Epilepsy Surgery

A Neurological Disorder in which brain electrical activity becomes abnormal causing unprovoked seizures.

Various factors such as head injury, injury to brain at the time of birth, abnormal development of brain, brain tumours, stroke etc., could give rise to symptoms like loss of consciousness, abnormal movements of one part or one side or whole body, confusion, weakness and loss of recent memory etc.

Approximately 70% of cases can be controlled with medication alone, however, the rest 30% of cases may need a surgery.

Epilepsy surgery is a highly specialized sub-specialty of Neuro-Surgery which involves Epileptologist, Epilepsy Surgeon, Neuro-Radiologist trained in functional imaging such as PET and SPECT scans

Surgery for Spasticity

A condition in which muscles stiffen and prevent normal smooth movement causing difficulty to walk, speak and abnormal walking gait. Spasticity is generally caused by damage either to spinal cord or brain.

  • Muscle stiffness, making certain tasks difficult to perform
  • Muscle spasms, causing uncontrollable muscle contractions
  • Involuntary crossing of the legs
  • Muscle and Joint deformities
  • Frozen Joints and contractures

    Intrathecal Baclofen Pump (ITB) and Selective Dorsal Rhizotomy (SDR) are usually considered in extremes and are effective in spasticity of upper or lower limbs.

    • Functional Neurosurgery

    Several conditions ranging from chronic pain to Neuro - degenerative diseases that cause disability in day-to-day life.

  • Parkinson’s Disease
  • Essential tremor (uncontrolled shaking of part of the body)
  • Dystonia (uncontrolled spasms of muscles of whole body)
  • Chronic pain
  • Spasticity in cerebral palsy, post-trauma, post stroke etc.

    are a few conditions of Neuromodulation also known as functional Neuro - Surgery in simple terms

    • Neuro Endovascular Treatments

    An innovative, minimal invasive surgical treatment for complex brain and spinal cord vascular disorders which involves use of small hollow tubes (catheters) and small devices through blood vessels.

  • Diagnostic brain angiogram like heart angiogram
  • Treatment of aneurysms
  • Placement of stents and angioplasty
  • Treatment of arteriovenous malformations of the brain
  • Tumour embolization

    are a few conditions that can be treated with this minimally invasive method

    • Deep Brain Stimulation

    Placement of electrodes within certain areas of the brain to provide electrical impulses that regulate abnormal impulses. Devices like the Pacemaker are placed in upper chest regulate the amount of stimulation.

  • Parkinson’s Disease
  • Essential tremors (uncontrolled shaking of part of the body)
  • Dystonia (uncontrolled spasms of muscles of whole body)
  • Chronic pain
  • Epilepsy & OCDs.

    are a few conditions to which this kind of surgery is the moist efficient, effective and safe

    • Stroke

    Stroke is caused by blockage of a blood vessel or rupture of blood vessel. There are two types of stroke Ischemic Stroke and Hemorrhagic Stroke.

    Ischemic stroke is the most common type of stroke and is caused by severe narrowing or blockade of blood vessel.
    Hemorrhagic Stroke is caused by rupture of blood vessels.

    The common risk factors are obesity, high blood pressure, smoking, high cholesterol, diabetes, heart diseases, family history of stroke etc., A few symptoms can be:

  • Paralysis
  • Difficulty in speech or swallowing
  • Stiffness of muscles
  • Loss of memory

    • Brain Tumours

    A brain tumour is growth of abnormal cells and results in a mass. A few of the tumours are non-cancerous (benign) and the others are cancerous (malignant).

    Tumours can arise from the brain itself or spread to brain from other parts of the body

    Symptoms include:

  • Headache
  • Nausea
  • Seizures (Fits)
  • Weakness
  • Memory problems
  • Difficulty in speech
  • Loss of vision / loss of hearing

    • Spinal Disorders

    Numerous conditions can affect the spine (back none) from neck to lower back may cause Congenital disorders - spinal cord malformations, myelomeningoceles, deformities.

    Inflammation- ankylosing spondylitis, rheumatoid arthritis. Infection- tuberculosis, brucellosis, other bacterial infections, Inherited disorders and Degenerative disease - sciatica, unstable spine, neck deformity etc.,

    Symptoms include:

  • Abnormally rounded shoulders
  • Back or Neck pain
  • Bladder or bowel dysfunction
  • Nausea, Stiffness
  • Weakness / numbness

    • Head Trauma

    Head injuries are one of the most common. Road traffic accidents, falls, sports, gunshots, child abuse, violence etc. can cause significant disability and death. Delay in the proper treatment will result in irreversible damage, paralysis or even loss of life.

    Symptoms may depend on severity of injury

  • Headache, Irritability, Confusion
  • Loss of memory
  • Nausea & Fits
  • Blurred vision
  • Loss of consciousness

    • Spinal Trauma

    Spinal Trauma is damage to bones surrounding spinal cord, soft tissues and spinal cord itself. Spinal trauma is also caused by road traffic accidents, fall from heights, gunshot injury, sports etc.

    Symptoms of spinal trauma include:

  • Paralysis - weakness of hands or legs
  • Leakage or inability to pass urine
  • Uncontrollable stool leak
  • Loss of sexual function
  • Numbness

    • Breast Diseases

    Breast Cancer, Fibroadenoma, Fibrocystic disease, Duct Ectasia, Nipple discharge, Mastalgia, Breast Cancer screening & counselling

    Thyroid Diseases

    Thyroid Cancer, Benign Goiters, Thyro-glossal cysts, Graves' disease and Hyperthyroid Goiters, Neck Lymph Node dissections

    Para Thyroid Diseases

    Primary / Secondary Hyper - ParaThyroidism, Parathyroid Adenoma, Parathyroid Hyperplasia, Parathyroid Carcinoma

    Adrenal Diseases

    Pheochromocytomas, Adrenal functional / non - functional Adenoma, Myelolipoma, Paraganglioma, Adreno-cortical Cancer

    GI / HPB Cancer Surgeries

    GI / HPB tract cancer incidence has been increasing Esophageal Cancers, Gastric cancers, Duodenal Cancers, Small Intestinal Cancers, Colorectal and Anal cancers, Hepatobiliary Tract Tumors, Pancreatic cancers, Adrenal Tumors

    Bariatric Surgeries

    Morbid obesity is generally termed when the BMI is over 40kg/m2 or when the BMI is 35kg/m2 and associated with other comorbidities. Morbid obesity is one of the most neglected easily treatable condition.

    Kidney & Ureteric Stones

    RIRS - for kidney stones-without any hole using laser through the urethra

    PCNL - for very large stones in kidney- small key hole in the back

    ECIRS - combination of both PCNL and RIRS for very large stones

    Urological Malignancies

    Laparoscopic Surgery, Radical Nephrectomy and Nephroureterectomies

    Turbot and Radical Cystectomy

    Laparoscopic Radical Prostatectomy and Bilateral Orchidectomy

    Neuro-Urological Problems

    Urinary problems like frequent urination, slow stream, urgency and incontinence of urine.

    Medication of overactive bladder and surgical procedures

    Laparoscopic Ureteroluthotomy - for very large ureteric stones

    Prostate Problems

    Elderly male with prostate problems like slow urine stream, frequent urination, urgency etc. may require surgery for prostate problem.

    Turp and laser turp-through urethra without any scars

    Infertility

    Male Infertility – Surgical Management Like Varicocele Surgery, Testicular Sperm Extraction for IVF / ART

    Urethral Stricture Diseases

    VIU – Per Urethral surgery for short segment disease

    Urethroplasty - for long segment disease

    Pelvic fractures with urethral disease

    2D Echocardiography

    2D Echocardiogram (2D Echo) is a non-invasive diagnostic tool (like ultrasonography) to see structure and function of heart. It is a routine diagnostic tool for Cardiologists.

    2D Echo can usually be performed in 1—15 mins without much discomfort. It may take a little while in children.

    Fetal Echocardiography

    Fatal echocardiography is uses sound waves to study the heart of developing baby who in the womb. Complete fatal echo is usually done by an expert who trained pediatric cases when routine screening shows some abnormality during pregnancy or some infections such as cytomegalovirus and irregular fatal heart beats.

    Holter Studies

    Holter monitor is a small wearable device that records hearts rhythm continuously. It is usually done when heartbeat is irregular and infrequent, unexplained fainting or giddiness and in conditions of heart which alter the heart rate. The results are usually analyzed by cardiologist. This is a non invasive test.

    TMT

    TMT (Tread Mill Test) is an excise stress test. It used to see if you have risk of developing some heart conditions. It also shows how much your heart can make up before it develops heartbeat irregularities and abnormal blood supply. Your ECG, BP and heart rate are monitored throughout the test.

    Cardiac Catheterisation

    It helps doctors to diagnose or treat certain heart conditions, such as clogged arteries or irregular heartbeats.

    In children, it is done to know pressures in various heart chambers and blood vessels to characterise type of heart defects and their extent.

    Congenital Heart Disease

    A congenital heart defect is a problem with the structure of heart that a child is born with. Some of these defects are simple and just need observation and resolve with time. Others may require medical attention and surgeries to treat them. The common conditions include atrial septal defect (ASD), ventricular septal defect (VSD), PDA, valve abnormalities etc.

    Device Closure of Congenital Heart Defects

    Device closure is used to close a defect formed abnormally in the heart. This method of treatment is done through Cardiac Cauterization and devices are deployed at defective areas of heart. Some common conditions that need this type of treatment are ASD, VSD, PDA, Vessel anomalies and valve abnormalities.

    Diagnosis and Treatment of Cardiac Arrythmias

    Diagnosing and localizing the source of arrythmias in heart is highly challenging. These conditions are usually diagnosed with ECG, 2D Echo, Holter Monitoring, excise stress test, implantable recorders and Electrophysiological testing and mapping. These conditions are treated with medicines, burning the area of abnormality in heart and placement of ICD (battery) etc.