Wednesday, April 26, 2017

Da Vinci Robotic surgery

     I attended the first National workshop on robotic surgery of head and neck.  I was invited as Guest faculty by Professor Ashok Kumar Gupta a data I moderated a live surgical session.  

I could get hands on the Da Vinci Robotic surgery system and could see trans axillary thyroidectomy (RATS), retro auricular thyroidectomy, radical tonsillectomy and trans oral robotic surgery of base of tongue lesions (TORS).  

Humble thanks to Professor Ashok Gupta and Professor Naresh Panda for giving this opportunity.   

Sunday, April 2, 2017

Adult Adenoidectomy & Tonsillectomy with coblation procise wand




Sleep Apnoea surgery

Palatal collapse can be anterior to posterior or lateral. both can be observed in same patient during the same night. So a circumferential palatoplasty should always be done

Ideally Dise should be done for 10-12 mins till you see proper Apnoea.

Use thin endoscope as far as possible and thick diameter endoscope may cause static obstruction as well.

Scope should be kept above the velum

Velum is not a 2 dimensional structure. It is a tube and it starts from the attachment of soft palate.

If soft palate is narrow higher up then any surgery would fail and 10-15% are such cases. In such cases anterior palatoplasty can be offered but still results are disappointing.

Glossoepiglottopexy is preferred over epiglottectomy

Palatopharyngeus muscle is key to any palatal surgery.

Scar formation plays a key role in final result so 3-6 months should be waited for final result.

Contraindications for sleep apnoea surgery

BMI above 30 is relative and above 40 is absolute contraindications for sleep apnoea surgery 

Static obstruction should be removed always 

• DO YOU ALWAYS GO FOR WT REDUCTION PROGRAM / OWP 
THERAPY BEFORE ANY KINO OF 
DBWTTE THERAPY ?

Answer tailored according to need of patients 

How long

Vary.  
3 days trial prior to taking for surgery 
Patient choose the length of conservative treatment 


AHI 
Between 30-40 may need CPAP
Above 40
70 needs CPAP and it's more of a problem of Anaesthesia 
It's more the length of apnea period that matters. 



ISSACON 2017