Apollo Gleneagles Hospitals, Kolkata has launched a dedicated Department of Comprehensive Hernia surgery. The department will address treatment of all kinds of hernias from the simple to the extreme, complex ones through the most modern surgical techniques. Hernia is basically a gap in the muscles and fascia of the abdominal wall through which the inner contents, small and/or large intestine, stomach, bladder etc, may protrude out from the abdomen, below the skin. Apollo Gleneagles Hospitals, Kolkata is the first ever hospital in India to have a dedicated department for comprehensive hernia treatment. The pioneering concept ensures a more specialized approach towards treating hernias. State-of-the-art facilities and advanced equipments assist the team of expert surgeons to tackle the most critical hernias. There are several types of hernias broadly divided into internal and external hernias. Internal hernias are not apparent on the outside and can be dangerous while external ones are the more common ones and are of several types. Following are the external hernias – Inguinal hernia, Femoral hernia, Incisional hernia, Umbilical hernia, Epigastric hernia, Lumbar hernia, Spigelian hernia, Paraesophageal and Diaphragmatic hernia, Parastomal hernias and Diastasis of recti. Common symptoms of hernia: Swelling in the groin or abdominal wall which increases on prolonged standing, coughing, sneezing or even a good laugh! Pinching or dull aching pain in the swelling. Constant pulling sensation inside the abdomen. Constipation. Backache due to poor posture. Hernias may lead to obesity and the reverse is also true. Surgery is the only way out to treat a hernia. In current times, laparo-endoscopic approaches have mitigated the fear involved with open surgery such as long cuts, prolonged and severe pain, delayed recovery, loss of work and wages. Using mesh is the gold standard followed worldwide to reduce the chances of recurrence. Many patients have difficult hernias that defy conventional surgical solutions. The department would serve as a tertiary referral centre for all such cases. At Apollo Gleneagles Hospitals, the latest hernia surgeries include minimal hospital stay and low pain scores. The patients are generally able to walk and eat within 4 hours of surgery and go home the next morning. Speaking on the occasion, Dr B Ramana, Senior Consultant Laparoscopic and Hernia Surgeon, Apollo Gleneagles Hospitals Kolkata, said, “We try to ensure speedy recovery of the patient so much so that s/he can get back to normal life almost immediately after the surgery. These modern laparoscopic surgery techniques lead to reduced post-operative pain, minimal blood loss and single day hospital stays in most cases. The department would offer the entire gamut of modern AWR procedures comprising of open, minimally invasive and robotic approaches. The most advanced surgery techniques include eTEP, TAR, SCOLA, BOTOX, PPP etc.” Incisional hernias occur to 20-30% patients who undergo any kind of open abdominal surgery. This is specially seen in women after pregnancy and C section. These hernias are typically difficult to cure using traditional surgeries and with more number of attempts to cure the hernia the complications increase along with increased failure rate. Hence the need for specialized hernia treatment using new techniques comes in picture. Women after pregnancy even have flabby abdomen due to the abdominal muscle losing its tenacity while giving space for the growth of the uterus. This goes mostly unaddressed till the belly becomes very saggy, or the patient feels low back pain. Using the modern SCOLA method, the shape and tone of the abdominal muscles may be regained, with the scars being barely visible. The modern hernia treatments at the Department of Comprehensive Hernia Surgery would include: e-TEP : the most advanced surgical approach for inguinal, incisional, umbilical, epigastric and lumbar hernias in the world. One can walk and eat within 4 hours of surgery and go home the next morning. TAR – complex hernias, hernias with loss of domain and multiply recurrent hernias may need this complex surgery known as Transversus abdominis release. This may be an open or endoscopic approach depending upon individual case. SCOLA – subcutaneous onlay laparoscopic approach is a minimally invasive approach for small umbilical hernia or epigastric hernia with diastasis of recti or diastasis of recti alone. BOTOX – Hernia with loss of domain may need temporary paralysis of abdominal muscles for complete reduction of hernia contents. PPP – Preoperative progressive pneumoperitoneum is also an adjunct used in modern day hernia surgery in cases of loss of domain hernia. Groin pain – pain in the groin could be related to problems of hips, spine, muscle and most importantly an occult/hidden hernia. Mesh related complications.

It’s never an easy task to walk again on your own when you have a fall at the age of 98 and fractured your hip. The lower body is immobile and the patient needs to be cared for long. Doctors say that the chance of success for patients undergoing surgery like Hip Replacement at that age is minimal. When no alternatives are available and pain relief is to be provided immediately, Hip Replacement surgery is the best alternative, to relieve a painful hip joint. Mrs. Lakshmamma, a nonagenarian, who had a fall resulting in hip fracture, underwent a successful Hip Replacement surgery and has been walking on her own now. Dr. Vasudev Prabhu, Senior Orthopedic Surgeon, and his team of doctors from Apollo Hospital, Sheshadripuram at Bangalore have accomplished a Hip Replacement for Lakshmamma who has recovered well post-surgery. A resident of Sira Taluk, Tumkur District, Lakshmamma fell at her home and sustained injury to her left hip in March 2018. When asked about the need and the procedure required, Dr Prabhu informed that the patient had already undergone a Hip Surgery on the right hip earlier, 10 years back. The fall in March 2018 had resulted in the left Hip, needing a replacement instead of the plate and screw, due to age related problems. The patient was immobile and had difficulty even to get a bedpan. Necessary precautions were taken, Doctors at the Apollo Hospitals headed by Dr. Vasudev Prabhu and team suggested patient to undergo the surgery for which the family agreed in full confidence. What made this surgery challenging was the risks involved. At that age risk factors included osteoporotic bones, Sub optimal lungs and cardiac status and high chances of pulmonary embolism due to immobilization. All the efforts paid off when the patient starting to walk the next day of surgery with the help of support staff. Dr. Anitha, granddaughter of Lakshmamma, informed that within eight hours after consultation with the Dr. Vasudev Prabhu, the patient was ready for the surgery the next day. The patient was anemic and blood had to be transfused to perform the aforesaid procedure. The confidence instilled in the patient, the will to stand on her own legs did it for the patient , and a day after, she was able to walk with the support of medical staff at Apollo Hospitals, Sheshadripuram at Bangalore. Availability of specialists like Cardiologists, Pulmonologists, Geriatric care team within the hospital and necessary equipment and availability of ICU facilities was the key to the success quotes Dr. Anitha. Within 12 days, the patient was mobilized to Tumkur where she now lives a healthy life. Dr. Anita and the patient’s family is full of raise and respect for the team of Doctors especially to Dr. Vasudev Prabhu and team, the medical care team that provided excellent post-operative care. The patient is walking towards completing her 100 years and the team of doctors wish her a healthy long life.

Mr. Anutosh Mishra now aged 53-year-old suffers from Ankylosing Spondylitis, a form of arthritis that primarily affects the spine. Mr. Anutosh, a bank employee was suffering from severe back pain and stiffness in both his hips because of which he couldn’t walk for the last 15 years. In order to treat this condition, Dr. Havind Tandon, Senior Consultant, Orthopaedics & Joint Replacement and his team operated him with both side hip replacement surgeries at Indraprastha Apollo Hospitals on 1st January 2019. Explaining about the disease, Dr. Havind Tandon said, “Ankylosing Spondylitis is chronic inflammation of the spine and Pelvis. Severe inflammation causes pain and stiffness. It causes deformity and joint destruction that lead to loss of mobility. The onset of the diseases usually starts in the second or third decade of life.” “In this case, the patient was suffering from back pain and had stiffness in both the hips. He was not even able to walk properly since last 15 years and had to depend on others for his day-to-day activities. Mr Anutosh Mishra had lost hope, as many efforts to get treatment had been turned down elsewhere. Post the necessary medical investigations, we decided to perform bilateral hip replacement surgery and replaced both his fused hips with artificial hips. Two days after the surgery i.e. on 3rd January the patient started to walk. As the spine is fused in this condition, it leads to various chest problems also. Surgeries of this kind have very high complication rates and thus, they require a multi-disciplinary medical intervention,” further added Dr. Tandon. After the successful surgery, Mr. Anutosh Mishra, at the time of discharge on 6th January 2019 said, “I was in terrible pain and always had to depend on others even for my day-to-day basic chores. I am thankful to Dr. Havind Tandon because of whom I am able to walk properly today and perform my daily routine activities all by myself. It feels like, I have got my life back again. All thanks to the doctors here at Indraprastha Apollo Hospitals.” Further Dr. Tandon said, “Ankylosing spondylitis is majorly a genetic disease, but is rapidly becoming prevalent due to high adoption rate of sedentary lifestyle, abuse of alcohol and tobacco within the population. Young age -onset of this disease leads to many young people in their 20s and 30s facing its debilitating symptoms. Incorrect use of steroid worsens the condition. There are many complications associated with this disease such as uveitis (eye inflammation), heart problems, chest problems, compression fractures, etc. The earlier this disease is diagnosed, the easier it becomes to manage its progression with exercise, medicines and various other therapies. In severe cases, such as this one, surgical intervention becomes necessary.” indraprastha-apollo-hospitals-delhi-successfully-performed-bilateral-hip-replacement

Hearing loss impacts one throughout life. While people with mild to moderate amount of hearing loss can cope with this disability with the help of hearing aids, the ones who suffer from severe to profound hearing loss require cochlear implants to deal with the deafness. If the hearing loss is not treated early enough, the children born with hearing loss will not develop normal speech and language. Diagnosed at birth with severe hearing loss in both his ears, the baby is a resident of Punjabi Bagh, New Delhi. His parents bought him to Indraprastha Apollo Hospitals in an effort to find a treatment to restore his hearing. At the hospital, his case was referred to Dr. (Prof) Ameet Kishore, and then assessed by the audiologists at the Speech & Hearing clinic (which supports the Apollo Cochlear Implant programme). He was initially fitted with hearing aids to ascertain the level of benefit, as per international protocol. The team eventually confirmed that the child would not get normal hearing with hearing aids, and the family was counselled for cochlear implants. Even though his young age of eight months presented a huge challenge, the doctors with the consent of parents decided to go ahead with the surgery. Dr. (Prof) Ameet Kishore, Senior Consultant, ENT & Cochlear Implant Surgeon, Indraprastha Apollo Hospitals, New Delhi said, “When dealing with hearing loss in children of such a young age, the most important part is to restore the hearing of the child as early as possible. In the child’s case the treatment of choice for good hearing restoration was cochlear implant, and on top of that, it was important to restore hearing in both his ears (bilateral simultaneous cochlear implant), which means that implantation was done in both ears at the same time. It requires extensive surgical expertise and efficiency to safely handle an eight months old baby, weighing just 10 kg, which is why many people would hesitate to do this surgery. With our experience of close to 1000 cochlear implants, this was not a concern as we have operated on many babies safely and efficiently.” The baby’s parents decided to outfit him with the latest cochlear implant Nucleus 7 (N7) devices, making him the youngest patient in the country to get bilateral simultaneous cochlear implant using the N7 device. “This has also been verified by Cochlear Corporation Company. He is probably one of the youngest children to have bilateral simultaneous cochlear implant in the country, and certainly one of the youngest in Apollo’s bilateral cochlear implant programme.” added Dr. Kishore. Dr. Kishore further highlights, “Nucleus 7 (N7) devices are the most recent cochlear implant devices in the world right now. N7 implants have a better chip and connectivity with digital devices. So such improvement in the quality of hardware and software further enhances the quality in sound that the patient gets, making it extremely good and clear. Getting the latest and most sophisticated cochlear implant will help the baby to do very well in the future.” “The implantation surgery went well without any complications,” said Dr. Kishore, “Post the surgery, N7 devices have been switched on by the audiologists at SpHear Clinic where he is also receiving the much needed hearing and speech therapy.” The baby has settled well with the cochlear implants, is attending the clinic for rehabilitation twice a week and doing very well so far, Ms. Neevita Narayan, Audiology Director & Cochlear Implant Specialist at SpHear Clinic added.

A 42-year-old man who got his right hand crushed by a machine that bends iron, has regained the use of his fingers after six months of battling pain, regret and the prospect of permanent disability. The initial prognosis was that the damaged hand might have to be amputated. However, doctors at Apollo Gleneagles Hospitals, Kolkata saved his hand by successfully performing a complicated surgery. Mr. Hirak Kumar Das had been standing in for a worker in his hairpin manufacturing unit at Belghoria, when he admittedly took the risk of hurrying through a task he wasn’t adept at. “A World Cup round-of-16 match involving my favourite team, Belgium, was to start in a few minutes and I was in a hurry to finish whatever I was doing. I should have been focused on the work at hand, more so because I wasn’t used to handling this machine. The accident happened because of my fault,” he recounted during his follow-up visit. Hirak’s index finger got severed from near the base. His thumb was severely damaged and the middle finger had a deep gash. Hirak’s right hand was a bloodied lump of flesh when some of his workers took him to a private hospital nearby. He was shifted to Apollo Gleneagles Hospitals, where doctors did a surgical procedure that involved using two abdominal flaps to preserve the thumb and the index finger. “The fingers remained in the flaps for 44 days, by which time lost tissue was regenerated. There was a problem with blood circulation to the fingers at first and he needed another surgery to fix that. The healing process started after the second surgery,” said Dr. Srinjoy Saha, Plastic Surgeon who carried out the twin surgeries. Six months later, the patient could write with his repaired hand. He is chuffed that his bank signature has been successfully verified. Plastic surgeon, Dr. Saha stressed the importance of concentration when handling even the simplest of factory equipment. “The injury suffered by the factory owner could have been far worse,” he said. With physiotherapy, patient was able to pinch with his forefinger and thumb and also hold a glass.

In a rare surgery, doctors at a Apollo Gleneagles Hospitals, Kolkata extracted a tooth from the nasal cavity of a 29-year-old Kolkata man, who works in UAE. Mr. Obaidullah Ahsan had been suffering from cold, discharge from nose and headache for years. He started having intense pain a few months ago after the problem got aggravated. After he flew down to Kolkata last week for medical help, doctors found that a full-grown tooth in his nasal cavity was the trigger behind the problem. The tooth was finally extracted on November 19 and Ahsan flew back to his workplace in UAE. Ahsan said that “I had consulted many doctors. Every time, they suggested that there was problem in the sinus and advised medication. But nothing eased my pain, headache and discomfort,” On reaching Kolkata, he consulted doctors at the ENT unit of Apollo Gleneagles Hospitals, where Dr. Shantanu Panja suggested a CT scan. The report detected a whitish mass and sinus infection in the nasal cavity. On extracting the mass through an endoscopic surgery on November 19, Panja found that it actually was a fully-grown tooth rooted in the nasal cavity. “We had no inkling that the calcified mass could actually be a tooth because a CT scan cannot detect the same. It is an extremely rare case. The tooth was like an obstruction in the nasal cavity, triggering pain, discomfort in the nose and head and discharge from the nose,” said the ENT and Head and Neck Onco-Surgeon. Doctors said that an extra tooth can show up mostly in the upper jawbone. But a tooth growing inside the nasal cavity is very rare and doctors are yet to find out the exact reason behind this. Ahsan had been suffering from the problem since his childhood. “Of late, the pain, headache and the fluid discharge from my nose had pinned me down. It had become difficult to concentrate on work. After the surgery, I feel relieved for the first time in many years,” Ahsan said. Patient got discharged two days after surgery and post follow-up visit flew back to his workplace in UAE.

A first-of-its-kind in the coastal districts of Andhra Pradesh, Neuro Navigation system was inaugurated by City Mayor Ms. Sunkara Pavani at Apollo Hospitals, Kakinada. The Mayor complimented Apollo Hospitals’ management for equipping the hospital with the most advanced computer aided navigation system, which helps in conducting brain tumor removals and spinal surgeries with more accurate and minimally invasive techniques. Rural MLA Ms. Pilli Anantha Lakshmi Satyanarayana Murty, inaugurated the new Neuro operation theatre. Dr. Chatterjee, Medical Superintendent, said that Apollo Hospitals management was always in the forefront in equipping the hospital with advanced technological systems for extending better medical care to the patients. Dr M V Kiran Kumar, Chief – Neuro Surgery said “Neuro navigation will help in achieving optimal accuracy, minimal incision, lower trauma and quicker recovery of patients.” He further added that the patients after brain tumour surgery can be discharged almost the next day. Chief Administrator of Apollo Hospitals, Kakinada Mr. Ramana mentioned “The Navigation technology aids the surgeons at every point to stay aligned with the surgical goals in a highly complex anatomical field.” He also said that the equipment is a boon to patients.

Apollo Gleneagles Hospitals, Kolkata saved a 74-year-old man’s life by removing a tumour from the windpipe. The tumour was in the thyroid gland and had penetrated to the windpipe, if left untreated the tumour would have grown in size and blocked the entire airway. It was a challenge for the doctors to operate on the windpipe but our competent doctors at Apollo Gleneagles Hospitals, Kolkata performed the tricky surgery which involved removing a portion of the windpipe and reconstructing it, after removal of tumour. Mr. Ranjit Kar, a resident of Sunderbans and a retired government employee, had been coughing blood for almost one year. He was initially wrongly diagnosed and treated for tuberculosis. He was bogged down by the bloodied cough even after completing the six-month course of tuberculosis, as suggested by a local doctor. Later, he underwent CT Scan and MRI which revealed a large tumour in his thyroid gland that had encroached into the windpipe. The tumour was bleeding, which in turn caused the blood in the cough. Despite the risk, Dr Nipun Saha operated upon the patient at Apollo Gleneagles Hospitals, Kolkata on November 21. The Onco-Surgeon took out the portion of the windpipe measuring about 3.5cm that had the tumour. Once it was removed, the windpipe was reconstructed. A tumour from the thyroid gland was also removed. The surgery lasted for six and a half hours. “The surgery was tricky because we had to operate on the windpipe, which is the tube through which patients are intubated for ventilation support during major surgeries. Even as cancer in the thyroid gland is common, the tumour encroaching into the windpipe is quite rare,” said Dr Saha. Bypassing the normal intubation route through the mouth, Dr. Saha created a hole in the windpipe below the tumour, though which the endo-tracheal tube was inserted. Patient recuperated well after the surgery and was discharged.

The department of Surgical Gastroenterology at Apollo Hospitals, Bhubaneswar has added one more feather to its cap by performing an extremely rare surgery on a middle aged lady in restoring her food pipe which had sustained injury following accidental swallowing of her denture.   A middle aged lady who had sustained injury to her esophagus following accidental swallowing of denture had undergone treatment in another hospital with an attempt to remove the denture. However, during the treatment process in that hospital she suffered severe damage to her food pipe. As an interim measure, her food pipe was diverted out of the neck (Esophagostomy). She was being fed through a tube placed in her intestine (feeding jejunostomy). This procedure was done in the previous hospital. To add to her problem, she developed blood clot in the leg veins (deep vein thrombosis) which posed immediate risk to her life. She was referred to Apollo Hospitals, Bhubaneswar in a very critical state. Patient was admitted immediately in the ICU with serious respiratory problems in addition to the existing ones. As the patient was having multiple issues, hence a comprehensive treatment was planned and at the initial level she was treated by Dr Manas Kar, Senior Consultant Interventional Radiology, Apollo Hospitals, Bhubaneswar who placed a filter in her IVC to prevent the clot in the leg veins to migrate up. This, in itself was a complex yet key procedure to save her life initially. She continued to remain in ICU for some time and recovered gradually. Having tided the patient over the initial crisis, the next challenge was to restore her food pipe so that she was able to eat normally. Elaborating in detail about the case Dr Md. Ibrarullah, Senior Consultant, Department Surgical Gastroenterology, said that reconstruction of food pipe is a complex and lengthy procedure and on first week of the December 2018, she underwent the surgery in which reconstruction of her food pipe was done by using a segment of large intestine. Esophago-coloplasty procedure was conducted by Dr Ibrarullah & his team comprising of Dr. MS Modi, Dr Salil Parida, Dr Sadananda Meher, Dr H Wani and Dr Srinivasulu. The Anesthesia team, headed by Dr Mami Parija and Dr Saumitra Satpathy provided efficient support in managing such a long & complex procedure. The patient had an absolutely smooth post-operative recovery and was discharged. She was able to eat normally. The happiness on her face after being able to taste normal food like a normal person really needs to be seen to be believed. Congratulating Dr Ibrarullah and his team, Mr. Sudhir M Diggikar, Regional CEO of Apollo Hospitals Enterprise Ltd Odisha and Chhattisgarh said that Apollo Hospitals, Bhubaneswar has always been in the forefront in providing all requisite treatment facilities to the needy. “Apollo Hospitals, Bhubaneswar is well equipped with all state-of-art facilities and has experienced doctors and paramedics to respond to any kind of emergency.”, he added.

Just like any other parent, Mrs. Meena and Mr. Vinod were delighted after the birth of their son, but their joy didn’t last long, as soon after his birth they got to know he was suffering from Transposition of Great Arteries which is a congenital heart defect where the large blood vessels that carry blood from the heart to the lungs, and to the body are connected exactly opposite of a normal heart’s structure. Adding to the criticality, the 20 dayold child also had two big holes in his heart (VSD & ASD) along with Patent ductus arteriosus (PDA), causing breathlessness. The critical surgery was performed by Dr.Muthu Jothi, Senior Consultant, Pediatric Cardiothoracic Surgeon, Indraprastha Apollo Hospitals and his team. Explaining about the case, Dr. Jothi said, “Within a week after the child’s birth, the parents witnessed discoloration in his skin tone. His body was turning blue so the parents took him to a local doctor in their area where his ECHO was done. The reports revealed that he had transposition of great arteries. In transposition of the great arteries, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle which is an exact opposite of normal heart anatomy.” At the time of admission at Indraprastha Apollo Hospitals, the child was on ventilation and weighed 2.2 kg. The doctors had earlier decided to allow the child to grow a bit and weigh at least 2.8 Kg -3 Kg before performing the major open heart surgery. For the same, the baby was kept in critical care on ventilation for a week but unfortunately his condition didn’t improve and he was not able to come off the ventilator. Every time the doctors tried to take him off the ventilation or lower the ventilation, he used to get breathless and turn blue. Considering the criticality of baby’s condition, Dr MuthuJothi along with team of expert Cardiologists, Anaesthetist and Intensivist decided to perform the five hour long surgical procedure. “Considering the weight of the child being 2.2 Kg, the surgery had a high risk. We had performed many such surgeries before, but this patient weighed the lowest and we generally don’t perform a surgery on patient with such a low weight. I had quoted a risk of about 25-40% which is a huge risk but considering the child’s condition and after family’s consent we performed the surgery. In order to treat the disease, we performed an Arterial Switch Operation in which the aorta and coronary arteries are disconnected from their place and are adjusted in the right place. Along with arterial switch, closure of VSD and ASD were done,” explained Dr. Jothi. “By god’s grace, the child recuperated enough to go home after 10-12 days post the surgery, which is not usually the case. He is doing absolutely fine now and is gaining weight too,” said Dr. Jothi. Mr. Vinod, father of the baby said, “We cannot thank Dr. Jothi enough for the miracle that he has done. He successfully performed the surgery even when our child was underweight and today, he is alive, all because of him. Our child has got a new life at Apollo Hospitals.”

Apollo Hospitals, Navi Mumbai formed the largest human image of a human bone and created a Guinness World Record®.The initiative was undertaken to create awareness onknee diseases and arthritis. Over 948 people from all walks of life united to form the largest human image of a human bone, highlighting the need to address the rise in osteoarthritis and knee disease. The event saw participants from Navi Mumbai, Mumbai and Thane as well as surrounding districts participate in creating the formation of the knee joint with immense enthusiasm. Mr. Kapil Dev, legendary cricketer and former Indian team skipper was present at the event to support the cause. Commenting on the initiative, he said, “It was commendable to see so many people come together to create awareness on this cause. It is a matter of concern that knee problems are developing in younger people! It was very rare to see this earlier. Through such initiatives, I hope to see people make more positive changes to improve their lifestyle and do more physical activity.” Osteoarthritis is the second most common orthopedic problem and the most frequent joint disease with a prevalence of 22 percent to 39 percent in India. This number is expected to grow to about 60 million by 2025 – a number that draws severe concern to the impact of knee disease on the health and growth of the citizens of the country. Dr Siddhart Yadav, Consultant Orthopaedic Surgeon, Apollo Hospitals, Navi Mumbai said, “Lifestyle factors have played a huge role in the early development of arthritis and knee disease. Obesity and lack of physical activity are two of the biggest contributors. Early detection and early intervention is key to help patient retain active movement in their knee joints and live a normal life. This will also help prevent complications arising in the future.” The record attempt was confirmed by Guinness World Records® officials present on the occasion, who awarded the Guinness World Records®, Official attempt certificate for forming the Largest Human Image of a Human Bone.

Apollo Speciality Hospitals, Madurai has now attained the distinction of being the pioneer to introduce and perform Total Knee Replacement by the Novo Technique. After doing more than 3000 knee replacement surgeries, Dr. Jayesh has developed a technique which consumes lesser time, lesser surgical instruments and provides precise alignment, with best results to patients.