Jeewan Mala Clinic (on call)

I am Dr. Malvika Sabharwal from jeevan mala hospital and apolo spectral hospital in Karol Bagh, New Delhi India.

I am gonna tell you about uterus removal. Uterus removal is a very common operation. Bht commonly isko kara jata hai k patient ata hai apko bolta hai k ji hamary ko flah flah flah problem hai or ap hamara uterus nikal dijiye. Sb sy phly to main apko btaungi kya indications hain. Chahye wo fibroid k hn, ya bleeding zyada ho rai ho. Koi fibroid nai hai per bleeding bht zyada ho rai hai ya koi changes a rhy hain. Jaisa k agr mouth of the uterus main agr koi peps pal krty hain routinely jo k karna chahye, her ek marez k liye. Ap regular apasnaol kar ry hain us main koi changes any lag jaty hain ya aisi koi bhi problem ho to patient ata hai or wo bara clear mind sy kehta hai k ji mje uterus remove krwana hai. Kbhi kbhi wo refered cases hoty hain. Ya marez ko kahein kaha jata hai or hamary pas aty hain. Q k hamary pas jo uterus removal ka tareka hai wo hai durbeen sy or ek pait khol k. pait khol kr jo karty hain, ek bara 8 centimeter, 8 inches k kareeb ek insection hota hai pait k upper or us k through hm uterus ko, us ko pakar k baher nikal k us ki puri surgery kr k as pas disconnect kr k us ko nikal dety hain. Or abdomen ko stitch kr dety hain. Laparoscopic surgery jb sy hm ny shuru kari hai. Year was 92. I think ye sb sy bara bone hai. Doctor k lye bhi, patient k lye bhi. Ek to patient friendly surgery hai. Or doctor k liye offcourse, doctor ko sekhny main thora samain zaror lgta hai,but once you have commanded the technique of Laparoscopic surgery, it is the best. It is the best for the patient and for you it’s a very affective way of taking out the uterus without any problems. Ap us ko Laparoscopicly nikalty ho or Laparoscopicly jb nikalty ho 1 din ka stay rehta hai hospital main. 1 din main mareez back to normal work hota hai. Wo ghr ja kr k, serhioyon sy charhta hai. Serhiyon par jaye, upper rahy, ghar k khanay bnaye, baheer ghumny jaye, hr roz piture dekhy, us py koi issue nai hai. Bht minimal unko btaya jata hai do’s and don’t’s. unka upper charhny main koi problem nai ati. Sirf halki phulki jo problem, sirf 2 chezain ki hm log btaty hain which Is hardly any issue. So patient is back to normal routine. Ap apny ffice dubara ja skty hain itni jaldi. Loss of working days is very less. To loss of working days jaisy e kam oty hain, aj kal apko pta hi hai, mostly ladies are working, most of the women are working today. Chahy wo ghr py, ghr ka bhi kam itna hota hai. Bachon k aj kal kitny kam hoty hain, us k ilawa office girls bht hoti hain. Jo k office ko bhi sambhalti hain or ghr ko bhi sambalti hain. Let me tell you hamary bht patients hain un ko kbhi ye problem nai I k hum uterus nikalny k bad hm ghr ka kam nai kar paye. Ya office ka kam nai kar paye. Hamary pas doctors aty hain. Dur dur sy aty hain, in fact patients are coming from dubai, London, America, Canada all over. Wo aty hain apna operation krwaty hain or 2 din k bad they are ready to go home. Because this surgery has really picked up so much k jb o dekhty hain k kitny aram sy ye kam ota hai to unko aisa koi hesitancy nai lagti. Un k roz mara ki zindagi main koi change nai ata. Unko minimalistic thory sy do’s and don’ts hoty hain which is hardly anything. And aam tor per jb hum uterus nikalty hain, jaisa k main apko dekhati hn. This is one uterus. Two tubes and two ovaries. Aj agr main uterus nikal rai hn, lady ka age hai 45, I will tell her definetly ovary tubes to ap nikal hi lijye. Ovaries jo hain, wo apko hormones deti hain. Hormones ek lady ko femerity bna k rakhti hai. Femariti sy ye bhi matlab hai, tubes ka koi aisa role nai hai per ovaries apko hormones dy k, hormones k karan apka skin, hair, heart, sb k upper us ka zor hai. So ovaries ko hum bina puchy bilkul nai nikalty. Us k lye permission lety hain tabhi nikali jati hai. Per agr uterus nikal ry hain to aam tor per hum tubes ko bhi nikal dety hain.

Thank you very much.

I’m Dr. Malvika Sabharwal, from Jeewan mala hospital and Apollo Spectra hospital, New Rohtak Road in Karol Bagh. In fact I’ve been a laparoscopic surgeon since the year 92, I introduced it in the North of india. 2000, we had got recognition at this hospital for managing most of the gyne problem laparoscopically.

Today I will tell you about fibroid uterus. It’s a very very common problem, seen almost in 25% of cases and at all ages, at any age and It causes various problems. In case agar ye bleeding cause kar ra hai, to bleeding k sath to mareez fatafat aatay hain k han g hamay bleeding ho rai hai, un ka diagnosis b ho jata hai. Kabi kabi wo infertility cause karta hai, infertility ka matlab k pregnancy nai ho rai hai. In such cases, agar pregnancy nai ho rai hai to b mareez aa jaat hain sooner or later. Par kai fibroids aise hain jo k hotay hain even after having couple of children. 2,3 bachay ho gae phr b wo fibroids hai. Ab basically fibroids hotay ki hai, ye normal uterus hai, 2 tubes hain 2 ovaries hain, ye muscle wall jo hai agar is me se ek bhi fibre barh jata hai, ye fibroid cause karta hai aur fibroids jo hain wo is tarha k tumors hain uterus k andar. Agar ye uterus me fibroid andar ki taraf jhukav de ga, agar 2cm ka b hai, wo bleeding cause karay ga aur us k liye aap fatafat doctor k paas pohnchen gey aur us ka samadhan ho jae ga. Agar fibroid boht barha hai, wo upper ki taraf jae ga aur us ka pata b nai chalay ga aapko. Kabi kabi kuch pata b nai chalta, kabi kabi us se aata hai patient k g hamy urine nai ho paa ra, hum peshaab nai kar pa rae aur ye hamay boht tang kar ra hai, tou tab diagnose hota hai. Any which ways, hamaray paas 2 hi options hain, ya tou uterus ka nikaalna ya fibroid ka nikalna. Agar hamay uterus ka kaam lena hai, patient young hai, aagay bachay paeda karne hain tou definiteky fibroid ko nikalna hi better hai par agar family complete hai, agar us ko bachay aur nahi chahye aur us ki umer b towards the maybe 40 years or above hai or even otherwise agar boht zaada takleef ho rai hai, many options are there par durbeen se hum fibroid b nikalte hain aur uterus b nikalte hain. Agar fibroid nikala jae tou sirf fibroid ko nikaal kar k hum bolte hain ab aap pregnancy shuru kar sakte hain. Once fibroids are removed laparoscopically ya ek aur tareeka hota hai hysteroscopically, uterus ko andar se ja kar k hum dekhte hain, muaaena karte hain aur jahan fibroid hota hai us ko nikaal letay hain. It’s a non-touch technique hysteroscopy wala. Laparoscopic jo karte hain, us me 2, 3 holes bante hain pait k andar aur us kop hr morselate kar k tareekay se nikaala jata hai. Ye morselation b boht zaada ajkal controversy me b aaya , is k baaray me tarah tarah k hare k forum me discussions hue k karna chahye ya nai karna chahye aur ye jo fibroid ko nikalne ka tareeka morselation ka hai, aaj kal in-bag b hai matlb aap bag k andar fibroid ko daalo aur us ko nikalo. Is se wo cheez jo hai wo phailti nai hai aur boht araam se wo aap k nikal aati hai. Ye ek din ka stay rehta hai hospital me fibroid nikalne k liye. Laparoscopic fibroid removal me patient is there in the hospital just for one day. Us k baad you’re back to normal and aap ko koi rok thaam nai hai, serhiyon pe jaana utarna, aap ko koi jhukna, travel karna. Log Hindustan k bahr se b aatay hain is ko remove karwanay k liye. So, this is one thing which is available in our hospital and we’ve been doing it since 92. 2000, we have already got to recognized training center for fibroid removal. Now there are situations jahan pe fibroids nahi nikal paatay, tou us me b koi aisi baat nai hai, it’s not k it’s the end, like k agar tubes k boht paas ho, agar boht zaada paas hai tou kabi kabi situationally aap nai nikaal paatay but that is something jo k aap ko us k liye koi aisi wo baat nai hai as long as the tubes are patent, matlb aap tube ko test karte ho aur pregnancy amooman hojati hai. Fibroid removal k baad sab ka question hota hai hum kab shuru Karen pregnancy? 3 maheenay is the ultimate time jo l hum log detay hain k us k baad hum kehte hain aap zarur us ko shuru karlo and jo ye fibroid ki problems hain this is something which is so common. I feel that we should look into it, regular checkup is the only answer at every age. Har ek umer ki larki ko apna every year checkup kara lena boht zarurui hai.