Hernioplasty is done in recurred or strangulated hernia. Most of the surgeries incorporate putting in a mesh.
Anal Fistula is of various types, numbers and sizes. It is associated with infection as well as bleeding. Surgery of the fistula involves draining pus, removing the fistulous tract and saving the anal sphincter muscle complex to avoid incontinence. At times, surgery has to be done in a phased manner.
Surgery for haemorrhoids could be open or closed haemorrhoidectomy or stapled haemorrhoirdectomy depending on the type and degree of haemorrhoids. For upto second degree haemorrhoids, banding is done.
Anal Incontinence Surgery
Fecal or anal incontinence is involuntary loss of control over passing of flatus or stools. If the cause is reason is injury to the anal sphincter, then repair of sphincter gives excellent results. This surgery is very useful especially where the sphincter is injured due to trauma, vaginal delivery or after surgery in the perineum for some other disease.
Surgery for Anal Fissure
Anal Fissure is a very painful condition and requires surgery, if the non operative treatment is not successful. LAS or Lateral Anal Sphincterotomy is the surgery of choice and gives excellent results.
Robotic Rectal Cancer Surgery
Rectum is located in the pelvis, which is a very constrained space with lot of organs and tissues. Robotic surgery provides precision in the surgeries for managing cancers of the high, mid and low rectal cancers. APR, High Anterior resection and Low Anterior Resection can be done with the help of a robot. Patient and case selection is vital.
Laparoscopic Rectal Cancer surgery
Rectal Cancer Surgeries for cancer of the rectum can be done laparoscopically, if there are no contraindications. Thus High and Low Anterior Resections as well as APR can all be done laparoscopically. The contraindications could be very large tumour, previous surgery, involvement of surrounding tissues or any other condition with high anaesthetic risk.
Laparoscopic Anterior Resection (High)
Laparoscopic assisted High Anterior Resections is removal of the sigmoid colon upto the recto sigmoid junction or upper rectum. It is done for many benign or malignant diseases. Commonly it is done for cancer of the sigmoid colon or upper rectum.
Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is the standard surgery of choice for Inguinal Hernia. It is an effective minimally invasive method for treating groin hernias as it avoids entry into the abdominal cavity and the entire surgery is done between the muscles of the abdominal wall. Bilateral groin hernia are also easily tackled with this method through the same small incisions.
Left Hemicolectomy is removal of left part of the colon and is done for both cancer as well as non cancerous diseases. It can be done through a keyhole or by open surgery, depending on the nature and stage of the disease.
Laparoscopic Left Hemicolectomy
Key hole surgery in the form of laparoscopic left Hemicolectomy is done for cancers of the left colon including left splenic flexure, descending and proximal sigmoid colon cancers. It reduces hospital stay as well as the postoperative pain. The incision used is much smaller than the open left Hemicolectomy.
We provide diagnosis and treatment for diseases including: colorectal cancer, inflammatory bowel disease, diverticular disease, polyposis syndromes, anorectal disorders, and pelvic floor dysfunction including rectal prolapse and faecal incontinence as well as common surgical disorders like gallstones, hernias and road traffic accidents. Surgery is offered for haemorrhoids, anal fistula and anal fissure.
Advanced surgical expertise is available for total mesorectal excision for rectal cancer minimally invasive keyhole surgical techniques including laparoscopy and robotic surgery; ileal pouches for ulcerative colitis or FAP; sphincter-preserving operations for low rectal cancers; and cutting edge surgical approaches to rectal prolapse and faecal incontinence. We offer treatment for ovarian cancer as well as surgery for endometrial cancer; cancer of the cervix and carcinoma of the vulva.
We interact and collaborate clinically with gastroenterologists, medical oncologists, radiation oncologists, and surgeons from other specialties to offer patients with complex colorectal and gynaecological problems an integrated treatment plan.