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Medical Service

Laparoscopic cholecystectomy

Service feature:
Cholecystectomy is surgery to removed the gallbladder. A laparoscopic cholecystectomy is a less invasive way to remove the gallbladder using a laparoscope.
Benefits of the laparoscopic cholecystectomy is a shorter recovery time.
Indications:
The general indications for laparoscopic cholecystectomy (LC) are the same as for the open procedure. Although LC was originally reserved for patients who are young and thin, LC is also offered today to patients who are elderly and obese; patients in the latter categories may, in fact, benefit even more from surgery through small incisions.
Contraindications:
Inability to tolerate general anesthesia
Uncontrolled coagulopathy.
Patients with severe obstructive pulmonary disease or congestive heart failure (eg, cardiac ejection fraction < 20%) may not tolerate carbon dioxide pneumoperitoneum
Principle Differences between Laparoscopic and Open Surgery
Less pain. Post operative pain related to size of incision
Less Handling of intestines results in little or no disturbance of normal function.
Avoidance of more trauma to abdominal wall by the incision allows rapid return to normal activity Magnified view allows precise dissection.
▲Equipment and specialization :
  • LaparoscopicCholecystectomy
▲Time required : 2 hours
▲Anesthesia :General anesthesia
▲Post-operative care :
Discharge typically within 2 days
Post-operative pain can typically be relieved with medications
Patient can resume normal daily activities in roughly 3~5 days
Heavy lifting should be avoided for a few weeks
Watch for drainage, bleeding, swelling around incision sites, and for mild fever, as this could indicate complication
[Update:2018-04-18]

Urology Clinic

Introduction
The treatment of stones requiring surgical intervention has evolved greatly in recent years. Laparoscopic techniques, which use miniature instruments and imaging equipment, have revolutionized kidney stone treatment and allow specialists to crush or remove stones using minimally invasive techniques.
The Stone Treatment section within the Urology division offers the latest treatments for urinary tract stones with success rates well above the national average.
Non-invasive extracorporeal shock wave lithotripsy (ESWL) – Involves the use of sound waves to crush the kidney stone into smaller pieces so they can more easily pass into the bladder.
Mechanism
Shockwaves are produced by various methods
• Electro Magnetic : In this method Shock waves are generated by electric currents which move a metallic membrane within a shock tube. Shock waves so generated are then focused by an acoustic lens to F1 (as in Siemens Lithostar) at the stone site or by a parabolic reflector.
• Electro Hydraulic : Shockwaves are produced by passing High Voltage electric current through a spark Gap kept underwater and focussed with a Parabolic reflector.(As in Direx, Econolith, StoneLith, Eurolith)
• Piezo Electric: Lithotripters using this type of shock wave generation have a high - frequency, high - voltage pulse, which excites a piezoelectric (ceramic) element. The elements are placed in a concave reflector (dish), and all the elements can be fired at once. Various machines have different numbers of elements. The Wolf machine has about 3000 elements, whereas the EDAP has approximately 325. The shock waves converge at F1 because the piezoelectric elements are positioned on a spherical dish.
Indications
Eswl is the "Treatment of Choice" for
• Small (Less than 2.0 Cms Diameter) Renal stones of any site, shape and composition
• Patients having diabetes, hypertension, respiratory disease, solitary kidney
• Patients unfit for surgery or anaesthesia
• Previously operated patients
• All age groups
Contra-indications
• PREGNANT WOMEN: Pregnancy remains absolute Contraindication as the risk of radiation used for imaging during Lithotripsy is too great for the foetus. Not enough data is available to foresee the effect of shockwaves on the foetus and the ovaries.
• RENAL ARTERY CALCIFICATION : Care should be taken to avoid having renal artery calcifications and aortic aneurysms in the blast path or F2. Vascular clips are apparently of no consequence. Iliac vein thrombosis has been reported following ESWL
• BLEEDING DIATHESIS
• URINARY TRACT INFECTION: In case of infection, it is vigorously treated with suitable antibiotics before ESWL.
• OBSTRUCTION DISTAL TO THE STONE: In such a case the distal obstruction is treated first, if a stone, with ESWL or Ureteroscopic Removal.
• CHILDREN: Children treated with ESWL should have the lungs shielded by styrofoam padding. Voltage and number of shock waves should be as low as possible. Placement of wet towels or plastic intravenous fluid bags at the shock wave exit site on the abdomen may prevent severe ecchymosis from occurring
SEVERE ORTHOPAEDIC DEFORMITIES: For successful ESWL, the stone has to be at F2. Orthopaedic abnormalities limiting this condition cannot be treated.
Our Service
We use heavy sedation, instead of anesthesia during the whole procedure. It works in a short induction period, and awake soon after the medicine discontinued. We still use the prophylactic antibiotics intravenously. If urinary tract infection was diagnosed recently, therapeutic antibiotics is necessary. After the procedure, we routinely arrange follow-up in two weeks, including urine analysis and KUB film. In our hospital, Urology division uses the latest advances in lithotripter intrarenal, intraureteral, and minimally invasive surgery. We have a reputation for successful management of difficult stones, achieving an 80 percent stone-free rate after surgery, compared to the national average of 73 percent.
[Update:2018-04-18]

Sport injury of knee joint

Service feature:
The undergraduate course and the medicine center are the synchronized studies. Because the movement injury concentrates in the young people, especially the athlete, because of the duty training demand accident result, at present every year approximately has 400 to 600 example cases.
Medical intervention needs to involve like:
1.Acute and chronic trauma
2.Survey of injury
3.Micro-incision surgery
4.Ultrasound and Shockwave
5.Simulation surgery and Far-distance visual medication
Equipment and specialization:
Arthroscopy and ultrasound
  • Arthroscopy and ultrasound
MIS surgery guided by C-arm x-ray:
  • MIS surgery guided by C-arm x-ray
Model teaching:
  •  Model teaching
Surgery:
Time required: 2 hours
Anesthesia: General / spinal
Arthroscopic surgery / micro-incision surgery , without complications, most patients are able to leave hospital within 1 week.
[Update:2018-04-18]