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PVS Institute Of Urology & Transplant Centre

Urology is that discipline in medical science that deals with all diseases affecting our urinary system from kidney to the urethra (urine passage). We cater to all the problems related to Genito urinary tract . One special mention to the fact that almost all our cases are perfomed by laparoscopy or endoscopy compared to the other centres , as a result early recovery and reduced hospital stay for the patients. The Urology and Renal Transplant Centre is well-known for urology and kidney transplantation (Tx) in Kerala. Kidney Transplantation (Tx) is the only permanent answer for End Stage Renal Disease (ESRD). The Department for Renal Transplant Surgery is one of the largest and most advanced centres for renal transplantation in South India. This centre is managed by an excellent team of doctors who has performed more than 660 transplantations including the first six cadaver kidney transplantations in Kerala. The department is headed by Dr. George P Abraham, MS, MCh (Uro), FICS the famous Urologist and Transplant Surgeon who has more than 1400 renal transplant surgeries to his credit.

Department Highlights


  • 1st 3 D Laparoscopic Urological centre in india.
  • Laparoscopic Donor Nephrectomy- one of the most advanced and patient friendly innovations in Transplant Surgery.
  • At an affordable cost, transplantation is done with Laparoscopic Donor Nephrectomy and advanced immuno suppression, eliminating the need for resection of the twelfth rib and blood transfusion and also reduces post-operative morbidity.
  • 3D laproscopic surgery is done routinely for precise advanced laproscopic procedures.
  • Routine Laparoscopic training programs.
  • Fellowship training programs in Laparoscopic urology procedures.

Procedures


The main procedures carried out here include Endourological procedures, all laparoscopic procedures, surgical and non-surgical management of male impotence and infertility.

Surgery for Stone disease


  • Extra corporeal shock wave lithotripsy for renal stones
  • Percutaneous shock wave lithotripsy for renal stones
  • Ureteroscopy and ureteric stone removal by laser
  • Flexiureteroscopy with laser for ureteric and renal stones
  • Cystolithotripsy for bladder calculi

Key hole Renal surgeries


  • BHP, Stricture, Posterior Urethral Valve
  • Female urology problems
  • SUI (Stress Urine Incontinence), Cystocoele

Laparoscopic Surgery


  • Laparoscopic pyelolithotomy for pelvic stone
  • Laparoscopic ureterolithotomy for ureteric stone
  • Laparoscopic Pyeloplasty for hydronephrosis
  • Laparoscopic ureterocalycostomy for PUJ restenosis
  • Laparoscopic Radical nephrectomy for renal tumours
  • Laparoscopic Partial nephrectomy for renal tumours
  • Laparoscopic heminephrectomy for large renal tumours
  • Laparoscopic radical nephroureterectomy for renal pelvis / ureteric tumours
  • Laparoscopic renal cyst deroofing for large simple renal cyst
  • Laparoscopic ureterolysis for retroperitoneal fibrosis
  • Laparoscopic nephrectomy for nonfunctioning kidney / ADPKD
  • Laparoscopic ureteroureterostomy for ureteric stricture
  • Laparoscopic boari flap for long segment ureteric stricture.
  • Laparoscopic B/l or U/Lureteric reimplantation for vesicoureteric reflux disease
  • Laparoscopic ureteric reimplantation for Vesicoureteric junction obstruction
  • Ureteroscopic access for ureteric evaluation ( ureteric tumours/ stricture)
  • Laparoscopic correction of retrocaval ureter.
  • Key hole bladder surgeries Cystoscopy for urethra and bladder Trans urethral biopsy and resection of tumour
  • Trans urethral resection of bladder tumour
  • Laparoscopic excision of bladder diverticulum
  • Laparoscopic partial cystectomy for bladder tumours
  • Laparosocopic total cystectomy for bladder tunours
  • Visual internal urethrotomy for urethral structure

Key hole prostate surgeries


  • Trans urethral resection of prostate for BPH
  • Trans urethral resection of prostate and bilateral orchidectomy for prostate cancer
  • Laparoscopic radical prostatectomy for prostate cancer
  • Transurethral drainage of prostatic abscess

Renal transplantation


  • Laparosocpic donor nephrectomy
  • Laparosocpic renal transplant recipient surgery

Andrology


Andrology focuses on the male reproductive system. It is mainly concerned with male infertility, erectile dysfunction and ejaculatory disorders. Surgery in this field includes:

  • Dorsal or ventral plaque removal in peyronnies disease.
  • Fertilization procedures.
  • Vasectomies.
  • Vasectomy reversals.
  • Implantation of penile prostheses either with semirigid or inflatable devices.

Urologic Oncology


Urologic oncology concerns the surgical treatment of malignant genitourinary diseases such as cancer of the prostate, adrenal glands, bladder, kidneys, ureters, testicles and penis. Prostate cancer occurs when cells in the prostate gland grow out of control.

Endourology


Endourology is the branch of urology that deals with minimally invasive surgical procedures. As opposed to open surgery, endourology is performed using small cameras and instruments inserted into the urinary tract. Traditionally, transurethral surgery has been the cornerstone of endourology. Via the urethra, the complete urinary tract can be reached upto the kidneys, enabling prostate surgery, surgery of tumors of the urothelium, stone surgery, urethral and ureteral procedures. The latest addition to endoscopic surgery is the flexiureteroscope and laser to tackle renal stones through the lower urinary tract.

Renal Transplantation


Chronic renal failure is a devastating debility that cripples the patients attitude towards life both physically and mentally. Renal transplantation is an unique entity that deals with removing a normal kidney from a healthy donor and is transplanted into a recipient with chronic end stage renal failure thereby preventing the hazards and cost of lifelong dialysis. After the transplant the patient can lead a normal life .This need All donor kidneys are removed by laparoscopic surgery adding to the advantage of only a small incision for kidney retrieval , more than 650 lap donor nephrectomies done till date at our centre. The recipient surgery is usually open and the kidney is placed either in left or right iliac fossa. We have recently started the Laparoscopic recipient surgery, a path breaking step as we are the third team in the world to do so.

Reconstructive Urology


Reconstructive urology reestablishes functionality of the genito-urinary tract. Strictures of the urethra or the ureter often require reconstructive surgery. Another frequent procedure is the reconstruction of the urinary bladder from small bowel in conjunction with cancer surgery. Reconstruction of the urinary bladder for ectopia vesicae is a challenging approach. Cosmetic surgery such as penis enlargement is rarely done in urology.

Female Urology


Female urology is a branch dealing with recurrent UTI , urethral stenosis, overactive bladder, pelvic organ prolapse, and urinary incontinence. Thorough knowledge of the female pelvic floor together with urodynamic skills are necessary to diagnose and treat these disorders. Depending on the cause of the individual problem a medical or surgical treatment can be the solution.

Pediatric Urology


Pediatric urology concerns the urologic disorders in children. This branch deals with problems in children such as cryptorchidism (unilateral or bilateral undescended testes) which can be corrected laparoscopically at our centre. The earlier the testis is brought down into the scrotum, more function will be regained. One common condition is phimosis with or without recurrent UTI. Usually we preserve the penile skin unless it is impossible to retract. Congenital abnormalities of the genito-urinary tract such pelviuretericjunction obstruction which causes hydronephrosis in the kidneys and UTI is treated by laparoscopy here. Urolithiasis in children is a rare problem which can be tackled endoscopically. underdeveloped genitalia with hypospadias or epispadias ( urethral opening towards the ventral or dorsal aspect) is corrected efficiently . Vesicoureteral reflux is a common problem in both male and female children leading to recurrent UTI. An UTI in children is to be addressed with caution and appropriate investigations have to be done in consultation with a urologist to assess the cause. Low grade refluxes can be treated with endoscopic injections at the ureteric orifices. High grade unilateral or bilateral refluxes can be corrected laparoscopically. Paediatric testicular ,renal and bladder tumours is of a major concern which has to be diagnosed and treated at a superspeciality centre.

PVS Institute Of Urology and Transplant Centre

Dr. George P Abraham


MS,MCh HOD & Sr. Consultant Urologist & Transplant Surgeon



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Dr. Vijay Radhakrishnan


MS, MCh Urologist



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Facilities

3D Laparoscopy

  • We are the first urology team in India to perform lap surgeries using 3 D laparosocpy.
  • 3 D laparoscopy is less costly compared to the robot as well as it gives the same results of a robotic surgery.
  • Especially complex tasks like intracorporeal suturing and precise dissection, require a high degree of skill and depth perception.
  • Three-dimensional vision offers the advantage of improved depth perception and accuracy and separate input from 2 unique images allows for neural summation on a cortical level .
  • The Einstein system, however, is a true three-dimensional imaging system with 2 separate optical channels and a light source.
  • The 3D images present directly on the 32” full HD 3D LC Monitor. The image separation for each eye is provided by passive polarized glasses. The right and left eye receive unique images from the camera. Two imagers with true full HD resolution each are used.
  • The 3-dimensional imaging system of the da Vinci robot, which is similar to the Einstein system, resulted in shorter performance times through increased peak velocity and acceleration and decreased rates of deceleration.
  • Surgeons are able to perform more precise adjustments by using 3-dimensional vision when compared with 2-dimensional vision. 3 D vision demonstrates a much better spacial resolution and depth perception.
  • This benefit might well be noticed when complex and detailed skills such as intracorporeal suturing or difficult dissection are needed.