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Advantages of Single Hole Surgery
The success of this technique kept climbing in further years since 1990 and now we are conducting following operations on regular basis 1-2 cm size hole 2-4 cm size hole Cholecystectomy Total Abd. Hysterectomy (upto 36wks size) Appendicectomy Cholecystectomy with Choledocholithotomy Ovarion cystectomy/Myomectomy/ Psedopancreatic Cysto-Gastrostomy Ectopic Pregnancy In nut shell here are some details of Cholecystectomy which I do by Ultraminilap.

1. Only 1-2 cm size SINGLE hole is made in the abdominal wall to enter the abdominal cavity and complete gall bladder along with the stones is removed. The cystic duct and arteries are ligated. All types of diseased gall bladder (except malignant ones) are dealt with this technique succesfully.

2. Post operative pain is minimal due to the minimal trauma given to the patient at the time of operation. Wound related problems (like wound dehescence, infection, postoperative bowel obstruction, incisional hernia etc.) are also negligible because of very small size of the wound operation.


3. As the gut is not disturbed, the intestines of the pt. starts functioning immediately after the operation and the patient takes oral diet within 4 to 6 hrs after the surgery as the patient is quite comfortable by now. Most of the patients leave the hospital after a overnight day.

4. Taruma to the patient is less and there is least disturbance to the body physiology, so Diabetics Hypertensive Cardiac & Pts. of geriatric group with other high risk systemic diseases can stand this operation in a better way than the traditional surgery and leparascopic surgery.

5. No Pneumoparitoneum (Peritoneal gas distension by Carbon Di Oxide gas) is done (this gas has hazardous effects in cardiac, hypertensive, asthmatic and COPD pts so a very close vigil has to be maintained to avoid any disaster) so safer in comparison to Laparascopic procedures.

6. Pts start routine life within 4-7 days.

7. If multiple surgeries are required on the same pt. like surgery for gall bladder with Kidneys stone or removal of uterus with gall bladder or removal of appendix with gall bladder etc. they all can be done together easily.

8. The western counterpart of this surgery Laparascopic Cholecystecystectomy is done by using expensive delicate instruments (Worth approx 15 Lacs Indian money ), while ultraMiniLap needs Simple set of routine surgical Instruments with mild modification (Worth 8-10 thousand only)

9. Another big difference with LapChole. is that conversion rate into traditional open operation is almost nil with the UltraMiniLap and almost all kinds of patients can be operated by this technique, while in LapChole first there is selection of patient who can be operated by this technique and even after selection there is a conversion rate of approx. 5% into open surgery.

10. Pneumoperitonium is produced in LapChole which means peritoneal cavity is distended by Carbon Dioxide gas, though the pressure of this gas is maintained within safety limits by the help of electronic machines but in a poor heamodynamic patients even this pressure is unsafe, secondly problems of CO2 gas absorption may have alarming effects over the health of patient-Asthmatic patients, Cardiac patients, Hypertensive patients are poor tolerant of CO2 absorption.

11. If multiple surgeries are needed then Lap Chole. doesn't offer the facility while with ultraminilap one can have Gall Bladder removal along with Appendicectomy, Hysterectomy, Hernia repairs, PCNL etc. in same sitting

Advantages over Laparscopic Cholecystectomy

 
LAP. HOLE
ULTRAMINILAP HOLE
No.of holes
3 or 4
1
Total scar size
3-4 cm
1-2cm
Anaesthesia exposure
45 to 60 mints
15-25 mints.
Hazard of  Pheumoparitoneum
Present
Absent
Conversion in open surgery
5-10%
       0.1% only         
(Nil in Hyterectomy and last 500 Cholecystectomy)
Relative contra-indicates
(Conditions where it is not attempted)  
Pregnancy empyematous Gall bladder, Ac.cholecystitis with cholengitis etc.
Nil
Multiple Surgeries if Required
cannot be done
GB with appendicectomy
GB with Kidney stones
GB with Hysterectomy etc.
Equipmentation
Expensive & Imported
Simple Indian InfoRoutine.


Our Experience is for more than 15000 patients for Gall Bladder Surgery Uterus removal Hernioplasty, & Appendicectomy etc.since 1990, we have rarely converted our procedures into open procedure and the overall complication rate is lesser than the traditional open operations. We are organizing free camps for last 8 yrs, where we operate good number of patients without any conversion to open surgery and with 100% success. This time we had 62 gall bladder patients who were operated in 16 hrs. nonstop session. Operative team had only one surgeon, two anesthetist and 4 paramedical assistants. This also defines the simplicity and perfection of the technique. In nutshell UltraMiniLap is a simpler, Faster,less expensive, more efficacious alternative to Lap Chole.Lap Chole stands not even a single advantage over the UltraminiLap. I hope with your blessings I will be able to establish this fact and will be able to carry this upt the grassroot level.

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