Novel methods and innovations in hypospadias surgery: A surgeon journey

Title : Novel methods and innovations in hypospadias surgery: A surgeon journey

Abstract:

Introduction: Last 20 years I performed 1978 cases of hypospadias surgeries and made various innovations in the technique of surgery. Most innovations are reported for the first time in medical literature. Materials and methods: 1) 718 cases done with continuous interlocking stitches instead of simple and every 5 Th stitch a knot is taken. They are water tight and knot prevents unwinding of complete suture line. 2) 1568 cases, IV amino acid solution was given which supplies essential amino acids which led to much better healing. 3) Glutaraldehyde Albumin induced laser tissue welding in 318 cases which reinforces skin suture line making it waterproof. 4) 13 hypospadias fistulae closed without surgery by above technique. 5) Methylene blue dye induced laser tissue welding in 58 cases, stopped bleeding which did not with cautery. 6) Urethral pull up operation on 135 cases, free of complications such as fistula, meatal stenosis, meatal regression and residual chordee and one that does not require Dartos flap and suprapubic diversion 7) Modified urethral pull up operation on 78 cases with urethra pulled through “Glans Tunnel”. 8) Appendicular Mucosal Tube Implant with Dartos Wrap Operation in 23 cases of bad quality urethral plate. 9) Extended Urethral Plate Mobilization and reimplantation surgery in proximal hypospadias with severe chordee in 108 cases. Urethral plate lifted, chordee released and proximal mobilization till bulbar urethra. 10) Implanting deli pated full thickness graft from inguinal area in stage 1 cases with bad quality urethral plates in proximal hypospadias. 11) Suprapubic diversion even in distal hypospadias cases as collagen is laid down in 3 weeks. 12) Low dose oral steroids in 38 cases for severe post op pain and in urethral stenosis requiring repetitive dilatations. Discussion: With techniques described conventionally, success rate could not cross 60%. All above innovations improved success rate from 60 to 99%. Results: Results were much better and statistically significant compared to control group. Conclusion: We need constant modifications in conventional techniques of hypospadias surgery for better results.

Audience Take Away Notes:

• The audience can learn extensively from my experience of hypospadias surgery to improve the success rate from 60% to nearly 99%

Biography:

Dr. Sagar Jawale is a pediatric surgeon turned into a scientist. He has more than 100 inventions done till date. He has 40 patents registered in Mumbai office. 25 of his inventions are for the first time in the history of medical sciences. He has developed 15 new operations and 37 new therapies in medicine which are under trial. Most of his research work is unique and reported for the first time in medical literature. His inventions are 20 to 50 times cheaper than peers, a great boon to the mankind. He has invitations from all over the world for the demonstration of his inventions. He has founded Vigyan Yog Foundation a research based no profit organization for distributing his inventions on no profit basis to doctors and medical institutions. What surprises many is his vast range of research which transcends the boundaries of pediatric surgery into almost all dimensions of medical sciences such as biomedical devises, surgery, medicine, psychology, mysticism and yoga. His hobbies are swimming and travelling. He has travelled half the world already. He has practiced variety of systems of yoga and achieved self-realization. He has done 15 years of research in yoga and found out a new system of yoga called Vigyan Yog in which yoga and samadhi is achievable through science and technology.