After more than 25,000 laparoscopic surgeries in the last 17 years, well known laparoscopic surgeon from NILES and Aakar IVF-ICSI Centre, Ghatkopar, Dr Prakash Trivedi, faced an unexpected challenge, when he was called out of Mumbai for more than 20 removals of uterus and another two cases of urine leak on cough to be done in just in two and half days
After more than 25,000 laparoscopic surgeries in the last 17 years, well known laparoscopic surgeon from NILES and Aakar IVF-ICSI Centre, Ghatkopar, Dr Prakash Trivedi, faced an unexpected challenge, when he was called out of Mumbai for more than 20 removals of uterus and another two cases of urine leak on cough to be done in just in two and half days. 
Dr Trivedi had his favourite assistant Dr Mahendra Borse from Pune's Dinnanath Mangeshkar hospital, his main operation theatre sister, Smita Samant from Mumbai. He had also carried the necessary instruments and equipment, including Enseal, the new vessel sealing device, the harmonic scalpel, dedicated bipolar cautery morcellator and all hand instruments needed for laparoscopic surgery and his designed set of vaginal removal of uterus.
On reaching at noon, he saw most of the patients and arranged a chronology of finishing 13 cases of laparoscopic removal and 5 cases of vaginal removal of uterus, and two urine leak cases with his new SUI sling adjustable tape. His team started operating from 1.10 pm, and on the second day from 9 am to 10.30 pm and kept the last difficult case only at 8 am, on the day he was supposed to leave for Mumbai by flight scheduled to leave before 2pm.
The 18 removals of uterus were cases of a large uterus with multiple fibroids till 24 weeks and few cases had had a previous Caesarean section or open surgery.
The laparoscopic removal of uterus was under general anaesthesia and the vaginal or urine leak on cough was under spinal anaesthesia.
The beauty of the new technique of laparoscopic removal of uterus is that no suture is necessary till full separation and removal of uterus from its support and blood supply. The tissue dissection was done with a Harmonic Ace 5mm, where one of the two blades oscillates 55,000 times per second, thus causing a cavitational effect, heat and tissue separation controlling small bleeders.
The urinary bladder and vital structures around are separated mechanically, pushing the tissues down by a closed Harmonic or actually dissecting it off.
The main blood vessels to uterus that is the ovarian and uterine artery and veins were sealed with the new Enseal vessel sealing 5mm device, which has heat-activated polymeric compound with an exclusive positive temperature coefficient PTC that maintains sealing temperature at 100 degrees Celcius.
Further, an offset of electrode configuration, the energy flow is within the jaws allows only 1 mm lateral thermal spread, which isu00a0 a huge safety feature. This makes laparoscopic removal of uterus bloodless, painless and sutureless, even for very large uterii. Uterus with fibroids were removed from below or removed into 1cm strips by a bipolar morcellator.
With the traditional Indian heritage, five big uterii upto 18 weeks were removed vaginally with Dr Trivedi's set of specially designed instruments. Most of the patients were discharged within 36 hours and were back to work within 10 days with no dietary, walking, travelling or weight lifting restrictions except to avoid sexual relations for 6-8 weeks.
In cases of female urinary leak on cough or sneeze or laugh, Dr Prakash Trivedi is known to be an expert in Asia. He fixed his National award wining TSUITape through the trans-obturator route and one of his new adjustable tape in one patient. These procedures were over in 20~25 minutes each; both patients were discharged on the same day relieved.
This unique feat was closest to a record achieved in January 2008 at Dr Trivedi's NILES hospital, Ghatkopar when Dr Prakash Trivedi and his friend Dr Vyomesh Shah had removed 24 uterii, seven laparoscopically and 17 vaginally in less than ten hours witnessed live by more than 500 gynaecologists and surgeons at Lavender Baug, Ghatkopar.
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For further info, call 9821055198 / 9833272076 / 9819937924
Email: dr.ptrivedi@gmail.com
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