Dr. Pragnesh Desai

05/01/2026

https://youtu.be/tYOVfdWznGc

Laparoscopic Pyeloplasty for Left PUJO – Explained Simply
What is Left PUJO?

Left PUJO (Pelvi-Ureteric Junction Obstruction) is a condition where the flow of urine from the left kidney to the urine pipe (ureter) gets blocked at a narrow point. Because of this blockage, urine collects in the kidney, causing swelling (hydronephrosis). Over time, this can lead to pain, repeated infections, stone formation, or damage to the kidney.

Common Symptoms

People with left PUJO may experience dull pain on the left side of the abdomen or back, repeated urinary infections, fever, nausea, or blood in urine. In some cases, especially in children or young adults, the condition may be detected during routine scans.

What is Laparoscopic Pyeloplasty?

Laparoscopic pyeloplasty is a modern, minimally invasive surgery done to correct the blockage in PUJO. Instead of making a large cut, the surgeon operates through 3–4 very small holes using a camera and fine instruments. The narrowed or blocked portion is removed, and the healthy ends are rejoined to allow urine to flow freely.

Why Choose Laparoscopic Surgery?

Compared to open surgery, laparoscopic pyeloplasty has many advantages:
Smaller cuts and minimal scarring
Less pain after surgery
Faster recovery and shorter hospital stay
Early return to daily activities
High success rate (more than 90%)

What Happens After Surgery?

A small tube (stent) is usually placed inside temporarily to help healing and ensure smooth urine flow. This is removed after a few weeks. Most patients feel significant relief from pain and symptoms once recovery is complete.

Who Needs This Surgery?

Laparoscopic pyeloplasty is advised when left PUJO is causing symptoms, repeated infections, stones, or affecting kidney function.

In Summary

Laparoscopic pyeloplasty is a safe and effective treatment for left PUJO. Early diagnosis and timely treatment can save kidney function and greatly improve quality of life. Public awareness is important so that symptoms are not ignored and proper care is taken at the right time.

Laparoscopic Pyeloplasty for Left PUJO – Explained SimplyWhat is Left PUJO?Left PUJO (Pelvi-Ureteric Junction Obstruction) is a condition where the flow of u...

30/12/2025

https://youtu.be/YFFNHpzbtN4

Public Awareness Article: PUJO and Robotic Pyeloplasty

Understanding PUJO (Pelvi-Ureteric Junction Obstruction)

Pelvi-Ureteric Junction Obstruction, commonly known as PUJO, is a condition where the flow of urine from the kidney to the ureter is partially or completely blocked. This blockage occurs at the junction where the kidney meets the ureter. PUJO can be present from birth (congenital) or develop later in life due to scarring, stones, infection, or external pressure on the ureter.

Why is PUJO Important?

When urine cannot drain properly, it starts accumulating in the kidney, leading to swelling called hydronephrosis. Over time, this can cause:

* Flank or abdominal pain
* Recurrent urinary tract infections
* Kidney stones
* Reduced kidney function
* Poor growth or pain episodes in children

Early diagnosis is crucial to protect kidney health and prevent permanent damage.

Diagnosis of PUJO

PUJO is commonly detected through:

* Ultrasound
* CT scan or MRI
* Nuclear renal scan to assess kidney function

These tests help doctors decide whether treatment is required.

Treatment: Robotic Pyeloplasty

The gold standard treatment for symptomatic or function-affecting PUJO is pyeloplasty, a surgery that removes the narrowed segment and reconnects the healthy ureter to the kidney.

Robotic pyeloplasty is a modern, minimally invasive technique performed using robotic assistance. It offers several advantages:

* Very small incisions
* High precision and accuracy
* Less pain and blood loss
* Faster recovery
* Shorter hospital stay
* Excellent long-term success rates

Robotic surgery is especially beneficial in children, young adults, and complex cases.

Life After Surgery

Most patients experience complete relief of symptoms and preservation or improvement of kidney function. Regular follow-up ensures long-term success.

Key Message

PUJO is a treatable condition. Early recognition and advanced treatments like robotic pyeloplasty can save kidneys and improve quality of life. Awareness leads to timely care.

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26/12/2025

https://youtu.be/YDDITE96Hco

Basilic Vein Transposition After Brachio-Basilic AV Fistula: A Simple Explanation for Patients

For patients with kidney failure who need long-term dialysis, a good vascular access is essential. One of the most reliable types of access is an arteriovenous (AV) fistula, where a surgeon connects an artery to a vein to allow strong blood flow for dialysis. When suitable veins in the forearm are not available, a Brachio-Basilic AV fistula in the upper arm is often created.

The basilic vein is a large vein located on the inner side of the upper arm. Although it is healthy and strong, it lies deep under the skin, making it difficult to use directly for dialysis needle insertion. To solve this problem, doctors perform a procedure called Basilic vein transposition.

Basilic vein transposition is usually done a few weeks after the initial Brachio-Basilic AV fistula surgery. During this procedure, the surgeon gently brings the basilic vein closer to the surface of the skin. The vein is repositioned and fixed in a more superficial (upper) position so that dialysis needles can be inserted easily and safely.

This procedure is done under anesthesia and is considered safe and effective. After surgery, the vein is allowed time to heal and mature. Once ready, it provides a durable and high-flow access for dialysis. Compared to artificial grafts or catheters, a transposed basilic vein fistula has a lower risk of infection, lasts longer, and offers better dialysis efficiency.

Patients may notice mild swelling or discomfort after surgery, which usually settles with time. Regular follow-up and proper care of the fistula arm are important to ensure long-term success.

In summary, Basilic vein transposition after a Brachio-Basilic AV fistula is a well-established method to create a strong, long-lasting, and safer dialysis access when other veins are not suitable.

Basilic Vein Transposition After Brachio-Basilic AV Fistula: A Simple Explanation for PatientsFor patients with kidney failure who need long-term dialysis, a...

24/12/2025

https://www.youtube.com/watch?v=bnKzLxNeLJ4&t=7s

Robot-Assisted Kidney Transplant: A New, Patient-Friendly Approach

Kidney transplant is the best long-term treatment for patients with end-stage kidney disease. Traditionally, kidney transplantation has been done through a large incision in the lower abdomen. While this method is effective, it can be associated with more pain, longer recovery time, and higher risk of wound-related problems. With advances in medical technology, robot-assisted kidney transplant has emerged as a safer and more comfortable option for selected patients.

In robot-assisted kidney transplant, the surgeon uses a highly advanced robotic system to perform the surgery through small keyhole cuts instead of one large cut. The robot does not work on its own. It is fully controlled by an experienced transplant surgeon who sits at a console and guides the robotic arms with great precision. The robot provides a magnified 3-dimensional view, allowing the surgeon to operate with better accuracy and control.

The donated kidney is placed inside the patient’s body through a small incision, and the blood vessels and urine pipe are connected using robotic instruments. Because the cuts are smaller, there is less damage to muscles and tissues.

One of the biggest benefits of robot-assisted kidney transplant is reduced pain after surgery. Patients usually need fewer pain medicines and are able to walk earlier. The smaller wounds also mean lower risk of infection and hernia, which is especially helpful for obese patients and those with diabetes. Recovery is faster, hospital stay is often shorter, and patients can return to daily activities sooner.

Another important advantage is better cosmetic results, as scars are small and less noticeable. Despite being minimally invasive, the success of the transplant and kidney function is comparable to traditional open surgery when done in suitable patients by trained teams.

Robot-assisted kidney transplant may not be suitable for everyone. The decision depends on patient factors, donor type, and the surgeon’s assessment. It also requires specialized equipment and expertise.

In summary, robot-assisted kidney transplant combines the proven success of kidney transplantation with the benefits of modern minimally invasive surgery. For many patients, it offers a safer, gentler, and faster road to a healthier life.

Robot-Assisted Kidney Transplant: A New, Patient-Friendly ApproachKidney transplant is the best long-term treatment for patients with end-stage kidney diseas...

23/12/2025

https://youtu.be/Vj8_kmJDI8k?si=vUl4zE2WixntPgaq

CAPD Catheter: A Simple Guide for Patients and Families

Chronic kidney disease can reach a stage where the kidneys are no longer able to clean the blood properly. At this point, dialysis becomes necessary. One common and patient-friendly type of dialysis is CAPD – Continuous Ambulatory Peritoneal Dialysis. For CAPD to work, a small soft tube called a CAPD catheter is placed in the abdomen.

The CAPD catheter is a flexible plastic tube that allows dialysis fluid to go in and out of the abdomen. It is usually inserted through a minor surgical procedure, often under local or short anesthesia. Once healed, the catheter stays in place and is hidden under clothes, allowing the patient to move around normally.

In CAPD, the lining of the abdomen (called the peritoneum) acts as a natural filter. Dialysis fluid is put into the abdomen through the catheter, where it absorbs waste products and extra water from the blood. After a few hours, this fluid is drained out and replaced with fresh fluid. This process is done several times a day and can be performed at home, at work, or while traveling.

The biggest advantage of CAPD is independence. Patients do not need to visit a dialysis center frequently and can manage their treatment themselves after proper training. It also provides gentle and continuous cleaning of the blood, which is easier on the heart and body.

Proper care of the CAPD catheter is very important to prevent infection. With good hygiene and regular follow-up, CAPD can be a safe, effective, and convenient dialysis option for many kidney patients.

CAPD Catheter: A Simple Guide for Patients and FamiliesChronic kidney disease can reach a stage where the kidneys are no longer able to clean the blood prope...

23/09/2025

🌟 Preemptive Kidney Transplant – A Step Ahead! 🌟

Did you know that a kidney transplant before starting dialysis offers the best outcomes for patients with kidney failure? Preemptive kidney transplant not only improves survival and quality of life but also reduces complications linked with long-term dialysis. Patients can return to normal routines faster, with fewer hospital visits and better overall health. 💚

Let’s spread awareness and encourage timely evaluation for kidney patients. Early referral and planning can change lives. Because when it comes to kidneys, the earlier the transplant, the brighter the future. 🌱

04/05/2025

Fully motivated on Sunday 🙏🙏🙏🙏

11/01/2025

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Dr MONIKA RAJPUT
MBBS/MS/DNB/ MNAMS/DM (AIIMS New Delhi)

Available from : Mon-Sat: 9AM-5PM
@ Bhagwati Hospital;Rohini

&

6PM-9PM: ALYSSUM Uro-gynae-IVFClinic@ Shahdara Delhi

For appointment
📞 on +91 92669 45007

05/01/2025

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31/12/2024

🌟 Happy New Year 2025! 🌟

As we step into this brand-new year, let’s embrace the endless possibilities that lie ahead. May 2025 bring you joy, good health, and the courage to chase your dreams with unwavering determination.

Let’s carry forward the lessons of the past year, cherish the memories we’ve created, and look forward to building brighter and better moments together. Whether it’s a personal milestone, a professional achievement, or simply spending time with loved ones, let’s celebrate every step of the journey.

Here’s to new beginnings, new opportunities, and a renewed commitment to make this year truly extraordinary. Let’s make 2025 a year of positivity, kindness, and growth—for ourselves and everyone around us.

Wishing you and your family a year filled with happiness, peace, and success. Let’s shine brighter than ever!

28/12/2024

Pioneering Surgical Excellence: Robotic Left Adrenalectomy with Nephrectomy, Bench RIRS with Pyelotomy, Vascular Reconstruction for Aneurysm, and Robotic Auto-Transplantation

We are proud to share a ground breaking achievement in advanced urological surgery! Our team under the guidance of Prof. Dr. Anant Kumar have recently performed a highly complex and rare procedure combining robotic left adrenalectomy, nephrectomy, bench retrograde intrarenal surgery (RIRS) with a pyelotomy for a 6 mm kidney stone, vascular reconstruction of a left main renal artery aneurysm, and Robotic auto-transplantation.
The Challenges
The patient presented with multiple critical issues:
1. A renal artery aneurysm posing a significant risk of rupture.
2. A 6 mm renal stone requiring precise removal.
3. The need for left adrenalectomy for myelolipoma
4. Left nephrectomy (better functioning Kidney for Auto Transplant)

The complexity of the case required a multidisciplinary approach, blending cutting-edge robotic technology with meticulous vascular and urological expertise.

Step-by-Step Approach
1. Robotic Adrenalectomy and Nephrectomy:
Utilizing robotic-assisted surgery, we achieved unparalleled precision in removing the adrenal gland and kidney while minimizing trauma to surrounding tissues. The advanced robotic platform ensured excellent visualization and control, leading to a safer procedure with faster recovery for the patient.
2. Bench Surgery – RIRS/pyelotomy and Vascular Reconstruction:
Post-extraction, the kidney underwent bench surgery outside the body. Using advanced RIRS/pyelotomy techniques, the 6 mm stone was removed with precision. Simultaneously, vascular reconstruction (excision of aneurysmal sac with end to end anastomosis) was performed to repair the renal artery aneurysm, ensuring restored blood flow and eliminating the risk of rupture.
3. Auto-Transplantation:
After the reconstruction, the kidney was successfully transplanted back into the patient’s body(Robotically). Meticulous anastomosis of the vessels and ureter ensured optimal function.

Why This Procedure Stands Out
* Minimally Invasive Advantage: The use of robotics ensured minimal blood loss, reduced postoperative pain, and quicker recovery.
* Multidisciplinary Expertise: Combining Urological, Transplant and Robotic surgical techniques showcased the synergy of innovation and skill.
* Bench Surgery Precision: The intricate repair of the renal artery aneurysm and stone removal outside the body ensured maximum accuracy.
* Patient-Centric Care: The procedure addressed multiple critical issues in a single surgery, minimizing the overall impact on the patient’s health and recovery time.

The Outcome

The patient has recovered well, with preserved renal function and complete resolution of adrenal myelolipoma, renal artery aneurysm and stone-related issues. This case highlights the power of innovation and collaboration in delivering life-changing outcomes.

Our Commitment to Excellence

At Max Super specialty Hospital, Saket, New Delhi, we are dedicated to pushing the boundaries of what’s possible in urological and robotic surgery. With a patient-first approach and access to the latest technology, we continue to lead the way in complex and high-risk procedures.

This achievement is not just a milestone for our team but a testament to the transformative potential of modern medicine.

🔬💪 For inquiries or consultations, contact us today to learn more about our advanced surgical solutions.

25/12/2024

https://www.facebook.com/share/p/12BSQz7osHx/

Pioneering Innovation in Organ Donation: Transvaginal Retrieval in Laparoscopic Donor Nephrectomy at Max Hospital Saket
We are proud to share a remarkable milestone achieved at Max Hospital, Saket, in the field of kidney transplantation and minimally invasive surgery. Our expert urology team under the guidance of Prof. Dr. Anant Kumar Sir , recently performed a transvaginal retrieval of the left kidney following a laparoscopic donor nephrectomy on a 24-year-old nulliparous woman, driven by the donor’s firm preference for this approach.
This groundbreaking procedure is a testament to the evolving possibilities in organ donation and transplantation. The donor, a brave young woman, demonstrated extraordinary compassion and resilience, choosing to donate her kidney to save her loved one’s life. Our team was honored to fulfill her wishes with a minimally invasive approach that prioritized her post-operative comfort and recovery.
The Procedure
Laparoscopic donor nephrectomy is already a gold standard for kidney retrieval, offering minimal scarring, faster recovery, and reduced postoperative pain. In this case, we advanced a step further by utilizing the transvaginal route for kidney extraction. This innovative technique, which is rarely performed, eliminates visible abdominal scarring and has the potential to further reduce postoperative discomfort.
The entire process required meticulous planning and expertise, given the unique anatomical considerations and the patient’s nulliparous status. Our multidisciplinary team, including urologists, gynecologists, and anesthesiologists, worked in harmony to ensure the highest standards of safety and precision throughout the procedure.
Why Transvaginal Retrieval?
The decision to perform transvaginal kidney retrieval was based on the donor’s insistence and her desire for a scar-free abdomen. While this technique is still considered unconventional, it offers several advantages:
• Cosmetic Benefits: No visible abdominal scars.
• Reduced Pain: The absence of abdominal incisions may lead to less post-operative pain.
• Faster Recovery: Patients often experience quicker return to daily activities.
The Outcome
We are pleased to report that both the donor and the recipient are doing exceptionally well. The donor experienced minimal post-operative pain and the recipient has shown excellent diuresis marking the success of the transplant.
A Step Forward in Patient-Centered Care
At Max Hospital Saket, we believe in tailoring treatments to meet the unique needs and preferences of our patients. This case underscores our commitment to pushing boundaries and offering the most advanced, patient-centered care possible.
We extend our heartfelt gratitude to the donor and her family for placing their trust in us and for inspiring us to achieve new heights in medical care.
If you or a loved one is considering organ donation or transplantation, rest assured that you are in the best hands at Max Hospital Saket. Together, we can create more stories of hope, healing, and innovation.