Telemedicine is starting to play an important role in the health field in India. In this case report we describe the successful use of telementoring to remove a parathyroid tumor in a patient with residual hyperparathyroidism after two previous unsuccessful attempts in tumor excision. A 21-yr-old patient crippled with advanced hyperparathyroidism was taken up for third-time exploration at Amrita Institute of Medical Sciences (AIMS), Kochi, with guidance from the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, using telemedicine technology. These two centers are located 2,500 km apart, and telementoring from the more experienced endocrine surgeons at SGPGIMS resulted in successful tumor localization and removal. For this session both the institutions were provided with a dedicated 512 Kbps very small aperture terminal (VSAT) link and two-way video-audio connectivity. Even though two previous explorations were unsuccessful, with the help of telemedicine technology the same surgeon was successful in locating and removing the tumor. The video and audio quality was of good enough quality for the expert at SGPGIMS to guide the team at AIMS satisfactorily. The patient benefited since he did not have to travel to a far-off specialized center for surgery. This case report testifies to the usefulness of telemedicine in the field of surgery, especially in developing countries, which have few medical experts in certain specialized areas.
Dependent drainage of a lower pole pyelocaliceal diverticulum was achieved by uretero-diverticulostomy in eight patients who already had compromised renal function due to bilateral megaureters or posterior urethral valves. This procedure preserves all functional renal parenchyma and the ureteropelvic junction is left undisturbed. This is the first description of such a procedure for the treatment of lower polar pyelocaliceal diverticulum.
Subcapsular pyelolithotomy was performed in 28 patients who had earlier undergone either one or more operations in the same kidney for renal calculi. This approach was useful in salvaging the kidney even in the presence of dense perirenal and periureteric adhesions obscuring the normal anatomy of these structures. Serious consideration should be given to this procedure before making the decision to perform nephrectomy in such cases. Surgical technique and the results are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.