Fortis Hospitals Recently was featured in Wired Magazine /Dailymail.co.uk and Sky TV,  Featuring “Dr Vivek Jawali” of Fortis  who had  pioneered this procedure almost a decade ago.

The patient stares out at the camera, his fragile heart exposed during life-saving surgery.The astonishing picture of Swaroup Anand shows just how far open-heart surgery has come in the last decade.The 23-year-old went under the knife in Bangalore at Wockhardt Hospital while he was still very much awake.

Doctors chose to numb his body with an epidural to the neck rather than send him to sleep with general anaesthesia.

The Seven Steps of Awake Open-heart surgery

1. Insert an epidural catheter into the patient the day before the operation.

2. Patient to theatre. Administer a test dose of the epidural below the nape of the neck.

3. Give the patient the full dose and wait 20 minutes for all sensation from the chest to be blocked. Test by prodding the patient’s skin with a needle.

4. Open breastbone using electric saw.

5. Main surgery.

6. Close the breastbone with steel wire and close skin.

7. Transfer patient to intensive care.

This article was taken from the February issue of Wired UK magazine.

To mark the spirit of womanhood and to create more health awareness amongst women, Fortis Hospitals on EM Bypass has initiated a program on spreading awareness on hernia in women called as “Hernia Care”. Under the initiative of Dr. B Ramana, Consultant Laparoscopic Surgeon, this special care program has been introduced to take care of all hernia related issues in women.

Speaking on the occasion, Dr. Ramana said, “Hernia is more common with men and a lesser known fact is that a large number of Indian women are victim to this disease called Hernia because of the issues peculiar to the gender, and specifically the reproductive function of women. With this program we intend to create more awareness around Hernia in women and offer them solution with the advanced technology and expertise in our hospital.”

A Hernia is a protrusion of an organ or the fascia of an organ through the abdominal wall of the cavity that normally contains it. This noticeable bulge under skin and the pressure of the tissue pushing its way through the weakened area can be a source of significant pain and discomfort. Surgery is the best way out of it.

He also added, “All hernias are not equal. There are different types of hernia like inguinal hernia, epigastric hernia, femoral hernia, internal hernia, hiatus hernia, incisional hernia and umbilical hernia. There is a significant incidence of abdominal wall weakness in women after pregnancy, caesarian section and hysterectomy operations which manifests into Incisional or Ventral Hernia. Though this is a common problem seen in surgical OPD’s, very little is known about the actual demographics of incisional hernia in women and especially Indian women. All we know is that of the approximately half a million hernia surgeries done annually in India, around 60,000 or so are ventral hernias (that occur mostly in women). Only one in five of these is done by the modern keyhole/laparoscopic approach, the rest being taken up by conventional surgery.”

Another specific problem is to detect Occult Hernia in women. Many women silently suffer with abdominal pain or pelvic pain without a diagnosis. The problem is found out to be due to an occult hernia. A simple surgery could relieve the problems of a lifetime. All it needs is awareness in the community of women and access to a Hernia Center that cares to screen patients.

To increase awareness in the population and in the medical community, Fortis
Hospital has taken the initiative. The center will provide counseling, various treatment facilities and latest technology in the world to cure patients and ensure quick rehabilitation of women to her home and workplace. Dr. Ramesh Agarwalla and Dr. Subhayu Banerjee are the other consultants in the center, providing a rich blend of skill and experience.

Among the various state-of-the-art technologies used in the center would be the scarless SILS approach, meshes impregnated with fish oils (omega-3 fatty acids derived from North Atlantic salmon) so as to prevent adhesions to internal organs, newer fixation devices and the ‘physiologic mesh’ that tends to cling on to the abdominal wall without the need for too much fixation.

At this time a national database of women and their related problems is highly required. We need direct research to address this gap in our knowledge. It will be our endeavor to develop a database of hernia cases in women in our community.

Mr. Hsieh Wei Tang, a 60-year-old business man running a Chinese restaurant in Kolkata, was diagnosed with osteoarthritis of right knee after pre-operative evaluation at Fortis Hospitals. He had severe knee pain and could not climb stairs without support. As his knee was swollen and straight he could not even squat. The custom fit knee replacement surgery was successfully performed on Hsieh Wei Tang by Dr. Rakesh Rajput, Orthopedic Consultant and his team and the patient was discharged within 7 days.

The difference that it makes to patients’ knee –

While conventional knee replacement surgeries retro-fit predetermined sizes of prosthetics on to the patients’ knee, this procedure is very different because it works on the principle that no two patients’ knees are similar. With this technology the patient’s knee is digitally recreated with 3D image mapping after taking into account, the bone structure, weight ratios, gender, age and even mechanical alignment. Based on this 3D model the customized knee is created. Something, that just fits them right. This technology ensures far greater accuracy and reduces the operation time by almost 40 % and also results in less loss of bone & tissues.

Read The Full Story

A team of Orthopedic Surgeons at Fortis Hospitals, Mulund led by Dr. Sachin Bhonsle, Consultant Orthopedic and Joint Replacement Surgeon, performed a complicated hip revision surgery on a 45 year old man who had a three times failed hip surgery in the previously.

Patient Mr. Vijay Joshi, age 45, underwent left hip surgery in mid 90’s. During surgery his blood vessels got severely damaged resulting into avascular necrosis which made hip replacement a necessity. (Avascular Necrosis is a disease resulting from the temporary or permanent loss of the blood supply to an area of bone. Without blood, the bone tissue dies and the bone collapses and the joint becomes arthritric).

He underwent first hip replacement in 1998. A year later he got severe hip infection due to which doctors had to perform a second hip replacement on him in 1999. The second hip worked for 4-5 yrs, but it thereby loosened out leaving his hip with severe pain.

“This case is a fine example of a very complicated hip replacement operation. Mr. Joshi’s hip had had become very fragile and brittle with a huge amount of scarring due to three previous operations in 10-15 years and needed high degree of accuracy & meticulous asepsis. I had to remove existing hip replacement as well as plates and screws already in the bone and then carefully position a brand new hip joint. It was highly challenging to perform a fourth revision without harming the bone any further and ensure we give the best result in long term to avoid further revision,” said Dr. Sachin Bhonsle

“Having undergone three surgeries before (one regular surgery and two hip replacements), I thought that a fourth correction could never be performed on my hip and I will have to lead a challenged life for the rest of my years. However, I did not lose hope,” said Mr. Vijay Joshi.

“I realized that the real reason for my misery has been a lack of treatment at the hands of right experts. Since my hip had become very fragile and vulnerable, I realized that I can no longer take a chance and will consult the best medical centre with proven expertise in the area of hips. This led me to come to Fortis Hospitals, which had a proven centre of excellence for joints. I consulted Dr. Sachin Bhonsle at the hospital, who had the experience of doing some complicated hip replacement surgeries with finesse.”

The surgery was successful with an uneventful recovery and patient was discharged after few days. Dr. Bhonsle is very optimistic that the patient will lead a normal life and will not require another revision in his lifetime.

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Fortis Hospitals Ushers In the Latest Technology in Knee Replacement Surgery

Case Story60- old man suffering from degenerative disease of the knee
Brought to Fortis Hospitals with complications of osteoarthritis , underwent East India’s first Custom Fit Knee Replacement Surgery

Patient was discharged within five days of the knee replacement operation

Benefits of Custom Fit Knee Replacement Surgery

• Patients started walking normally within a fortnight, unlike the usual 6-8 weeks required before resuming normal activities in the conventional surgery Some Other Benefits of   Custom Fit Knee

• Less soft tissue damage
• Variation in anatomy easily addressed
• Surgical insertions 10-11cms (minimal invasive surgery)
• Lesser operative time (60 min)
• Reduced infection rate
• Better life span of the processes because of the accurate fit and alignment
• Surgeon friendly instrumentation hence less loss of bone
• Patients started walking normally within a fortnight, unlike the usual 6-8 weeks required before resuming normal activities in the conventional surgery

Ushering in the latest in Joint Replacement Surgery Fortis Hospitals Kolkata today announced Eastern India’s first ‘Custom Fit Knee Replacement Surgery’ performed on a patient with degenerative disease of the knee. Lead orthopedic surgeon Dr. Rakesh Rajput and his team at Fortis Hospitals Kolkata performed this revolutionary surgery by literally remodeling the anatomy of the patient’s knee and recreating or customizing a knee with the right kind of technology and expertise. The new custom fit knee replacement technology designs a perfect instrumentation system that matches the patient’s knee and ensures lesser pain, less tissue damage and faster mobilization.

Dr. Rakesh Rajput, Senior Orthopedic Surgeon, Fortis Hospitals, said, “The operation for knee replacement has been performed for the first time in Eastern India by using the custom fit knee replacement technology. This is indeed a medical breakthrough as this procedure is error free as the planning is done before the operations and likely to revolutionize the way knee replacement surgeries are performed in India. With this technology the outcome bar of knee replacement surgeries had been raised to a much greater level.  We are glad to be the first adapters of this technology.”

Mr. Faisal Siddique, General Manager Fortis Hospitals Kolkata said, “Fortis Hospitals has always been the frontrunner in performing complex surgeries using the latest technologies. Our ultimate objective is to ensure the best treatment for patients with better results. We are confident that going forward, we will continue to break new grounds in new medical technology and bring the best in super specialty treatment to India.”

“We were the first ones to perform Euro-Asia’s Custom Fit knee replacement and now we take pride in performing Eastern India’s first custom fit knee replacement. This testifies our commitment towards combining advanced technology and clinical expertise to offer quality care to our patients added Dr. Lloyd Nazareth, COO, Fortis Hospitals.

The difference that it makes to patients’ knee –

While conventional knee replacement surgeries retro-fit predetermined sizes of prosthetics on to the patients’ knee, this procedure is very different because it works on the principle that no two patients’ knees are similar. With this technology the patient’s knee is digitally recreated with 3D image mapping after taking into account, the bone structure, weight ratios, gender, age and even mechanical alignment. Based on this 3D model the customized knee is created. Something, that just fits them right. This technology ensures far greater accuracy and reduces the operation time by almost 40 % and also results in less loss of bone & tissues.

Faster Recoveries That Get Patients Back To Life Faster –

Right from diagnosis, Fortis Custom Fit Knee Replacement procedure aims to get patients back on their feet faster. It takes about 4 week duration to get the custom fit instrumentation and the doctor being ready with the perfect procedure, the incision is just about 4inches which itself minimizes the pain, infection, blood loss, and tissue damage are also reduced to a great extent. And specialized post-operative recovery procedure ensures that the patient achieves early and full mobility within days after his/her surgery.

Stand tall in 4 weeks

The instrumentation specific to the patient is ready for surgery in less than 4 weeks after the CT scan. Moreover, the alignment settings exclusive to the patients’ bone structure contained within the instrumentation enabling the patient to get back on his/her feet faster after the knee replacement procedure.

How Custom Fit Knee Works –

4 weeks. That’s the time we take to find the knee procedure complete with the instrumentation that fits you perfectly as opposed to the trial and error that you need to endure in the conventional procedure. Fast and convenient, it is a simple 4 step process.

Step 1: Understanding your knee

The process starts with a CT Scan of the whole leg from the hips to the ankle which is then used to create an advanced 3D image of the leg structure. The age, weight and gender are also taken into account, creating a complete patient imaging.
Step 2: Processing and planning

With the 3D plan of the leg structure in place, an anatomical model is created to determine the mechanical alignment – the basic philosophy on which the entire process rests. Virtual instrumentation is then done and the surgery is planned accordingly.

Step 3: Recreating the knee

Once the surgery is approved, the Custom Fit instruments are manufactured at state-of-the-art dedicated manufacturing centers. Even the individual patient name and data are etched on each unit to confirm identification during the surgery

Step 4: Fitting the knee

With the Custom Fit instrumentation in place, the knee bone is chiseled to perfection so that the prosthetics fit exactly without any requirement for later corrective surgeries. After a 60 minute surgery, the patient ill have the knee that fits you perfectly.
Case Details:

Mr. Hsieh Wei Tang, a 60-year-old business man running a Chinese restaurant in Kolkata, was diagnosed with osteoarthritis of right knee after pre-operative evaluation at Fortis Hospitals. He had severe knee pain and could not climb stairs without support. As his knee was swollen and straight he could not even squat. The custom fit knee replacement surgery was successfully performed on Hsieh Wei Tang by Dr. Rakesh Rajput, Senior Orthopedic Consultant and his team and the patient was discharged within 7 days.