Heller Myotomy and Nissen Fundoplication: Robotic Oesophageal Surgery

In females the urethra is only about 4 centimetres long, and incontinence happens when the internal urethral meatus — where the urethra meets the bladder — sags downward and loses muscular control. My job is to lift that junction back into its correct anatomical position, using a procedure called Burch colposuspension: three sutures on each side of the urethra along the anterior vaginal wall, lifted and fixed to Cooper's ligament. Doing this robotically lets me suture in that very narrow retropubic space with far more precision than laparoscopically. The surgery takes about an hour and the patient goes home happily the next day.

No. If the lifestyle is maintained correctly — diet, exercise, behaviour — there is no chance of weight regain. It's entirely lifestyle-related.

I can teach laparoscopic surgery in one to two months to any doctor or surgeon who wants to travel to India — I can generate good surgeons, and at least my students say I'm a good teacher. For the financial and logistical side of a patient's journey, that's where Jivo's team comes in: share the case with us, and even before a patient decides to travel, the hospital can give a tentative cost estimate to work from.

The ‘recurrence’ there refers to regain of body weight, not recurrence of disease. It happens when the patient's lifestyle doesn't change after surgery — the sleeve gradually dilates over time, though the stomach never reverts to its original size. When that happens, we convert the sleeve into a mini gastric bypass, and the patient starts losing weight again.

Think of it like Formula One racing — an F1 driver put on a city road will crash everywhere, and a city driver put on an F1 track won't know how to handle it. Every surgical approach needs specific training, and with the right training complications are very few. The key criterion is size: if the thyroid nodule or lobe is under 6 centimetres, I do it robotically or laparoscopically; above that, I advise open surgery regardless of cosmetic preference. In every case I identify the recurrent laryngeal nerve on both sides and all four parathyroid glands before removing the thyroid — the rule is, don't touch what you haven't seen.

A tightening at the gastro-oesophageal junction caused by hypertrophied, poorly relaxing muscle, causing difficulty swallowing, regurgitation and vomiting.

The circular muscle fibres at the junction are divided to release the pressure and restore normal passage, with an intraoperative endoscopy of the entire GI tract confirming there is no leak before closing.

Patients with gastro-oesophageal reflux disease from a loose lower oesophageal sphincter.

Identifying the vagus nerves, performing the shoe-shine manoeuvre to mobilise the oesophagus, repairing the diaphragmatic crura, and wrapping the stomach fundus 360 degrees around the oesophagus.

The robotic wrist's extra dexterity makes suturing in the narrow space behind the oesophagus achievable with the precision of open surgery, through a keyhole approach.