KIDNEY TRANSPLANT PROGRAMME

Understanding Kidney Failure

Kidneys are your body’s filters. They purify blood several times a day, maintain your body’s fluid and electrolyte balance and produce urine.

So when the kidneys fail to function, your body starts getting poisoned. Each of your kidneys comprises a million microscopic filtering units called nephron. The most dangerous fact about kidney or renal failure is that one might not know about it till 90% of the function is lost.

The symptoms of kidney or renal damage include symptoms like swollen ankles, vomiting, weakness, poor sleep, and shortness of breath. If not addressed medically, the kidneys will eventually become dysfunctional – a condition that’s life threatening.

What causes kidney failure?

Chronic kidney disease (CKD) occurs when your kidneys have been malfunctioning for more than 3 months. It’s an irreparable, life threatening condition and there might be no visible symptoms at all.

Diabetes (types 1 and 2), high blood pressure, immune system diseases such as Lupus and chronic viral illnesses like AIDS, Hepatitis B and Hepatitis C can also cause kidney failure.

The other reasons for kidney failure include:

Multiple episodes of urinary tract infection

Post-strep infection

Polycystic kidney disease

Inherited kidney diseases

Congenital or birth defects - In many cases, the defect is rectified while the baby is still in mother’s womb; whereas those with major complications can only be managed at a later stage.

Drugs and toxins, including long-term use medications like NSAIDs (Non Steroidal Anti Inflammatory Drugs

Long-term exposure to certain chemicals

What is Kidney Transplant?

Kidney transplant is the process of replacing the diseased kidney with a healthy, donated kidney. It is recommended only if the kidneys are so damaged that they cannot be managed medically (Chronic Kidney Disease or End Stage Renal Disease).

In some cases, transplant might not be a practical solution if the patient has an active infection or another life-threatening disease such as cancer, severe heart or lung diseases.

Fortunately, according to worldwide figures, the success rate of kidney transplant is above 95%. This not only comes as a reassurance for those opting for transplant, but also reaffirms the fact that kidney transplant is indeed an effective mode of treatment.

What are the types of kidney transplant?

There are two types of kidney transplants: Live donor Transplant and Cadaver Transplant

When a person is transplanted with a kidney from a live donor, it is called Live Donor Transplant. The donor could be anyone - a family member, friend, colleague or even a random person who is generous enough to gift life by donating one of his/ her kidney.

Usually, the success rates of kidney transplants in which the donor and recipient belong to one family (parent/ sibling) are higher. This is because of high donor-recipient compatibility, which means the chances of rejection are very low. A live donor makes things easy as the waiting period is lesser and the patient gets well faster.

Cadaver transplant is when the kidney is got from a donor who is certified brain-dead. He or she would have would have signed up for donation before death. The kidney is surgically removed after obtaining consent from the deceased’s family and transplanted in the recipient.

What are the pre-transplant formalities?

You will have to go through a series of investigations before the surgery to ensure that the donor kidney matches your tissue and blood type. You will also be screened for other health problems including heart or lung diseases.

After these tests, you will be enlisted on the transplant list and also on the organ sharing network list. As soon as a matching recipient is available, we will let you know; and if all factors are favourable, our entire team will work as one to ensure you undergo the surgery without any issues.

What is robotic kidney transplant?

Robotic kidney transplant is a high-precision procedure in which the transplant surgery is performed with the help of a surgery robot. Aster Centre of Excellence in Multi-Organ Transplant is one of the few facilities in India to offer robotic kidney transplant. The first hospital in Kerala to offer da Vinci surgical system (surgery robot), we have the finest team of robotic surgeons with several years of international training.

In this procedure, our surgeon will use the da Vinci to remove the diseased kidney and replace it with the healthy, donated kidney. A highly advanced and minimally invasive procedure, the advantage of robotic surgery is that the pain, blood loss and recovery time are significantly lesser compared to the conventional open surgery. The scarring too is minimal.

What are the possible post-transplant risks?

The post-surgical risks, like every other transplant surgery, include rejection, infection, bleeding or reaction to anaesthesia.

Rejection happens when the body fails to recognise the new kidney and fights to destroy it. During the first few weeks or months post-surgery, your body may try to reject your new kidney. This is called acute rejection and occurs in 25 - 55% of the recipients. You’ll be given immuno-suppressants to counter this problem. Remember, it is mandatory to continue these medicines for the rest of your life.

There is also a chance of chronic rejection - a gradual, progressive loss of kidney function that may occur over many years. Unfortunately, there’s no known treatment for chronic rejection and the patient may have depend on dialysis again or opt for another transplant.

Aster Centre of Excellence in Multi-Organ Transplant has a very strong infection control system that’s managed by a highly-trained team of infectious diseases & infection control Physicians. Besides, we also have advanced technology like the HEPA Filter that purifies air to 0.3 microns, creating a safe and sterile environment for the patient.

What will it be like after the surgery?

You’ll be under continuous medical observation for 7 to 10 days post surgery, so that we can check whether your new kidney is functioning properly. At times, the new kidney might take some time to start functioning and produce urine. You might have to undergo dialysis till then and also take medications like diuretics to help the kidney expel excess water and salt from your body.

Our nurses and rehabilitation experts will take good care of you and guide you through your recovery.

We have state-of-the-art hemodialysis and peritoneal dialysis facility, complete with a water treatment plant to ensure high-quality dialysis for patients.

Follow-up

It is very important to visit your consulting doctor regularly and undergo all prescribed follow-ups and test to make sure that your new kidney is functioning well. Remember, a transplant surgery is a second chance at life and you need to be responsible for your own well-being.

Doctors

Dr. V. Narayanan Unni

Senior Consultant

Dr-narayan-unni sr-consultant

One of the most respected medical professionals in the region, Dr. V. Narayanan Unni is is a Nephrologist with more than 31 years of experience to his credit. A expert in management of complex kidney disorders, his areas of special interest include kidney transplantation and hemodialysis. A key opinion leader for kidney transplantation in the International Transplantation Society, he has played an instrumental role in creating awareness on organ transplantation in Kerala. Dr. Narayanan Unni is the Director of Academic Affairs of Aster Medcity.

Qualifications

FRCP (Glasgow, UK) | FISN|DM in Nephrology (PGIMER, Chandigarh) | DNB (National Board of Examinations, New Delhi) | MD in General Medicine (CMC, Vellore) | MBBS (Calicut Medical College)

Achievements

Professor & Head of Nephrology - Amrita Institute of Medical Sciences

Asst. Professor, Associate Professor, Professor & Head of Nephrology-Kasturba Medical College, Manipal

Nephrologist, Dammam Central Hospital, K.S.A.

Awarded the Fellowship of Royal College of Physicians and Surgeons (Glasgow, UK)

Fellowship of Indian Society of Nephrology

Key Opinion Leader in Kidney transplantation of the International Transplantation Society

Member of many national and international professional associations in Nephrology

Invited to deliver talks and guest lectures at national and international conferences.

President of Nephrology Association of Kerala

Published 54 articles in International and Indian Medical Journals

Fellowship of Indian Society of Nephrology

Recipient of six Gold Medals for MBBS

Chapters in textbooks - Essentials of Nephrology and Urology, Renal Replacement therapy in Text Book of Medicine &Text book of Medicine

Examiner for DM in Nephrology at P.G.I.M.E.R Chandigarh,C.M.C. Hospital, Vellore , Sri Ramachandra University, Chennai & Amrita Viswa Vidyapeetham University

Examiner for Nephrology in the National Board of Examinations, New Delhi

Proficient in English, Malayalam, Hindi

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Dr. Suresh G Nair

Senior Consultant

Dr-suresh-g-nair sr-consultant

Dr. Suresh G Nair is Senior Consultant, Department of Anaesthesiology, Pain Medicine and Critical Care Services. A veteran in Anaesthesiology with more than 25 years of experience in pain and Critical Care, Medical Intensive Care, Transoesophageal Echocardiography and Mechanical ventilation, he is an expert capable of handling even the most complicated cases, across multiple Specialities. He also has 15 years of experience in teaching as Professor and Head Of Department.

Qualifications

FIACTA (HON) | FTEE (HON)| MS (Baroda Medical College)| MBBS (Govt. Medical College, Thiruvananthapuram)

Achievements

Associate Professor, Sree Chithira Thirunal Institute of Medical Sciences, Thiruvananthapuram

Professor and Head of Department, Anaesthesia and Critical Care, AIMS, Kochi

22 years of teaching experience

Examiner for MD anesthesia

Examiner for DNB anesthesia

Examiner for fellowship in cardiac anesthesia

Teacher in Transoesophageal Echocardiography

Published 46 Research articles in International and Indian Journals

Proficient in English, Malayalam, Hindi, Gujarati and Tamil

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Dr. Jojo Pullockara

Senior Consultant

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A highly trained Nephrologist, Dr. Jojo Pullockara has more than 19 years of experience in management of kidney diseases in both adults and children. His areas of special interest are Critical Care Nephrology and Transplant.

Qualifications

DM in Nephrology (Govt. Medical College, Kottayam) | DNB in Nephrology | MD in Internal Medicine (Govt. Medical College, Thiruvananthapuram) | MBBS ((Govt. Medical College, Thiruvananthapuram)

Achievements

Asst. Professor, Department of Nephrology, Amrita Institute of Medical Sciences

Teaching Post Graduates - DM/DNB Nephrology

Consultant, Little Flower Hospital

Proficient in Malayalam, Hindi, English

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Dr. Vinod Kumar K

Consultant

Dr-vinod-kumar-k s-specialist

Dr. Vinod Kumar K is Consultant , Nephrology. He specialises in General Nephrology and his areas of special interest are critical care nephrology and renal transplantation. He is former Assistant Professor of General Medicine at Kannur Medical College.

Qualifications

DNB in Nephrology (St. John’s Medical College, Bangalore)| MD (KIMS , Hubli) | MBBS (JSS Medical College ,Mysore)

Achievements

Asst. professor, General Medicine, Kannur medical College

Senior Resident, Department of Nephrology, St. John’s Medical College, Bangalore

BMH Care Hospital

Published multiple articles in national and international journals

Proficient in English, Malayalam, Hindi & Kannada

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Dr. Sangeeth P.S

Consultant

Dr-sangeeth s-specialist

Dr.Sangeeth.P.S is Senior Specialist, Department of Anaesthesiology, Pain Medicine and Critical Care Services. An Anaesthetist with more than 5 years of experience, he specialises in Hepato Biliary & Solid Organ Transplant Anaesthesia. His areas of special interest are high risk Hepato Biliary & Pancreatic Surgery & GI Critical care. He is former Assistant Professor at Jubilee Medical Mission College.

Qualifications

International Fellowship in Liver Transplant (ASAN Medical Centre, Seoul) | Fellowship in Liver Transplant AIMS Kochi| MD (BJMC Ahmedabad) | DA (Govt. Medical College, Calicut)| MBBS (Govt. Medical College Thrissur)

Achievements

Assistant Professor, Jubilee Mission Medical College

Department of Anaesthesia, AIMS, Kochi

Junior Intensivist Paediatric Cardiac Surgery – MIMS Calicut

Expertise in Solid Organ Transplant Anaesthesia including Liver & Renal Transplant Anaesthesia for high risk HepatoBiliary &Pancreatic Surgery Anaesthesia for Vascular Surgery

Trained in Livet Transplant Anesthesia at ASAN Medical Centre, Seoul

Proficient in English, Hindi and Malayalam

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Dr. Kishore T.A

Consultant

Dr-kishore consultant

One of the top Urologists in the region, Dr. Kishore T A has more than 13 years of experience in comprehensive management of complex genitourinary diseases. Trained at some of the finest medical institutes in the United States and India, he is an expert in robotic surgery, renal transplantation, urological oncology, advanced endourology and laparoscopic urology.

Dr. Kishore is the first Urologist to perform NOTES assisted vaginal donor nephrectomy, robotic assisted radical nephrectomy and IVC thrombectomy in India; the third in the world to perform Transvaginal Assisted Robotic Renal Transplantation; the fourth in world to complete 50 robotic renal transplantation surgeries and first in south India to perform Robotic Assisted Renal transplantation.

Qualifications

Fellowship in Robotic Surgery (Columbia University Division Of Urology, Miami, United States) | Fellowship in Urologic Oncology (University of Miami & Accredited by the Society of Urologic Oncology) | Fellowship in Endurology (University of Minnesota & Accredited by the Endo Urological Society) | MCh in Urology (Govt. Medical College, Kottayam) | DNB in General Surgery (National Board of Examinations, India) | DNB in Urology (National Board of Examinations, India) | MRCS (Royal College of Surgeons, Edinburgh, United Kingdom) | M S in General Surgery (Govt. Medical College, Calicut) | MBBS (Govt. Medical College, Thrissur)

Areas Of Expertise

Robotic Surgery: Robotic Prostatectomy /Cystectomy, Partial Nephrectomy

Laparoscopy: Partial Nephrectomy, Radical Nephrectomy, Donor Nephrectomy

Genitourinary Oncology: Open/ Laparoscopic and Robotic Prostatectomy, Cystectomy, Neobladder

Robotic Renal Transplantation

Advanced ablation procedures like RFA, Cryotherapy

Endourology procedures including Flexible Ureteroscopy, PCNL, TURP, TURBT, laser prostate surgeries

Achievements

Performed more than 600 laparoscopic donor nephrectomies & renal transplantations

Performed over 500 robotic surgeries including 200 robotic radical prostatectomies

First in India to perform NOTES assisted Vaginal Donor Nephrectomy

First in India to perform robotic radical nephrectomy and IVC thrombectomy

Third person in the world to perform transvaginal assisted robotic renal transplantation

Fourth in the world to complete 50 robotic renal transplants

First in South India to perform robotic renal transplant

First in Kerala to perform Single Incision Donor Nephrectomy

First surgeon in Kerala to use da Vinci Surgery Robot (at Aster Medcity, Kochi)

Has the second largest published series in the world on NOTES assisted vaginal donor nephrectomy

Worked As

Associate Urologist, MS Ramaiah Hospital and Medical College, Bangalore

Assistant Professor of Urology, Amala Cancer Centre and Medical College, Thrissur

Teaching Instructor in Oncology and Sexual rehabilitation, Department of Urology, University of Miami

Consultant Urologist & Transplant Surgeon, Department of Urology, Medical Trust Hospital, Kochi

Awards & Accolades

Chandigarh best video prize USICON 2016

Best video award in SZUSICON 2015 and 2016

Chandigarh best video prize USICON 2013

Best paper award Indian Journal of Urology 2013

Best video award UAKON 2013

SS Bapat prize for the best innovation in urology in USICON 2014

Editorial Memberships

Member of the Editorial Board of:

International Journal of Urology and Nephrology

Asian Network for Scientific Information

Open Urology and Nephrology Journal


Open Prostate Cancer Journal

Reviewer
 of:

Journal of Endourology
; Journal of Urology, Urologic Oncology; European Urology; British Journal of Urology; Advances in Urology; International Journal of Urology and Nephrology; BMC Urology;
 International Journal of Urogynecology,; International Journal of Nephrology and Urology;
 Urotoday International and
 Urology Journal Publications

Published 38 articles

Proficient in English, Malayalam, Hindi

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Dr. Rajappan Pillai. P

Consultant

Dr-rajpillai consultant

Dr. Rajappan Pillai .P, Consultant, Paediatric Intensive Care, CoE Child and Adolescent Care is a Paediatric Intensive Care Physician since 2006, and specialised training at the finest facilities in the United Kingdom, including the Great Ormond Street Hospital. An expert in providing highly advanced life support facilities like Inhaled Nitric Oxide, ECMO and Mechanical Ventilation to critically ill children and also stabilising and transporting them from peripheral hospitals to the main hospital, he specialises in Cardiac Intensive Care, Retrieval Services, Post Solid Organ Transplant Intensive Care and Aeromedical Transfer.

Qualifications

Fellowship - Paediatric (Kings College Hospital, London) |Fellowship- Retrieval& Aeromedical Transfer (Children’s Acute Transfer Services, London) | Fellowship - Paediatric & Cardiac Intensive care (Great Ormond Street hospital, London, United Kingdom) | MD in Pediatrics (JJM Medical College, Davangaree| MBBS (Government Medical College, Alappuzha, University of Kerala) |

Achievements

Previuos faculty in Neonatal and Paediatric Intensive Care at Christian Medical College, Vellore

Trained in triaging, stabilisation and retrieval of critically ill children at CATS, one of the largest specialist Paediatric retrieval services in Europe

Trained in Aeromedical transfer of critically ill children

Trained in highly complex Paediatric medical and surgical emergencies at Great Ormond street hospital for childre, London, one of World’s best Children’s Hospitals

Trained in managing post op cardiac patients and ECMO patients at the Cardiac intensive care unit at Great Ormond street hospital for childre- one of the busiest center of Children’s cardiac surgery in the World and among the biggest ECMO center for children in Europe.

Trained in Post-operative management of Pediatric Liver Transplant patients at King’s College Hospital, London- the biggest center for pediatric liver transplant in the World

work Experience

Clinical Fellow, Paediatric Liver transplant & Intensive care unit, Kings College Hospital, Denmark hill. London

Senior Clinical Fellow, Paediatric & Cardiac Intensive Care Unit, Great Ormond Street hospital. London

Retrieval Fellow, Children’s Acute Transport Service (CATS), Great Ormond Street Hospital, London

Clinical Fellow, Paediatric Intensive care unit, St Mary’s hospital, Imperial Healthcare trust. London

Assistant professor, Paediatric intensive care unit, Christian Medical college, Vellore

Assistant Professor, Neonatal intensive care unit, Christian Medical College, Vellore

Associate Professor, Neonatal intensive care unit, Pushpagiri Medical College, Thiruvalla

Proficient in English, Malayalam Hindi, Tamil & Kannada

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Dr. Anup R Warrier

Consultant

Dr.-anup-r-warrier

Dr. Anup R Warrier is Consultant, Department of Infectious Diseases & Hospital Infection Control. A Physician with over 9 years of experience and specialised training in management of infectious diseases and infections in hospitals, his special interests are Tropical Infections, Fever of Unknown Etiology evaluation, infections in the ICU & HIV Medicine, Antimicrobial Stewardship and cost – effective, evidence based infection Control.

Qualifications

DNB in General Medicine | Fellowship in Infectious Diseases (P D Hinduja Hospital,Mumbai) | Board Certified in Infection Control, Certification in Travel Health, European Diploma in Surgical Infections (SIS-Europe)| MBBS (Govt. Medical College, Thiruvananthapuram)

Achievements

Infectious Diseases Specialist, KIMS Hospital, Trivandrum

In-Charge of Infection Control Program at KIMS Hospital, Trivandrum

Specialized training in Infectious Diseases from premier Institutes in India & USA

Close association with the Intensivists helped gain experience in managing infections in the critically ill

Developed the Infection Control Program at KIMS to the effect that international benchmarking could be done in line with INICC

One of the few Physicians in Kerala formally trained and practicing HIV Medicine

Experienced in evaluation & management of prolonged & undiagnosed fevers and also complicated Tropical Infections.

Management of adult immunizations, fever & infections in travelers

Published Research articles

Proficient in English, Malayalam, Hindi and Telugu

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Dr.Nanda D Kachare

Consultant

1dr-nanda consultant neuro-pathology nov 3

Dr.Nanda D Kachare, Consultant, Department of Pathology, is a highly trained Pathologist With 11 years of experience to her credit. Her areas of special interest are Surgical Oncopathology, Neuropathology, Renal and transplant pathology. She has worked with some of the finest facilities in the country and is former Professor, Department of Neuropathology, Christian Medical College and Hospital, Vellore.

Qualifications

MD in Pathology (Government Medical College, Kolhapur) | MBBS (Government Medical College, Kolhapur)

Specialised training in:

Intraoperative Frozen section (AIMS, Kochi,India) |Neuropathology including neuro-oncology, (CMC Vellore, AIMS, Kochi,India)|Nerve and muscle biopsy (Christian Medical College, Vellore,India)|Surgical Oncopathology (AIMS, Kochi,India )|Renal and transplant pathology with Immunofluorescence (AIMS, Kochi,India)|Respiratory pathology (AIMS, Kochi,India,)|Gastrointestinal pathology ( Govt Medical College, Miraj AIMS, Kochi,India)|Hematopathology, endocrine and breast pathology(AIMS, Kochi,India)|Automation in Histopathology, Cytology and Hematology( Govt Medical College, Miraj,AIMS, Kochi,India)|Cytopathology including PAP screening(( Govt Medical College, Miraj , AIMS, Kochi,India)|Adult and Paediatric Autopsy( Govt Medical College, Miraj,B.J.Medical College, Pune, India)|Immunohistochemistry in Surgical Pathology (AIMS, Kochi,India )|Fine Needle Aspiration Cytology ( Govt Medical College, Miraj, B.J.Medical College, Pune, India)|FISH (Christian Medical College, Vellore,India)|Electron microscopy (Christian Medical College, Vellore,India)| Basics of Molecular genetics (Christian Medical College, Vellore,India)|Quality Control and Assurance (AIMS, Kochi,India )

Achievements

Assistant professor Neuropathology, Department of Neuropathology

Christian Medical College, vellore

Consultant, Histopathology and Cytopathology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra,India

Associate Professor, Pathology, AIMS, Kochi

Lecturer in Pathology, P.D.Hinduja National Hospital and Medical Research Centre Mumbai

Life Member of Neurological Society of India

Member of Indian Association of Pathologists and Microbiologist (IAPM)

Member of International Academy of Pathologists- Indian Division

Member of Indian Association of Pathologists and Microbiologists, Kerala

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Dr. Ramprasad M.K

Consultant

Dr-ramprasad s-specialist

Dr. Ramparasad M.K is Consultant, Urology, with more than 1 year of experience in Surgery. He specialises in Genitourinary Surgery and has special interest in Endourology, Stone management, RIRS & HOLEP. He is into research on DJ Stents for ureteric & renal stones - the ongoing research being Encrustations on DJ Sents FTIR Analysis.

Qualifications

Mch in Urology (Govt. Medical College,Kottayam) ||MS in General Surgery (Govt. Medical College, Thiruvananthapuram) | MBBS (Govt. Medical College,Thrissur)

Achievements

Trained in Endourology and Stone Surgery

Ongoing Research on encrustations on DJ Stent FTIR Analysis

Numerous presentations made at general Surgery Conferences

Published multiple articles

Proficient in English & Malayalam

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Dr. Bipi PK

Senior Specialist

Bipi pk dtl page

A Nephrologist, Dr. Bipi PK is trained in critical care nephrology, paediatric nephrology and renal transplantation. He is also a trained General Physician.

Qualifications

DM in Nephrology (Govt. Medical College, Thiruvananthapuram) | MD (Govt. Medical College, Chennai) | MBBS (TD Medical College, Alappuzha)

Achievements

Department of Paediatric Nephrology, SAT hospital, Thiruvananthapuram

Lecturer in Nephrology, Medical College, Thiruvananthapuram

Consultant Physician, Co-operative Hospital, Thodupuzha

Proficient in English, Hindi, Malayalam andTamil

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Dr. Vishnu Raveendran

Senior Specialist

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An Urologist with more than 6 years of experience in comprehensive management of genitourinary diseases and disorders in adults, Dr. Vishnu has specialised training in urological laparoscopy/ endoscopy surgery and advanced endourology procedures like HoLEP (laser assisted removal of the prostrate), endoscopic stone removal (RIRS) and PCNL & mini PCNL (percutaneous stone extraction).

Qualifications

MCh in Urology (Govt. Medical College, Thiruvananthapuram) | DNB in Urology (National Board of Examinations, New Delhi) | MS in General Surgery (JIPMER, Pondicherry) | MBBS (T D Medical College, Alappuzha)

Achievements

Trained in all advanced urology/ endourology procedures for management of kidney and genitourinary related diseases and disorders.

Part of the MARS (Minimal Access Robotic Surgery) team at Aster Medcity that has various landmark achievements to its credit.

More than 9 years of teaching experience in surgery.

Reviewer of World Journal of Surgical Oncology.

Worked as a medical officer in health service and later as a research officer in Filariasis Chemotherapy Unit.

Presented papers at national and international conferences.

Awarded best video prize in 2015 by the State Chapter in urology.

Published articles in international peer reviewed journals.

Published papers on advanced robot assisted kidney transplantation.

Invited to the Best Video Session of the prestigious AUA (American Urological Association) Annual Meet, San Francisco 2018.

Proficient in Malayalam, English, Tamil, Hindi.

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