Dr. Nikhil Tandon

Robotic Milestone in Advanced Cancer Surgery: Combined Robotic LAR with Portal Vein Ligation

Our surgical oncology team recently achieved another important milestone in minimally invasive cancer surgery by successfully performing a Robotic Low Anterior Resection (LAR) combined with robotic ligation of the right portal vein in a 50-year-old female diagnosed with rectal cancer and synchronous liver metastasis.

The patient presented with rectal adenocarcinoma along with metastatic disease involving the right lobe of the liver. Managing such complex cases requires meticulous planning to achieve complete oncological clearance while preserving adequate liver function.

After multidisciplinary tumor board discussion, a staged surgical strategy was planned with curative intent. In the first stage, a robotic low anterior resection was performed following total mesorectal excision principles to remove the rectal primary tumor. During the same sitting, robotic ligation of the right branch of the portal vein was carried out. This step is designed to induce hypertrophy of the future liver remnant, allowing safe completion of a planned right hepatectomy after approximately four weeks.

The use of robotic technology enabled precise pelvic dissection, superior visualization, and delicate hilar vascular control, allowing two major oncologic objectives to be achieved through a minimally invasive approach. The patient tolerated the procedure well and is recovering satisfactorily while awaiting the second-stage liver surgery.

This combined robotic approach highlights the evolving role of advanced minimally invasive surgery in complex gastrointestinal and hepatobiliary oncology. By integrating colorectal and liver strategies in a single operation, patients benefit from reduced surgical trauma, faster recovery, and preservation of curative treatment pathways.

The case reflects our institution’s continued commitment to innovation, multidisciplinary collaboration, and delivery of world-class cancer care using cutting-edge robotic surgical techniques.

Treatment By:
Dr. Asim Rizvi

A professional WWE wrestler sustained a knee injury during a wrestling bout while on tour in India, resulting in acute pain, instability, and inability to continue performance. Clinical and radiological evaluation confirmed an anterior cruciate ligament (ACL) tear along with a concomitant meniscus injury.

He was evaluated by the orthopaedic team, led by Dr. Brajesh Koushle, and was advised to undergo surgical intervention to restore knee stability and enable early return to high-impact activity. Given the functional demands of a professional athlete, a minimally invasive, precision-driven approach was planned.

The patient underwent arthroscopic ACL reconstruction using an advanced Xiros ligament system, along with an all-inside meniscus repair. The procedure was performed using keyhole techniques, ensuring minimal tissue disruption and optimal anatomical restoration.

Postoperatively, the patient showed rapid recovery. Early mobilisation was initiated, and he was able to bear weight and walk on both limbs from the very next day. With structured rehabilitation, he is on track for a timely return to professional wrestling within a few weeks.

Treatment By:
Dr. Brajesh Koushle and Team

A 71-year-old female from Kazakhstan presented with persistent hip pain and a limp, significantly affecting her mobility and quality of life. She had a history of prior fracture fixation surgery of the left hip, which had failed over time, leading to joint deterioration, chronic pain, and functional limitation.

On clinical and radiological evaluation, the left hip joint was found to be severely compromised due to failed implant fixation. She was assessed by the orthopaedic team, who recommended revision hip arthroplasty as the definitive treatment, given the extent of joint damage and prolonged disability.

The patient underwent a complex revision procedure involving the removal of the existing implant with careful preservation of bone stock, followed by a revision total hip replacement. The surgery required meticulous planning and execution due to altered anatomy and previous surgical intervention.

Postoperatively, the patient demonstrated excellent recovery. Early mobilisation was initiated, and she was able to take her first steps the following day with a stable, pain-free gait. After nearly two decades of impaired mobility, she achieved independent ambulation without a limp and was discharged in stable condition.

Treatment By:
Dr. Brajesh Koushle, Dr. Gaurav Thakral, and Team

A 59-year-old female from Comoros presented with severe bilateral knee dysfunction and associated implant-related complications. She had a Grade 3 valgus deformity with advanced osteoarthritis, a failed primary total knee replacement of the left knee, and significant implant impingement at the left ankle, resulting in marked pain and restricted mobility.

She was evaluated by the orthopaedic team at Yashoda Medicity led by Dr. Brajesh Koushle and Dr. Gaurav Thakral, at Yashoda Medicity. Given the complexity of her condition and functional limitations, a comprehensive surgical plan was formulated. 

The patient underwent primary total knee replacement of the right knee, revision total knee replacement of the left knee, and removal of the impinging implant from the left ankle in the same sitting. The surgery was successfully completed with meticulous intraoperative management.

Postoperatively, the patient showed excellent recovery. Early mobilisation was initiated, and she was able to stand and walk from the first post-operative day. She was discharged in a stable condition, walking unassisted and with significant improvement in functional outcomes.

Treatment By:
Dr. Brajesh Koushle, Dr. Gaurav Thakral, and Team

A patient diagnosed with a tumour in the head of the pancreas presented for specialised evaluation and management. Given the complexity of the condition, a detailed clinical assessment and surgical planning were undertaken by the expert team.

The patient was planned for a Robotic Pancreaticoduodenectomy (Whipple’s Procedure), a highly specialised surgery used to treat tumours in this region. The procedure was performed under the expertise of Dr. Syed Asim Rizvi, Principal Director – Surgical Oncology and Robotic Surgery, along with his team, using advanced robotic surgical technology.

The robotic approach provided enhanced precision and superior visualisation, enabling meticulous removal of the tumour while preserving surrounding structures. This minimally invasive technique also helped reduce intraoperative blood loss and supported a more controlled surgical environment.

The patient demonstrated a smooth postoperative recovery with reduced pain, early mobilisation, and overall improved comfort. He was discharged in stable condition.

This case highlights the role of advanced robotic surgery in managing complex pancreatic tumours, combining surgical expertise with precision technology to achieve optimal patient outcomes.

Treatment By:
Dr. Asim Rizvi

A 39-year-old patient from Nairobi presented with symptoms of obstructive jaundice and required urgent evaluation. A comprehensive diagnostic workup, including advanced imaging and endoscopic assessment, confirmed the diagnosis of pancreatic cancer.

The clinical team first focused on stabilising the patient and relieving the obstruction. A therapeutic endoscopic procedure with stenting was performed, leading to improvement in symptoms and liver function. Once optimised, the patient was carefully planned for definitive surgical management.

The surgery was performed under the expertise of Dr. Syed Asim Rizvi, Principal Director – Surgical Oncology and Robotic Surgery, using advanced robotic surgical technology. This approach enabled enhanced precision, minimal blood loss, and a minimally invasive pathway to treatment.

The patient showed a smooth postoperative recovery, with early initiation of oral intake, timely mobilisation, and reduced discomfort. He was discharged in stable condition within a week of the procedure.

This case highlights the importance of timely diagnosis, structured clinical management, and the role of advanced robotic surgery in improving outcomes for complex pancreatic cancer cases.

Treatment By:
Dr. Asim Rizvi

A patient with a long-standing history of lymphedema in her right arm since 2014 presented with persistent swelling and concerning changes in the affected limb. Clinical evaluation and further investigations, including PET scan and FNAC, confirmed the presence of a rare and aggressive malignancy involving the cutaneous and subcutaneous tissues of the forearm, diagnosed as lymphangiosarcoma.

Given the complexity of the condition and the risk to limb function, a carefully planned, patient-centric treatment approach was undertaken under the care of Dr. Manish Singhal, Vice Chairman – Medical Oncology, Yashoda Institute of Cancer Care.

The patient was treated with a combination of advanced chemotherapy and targeted therapy. The treatment was precisely tailored to control disease progression while prioritising limb preservation.

She responded well to therapy, with effective disease control achieved without the need for amputation. The limb was successfully preserved, maintaining both function and quality of life.

This case highlights the role of precision oncology and timely intervention in managing rare and challenging cancers, demonstrating how advanced treatment strategies can achieve optimal outcomes while preserving function and improving patient well-being.

Treatment By:
Dr. Manish Singhal

A 78-year-old male patient presented with difficulty in swallowing and a small growth at the base of the tongue. Initial evaluation, including biopsy and imaging, confirmed a malignancy involving the tongue along with an affected lymph node in the neck.

As part of routine staging, a whole-body scan revealed an additional lesion in the upper lobe of the lung with associated chest lymph nodes. Further evaluation confirmed this to be a second, unrelated primary cancer. This rare presentation of two simultaneous primary cancers required a carefully coordinated and highly specialised treatment approach.

After a detailed assessment by a multidisciplinary team, a comprehensive treatment plan was developed with curative intent. The patient was treated using advanced adaptive radiotherapy, a technique that allows real-time adjustments to radiation delivery based on daily imaging and anatomical changes, ensuring high precision and safety.

Both cancers were treated concurrently. The lung and chest lymph nodes received a planned course of radiation over six weeks, while the tongue and neck region were treated over seven weeks. Each session was guided by high-resolution imaging, enabling accurate targeting of the tumours while preserving surrounding healthy structures. The patient completed the treatment successfully with good tolerance. He showed a steady recovery and continues to remain stable on follow-up.

This case highlights the power of advanced radiation technology and multidisciplinary expertise in managing rare and complex cancer presentations.
 

Treatment By:
Dr. Gagan Saini

A 55-year-old woman diagnosed with advanced high-grade serous ovarian cancer presented after completing three cycles of neoadjuvant chemotherapy. She had responded well to treatment, with imaging showing significant disease resolution and tumour markers returning to normal levels. Following a comprehensive evaluation, she was planned for interval debulking surgery combined with Heated Intraperitoneal Chemotherapy (HIPEC).

After detailed counselling and preoperative optimisation, the patient underwent surgery under the care of the expert team. A meticulous cytoreductive procedure was performed to remove all visible disease, followed by the administration of HIPEC, a targeted chemotherapy delivered directly into the abdominal cavity using specialised equipment over a controlled duration. The entire procedure was carried out with precise monitoring and a highly coordinated approach.

Postoperatively, the patient was closely monitored with a structured care protocol, including optimal fluid management and regular assessment of clinical parameters to support recovery.

The patient demonstrated a smooth and steady recovery and was discharged in stable condition on the eighth postoperative day. She continues to do well on follow-up.

This case marks a significant milestone as one of the successful HIPEC procedures performed at Yashoda Medicity, highlighting the team’s expertise in delivering advanced oncological care with precision and safety.

Treatment By:
Dr. Satinder Kaur, Dr. Hemlata Garg, and Dr. Ipshita Sahoo

A 30-year-old woman presented with abdominal fullness and on/off pain for the last 3 months, without any menstrual concerns. Imaging revealed a large abdomino-pelvic mass with multiple nodular growths extending into the abdomen, suggestive of a rare condition where multiple fibroids are spread across the abdominal cavity and involve surrounding organs.

After detailed evaluation and counselling, a surgical plan was carefully designed with a strong focus on preserving her fertility. The patient underwent exploratory surgery under the care of the expert team.

During the procedure, multiple fibroids of varying sizes were identified arising from the uterus and extending into the pelvic and upper abdominal regions. A highly precise and carefully controlled surgical approach was adopted to safely remove the fibroids while preserving the uterus and both ovaries.

The surgery lasted approximately five hours, during which 15 fibroids weighing nearly 3 kg were successfully removed with minimal blood loss. The uterus and both ovaries were preserved, maintaining the patient’s reproductive potential.

The patient had a smooth recovery and was discharged in stable condition. This case highlights the team’s expertise in managing rare and complex conditions with a focus on precision, safety, and organ preservation, ensuring the best possible outcome for the patient.

Treatment By:
Dr. Satinder Kaur, Dr. Hemlata Garg, and Dr. Ipshita Sahoo

First Navigation-Guided Minimally Invasive Spine Surgery at Yashoda Medicity
A patient with a spinal condition was treated at Yashoda Medicity through a navigation-guided minimally invasive spine surgery, marking the first such procedure in the state. The surgery was performed in our state-of-the-art Neuro-Spine OT, equipped with O-arm, Stealth-8 Neuronavigation, Allen table, and IONM.

The procedure was led by Dr. Dibya Jyoti Mahakul, Consultant – Minimally Invasive Neuro-Spine Surgeon, who performed the surgery with unmatched precision. Using the neuronavigation system, the team could visualize the movements of all instruments in real time, ensuring the accurate placement of implants.

The minimally invasive approach resulted in minimal blood loss and muscle damage, and the patient experienced immediate pain relief. This achievement underscores our commitment to leveraging cutting-edge technology to provide safe, precise, and effective surgical solutions for spine problems.

At Yashoda Medicity, we care about your back. When it comes to spine conditions, you’re in safe hands.

Treatment By:
Dr. Dibya Jyoti Mahakul

A 51-year-old lady with left arm pain more than neck pain of 10 years duration, with BMI 44 and a short neck nearly the chin touching the chest, was diagnosed with OPLL C3-6 with myelopathy and fixed kyphosis of 20°. MRI showed cord signal changes at C5, and CT  confirmed OPLL C3 -6 with high probability of intradural mass ( double density sign). Conventional wisdom (K line, kyphosis, anterior pathology etc.) dictated towards an anterior surgery, but possibility of dural laceration (intradural OPLL mass), with potential for other complications (cord / trachea / esophageal compression by pseudomeningole, meningitis, spinal cord hernia etc.) were discussed in detail and a decission was taken to decompress and fix from the posterior aspect. The pre-op CT angio showed B/L high-riding vertebral arteries, which precluded the  C2 screw. 
 

Per operatively, the patient was positioned prone with the head clamped and a posterior exposure done. LM screw entry points were made from C3-6, followed by grade 1 facet resection at C3-4, C4-5, and C5-6 bilaterally. Further lordosis was achieved with manipulation of the head with the head clamp and closing the osteotomy gaps. LM screws (C3-6), a laminar screw at C2, and a pedicle screw at T1 & 2 were inserted and connected with rods. 
 

C3-6 laminectomy was done, and the surgical site was closed after bone graft mixed with vancomycin was applied laterally.
 

Postoperative x-ray showed adequate lordosis (approximately 10 degrees) attainment.

The patient reported complete pain relief in the left shoulder and arm postoperatively.

Treatment By:
Dr. Ankur Goswami