DR. PATIL’S HOSPITAL Near Hotel Garden, Thana Naka, Panvel – 410206, Dist – Raigad. Phone: 27451717 / 27451217, Telefax: 27451217, PCO : 27491196. ISO 9001:2000 CERTIFIED HOSPITAL FULL-TIME DOCTORS • DR. D. B. PATIL M.S., F.M.A.S.; Dip A.L.S.; F.A.C.R.S.I. • DR. MRS. J. D. PATIL D.G.O. We, Dr. D. B. Patil as General Surgeon & Dr. Janki D. Patil as Obstetrician & Gynaecologist form an ideal team. We have a very well equipped set-up for laparoscopic surgery. We are performing laparoscopic surgeries since 1995. • We are providing advanced laparoscopic surgeries for many years. • Now we are doing cancer surgery also laparoscopically. • We are doing diagnostic gastroscopy & colonoscopy for many years. • Now we are providing advanced therapeutic endoscopy. • We have the best set-up for laparoscopic surgery in whole of the Navi Mumbai & Raigad district. • We have two operation theaters & one endoscopy room. OPERATION THEATRE - 1 OPERATION THEATRE - 2 ENDOSCOPY ROOM • We have state of the art hightech world class equipments. • We have two sets of equipments so that laparoscopic surgery need not be converted to open surgery for instrument failure. TWO SETS OF EQUIPMENTS PATIENT SAFETY FIRST! • We have all equipments to monitor patient’s all vital parameters which confirms our motto “Patient’s safety first!” • To highlight following are the few important equipments which speak about our quality & care. PHILIPS MULTIPARA CAPNOMETER ONLY ONE OR TWO HOSPITALS HAVE HARMONIC SCALPEL THE ONLY ONE OF IT’S KIND IN NAVI MUMBAI & RAIGAD HARMONIC SCALPEL • No electricity passes through the body. Uses ultrasound energy, so safer than usual cautery. • No lateral thermal damage so safer near vital structures. • Dissection & simultaneous cutting with coagulation by same instrument reduces time of surgery. • No smoke so clear visibility, & thus increased safety. • No charring so dissection becomes easy. CAMERAS & XENON LIGHT SOURCE ARE OF STORZ : THE WORLD LEADERS These are eyes of the laparoscopic surgeon OLYMPUS VIDEO-ENDOSCOPE Visualises everything inside the gut. C – ARM : Makes advanced therapeutic endoscopy possible. • We have special recording & reporting system. • We have special softwares for this. ELECTRICITY SHUTDOWNS We have two different back-up systems. • Two sets of 3KW invertors • 30KW Cummins generator. LAPAROSCOPIC SURGERY We are proud to announce that we introduced the laparoscopic surgery to Panvel & Raigad district. Laparoscopic surgery basically encompasses two specialities, one general surgery & second Obstetrics & gynecology, Laparoscopic surgery means abdominal surgery done through keyholes with the help of telescope. It has many advantages over conventional surgery & at the same time it can be done as meticulously as open surgery. Important structures can be identified easily because of magnification. It has following advantages. 1. Post operative pain is very less. 2. Post operative recovery is very fast. 3. Shorter hospital stay. 4. Early resumption to full work. 5.Complications such as wound infection & incisional hernia are virtually eliminated. However laparoscopic surgery is more expensive. But in our hospital most of the common surgeries, are performed at concessional charges , so that expenses are nearly equal to conventional surgery. Following laparoscopic surgeries are routinely done at our hospital. Diagnostic: Done to know the cause of illness in following conditions. 1. Undiagnosed Chronic abdominal Pain. 2.Infertility. 3.Undiagnosed acute abdominal pain. Therapeutic: Surgeries done as treatment. 1. Tubal ligation 2. Cholecystectomy 3. Appendicectomy 4. Adhesiolysis 5. Salpingectomy 6. Oophorectomy 7. Total Laparoscopic Hysterectomy (TLH) 8. Hernia repair DIAGNOSTIC LAPAROSCOPY IN CHRONIC ABDOMINAL PAIN This is done to know the cause of long standing abdominal pain where all other investigations could not lead to any conclusion. The conditions which may be detected only on laparoscopy are, chronic recurrent appendicitis, adhesions, chronic ectopic, chronic pelvic inflammatomy disease, abdominal tuberculosis etc. DIAGNOSTIC LAPAROSCOPY IN INFERTILITY This is done to know the intraabdominal problems causing difficulty in getting child. It is superior & supplementary, to all other investigations. You can directly visualise internal reproductive organs directly. We can assess tubal patency, condition of ovaries & tubes. We can detect diseases such as chronic PID leading to adhesions, & endometriosis, which can be treated laparoscopically. Conditions such as abdominal tuberculosis & genitourinary tuberculosis can be diagnosed & treated at early stage. DIAGNOSTIC LAPAROSCOPY IN ACUTE ABDOMINAL PAIN In some cases of acute abdominal pain, some-times it is very difficult to decide whether immediate surgery is required or not. This is because of atypical presentation, in some cases of ectopic pregnancy, contd. subacute appendicitis, blunt abdominal trauma etc. Out of these, many conditions can be treated laparoscopically, through same ports. Few conditions which can be treated only by open surgery, we will have an idea of extent of surgery. LAPAROSCOPIC TUBAL LIGATION This is the simplest & best laparoscopic surgery. These surgeries conducted on a mass scale in camps, in the remotest of villages, which itself indicates its simplicity, safety & comfort. Patient can resume to full work as rapidly as it is done. Cosmetically very good. However there are many misunderstandings about this surgery, because of lack of time, where patient is not explained fully e.g. 1. Shock is given in this surgery. 2. Failure rates are high. No shock is given in this surgery. Light is used to see inside of the abdomen. Failure rates are same as open surgery. LAPAROSCOPIC CHOLECYSTECTOMY Now its superiority over conventional open cholecystectomy is proved beyond doubt. It can be done precisely with more comfort to the patient & cosmetically fine results. Patient can resume to full work very fast. Surgery can be done through two 1cm & two 1/2cm. incisions & can be discharged from the hospital within two days. LAPAROSCOPIC APPENDICECTOMY This is also superior to open appendicectomy in respect of post operative comfort, wound infection, early resumption to full work & cosmetic results. Laparoscopy is the only method by which appendicitis can be confirmed with certainty. At the same time whole of the inside of the abdominal can be visualised, so that co-existing disease if any can be detected, & treated through the same incisions, thus without increase in pain & discomfort. LAPAROSCOPIC ADHESIOLYSIS Means division of adhesions. Adhesions are formed following previous open surgery or previous episodes of intraabdominal infections. Adhesions are detected either during diagnostic laparoscopy for chronic abdominal pain or infertility or during laparoscopic surgery for some other condition. Adhesiolysis helps to relieve chronic abdominal pain or conceive as the case may be. LAPAROSCOPIC SALPINGECTOMY Here the diseased fallopian tube in conditions such as ectopic pregnancy hydrosalpinx or pyosalpinx is removed. This surgery is done through one 10mm and two 5mm incisions in laparoscopic method, there by avoiding large incision required in open method. LAPAROSCOPIC OOPHORECTOMY & OVARIAN CYSTCTOMY Laparoscopy oophorectomy indicated as adjuvant therapy in carcinoma of breast, is performed quite easily & safely. Removal of ovarian cyst, with or without ovary depending upon indication, can also be done easily. TOTAL LAPAROSCOPIC HYSTERECTOMY (TLH) Vaginal hysterectomy has very low morbidity. But is easy & safe only in cases of prolapsed, normal sized uterus. In bulky & non-prolapsed uterus, where vaginal hystere-ctomy is difficult, abdominal hysterectomy is safe, but has more morbidity. In such cases if TLH is done it will be safe, & gives all advantages of vaginal hysterectomy i-e • • • • • Very less postoperative pain. Fast post operative recovery. Short hospital stay. Early resumption to full work. Cosmetically very good. ENDOSCOPY • We have state of the art video-endoscopes to study upper & lower Gastrointestinal (GI) tract. • Upper GI tract study includes oesophagus, stomach & duodenum (OGD SCOPY). • Lower GI tract study includes colon, rectum, anal canal & terminal ileum (COLONOSCOPY). OGD SCOPY Done either for diagnosis or treatment. DIAGNOSIS : – Diagnose or confirm acid peptic disease. – Diagnose or confirm Gastro-oesophageal Reflux Disease (GERD). – Diagnose hiatus hernia, diverticuli or stricture of oesophagus. – Diagnose & confirm by biopsy the nature of neoplastic lesion. TREATMENT : • Foreign body removal from oesophagus, stomach & duodenum. • Injection sclerotherapy or band ligation for oesophageal varices & glue injection for fundic varices. • Dilatation of benign oesophageal strictures, achalesia cardia etc. • Stent insertion for cancerous oesophageal lesion. Continued… • ERCP for removal of common bile duct (CBD) & pancreatic duct (PD) stones. • Stenting for CBD strictures & injuries. • Stenting for PD strictures. • Stenting for pancreatico-biliary cancers. COLONOSCOPY Done for diagnosis & treatment. DIAGNOSIS : • Chronic diarrhoea • Chronic constipation • Change of bowel habit. • Chronic unexplained left lower abdominal pain. • Unexplained rectal bleeding in elderly. • Solitary rectal ulcer syndrome. Continued… • Followup study in ulcerative colitis to assess response to treatment & early detection of cancerous changes. • Biopsies can be taken to ascertain the nature of neoplastic growth. TREATMENT : • Polypectomy • Controll of bleeding from vascular lesion. • Argon plasma coagulation. HYSTEROSCOPY • Shows inside of uterus. • We can detect abnormalities like septum, adhesions, fibroids, polyps, tubal opening block etc. • We can also treat above problems. VIDEO-CLIP OF LAPAROSCOPIC CHOLECYSTECTOMY • Video-clip of Laparoscopic Appendicectomy. • Video-clip of Rt. Salpingectomy done for twisted hydrosalpinx (collection of fluid in the tube). Video-clip of laparoscopic removal of Lt. ovarian cyst. Endoscopic removal of foreign body : coin. Video-clip of endoscopic removal of Foreign body : partial denture. Video-clip of colonoscopy : Normal findings Video-clip of colonoscopy : Ulcerative colitis Video-clip of endoscopic biopsy from Ca-oesophagus PORT PLACEMENT & INITIAL DISSECTION TO SEPARATE CYSTIC DUCT & CYSTIC ARTERY Applying clips & cutting cystic duct & cystic artery. Dissecting out gallbladder from liver. Removal of gallbladder & placement of drain. ISO 9001:2000 CERTIFIED HOSPITAL • For such best set-up & seniormost experienced laparoscopic surgeons charges are reasonable. • Quality & care comes at the cost. It can be made affordable but not cheap. • Our hightech laparoscopic surgeries are definately affordable.