At Suguna Hospital

First of its kind prostrate operation

Bangalore based RG Stone Urology Centre, at Suguna hospital has performed a rare surgery on 78 old year patient S.B.Veerana residing at #1909, Moksh, 17th cross, 1*" blk, Rajajinagar, Bangalore-10 - cell no 9980044660, who was suffering from Enlarged Prostate of 220 grams, which was successfully enucleated by HoLEP (Holmlum Laser Enucleation of Prostate) method without any requirement of blood transfusion or open surgery.
Today, HOLEP (Holmium Laser Enucleation of Prostate) is worldwide accepted modality used in the management of Enlarged Prostate and also known as platinum standard. In this procedure, a 550 Micron Fibre attached to a 100-Watts Holmium Laser machine is used to remove obstructive prostatic tissue and seal blood vessels. The enucleated gland is then pushed into the bladder, which is later sucked out with the help of an equipment called Morcellator. The whole procedure takes around 45-90 minutes, depending on the size of the gland. This procedure is nearly bloodless as the laser beam also seals the blood vessels as it cuts through the gland. In most of the cases there is no need for blood transfusion.
Dr. ANAND.M Chief Urologist of RG Stone at Suguna Hospital, who operated on this patient, said this patient came with severe outlet obstruction and was unable to empty his bladder effectively. He had been diagnosed to have a massively enlarged prostate (220 gms) and had been advised open surgery at another hospital as the conventional TUR-P would not have been technically feasible.
100W Holmium laser Enucleation of the prostate with transurethral tissue morcellation provides significant reduction in morbidity, bleeding and hospital stay for patients with large prostate adenomas. It does not produce impotence or incontinence as seen with conventional surgery. For smaller prostates the procedure can be carried out without the need of a catheter & with short duration of hospital stay less than 48 hrs. RG STONE has a proven record of having successfully carried out more than 5000 HoLEP surgeries throughout its various branches across India on patients from India & abroad, and blood transfusions are almost unheard of.
Of various laser procedures available for prostate treatment, the two which have gained wide spread acceptance are green light (KTP) laser and 100W Holmium laser (HoLEP). Both lasers have advantages over conventional TURP surgery for prostate in terms of less bleeding (almost blood less procedure) and no incidence of TUR syndrome (a rare but life threatening complications of TURP). The major difference in treating prostate by these lasers is the surgical technique. In green light (KTP) laser prostatectomy, prostate is vaporized, thereby relieving the blockage that it is causing to urinary flow. But, In Holmium laser prostatectomy (HoLEP), the entire enlarged inner part of the prostate is enucleated (removed) and then minced in small pieces to be removed from body. The advantage of ENUCLEATION (HoLEP) over VAPORIZATION (KTP) is that it provides prostate tissue for postoperative histopathological examination (biopsy). This can help in diagnosing occult or unsuspected cancer of prostate in approximately 2-10% patients undergoing surgery for enlarged prostate. In these patients, the cancer would otherwise be missed in an early and curable stage.
Another potential limitation of KTP prostatectomy is its long-term durability. Pfitzermaier J. et.al. recently in August 2008 issue of British journal of Urology (one of the most reputed journals) found that 23% patients needed re-operation within 11.7 months of their initial surgery after KTP laser prostatectomy, if their prostate weight was above 80gms. This reoperation rate was 10% for smaller prostates. This means that almost 1 in 4 patients undergoing KTP laser prostatectomy for large prostate will need another operation for prostate within a year of the initial surgery. In view of the same Dr.Mehmood Hai in his interview to Urology times said that larger prostate would probably be treated with open prostatectomy as KTP is not suitable. In a pioneering study published in June 2006 issue of British journal of Urology, M.A.Hai and co-workers found that the improvement after KTP laser prostatectomy is inferior in patients with higher PSA (prostate specific antigen - a marker for prostate cancer) and larger prostate than their counterparts.
HoLEP takes care of both these disadvantages of KTP laser prostatectomy. Its outcome is durable with re-operation rates of only 4% at 8 years follow-up. In addition it has all the advantages that KTP laser prostatectomy offers to its patients. Prof. Kuntz RM from Germany reviewed 6 years medical literature on laser prostatectomy and concluded that HoLEP appears to be a size independent new "Gold Standard" in surgical treatment of enlarged prostate. Dr. Hemendra Shah from R.G. Stone Urology and Laparoscopy Hospital. Mumbai, also published Indian experience in treating enlarged prostate by Holmium laser in June 2008 issue jq| British Journal of Urology. He concluded that "HoLEP is safe and effective procedure in treating enlarged prostate, independent of the size."
In Karnataka 100 watt Holmium laser facility is available only at RG STONE Urology & Laparoscopy Hospital, which is based in SUGUNA Hospital, at Rajajinagar, Bangalore. Currently this is the only centre with this facility in the whole of South India along with its branch at Chennai. The centre can boast of having treated a near 300 gram prostate successfully by the HoLEP technique in Delhi, again a testimony to the fact that the size is of no consequence for this versatile technique.
Laser prostatectomy is gaining widespread acceptance amongst urologists worldwide due to its safety in treating patients with enlarged prostate. This surgery is mainly beneficial in high-risk patients with cardiac (heart) or pulmonary (lung) compromise, those having bleeding tendency and those on "Blood thinner" medications for heart diseases or stroke.
Dr.Anand also said, "At RG Stone we have become increasingly cognizant of a rising lack of awareness & several misconceptions among the elderly population about urinary diseases & the modern treatment modalities that are available. We come across a lot of elderly patients who are simply not aware of or choose to ignore serious urinary problems till they assume dangerous proportions & reach an advanced stage. Some people are under the impression that these diseases are solely due to ageing & therefore not treatable & tend to suffer in isolation & silence. Others do not wish to discuss their problems considering them a taboo or social stigma. Many are not aware about the latest minimally invasive treatment facilities available at Super Specialty Centre's like RG Stone Urology Centre, which unlike traditional open surgeries, are very safe even for elderly patients and are less morbid with shorter hospital stay. Others carry impressions of these facilities as "Costing The Moon "while in reality the cost difference as compared to traditional /open surgery is just around Rs.lO.OOO/-,which is a small price to pay, when we consider the high safety and faster recovery that these state-of-the-art procedures offer."
Mr. Prashanth Arer who is heading the south region for RG STONE added & said "As we became aware of the myths pertaining to urinary diseases that were influencing the elderly and robbing them of the opportunity to enjoy better health & quality of life, we have decided to launch this Special campagain for roaming for rural part of Karnataka with packages affordable even by acommon man.  & we plan to make it monthly event that will visit different locations in & around Bangalore in the months to come. Also special discounts on
surgery are being offered to the senior citizens as a part of the Free check-up"
The RG Stone Urology & Laparoscopy Hospital chain is India's only national chain of super speciality hospitals for Urology & Laparoscopy offering all available modalities of stone disease management & Prostate disease management in addition to minimal access surgery and conventional urology under one roof. The ISO 9001:2000 certified organization was established in 1987 with its foundation in Mumbai.
Today RG Stone urology centre has its presence in 12 cities in India including Mumbai, Delhi, Kolkata, Rajkot, Goa, Mohali, Jaipur, Agra , Chennai, Ludhiana , Moradabad and Bangalore. The Founder CMD of the chain. Dr. Bhim Sen Bansal, is widely recognized as the 'Father of Lithotripsy' in India. He began with a vision of providing new & revolutionary technologies in the field & quality standards at par with international levels, to the Indian masses. Today the hospitals offer US FDA approved, State-of-the-Art equipment along with eminent specialists with unmatched expertise in the field of Urology. The combination of the most advanced equipment with the best doctors in the field as helped RG Stone Urology to achieve many "first's and "only in India.

RG Stone holds the Guinness Records for treating a 13 cm Kidney Stone. RG Stone is the first Super Speciality Urology Hospital in India. It is also the first hospital to install Siemens Lithotripsy in India and the first to install 100 Watt Holmium Laser in India. RG Stone is the first institute in India to treat a Kidney Stone patient with permanent cardiac pacemaker. It is also the first institute to perform Laparoscopy assisted PCNL for a pelvic kidney Staghorn. RG Stone has treated stone patients as young as 9 months & as old as 107 years. With over twenty years of experience in the field, the RG Hospitals have treated over 1, 00, 000 patients all over India, Including 6,500 patients from abroad.
For further information contact PRASHANTH.A.S Regional Manager- South India # 1 A/87, Dr.Rajkumar road, 4th N blk Rajajinagar,BANGALORE Ph:+91 8023121099, 40194422 Telefax:+91 8023128111 Helpline:+91 9341147771 website: www.rghospital.com