Spine Surgery in Indraprastha Apollo Hospitals Delhi, India

Apollo Hospitals has dedicated some of the best surgical teams in the country at the helm, for spine surgery in India. The Spine Surgery Centres of Apollo Hospitals, India have many medical milestones to their credit - the first lumbar disc replacement in the country was performed at Apollo hospitals, and several cervical disc replacements and lumbar disc replacements have also been performed. The Centres perform the full range of spinal procedures from Minimally Invasive Spine Surgery (MISS), to major spine surgery procedures like complex spinal reconstructions. The units are also well known internationally for complex deformity surgeries as well as revision spine surgery. Apollo hospital is indeed a pioneer and one of the foremost institutions for Spine surgery in India. Indeed Spine surgery in India has seen many advancements and innovations due to the excellent Spine centres and the exemplary expertise of our Spine surgeons.

Milestones of Apollo Hospitals

·         The first to introduce 3rd generation spinal implants in India.

·         The first to do a lumbar disc replacement in India.

·         Performs the maximum number of spinal deformity corrections in the private health care segment in India.

Designed anterior stabilization spinal implant which was approved by FDA and is being used now throughout the world.

Treatment & Services in Emergency & Trauma Centre at Indraprastha Apollo Hospitals Delhi, India

When you arrive at the Emergency Department, your first stop is Triage. This is the place where each patient's condition is prioritized, typically by a nurse or doctor, into three general categories. The categories are:

·         Immediately life threatening

·         Urgent, but not immediately life threatening

·         Less urgent

This categorization is necessary so that someone with a life-threatening condition is not kept waiting because they arrive a few minutes later than someone with a more routine problem. Apollo ER receives all patients i.e. Stroke, Heart attack, Polytrauma, Seizures, Poisoning, Gastroenteritis, Febrile illness, foreign body ingestion and many others.

Depending on a patient's specific medical condition, physicians will admit the patient to the hospital, discharge the patient, or transfer the patient to a more appropriate medical facility.

Road Ambulance Services - Local, NCR & Outstation

State-of-Art Cardiac Ambulances (Mobile ICU) equipped with lifesaving equipment and manned by experienced and qualified medical and para-medical personnel are stationed at the hospital in a continuous state of alertness to ensure patients arrive at Indraprastha Apollo Hospitals quickly and safely.

The 1066 Emergency Helpline and the direct Apollo Hospitals ER / Triage Helpline (+91 - 11 - 2692 5888) receive all calls and strive to provide a response time that is among the best in the world.

Air Ambulance – National & International

Saving time is the first step in saving lives. Air Ambulance Services are used when ground transport could endanger a patient's life. They are also indispensable when the patient is in a remote area and time is critical.

Apollo is equipping each of its Hospitals with emergency air ambulance services. Both fixed wing aircrafts and helicopters provide the services. Aviation companies take care of the aviation logistics. Medical aspects like trained personnel, equipment and care are provided by the 1066 emergency services.

Apollo's Air Ambulance services conquer time and distance in emergencies and saves lives. 

24-Hour Trauma response and represents a wide range of experienced and qualified surgeons and all major sub-specialties including:

·         Trauma and Burns Surgery

·         General Surgery

·         Neuro-surgery

·         Orthopedic Surgery

·         Emergency Medicine

·         Cardiothoracic Surgery

·         Obstetrics and Gynecology

·         Anesthesiology

·         Intensive Care

·         Radiology

·         Plastic and Reconstructive Surgery including Reimplantation

·         Hand and Microsurgery

·         Maxillofacial Surgery

·         Pediatric Surgery

·         Ophthalmology

·         Oncological Surgery

·         Vascular Surgery

·         Hyperbaric Oxygen Therapy

·         Gastrointestinal Surgery

Trauma Care areas and support units are always available for trauma patients.

·         Emergency Department

·         Surgery Suites (including a Trauma OT)

·         Critical Care Unit

·         Blood Bank

·         Lab services (NABL accredited)

·         24-hour multi-slice CT scan, 3T MRI and Digital Subtraction Angiography (DSA)

·         Hyperbaric Oxygen Therapy

Rehabilitation Center

Medical Oncology at Indraprastha Apollo Hospitals Delhi, India

The department of medical oncology deals with diagnosis and treatment for the entire gamut of solid tumors. Correct diagnosis and management of cancer is of paramount importance. 
The complete spectrum of Cancers is managed in this specialty including:

·         Leukemia, Lymphoma and Myeloma

·         All types of tumors of Head and Neck, Gastrointestinal, Brain, Lung, Urological (Prostate, Urinary Bladder etc.), Gynecological (Cervical, Ovarian etc.), Breast and sarcomas.

The latest modalities of treatment offered are:

·         Chemotherapy including as a daycare procedure

·         Adjuvant Chemo

·         Neo-adjuvant Chemo

Newer drug formulation Chemo to minimize toxicity in chemotherapeutic drugs Targeted Therapy (biological immunotherapy) is employed. With improved understanding of biology of cancer and genetic makeup of an individual, targeted therapies are improving survival in cancer.

Radiation Oncology at Indraprastha Apollo Hospitals Delhi, India

The Radiation Oncology Department at the Apollo Cancer Institute is equipped with state of the art equipment manned by expert Radiation Oncologists, Medical Physicists and Radiation Technologists. The sophisticated equipment we use for delivering the best in Cancer Care are as follows: 

NovalisTx with Exact Trac: A Special linear accelerator designed for high precision treatments such as Frameless Radiosurgery and Stereotactic Body Radiotherapy, this linear accelerator is equipped with a Beam Shaper, on board Imager, Exactas in Room X-ray and a 6D robotic couch.

The Beam Shaper is a fine multileaf collimator that shapes the radiation beam to match the shape of the tumor, thus protecting the adjacent collimator that shapes the radiation beam to match the shape of the tumor, thus protecting the adjacent normal tissues form the ill effects of radiation.

Treatment accuracy is ensured using the On Board Imager to conduct a cone beam CT or x-rays of the patient, while on the treatment couch, to direct the radiation beam accurately.

The 6D robotic couch addresses shifts in position, linear as well as rotational such as pitch, roll and yaw.

The Exactrac in room x-rays with automated matching are a special feature of NovalisTx. Clinac ix Silhouette, HDR brachytherapy from Bebig, Eclipse and iPlan treatment planning computers, AIO Patient Immobilization System and the Radio-Frequency Ablation (RFA) complete the spectrum of technology required for precision radiotherapy.

Surgical Oncology at Indraprastha Apollo Hospitals Delhi, India

The discipline is managed by site specific specialists in the areas of:

·         Breast cancer

·         Mammographic localization of small microscopic lesions and sentinel node biopsy.

·         Colorectal cancers

·         Endocrine tumors & Neuroendocrine tumors

·         Tumors of the Stomach, small intestines, Pancreatic tumors, hepatic tumors and tumors of the gall bladder

·         Head and neck tumors

·         Tumors of the Brain and spine

·         Soft tissue and bone tumors

·         Limb conserving surgery in bone tumor and soft tissue tumor

·         Plastic and reconstructive surgery including Micro vascular reconstruction of flap

·         Thoracic surgical oncology

·         Thoracoscopic & Laparoscopic surgery in staging and diagnosis

·         Urologic and gynecological oncology

·         Extensive resection of hepatic and lung tumor

·         Robotic surgery

Cancer Institutes (Cancer Care) at Indraprastah Apollo Hospitals Delhi, India

Apollo Cancer Institute at Indraprastha Apollo Hospitals is a comprehensive multidisciplinary institute. It brings inthe latest technology with the most competent and highly skilled health care professionals under one roof.

Apollo Cancer Institute has the unique advantage of not only being a standalone cancer unit but also having themost modern backup from all super specialists and diagnostics. The institute offers the following facilities:

Cancer Screening Programme

To bring about early detection of cancer these screening programmes have been devised. One out of fourteen men/women will get affected by cancer in their lifetime.

It can come anytime to anyone. Early detection can ensure prevention and/or cure in most of cases. Robotic Surgery Benefits of the da Vinci Surgical System: da Vinci Robotic Surgical System is a new technology to perform complicated surgeries with greater ease and precision in regions of the body which are difficult to access by conventional open surgery.

Robotic technology employs fine operating instruments which simulate the motion of the human wrist. Hand motions are scaled through a computer interface to eliminate tremor allowing for incredibly precise maneuvers.

On the patient's end, the robot's arms are fitted with 5 to 12 millimeter surgical instruments and a small camera scope that provides a detailed view of the patient. Seated only a few feet away from the operating table, surgeons view the patient's anatomy through a screen that produces a THREE DIMENSIONAL image magnified ten times.

The robot that operates on the patient is controlled by this expert surgeon who carefully maneuvers a pair of knobs to control the instruments. By using the da Vinci system, surgeons are able to avoid making large incisions.

Because there are several small incisions, instead of a single large opening, Patients usually realize a number of benefits that include:

·         Shorter hospital stay

·         Less pain

·         Quicker recovery

·         Reduced chance of infection and other complications

·         A quicker return to normal lifestyle

·         Less scarring

·         Less bleeding and reduced need for blood transfusion

·         Decreased inflammation of body tissue

Robotic Surgery is indicated in wide variety of surgeries including complicated cancer surgeries e.g. Urological (cancer of prostate, cancer of the urinary bladder and cancer around the kidneys), Thoracic (Cancers of the lungs & Cancers of the chest region like thymoma), Gynecologic (cancer of uterus, cancer of ovary),Pelvic, Gastrointestinal (Cancers of the Stomach, Cancers of the Pancreas as well as Gall bladder), and head and neck surgeries.

It can also be used for Chemoembolization of liver tumors and sarcomas. Paediatric Oncology and Haematology Successful treatment of children with cancer is one of the biggest achievements of modern medicine. Over 75% of children with cancer can be cured completely.

The pediatric oncology unit at Indraprastha Apollo Hospitals strives to get the best outcomes for these children with treatments delivered in a child friendly environment. There are comprehensive treatment facilities for pediatric hematology and oncological disorders. Treatment is given as per the protocols currently buffering best outcome for individual diseases.

This service is backed by the state of art facilities from radiation oncology and surgical oncology including pediatric neurosurgery. as well as pediatric, orthopaedics. There is a dedicated Thalassemia unit for patients with Thalassemia major.

Multispecialty Thalassemia clinic also caters to all patients suffering from Thalassemia in a holistic way. For more details contact 011-29871170 or 011-29871171 Bone Marrow Transplant Programme The blood and marrow transplant unit is offering allogeneic and autologous bone marrow transplant to children and adults with malignant and non-malignant conditions.

The diseases that are routinely treated are leukemia, lymphoma, neuroblastoma, thallesemia , a plastic anaemia and other immune deficiency and storage disorder. A six bedded HEPA – filtered laminar airflow unit and state-of-the-art stem cell processing unit backed by excellent laboratory services compares with the international standards of care.

Treatment & Services of Obesity and Metabolic Surgery at Indraprastha Apollo Hospitals Delhi, India

Indraprastha Apollo Hospital’s dedicated Apollo Obesity and Metabolic Surgery Centre” provides a truly world class service to patients right here in New Delhi. Our surgeons are renowned figures in the field, who have trained and worked in the best centers in the world.

They have vast experience with this type of surgery and are supported by an excellent team of experienced, dedicated anesthetists, surgical registrars, junior doctors, dieticians, nurses, physiotherapists, and managers.

We have taken great care to ensure that our infrastructure all over the hospital can meet the very specific needs of obese patients. At Apollo Obesity and Metabolic Surgery Centre, we provide the full spectrum of services for obesity management, including dietary and exercise advice, gastric balloons, and a range of surgical procedures, carried out laparoscopically and robotically.

Our surgeons perform all established bariatric procedures and will recommend the best procedure for you, depending on your individual needs. Typically we perform Sleeve Gastrectomy, Mini (Omega Loop) Gastric Bypass, Roux –en – Y Gastric Bypass, Gastric Banding, and Gastric Balloon insertions.

 

Sleeve Gastrectomy:

This operation involves removing a large portion of patient’s stomach using surgical staplers. Stomach capacity is reduced from the normal of 1.0 – 1.5 liters to 50-150 ml, thus decreasing food intake. 

It also decreases patient’sappetite. Since the transected part of stomach is physically removed from patient’s body, it is an irreversible operation. Some patients prefer it, as it does not involve surgery on bowel and has a better safety profile than bypass. 

Patients should however be aware that some patients can develop acid reflux after this operation and the weight loss is generally poorer than the bypass. 

There is less need for long term vitamin and mineral supplements after this procedure.

Gastric Bypass (Mini and Roux en Y):

Gastric Bypass: Gastric Bypass involves creation of a small gastric pouch which is connected directly to small bowel. Most of the stomach and approximately 2.0 meters of small bowel is bypassed, using surgical staplers.

This operation decreases the amount of food a patient can eat, also prevents absorption of some of the consumed calories, and reduces appetite. It is possible to reverse gastric bypass. Though Mini Gastric Bypass can be reversed relatively easily, reversing a Roux en Y Gastric Bypass laparoscopically can be very challenging. 

Weight loss and improvement in diabetes are superior with bypass but that comes at a higher need for vitamin and mineral supplements in the long term, and a slightly worse safety profile compared to sleeve gastrectomy.

Gastric Banding:

It involves placement of a silicon band at the top of patient’s stomach. The band works by reducing the food intake but results can be highly variable and depend largely on a patient’s ability to work with it. 

Patients need regular band adjustment and many patients need reoperations in the long term to adjust band port/tubing or to remove the band.

Gastric Balloon:

It is carried out endoscopically and involves placement of a balloon inside patient’s stomach. Balloon reduces the food intake by taking up the space inside a patient’s stomach. 

It is however a temporary device and has to be removed after 6 months. Weight lost during this period tends to come back if individuals are not careful. Your surgeon may recommend this to you to improve your safety profile prior to your bariatric surgery or if you do not meet criteria for surgery.

Obesity and Metabolic Surgery Center at Indraprastha Apollo Hospitals Delhi, India

Obesity is no longer just a lifestyle or cosmetic condition. It is now globally recognised as a disease itself. It is a disease that not only predisposes individuals significantly to a range of other diseases (like Type II Diabetes, high blood pressure, heart disease, asthma, COPD, sleep apnoea, acid reflux, gall stones, infertility, impotency, and many cancers amongst others), but also significantly reduces the life span of individuals suffering from it.

We are going through an obesity and diabetes pandemic, unprecedented in the history of the world. In most of the western countries, between 50-80% of the population is either overweight or obese. India is already the diabetes capital of the world and the prevalence of obesity is rising very rapidly.

Surgery for obesity and metabolic conditions (like type 2 diabetes mellitus, nonalcoholic fatty liver disease etc.), also known as bariatric and metabolic surgery, has grown rapidly in most western countries over the last two decades as a safe and effective treatment for patients with severe obesity and/or uncontrolled diabetes mellitus. This type of surgery is performed laparoscopically or robotically using 5-6 small key-holes, which are hardly visible.

  Hospital stay for most patients is between 48 -72 hours. It is    extremely safe and high volume surgeons consistently report very  low complication rates and close to zero mortality. Overall, bariatric  (obesity) and metabolic surgery improves quality of life of the  patient, improves survival, and is very cost effective (by allowing  saving on future healthcare costs and increasing individual’s  economic productivity).

Gynecology & Obstetrics Treatment in Indraprastha Apollo Hospitals Delhi, India

At Indraprastha Apollo we believe that preventive healthcare begins with the care of the healthy. We have programmes in both gynaecology and obstetrics for prevention and early detection of disorders. Well Women check-up is designed to detect early evidence of:

·         Gynaecological diseases

·         To provide contraceptive advice

·         Preconception counseling

·         Gynaecological cancer screening

Antenatal Care

A regular antenatal care starting early in pregnancy prevents most medical problems and early detection helps to improve pregnancy outcomes. We offer a full range of screening tests and antenatal check-ups as per international guidelines. With the backup of a specialized fetal medicine department, the fetus can be screened for various possible abnormalities and its growth and well-being can be monitored in the most appropriate manner. Facility of Dedicated LDR (Labour- Delivery- Recovery) room is available on request.

High Risk Pregnancy

We have well trained obstetricians to look after patients with high risk pregnancies in conjunction with various medical specialities. Those with diabetes, high blood pressure, heart disease, blood disorders, tumours, previous pregnancy losses, pre-term labour, growth restricted babies post-transplant pregnancies etc are looked after throughout the pregnancy and labour by this team. Our advanced neonatal care services, state of the art ICU facilities and an excellent blood bank provide essential backups for the best possible care of even the most challenging cases.

Painless Labour

Apart from the conventional analgesics and prophylaxis we offer pain relief in labour by entonox and epidural. Painless labour is provided by our team of senior anesthetists available 24 hours a day. T.E.N.S (Trans Cutaneous Nerve Stimulation) facility is also available on request. We have postgraduates and trained senior resident obstetricians monitoring the condition of mother and child round the clock under supervision of senior consultants.

Gynaecological oncology

Comprehensive treatment of cancer of the uterus, cervix, vagina, vulva and ovaries is provided by site specific gynaecological oncosurgeons in combination with medical oncologist and radiotherapists where ever needed.

Conventional Gynaecology

Our gynaecologists provide specialized medical and surgical management of varied gynaecological problems like menstrual abnormalities, infertility, prolapsed uterus, fibroids, other tumors of the uterus and ovaries. Gynaecological endocrinological services including adolescent, menopausal and other reproductive age problems are also provided at our hospital.

Treatments & Services of Gastrointestinal and Hepatology Surgery in Apollo Hospitals Delhi, India

The Institute of Gastroenterology & Hepatology provides various diagnostic and therapeutic endoscopies of different kinds as mentioned below:

 

1. Diagnostic Endoscopy:

·         Upper Gastro Intestinal Endoscopy

·         Sigmoidoscopy/Left Limited colonoscopy

·         Full length colonoscopy

·         Colo-Ileoscopy

·         ERCP (Endoscopic Retrograde Cholangio Pancreatography)

2. Therapeutic UGI Endoscopy:

·         Dilatation of oesophageal strictures/webs

·         Pneumatic dilatation for achlasia

·         EVL(Endoscopic Variceal Ligation (Oesophageal varices)

·         EST ( Endoscopic Sclero Therapy) (Oesophageal varices)

·         Glue Injection for Gastric varices

·         APC (Agron Plasma Coagulation) for Gastric lesions

·         Injection Sclerotherapy

·         Oesophageal stenting

·         Entero duodeno stenting

·         Percutaneous endoscopic gastrostomy(PEG)

·         Endoscopic placement of feeding tubes (NGFT)

·         Foreign Body Removal

·         Gastric duodeno polypectomy

3. Capsule Endoscopy: The Institute has been using capsule endoscopy for last several years for the evaluation of patients with small bowel diseases like obscure gastro intestinal bleed, Crohns disease, Tuberculosis & chronic diarrhoea with very encouraging results.

4. Therapeutic colonoscopy

·         Colonoscopic polypectomy

·         APC for radiation proctitis/colitis

·         Sclero therapy for bleeding lesions in colon and ileum

·         Colonic stents

·         Colonoscopic decompression in Pseudo obstruction

·         Therapeutic ERCP

·         Removal of CBD stones

·         Biliary stenting to relieve jaundice and cholangitis (plastic stents and metallic stents)

·         Bile duct stricture dilatation and stenting

·         Stenting of Pancreatic duct

5. Endoscopic ultrasonography: We have the state of art Olympus equipment for carrying out endoscopic Ultrasonography for evaluation of mediastinal masses, pancreatic lesions, and bile duct lesions. Besides diagnosis, fine needle aspiration and biopsy are done routinely which help tremendously in making a diagnosis.

 6. The Institute of Medical Gastroenterology/Hepatology works in close cooperation with the department of Surgical Gastroenterology and the hospital provides facilities for carrying out advanced surgical procedures for various complicated disorders. Along with the department of liver transplant, we are carrying out an excellent liver transplant programme for management of patients having chronic end stage liver disease as well as acute liver failure.