Home About MIS Department Consultants Procedures Facilities Achievements

About Minimally Invasive Surgery

Minimally invasive surgery, also known as keyhole surgery or minimally invasive surgery, is a type of surgical procedure that facilitates a surgeon to easily access the interior of the abdomen and pelvis using an instrument called a laparoscope. The laparoscope is a small tube equipped with a light source and a camera, which transmits images of the interior of the abdomen or pelvis to a television monitor. One of the major benefits of minimally invasive surgery over traditional surgery is that large incisions could be avoided. Minimally invasive surgery is generally used in gynaecology, gastroenterology, and urology.

How is Minimally invasive surgery performed?

Minimally invasive surgery is performed under general anaesthesia. During this procedure, the surgeon makes one or more small incisions or ports, measuring 0.5-1cm, in the abdomen. A tubular instrument called a ‘trocar’ is inserted at each port. Certain specialized surgical instruments and a laparoscope are then passed through the trocars. The patient’s abdomen is inflated with carbon dioxide gas in order to separate the wall of the abdomen from the underlying organs, thus providing the surgeon a clear and precise view of the internal organs. The laparoscope transfers the images from the abdominal cavity to high-resolution video monitors placed in the operating room, allowing the surgeon to operate effortlessly. After the procedure, the gas is released from the abdomen, the incisions are closed, and a dressing is applied.

Advantages

Minimally invasive surgery offers numerous advantages over conventional surgical techniques, such as:
  • Shorter hospital stay
  • Quicker recovery period
  • Minimal pain and bleeding
  • Reduced scarring
  • Superior results

Conditions diagnosed or treated by Minimally invasive surgery

Minimally invasive surgery is used to diagnose and treat a varied range of conditions such as:
  • Crohn's disease which causes blockage or is unresponsive to medical therapy
  • Colorectal cancer
  • Recurrent attacks of Diverticulitis or failure of medical therapy
  • Familial polyposis
  • Bowel incontinence
  • Rectal prolapse
  • Ulcerative colitis unresponsive to medical treatment
  • Colon polyps
  • Chronic severe constipation
  • Tubal ligation
  • Hiatal hernia or inguinal hernia
  • Abnormal growths or tumours in the belly or pelvis.
  • Endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
  • Cysts, adhesions, fibroids, and infection.

Minimally invasive surgery is also used to perform surgical procedures, which involves removing a damaged or diseased organ, or extracting a tissue sample for biopsy.

Credence Institute for Minimally Invasive Surgery

The Minimally Invasive Surgery unit at Credence hospital is a full-fledged, specialised centre for keyhole surgeries. With our state-of-the-art equipment, excellent infrastructure, and a team of internationally trained surgeons, we provide you the most advanced minimal access surgeries, thus ensuring quality medical care for our patients. Our surgeons have extensive experience and expertise in treating various conditions that require surgical intervention. Over the years, we have performed several advanced laparoscopic surgeries and handled some of the most complicated cases, with tremendous success and patient satisfaction.

Minimally Invasive Gynecological Surgeries

DR. BIMAL JOHN MS, Dip. AES(France), Dip. AES(Germany)

DR. SANTHAMMA MATHEW MBBS, MD, DGO

DR. P G PAUL MD, DGO

Minimally Invasive General and Gastrointestinal Surgery

DR. S DILIPKUMAR MS, FMAS

DR. BAIJU SENADHIPAN MBBS, MS

DR. ANU ANTONY VARGHESE MBBS, MS (Surgery)

Gynaecology

Uterus Surgery

Uterus surgery or Hysterectomy refers to the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes, and other adjacent structures. Hysterectomy is done to treat various conditions, such as those associated with periods, pelvic pain, and tumours. A laparoscopic hysterectomy is a minimally invasive surgical procedure which involves the removal of the uterus. Basically, there are three laparoscopic approaches: Total laparoscopic hysterectomy (TLH), Laparoscope-assisted vaginal hysterectomy, and Laparoscopic supracervical hysterectomy (LSH).

Fibroid Removal

Uterine fibroids are noncancerous growths of the uterus that commonly occur in women during their pregnancy period. Surgery might be recommended if the symptoms are severe and medication has proved ineffective. The main procedures used to treat fibroids are: Hysterectomy (surgical removal of the uterus) and Myomectomy (removal of fibroids while preserving the uterus). In laparoscopic or robotic myomectomy, the surgeon accesses and removes fibroids through numerous small abdominal incisions. Laparoscopic myomectomy offers numerous benefits to the patient including minimal pain, less blood loss, and faster recovery.

Ovarian Surgery

Ovarian cysts are fluid-filled sacs that occur inside or on the surface of an ovary. Typically, ovarian cysts do not require treatment and tend to disappear within a few months. However, large cysts need to be removed surgically. Ovarian cyst removal is often performed using laparoscopy or laparotomy. If the laboratory results indicate that the cyst is cancerous, the ovaries, uterus, and part of the surrounding tissue may have to be removed.

Ectopic Surgery/Tubal Pregnancy Surgery

An ectopic pregnancy refers to a pregnancy that develops outside a woman's uterus and generally occurs in the first 5-10 weeks of pregnancy. Ectopic pregnancy can also occur on the ovaries, fallopian tubes, or is attached to the bowel. A great majority of ectopic pregnancies occur in the fallopian tubes, which transports the egg from the ovary to the uterus. Sometimes, a tubal pregnancy could result in heavy internal bleeding that could prove extremely fatal. Surgical removal of an ectopic growth and/or part of the fallopian tube where it has implanted is the quickest treatment. Keyhole Surgery or Minimally Invasive Surgery is the most commonly used surgical procedure for the treatment of ectopic pregnancy.

Endometriosis Surgery

Endometriosis is a painful condition in which the endometrium- the tissue that normally lines the inside of your uterus – develops outside the uterus. Endometriosis affects your ovaries, bowel, or the tissue lining your pelvis and can result in fertility problems. Treatment for endometriosis usually involves medications or surgery. Surgery could be performed either laparoscopically or through traditional abdominal surgery. Assisted reproductive technologies, such as In vitro fertilization, are at times considered. In severe cases of endometriosis, total hysterectomy (surgical removal of the uterus, cervix, and ovaries) is often the recommended treatment.

Hysteroscopy

Hysteroscopy is a diagnostic and surgical procedure that facilitates the doctor to examine the inside of the uterus without making an abdominal incision. Hysteroscopy is performed using a hysteroscope, a thin, lighted tube which is inserted into the vagina for examining the cervix and inside of the uterus. This procedure is often used to diagnose and treat causes of abnormal bleeding or bleeding that occurs after a woman has attained menopause, remove fibroids or polyps, and to diagnose if there is a problem in your uterus that is preventing you from becoming pregnant.

Endometrial Resection and Ablation

Endometrial ablation is a surgical procedure done for destroying or removing the endometrium (the lining of the uterine cavity). Ablation is used to treat various conditions such as endometriosis, heavy periods/menorrhagia, and abnormal uterine bleeding. Endometrial ablation can be done in different ways: using Laser beam (laser thermal ablation); Heat (thermal ablation), Electricity, Freezing, or Microwave. Following the procedure, the endometrium heals by scarring, which generally reduces or prevents uterine bleeding. When compared to a hysterectomy, an endometrial ablation has lesser complications and a faster recovery time.

General surgery

Colon Surgery

Colectomy, or Colon surgery, is the surgical removal of all or part of your colon (large intestine). The surgery is often done to treat various diseases and conditions that affect the colon such as severe bleeding, bowel obstruction, colon cancer, Crohn’s Disease, Ulcerative colitis, and Diverticulitis. Colon surgery could be performed in two ways: Open Colectomy and Laparoscopic colectomy. Laparoscopic-assisted colectomy is an option for earlier stage cancers.

Hernia Surgery

Hernia refers to the protrusion of an organ through an opening in the muscle or the surrounding tissue wall. The most common type of hernia is inguinal hernia, characterized by a painful swelling or lump in the groin, or an enlarged scrotum. Surgery is often recommended for inguinal hernia to avoid complications such as strangulation (a loop of intestine gets tightly trapped in a hernia, which obstructs the blood supply to that part of the intestine). An inguinal hernia repair can be performed either by Open surgery or Laparoscopic surgery.

Appendix Surgery

Appendicitis refers to a condition in which the appendix becomes inflamed, swollen and infected, resulting in severe abdominal pain and other related symptoms. Appendicitis usually occurs in children and adolescents between the ages of 10 - 19 years. Appendectomy or surgical removal of the appendix is the recommended treatment for appendicitis and may be performed in two ways: Open appendectomy and Laparoscopic appendectomy. Cases of acute appendicitis are often treated laparoscopically.

Gallbladder Surgery

Cholecystectomy is a surgical procedure which involves the removal the gallbladder. It is a common treatment for symptomatic gallstones and several other gallbladder conditions such as cholelithiasis, cholecystitis, or gallbladder cancer. Surgical options mainly include Laparoscopic cholecystectomy and Open cholecystectomy.

Piles Surgery

Piles or Haemorrhoids are common ailment that affects men or women of any age and are generally caused due to continuous high pressure in the veins, constipation, excessive straining during bowel movements, and persistent diarrhea. Surgery is often recommended if other treatments have failed to produce the desired result, or if you have haemorrhoids that are unsuitable for non-surgical treatment. Different surgical procedures are used for the treatment of piles, such as haemorrhoidectomy, Transanal haemorrhoidal dearterialisation (THD) or Haemorrhoidal artery ligation (HALO), and Stapling.

Varicose Vein Surgery

Varicose veins refer to enlarged, twisted veins under the surface of the skin. They most commonly occur in the legs and ankles and are caused by weakened valves and veins in the legs. Some of the significant factors that contribute to this condition include heredity, pregnancy, standing or sitting for a long period of time, obesity, aging, hormonal therapy, and birth control pills. Minimally invasive options for the treatment of leg veins include Sclerotherapy, Surface therapy (laser), and Internal therapy (laser or radiofrequency or endovenous techniques).

Obesity Surgery

An individual is classified as severely obese when his/her Body Mass Index (BMI) is greater than 40, or the body weight is more than 100 pounds. A person who has a BMI of 35 or greater with an existing co-severity, such as diabetes, hypertension etc; is also categorized as severely obese. Laparoscopic surgery is recommended for people who are severely overweight. At present, there are three laparoscopic weight loss operations that are generally performed for obesity: Laparoscopic adjustable gastric banding, Laparoscopic roux-en-Y gastric bypass, and Laparoscopic biliopancreatic diversion.

Single Incision Surgery

Single Incision Laparoscopic Surgery (SILS) is a relatively new, non-invasive laparoscopic technique. As opposed to the multiple entry points required in traditional minimally invasive surgery, single incision surgery uses only single 20 mm incision through the belly button. This further improves the benefits of laparoscopic surgery by reducing the scars and wound pain. Some of the other benefits of this technique include less possibility of infection, minimal scarring, quicker recovery time, and better cosmetic results. This technique is used to perform various procedures such as Adrenalectomy (removal of adrenal gland), Appendectomy (removal of the appendix), Gallbladder removal, Hysterectomy, Lap-Band placement, and Nephrectomy (removal of kidney).

Urology

Prostate Surgery

Benign prostatic hyperplasia (BPH) refers to the non-cancerous enlargement of the prostate gland. Although it is a common urological condition, medications may not always prove effective. In such cases, various minimally invasive and surgical procedures, such as Prostatic stent (stenting), High-intensity focused ultrasound (HIFU), Holmium laser enucleation of prostate (HoLEP), Interstitial laser coagulation, Transurethral electroevaporation of the prostate (TUVP), Transurethral microwave thermotherapy of the prostate (TUMT), Transurethral radio frequency needle ablation of the prostate (TUNA), Photoselective vaporization of the prostate (PVP), and Catheterization, are used for the treatment of moderate-to-severe symptoms.

Cystoscopy

Cystoscopy is a procedure that enables the doctor to view the interior of the urinary bladder and urethra using a thin, lighted instrument known as a cystoscope. The cystoscope is inserted into the urethra and gradually advanced into the bladder. The cystoscope is attached with a lens to carefully examine the lining of the bladder and the urethra. Cystoscopy is used to diagnose, monitor, and treat certain conditions affecting the bladder and urethra. It is also used to check for defects in the bladder, remove samples of bladder tissue for biopsy, remove small bladder stones, and in cases of suspected cancer.

Urethra & Bladder Surgery

Bladder suspension, or bladder neck suspension, refers to a surgery that helps to place a sagging bladder back into its usual position. This procedure is used to treat stress incontinence or uncontrollable urine leakage caused by childbirth, menopause, problems with the muscles in the bladder and urethra, or surgery. Bladder suspension surgical techniques mainly include Open retropubic suspension surgery, Laparoscopic retropubic suspension surgery, and Needle bladder neck suspension surgery.

Varicocele Surgery

Varicoceles refer to enlargement of varicose veins in the scrotum. Varicocele repair is done to increase male fertility. In this procedure, a small incision is created in the abdomen adjacent to where the testicles initially descended through the abdominal wall. Then the veins that produce the varicocele are identified and cut to prevent the flow of blood to the varicocele. Alternatively, a nonsurgical procedure known as percutaneous embolization could be performed to repair a varicocele.

Ureteroscopy

Ureteroscopy refers to an examination of the inside of the urinary tract performed using an instrument called a ureteroscope and is used to treat various conditions such as frequent urinary tract infections, hematuria, abnormal cells found in a urine sample, urinary blockage caused due to an unusual narrowing of the ureter, kidney stone in the ureter, or an abnormal growth, polyp, tumor, or cancer in the ureter. In this procedure, the ureteroscope is first inserted into the urethra. Then it is passed through the bladder and the ureter to locate the kidney stone. Through the ureteroscope, the doctor can view the stone in the ureter and remove it either with forceps or a small basket that grabs the stone. Stones can also be broken up using laser.

Bladder Stone Removal

Bladder stones are formation of solid masses of minerals in your bladder. They often develop when urine in the bladder becomes concentrated, resulting in the crystallization of minerals in the urine. Bladder stones are removed by a procedure called cystolitholapaxy. A cystoscope, a small tube equipped with a camera at the end, is inserted through the urethra and into the bladder to view the stone. The doctor then uses a laser, ultrasound, or mechanical device to disintegrate the stone into small pieces and flushes them out from the bladder.

Cosmetic

Brow Lift

A brow lift or a forehead lift refers to a cosmetic surgery procedure that is done to reduce the development of wrinkle lines on the forehead, the bridge of the nose and between the eyes, improve frown lines, and to raise sagging brows. Endoscopic brow lift is the latest method used in forehead and eyebrow lifting. In this minimally invasive procedure, an endoscope and certain special instruments are placed through minor incisions made within the hairline. This enables the adjustment of the tissue and muscle beneath the skin, thus rectifying the sources of creases and furrows in the forehead. This procedure offers numerous benefits such as simpler post-operative rehabilitation, faster recovery, and patient satisfaction.

Face Lift

Facelift surgery or Rhytidectomy is a procedure that helps to improve the appearance of the face and jaw by reducing the appearance of facial wrinkles and other signs of aging. Endoscopic face lift is ideal for patients who have little extra skin or laxity, and no problems with their lower face and neck. In this surgical procedure, only a few minor incisions are made in the scalp and temple region. The descending fat in the cheeks is raised using an endoscope. Thus facial rejuvenation is done without creating any visible scars, reducing discomfort and downtime.

Liposuction

Liposuction is a surgical procedure that slims and reshapes specific regions of the body, such as thighs, hips and buttocks, abdomen and waist, upper arms, back, inner knee, chest area, cheeks, chin and neck and calves and ankles, by eliminating excess fat deposits and enhancing your body contours. Today, various techniques are available that have made liposuction easier, safer, and less painful. This includes Tumescent liposuction, Ultrasound assisted liposuction, and Laser-assisted liposuction.

Breast Augmentation

Breast augmentation, or augmentation mammoplasty, is a surgical procedure that is done to enhance the size and shape of a woman's breast. Besides, it also helps to restore the volume of the breasts after weight reduction or pregnancy, improve the appearance of the breasts, correct the asymmetry in size of the breasts, and enhances self-image and confidence levels. Endoscopic breast augmentation, which utilizes an endoscope, is a new technique of breast enlargement that involves the placing of breast implants through an armpit incision. When compared to traditional procedures, endoscopic breast augmentation offers a lot of benefits for the patient including fewer scars, minor incisions, minimal downtime, and faster recovery.
  • Expert team of surgeons
  • 5 state-of-the art operation theatres
  • Comprehensive diagnostic setup
  • High frequency cautery machine
  • Most advanced version of the endoscopy unit from Karl Storz, Germany
  • Latest 3 chip camera for the endoscopy unit from Karl Storz, Germany
  • Cutting edge imaging technology from the world's most innovative companies
  • Centralized critical care unit with multi-channel monitoring devices
  • Strict infection control policies
  • Dedicated outpatient department