Microsurgery

  • Microsurgery refers to a specialized type of surgery where the surgeon uses a high power magnification to look at fine tissues and organs to perform delicate surgeries (usually reconstruction surgeries).

  • Vasectomy reversal is a surgery to undo a previously done vasectomy surgery and has a success rate of about 40-90%. During vasectomy, vas deferens (tubes that carry sperm from the testicles to the penis) are either cut or blocked by the surgeon. The vasectomy reversal procedure helps reconnect each tube to allow the sperm to reach the semen when you ejaculate. Once the vasectomy reversal procedure is done, the sperms are again present in the semen and can get your partner pregnant.The Procedure: There are two approaches to do a vasectomy reversal. Vasovasostomy is the procedure in which the surgeon sews the tubes from the testicles back to the penis to allow the sperm to enter the semen. Another approach for vasectomy reversal is known as vasoepididymostomy. In this procedure the surgeon attaches the tubes (vas deferens) to a small organ at the back of each testicle that holds the sperm.Vasectomy reversal is an outpatient procedure and is performed under an anesthesia. The procedure takes about 2-4 hours. Recovery usually takes about 2 weeks.

  • Hemodialysis, more commonly known as kidney dialysis is a blood purifying procedure for a patient whose kidneys are not working normally or have failed completely.

  • Laparoscopy is one of the best procedures to diagnose impalpable undescended testis. At an initial stage, diagnostic laparoscopy is performed to check the location of the testis, its size, its distance from the internal ring, presence of hernia on affected as well as unaffected side, etc.

  • An AV fistula is a connection between an artery and a vein made by a vascular surgeon. AV fistula is placed in the forearm or upper arm of the patient. It causes extra pressure for the blood to flow into the vein.

Microsurgery(Brief)

Microsurgery refers to a specialized type of surgery where the surgeon uses a high power magnification to look at fine tissues and organs to perform delicate surgeries (usually reconstruction surgeries).

Microsurgical Varicocelectomy

Vericoceles is a condition in which enlarged scrotal veins may be a major source of male infertility. It results in low sperm production and can decrease the sperm quality and may also hinder in testosterone production. These varicocele are very similar to the varicose veins that occur in the legs. Varicoceles can also cause testicles to shrink or develop normally.

Vasectomy Reversal

Vasectomy reversal is a surgery to undo a previously done vasectomy surgery and has a success rate of about 40-90%. During vasectomy, vas deferens (tubes that carry sperm from the testicles to the penis) are either cut or blocked by the surgeon. The vasectomy reversal procedure helps reconnect each tube to allow the sperm to reach the semen when you ejaculate. Once the vasectomy reversal procedure is done, the sperms are again present in the semen and can get your partner pregnant. The Procedure: There are two approaches to do a vasectomy reversal. Vasovasostomy is the procedure in which the surgeon sews the tubes from the testicles back to the penis to allow the sperm to enter the semen. Another approach for vasectomy reversal is known as vasoepididymostomy. In this procedure the surgeon attaches the tubes (vas deferens) to a small organ at the back of each testicle that holds the sperm.Vasectomy reversal is an outpatient procedure and is performed under an anesthesia. The procedure takes about 2-4 hours. Recovery usually takes about 2 weeks.

Arteriovenous fistula for hemodialysis

Hemodialysis, more commonly known as kidney dialysis is a blood purifying procedure for a patient whose kidneys are not working normally or have failed completely. The treatment is done with the help of a machine that is responsible for purifying the patient's blood by passing it through a filter, called a dialyzer, outside the body. A vascular access (Arterioveneous fistula) is surgically created vein that is used to remove the blood and then return it during hemodialysis.

The Procedurey

Procedure of Hemodialysis:
- The blood goes through a needle, a few ounces at a time.
- The blood then travels through a tube that takes it to the dialyzer.

Inside the dialyzer, the blood flows through thin fibers that filter out wastes like creatinine and urea and extra fluid.
- The machine returns the filtered blood to the body through a different tube.
- A vascular access, arteriovenous (AV) fistula allows large amounts of blood to flow during hemodialysis treatments to filter as much blood as possible per treatment.

What is Arteriovenous (AV) fistula?

An AV fistula is a connection between an artery and a vein made by a vascular surgeon. AV fistula is placed in the forearm or upper arm of the patient. It causes extra pressure for the blood to flow into the vein. This makes the veins large and strong for easy access to blood vessels. AV fistula provides good blood flow for dialysis and lasts longer as compared to other types of vascular access, AV graft and venous catheter. It is less likely to get infected or cause blood clots.

The Procedure:

Step 1: Vessel mapping test using Doppler ultrasound is done before the AV fistula surgery. This is to evaluate blood vessels that may be used to make AV fistula. The results from this ultrasound, lets the surgeon decide which blood vessel would be best to use. This is an outpatient procedure and doesn't need anesthesia.

Step 2: The vascular access is then created. It is usually an outpatient procedure, but may require an overnight stay and is performed under a local anesthesia to numb the area where AV fistula is to be created. AV fistula needs 2-3 months to develop or mature, post which a patient can use it for hemodialysis. The procedure may be repeated is an AV fistula fails to mature in 2-3 months.

Step 3: If the AV fistula is matured, hemodialysis sessions can begin. The session starts with insertion of two needles, arterial needle and venous needle into the AV fistula, the vascular access. Arterial needle carries blood from the body to the dialyzer and venous needle carries filtered blood back to the body.

Case Study

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