A smile is often one of the first things people notice about you, and it can leave a lasting impression. Whether it’s a result of genetics, aging, or oral habits, many people feel self-conscious about their smile. Fortunately, modern cosmetic dentistry offers a variety of treatments that can enhance your smile and, more importantly, boost your confidence. 

In this blog, we’ll explore the different options available for smile makeovers, how they work, and how they can help you achieve the smile you’ve always dreamed of. From teeth whitening to dental veneers, the possibilities are endless for creating a healthier, more radiant smile. 

What is a Smile Makeover? 

A smile makeover is a personalized treatment plan designed to address a variety of dental issues, such as crooked teeth, discolored enamel, chipped teeth, or missing teeth. By combining several cosmetic dental procedures, a smile makeover can completely transform the appearance of your smile, leaving you with improved aesthetics and enhanced self-confidence. 

Popular Cosmetic Dentistry Procedures for a Smile Makeover 

There are several cosmetic dental procedures that can contribute to a smile makeover. Depending on your needs and goals, your dentist may recommend one or more of the following treatments: 

1. Dental Veneers: Achieve a Perfect, Natural-Looking Smile 

Dental veneers are thin shells of porcelain or composite resin that are custom-made to cover the front surface of your teeth. They are ideal for correcting issues such as chipped, stained, or slightly misaligned teeth. Veneers can provide a flawless, natural-looking result that can enhance the overall symmetry and shape of your smile. 

2. Teeth Whitening: A Brighter, Whiter Smile 

Teeth whitening is one of the most popular and least invasive cosmetic treatments. Over time, teeth can become stained or yellow due to various factors such as food, drinks, and tobacco use. Professional teeth whitening treatments can significantly lighten the shade of your teeth, making your smile brighter and more youthful in the most natural and drill-free way.  

3. Dental Implants: Restore Your Smile with Permanent Solutions 

If you’re missing one or more teeth, dental implants can provide a permanent solution that looks and functions like natural teeth. Implants are surgically placed into the jawbone and act as a base for crowns or bridges, restoring both the function and appearance of your smile. 

4. Bonding: A Quick Fix for Small Imperfections 

Dental bonding or tooth-colored restorations involve applying a tooth-colored resin to repair minor imperfections, such as chips, gaps, or discoloration. It’s a cost-effective and quick way to improve your smile without the need for extensive procedures. 

5. Invisalign: Straighten Your Smile with Clear Aligners 

For those with crooked or misaligned teeth, Invisalign offers a discreet alternative to traditional braces. These clear, removable aligners gradually shift your teeth into their ideal position, improving both the appearance and functionality of your smile. 

The Benefits of a Smile Makeover 

Undergoing a smile makeover can provide a wide range of benefits, from aesthetic improvements to psychological boosts. Here are just a few ways a smile makeover can transform your life: 

• Enhanced Confidence: A beautiful smile can make you feel more confident in social situations, whether at work, with friends, or on a date. 

• Youthful Appearance: Dental procedures like whitening and veneers can create a youthful, vibrant smile that rejuvenates your overall appearance. 

• Improved Oral Health: Many smile makeover treatments, such as dental implants or teeth straightening, not only enhance your smile but also improve the health and function of your teeth and gums. 

• Lasting Results: With proper care, the results of your smile makeover can last for years, providing long-term satisfaction. 

Before and After: What to Expect from a Smile Makeover 

The transformation provided by a smile makeover can be dramatic. Before undergoing the procedures, your dentist will conduct a thorough evaluation of your teeth and gums. They will discuss your goals and create a personalized treatment plan that meets your needs. The timeline for a smile makeover varies depending on the complexity of the procedures, but many treatments can be completed within a few months. 

After your treatments, you’ll be able to enjoy a radiant smile that reflects your personality and boosts your self-esteem. Whether you’re going for subtle improvements or a complete transformation, the results can be life-changing. 

Choosing the Best Dentist for Your Smile Makeover 

The key to a successful smile makeover is finding a skilled and experienced cosmetic dentist who understands your needs and goals. Look for a dentist who has expertise in various cosmetic procedures and can offer a personalized treatment plan. Patient reviews and before-and-after photos of previous patients can also give you a better sense of the dentist’s capabilities. 

Affordable Smile Makeovers: Is It Possible? 

While cosmetic dentistry can sometimes come with a significant price tag, there are options for those seeking a more affordable smile makeover. Many dental offices offer financing plans or payment options that make treatments more accessible. Additionally, some procedures, like bonding or teeth whitening, may be more budget-friendly than others. Consult with your dentist to explore all available options that fit your budget. 

The Latest Cosmetic Dentistry Trends 

Cosmetic dentistry is constantly evolving, with new technologies and materials making treatments more effective and natural-looking than ever before. From 3D smile design software that allows patients to visualize their results before treatment to advancements in ceramic materials for veneers, the trends in cosmetic dentistry are all about precision, comfort, and aesthetic beauty. 

Self-Care After a Smile Makeover 

To ensure the long-lasting success of your smile makeover, it’s important to maintain good oral hygiene. Regular brushing and flossing, along with routine dental check-ups, are essential to keep your smile looking its best. Additionally, if you’ve had treatments like teeth whitening or veneers, be mindful of your diet and avoid habits that may stain your teeth, such as smoking or excessive coffee consumption. 

Final Thoughts 

A smile makeover can do more than just improve the appearance of your teeth—it can elevate your self-esteem, boost your confidence, and change the way you feel about yourself. Whether you’re looking to address small imperfections or undergo a complete transformation, cosmetic dentistry offers a wide range of solutions that can help you achieve the smile of your dreams. 

Investing in your smile is an investment in yourself, and the right cosmetic dental treatments can provide you with results that last a lifetime. So, why wait? Start your smile transformation today and experience the confidence boost that comes with a radiant, beautiful smile. 

Joint replacement surgery can be life-changing, offering significant relief from pain and improved mobility. Whether you’ve had a hip, knee, or shoulder replacement, the road to recovery and long-term health involves careful attention to rehabilitation, physical therapy, and lifestyle adjustments. This guide will help you understand what to expect after surgery, how to optimize recovery, and how to thrive post-joint replacement. 

1. Immediate Recovery: What to Expect Right After Surgery 

The first phase of recovery after joint replacement is the immediate post-surgical period. Right after the procedure, you’ll spend time in a recovery room where healthcare professionals monitor your vital signs and pain levels. Pain management is a key focus during this period to ensure that you remain as comfortable as possible. You’ll likely be prescribed pain medications, and your healthcare team may use ice packs or other techniques to reduce swelling. 

What to Expect: 

• You may stay in the hospital for a few days, depending on your recovery progress and the type of surgery. 

• Swelling, bruising, and discomfort are common in the initial recovery phase. 

• You will begin using a walker or crutches as you start to mobilize, even while still in the hospital. 

2. Post-Surgery Rehabilitation: Key to Regaining Mobility 

One of the most important aspects of life after joint replacement is rehabilitation. Physical therapy begins soon after surgery and plays a crucial role in your recovery. Therapy helps to rebuild strength, increase joint flexibility, and improve mobility. You will work closely with a physical therapist to learn exercises designed to help you regain normal function in the joint. 

What to Expect: 

• You’ll start with gentle, range-of-motion exercises to help the joint heal and prevent stiffness. 

• Over time, you’ll move on to strengthening exercises to build the muscles around the new joint. 

• Your physical therapist will monitor your progress and may adjust your exercises to ensure you’re recovering at a healthy pace. 

3. Pain Management: Finding the Right Approach 

While joint replacement surgery offers long-term pain relief, the initial stages of recovery may involve some discomfort. Pain management is essential during this time to help with mobility and daily activities. Your doctor will prescribe pain relief options tailored to your needs, which may include oral medications, topical treatments, or even nerve blocks for more significant pain. 

What to Expect: 

• Pain levels typically decrease significantly after the first few weeks. 

• It’s essential to follow your doctor’s instructions on how and when to take medications to manage pain effectively. 

• Non-medication methods such as ice, heat, and elevation can also help manage swelling and discomfort. 

4. Improving Mobility: Slowly Getting Back to Daily Activities 

One of the most exciting outcomes of joint replacement is the improvement in mobility. As the months progress, you’ll find that your ability to move and participate in daily activities becomes easier. Simple tasks like walking, climbing stairs, and sitting down and standing up should become more manageable. 

What to Expect: 

• With consistent physical therapy, you’ll notice gradual improvements in your joint’s range of motion and overall function. 

• It’s normal to experience some stiffness, especially in the mornings or after periods of inactivity, but regular movement will help prevent this. 

• Your physical therapist will encourage you to practice walking, using stairs, and engaging in low-impact activities as you progress. 

5. Lifestyle Changes: Supporting Long-Term Health 

After joint replacement surgery, some lifestyle changes may be necessary to ensure the long-term success of the prosthetic joint and maintain overall health. Maintaining a healthy weight is crucial to reduce excess stress on the joint and preserve its functionality. Additionally, adopting a more active lifestyle with joint-friendly exercises can improve your overall well-being. 

What to Expect: 

• Healthy eating and maintaining an appropriate weight can significantly improve your recovery and prevent undue stress on your new joint. 

• Low-impact exercises such as swimming, cycling, and walking are excellent choices for maintaining joint health. 

• Be mindful of any activities that may put too much strain on your joint, such as running or high-impact sports. 

6. Prosthetic Care: Keeping Your New Joint in Top Condition 

Your new prosthetic joint requires care and maintenance to ensure its longevity. While joint replacement surgery typically lasts many years, avoiding unnecessary wear and tear is key to maximizing the lifespan of your prosthetic. Your doctor or orthopedic surgeon will provide guidance on how to care for your joint and what to avoid. 

What to Expect: 

• Regular follow-up appointments with your surgeon to monitor the condition of your prosthetic joint. 

• You may need X-rays or other imaging tests periodically to ensure the joint is in proper alignment. 

• It’s crucial to avoid high-impact activities that could stress the new joint prematurely. 

7. Long-Term Outcomes: Expecting a Better Quality of Life 

The majority of joint replacement patients experience significant improvement in their quality of life. Most people report reduced pain and increased mobility, making it easier to return to activities they enjoy. While there are risks associated with any surgery, the benefits of joint replacement often far outweigh the drawbacks, especially in older adults or those with severe joint deterioration. 

What to Expect: 

• Most patients see a noticeable reduction in joint pain and increased ability to engage in everyday activities. 

• The prosthetic joint may wear out over time, but modern materials and surgical techniques allow most replacements to last 15-20 years or more. 

• You’ll likely have a better range of motion and greater independence in daily life. 

8. Patient Education: Being Your Own Advocate 

Patient education is an essential part of life after joint replacement. Understanding your recovery process, how to care for your new joint, and what to do if complications arise will help you make informed decisions and improve outcomes. Regular communication with your healthcare team and a commitment to learning about the recovery process are vital for successful rehabilitation. 

What to Expect: 

• You’ll receive detailed instructions about exercises, pain management, and activity modifications. 

• Be proactive in asking questions about what you can do to support your recovery, including potential lifestyle changes. 

• Learning about signs of complications (such as infection or joint loosening) is crucial for timely intervention. 

Final Thoughts: Thriving After Joint Replacement 

Joint replacement surgery offers a promising path to pain relief and improved mobility. With the right post-surgery rehabilitation, pain management, and lifestyle adjustments, you can regain your independence and enjoy a higher quality of life. By following your healthcare team’s guidance, staying consistent with physical therapy, and taking steps to protect your joint, you can expect long-term benefits and a vibrant, active future. 

Introduction

Burjeel Royal Hospital Al Ain has demonstrated exceptional neurosurgical capabilities with the successful resection of a large and complex supratentorial tumor. This case highlights the critical role of advanced neuro-navigation technology, multidisciplinary collaboration, and precise surgical technique in managing challenging brain lesions while preserving neurological function.

Patient Presentation

The patient presented with multiple seizure episodes associated with a large supratentorial tumor. Imaging studies revealed an extensive intra-axial mass lesion in the left frontal-parietal region measuring approximately 7.8 × 6 × 6.4 cm with surrounding edema and significant mass effect. The tumor was causing partial effacement of the left lateral ventricle and extending into critical neurological structures, including:

• Left basal ganglia
• Body of corpus callosum
• Motor cortex regions
• Left insular cortex
• Primary auditory cortex regions
• Wernicke’s area (language processing center)

This extensive involvement of eloquent brain regions posed significant challenges, as damage to these areas could result in permanent motor, speech, and language deficits.

Surgical Planning and Approach

The neurosurgical team, led by Prof. Dr. Tamer Ibrahim Metwaly and Dr. Mutaz Jamal Abu Nassar, Consultants in Neurosurgery at Burjeel Royal Hospital Al Ain, employed advanced surgical planning and intraoperative technology:

1. Preoperative Imaging: Detailed MRI sequences were used to map the tumor’s boundaries and its relationship to critical brain structures.
2. Advanced Neuro-Navigation: This GPS-like technology provided real-time guidance during the procedure, allowing precise localization of the tumor and surrounding critical structures.
3. Surgical Strategy: The team performed a frontal craniotomy to access the tumor, meticulously excising the glioma while continuously monitoring to avoid damage to functional brain tissue.
4. Decompression: Significant effort was directed at relieving intracranial pressure caused by the tumor and surrounding edema.
5. Reconstruction: Following tumor removal, careful cranio- and duroplasty procedures restored the integrity of the brain’s protective layers.

Perioperative Management

The complex nature of the case required meticulous perioperative care:

1. Seizure Management: Both pre- and postoperatively, the patient experienced focal seizures, which were promptly addressed with dual-dose antiepileptic treatment based on neurologist recommendations.
2. Neurological Monitoring: Continuous assessment of neurological status guided postoperative management and rehabilitation.
3. Multidisciplinary Approach: Collaboration between neurosurgeons, neurologists, intensivists, and rehabilitation specialists ensured comprehensive care.

Recovery and Outcomes

Despite the formidable challenges posed by this case, the patient demonstrated a remarkable recovery trajectory:

• Stable hemodynamic parameters throughout the perioperative period
• Progressive improvement in consciousness level
• Recovery of verbal communication abilities
• No further seizure episodes following optimization of antiepileptic therapy
• Favorable prognosis confirmed by the intensivist team

Technological Advantages

The successful management of this case was significantly enhanced by Burjeel Royal Hospital Al Ain’s advanced neurosurgical infrastructure:

1. Intraoperative Imaging: The hospital’s integrated MRI operating room provided precise guidance for tumor removal.
2. KINEVO 900 Microscope: This state-of-the-art operative microscope features robotic visualization, 4K imaging technology, and advanced fluorescence capabilities, allowing for optimal visualization throughout the procedure.
3. Neuro-Navigation System: Advanced computer-assisted navigation allowed real-time tracking of surgical instruments in relation to the patient’s anatomy.

Conclusion

This case exemplifies the exceptional level of neurosurgical care available at Burjeel Royal Hospital Al Ain. By combining advanced technology, surgical expertise, and multidisciplinary collaboration, the team successfully managed a challenging brain tumor that involved multiple critical neurological structures. The patient’s favorable recovery highlights the importance of specialized neurosurgical capabilities in achieving optimal outcomes in complex intracranial cases.

Experts

Introduction

Burjeel Hospital Abu Dhabi has successfully performed a groundbreaking hip revision surgery utilizing custom-designed 3D-printed implants, offering new hope for patients with severe pelvic bone loss. This case demonstrates how advanced imaging, collaborative biomedical engineering, and surgical expertise can transform seemingly impossible cases into successful outcomes, even after previous implant failures.

Patient History

The patient had undergone a fully cemented left hip replacement more than a decade ago outside the UAE. Six months prior to the current intervention, the patient was diagnosed with a left periprosthetic infection in the UAE. In July 2024, the infected total hip replacement was explanted, and the patient was left with static antibiotic-loaded spacers in a disarticulated hanging hip configuration due to the severity of bone stock loss, which made implantation of a traditional hip spacer impossible. An X-ray guided hip needle aspiration for culture in October 2024 confirmed that the infection had been successfully eliminated.

Complex Challenges

The surgical team, led by Dr. Gianluca Cusma, Consultant Trauma & Orthopedic Surgeon at Burjeel Hospital Abu Dhabi, faced an exceptionally challenging case:

1. Severe Bone Loss: Imaging studies revealed catastrophic bone deficiencies:
   • Complete deficiency of the medial wall
   • Partial deficiency of the posterior wall
   • Complete deficiency of the superior wall
   • Complete resorption of the greater trochanter
2. Classification: The condition was classified as Paprosky 3B pelvic bone loss, representing one of the most severe scenarios in revision hip arthroplasty.
3. Functional Limitations: The patient had been in a disarticulated state for five months, resulting in significant soft tissue adaptations, muscle damage, and limb shortening.

Innovative Solution

The management approach required innovative solutions customized specifically to this patient’s unique anatomy:

1. Custom Implant Design: In collaboration with specialized biomedical engineers, the team designed a CT-based custom-made acetabular component. The process involved:
   • Detailed 3D reconstruction of the remaining bone anatomy
   • Digital design of a tri-flanged component
   • Selection of 3D-printed trabecular titanium material to promote bone ingrowth
   • Engineering of flanges positioned to secure to the remaining viable bone
   • Integration of features to reconstruct the medial wall separating the acetabular cavity from the abdominal cavity
2. Manufacturing Process: The design-to-delivery process took approximately four weeks, culminating in the receipt of a sterile, patient-specific implant.

Surgical Procedure

Under spinal anesthesia provided by Dr. Srinivas Boddupally, Dr. Cusma performed the complex revision hip replacement:

1. Acetabular Reconstruction: The custom-made cementless acetabular component was precisely positioned to engage with the remaining bone structure.
2. Femoral Reconstruction: A cementless off-the-shelf conical stem was implanted to provide stable femoral fixation.
3. Articulation System: The surgeon selected a dual mobility ceramic-on-polyethylene tribology system to enhance stability while minimizing wear.

Postoperative Course and Recovery

The patient experienced an excellent immediate postoperative recovery:

• Neurovascular status remained intact
• No blood transfusions were required
• The surgical wound healed well
• Daily physiotherapy focused on regaining active hip flexion/extension control
• The patient achieved comfortable positional transfers and in-room ambulation
• Discharge occurred on the fifth postoperative day

Technical and Emotional Challenges

This case highlighted several critical challenges in complex revision hip surgery:

1. Technical Challenges:
   • Designing a custom implant that would integrate with severely compromised bone
   • Executing precise surgical exposure and preparation for the implant
   • Managing damaged soft tissues and muscles
   • Establishing appropriate limb length and tension to balance hip stability and gait after prolonged disarticulation
2. Psychological Aspects:
   • Managing the patient’s emotions and expectations throughout the process
   • Providing confidence in a positive outcome despite the extreme complexity

Conclusion

This case exemplifies Burjeel Hospital Abu Dhabi’s capability to tackle exceptionally complex orthopedic challenges through innovative approaches and multidisciplinary collaboration. By combining advanced imaging, custom 3D-printed implant technology, and skilled surgical technique, the team successfully restored hip function in a case that would have been deemed inoperable using conventional methods. This approach represents the cutting edge of orthopedic reconstruction and offers new possibilities for patients with severe bone loss following failed arthroplasty.

Experts

Patient Presentation

A 66-year-old male presented with symptoms of benign prostatic hyperplasia (BPH) that had become increasingly refractory to medical management. His symptoms included weak urinary stream, increased frequency of micturition, sensation of incomplete bladder emptying, nocturia (4-5 times nightly), and urgency.

Diagnostic Findings

Ultrasound examination revealed a significantly enlarged prostate measuring approximately 180 grams with post-void residual urine exceeding 200 ml.

Treatment Considerations

Dr. Qaraschouli thoroughly discussed all available surgical options with the patient and his family, including:

• Transurethral resection of the prostate (TURP)
• Holmium laser enucleation
• Other laser therapy options
• Steam therapy (Resume)
• Open transvesical prostatectomy

After careful consideration of the massive prostate size and the patient’s clinical presentation, the decision was made to proceed with open transvesical prostatectomy.

Surgical Outcome

The surgical and postoperative courses were uneventful. Following removal of the indwelling catheter, the patient experienced satisfactory micturition with only mild stress incontinence (Grade 1) during the first postoperative week, which subsequently resolved completely. Follow-up ultrasound confirmed the absence of residual urine, in stark contrast to the preoperative findings.

Histopathology confirmed prostatic adenoma with chronic prostatitis, with no evidence of malignancy.

The Continued Relevance of Open Surgery

These cases demonstrate that open surgery remains the optimal choice in specific urological scenarios. Key advantages in these cases included:

1. For Complex Renal Tumors:
   • Better control of bleeding in high-risk patients with coagulopathy
   • Reduced operative time in patients with multiple comorbidities
   • Enhanced ability to manage unexpected intraoperative findings
   • Lower risk of major vascular complications
2. For Massive Prostatic Hyperplasia:
   • Complete removal of prostatic adenoma regardless of size
   • Definitive solution with lower recurrence rates compared to some minimally invasive approaches
   • Shorter operative duration in cases of extremely enlarged prostates
   • Excellent functional outcomes with rapid recovery

Conclusion

While minimally invasive and robotic approaches continue to advance, these cases from Burjeel Royal Hospital Asharej highlight that open surgical techniques remain essential tools in the modern urologist’s armamentarium. The surgical team’s ability to select the most appropriate surgical approach based on individual patient factors—rather than simply following technological trends—represents the true art of surgical practice. This patient-centered approach ensures optimal outcomes in complex urological cases where traditional open techniques may still offer significant advantages.

Experts

Patient Presentation

A 62-year-old female presented with irregular left flank pain persisting over several months. The pain pattern was intermittent and occasionally relieved with analgesics. The patient also reported occasional dysuria but no visible hematuria. Despite these concerning symptoms, she had not sought earlier medical attention.

Diagnostic Findings

Initial ultrasound examination revealed a large 10 cm diameter tumor in the left kidney. Subsequent CT scanning confirmed a 10 x 10 cm mass with features suspicious for malignancy, accompanied by multiple prominent collateral vessels in the perinephric region.

Preoperative assessment identified the patient as having high surgical risk, supported by abnormal laboratory parameters including:

• Significantly elevated APTT
• Increased INR and prothrombin levels
• Elevated creatinine indicating impaired renal function

Surgical Approach and Outcome

After thorough discussion with the patient and her family regarding available options, Dr. Humam Qaraschouli, Consultant Urologist, proceeded with an open radical tumor nephrectomy. The surgery was completed without complications, and the patient experienced an uneventful postoperative course, allowing for discharge as scheduled.

Histopathological examination confirmed renal cell carcinoma (pT2a, size 9.6 cm, G4, R0). Postoperative CT scanning of the thorax and abdomen showed no evidence of metastatic disease and demonstrated a satisfactory appearance of the left renal fossa. The oncology team subsequently established a regular follow-up protocol.

Experts

Introduction

Burjeel Medical City’s Advanced Gynecology Institute continues to push the boundaries of minimally invasive gynecological surgery with a remarkable case that demonstrates the power of combining medical optimization with robotic surgical techniques. This complex case highlights how innovative approaches can transform previously inoperable conditions into successful fertility-preserving procedures.

Patient History

A 49-year-old single female was referred from the Obstetrics and Gynecology department with debilitating symptoms including excessive and prolonged vaginal bleeding, a palpable abdominal mass, and persistent anemia causing fatigue, weakness, and lethargy. The condition had significantly impacted her daily activities and quality of life, affecting her ability to concentrate and function normally.

Clinical Assessment

Diagnostic imaging including ultrasound and MRI revealed multiple large fibroids that had completely distorted the uterine architecture. The uterus had expanded to such a massive size that it left virtually no space to enter the abdominal cavity laparoscopically. Additionally, a previous attempt at uterine artery embolization had failed to resolve the condition, further complicating the management approach.

Treatment Strategy

Despite the complexity of the case, the patient strongly expressed her desire to preserve her uterus for future fertility potential. She was also concerned about the cosmetic implications of a large vertical abdominal scar that would result from traditional open surgery.

The medical team developed an innovative stepwise approach to convert what appeared to be an inoperable case into one that could be managed with minimally invasive techniques:

1. Medical Optimization: The patient was prescribed six monthly doses of GnRH analog (3.75 mg) with the following objectives:
   • Induce temporary amenorrhea to reduce menstrual blood loss
   • Gradually shrink the fibroids and overall uterine mass
   • Create sufficient space for a minimally invasive surgical approach
   • Improve hemoglobin levels to ensure safer surgery
2. Response Assessment: After completing five doses, the patient showed remarkable improvement with:
   • 40% reduction in fibroid size
   • Increase in hemoglobin to 13 g/dL
3. Multidisciplinary Planning: The Advanced Gynecology Institute team collaboratively reviewed the case and determined that robotic myomectomy was now feasible, allowing for preservation of the uterus while avoiding a large abdominal incision.

Surgical Approach

Under the guidance of Dr. Sandesh Kade, Specialist in Laparoscopic, Endometriosis & Pelvic Floor Repair Surgeries, and with anesthesia support from Dr. Baby Thampuru Vamadevan, a robotic myomectomy was successfully performed.

The procedure resulted in:

• Removal of 21 uterine fibroids
• Excision of a large left ovarian cyst discovered during surgery
• Specimens were extracted through a minimal 2 cm incision, as they were too large for standard laparoscopic extraction ports

Clinical Outcome

The patient tolerated the procedure well and was discharged in stable condition. The surgery successfully preserved her uterus while avoiding the large abdominal scar that would have resulted from traditional open surgery.

Challenging Aspects

This case highlights several challenges in gynecological surgery management:

• Extremely large fibroids leaving virtually no space for standard laparoscopic access
• Previous failed uterine artery embolization
• Balancing the patient’s strong desire for fertility preservation against the technical complexity of the case
• Need for extensive preoperative medical optimization to create conditions suitable for minimally invasive surgery

The Role of Robotic Surgery

Burjeel Medical City’s Da Vinci XI Robotic Surgery System proved instrumental in this case, providing:

• Enhanced visualization through 3D imaging
• Improved precision with articulated robotic arms
• Better tissue manipulation during the complex dissection
• Ability to perform intricate suturing for uterine reconstruction
• Minimal tissue trauma compared to open surgical approaches

Conclusion

This case exemplifies how combining thoughtful medical optimization with advanced robotic surgical technology can transform previously inoperable gynecological conditions into successful minimally invasive procedures. The patient-centered approach that prioritized fertility preservation and cosmetic outcomes while effectively addressing the underlying pathology represents the cutting-edge capabilities available at Burjeel Medical City’s Advanced Gynecology Institute.

Experts

Introduction

A recent case at Burjeel Royal Hospital Asharej highlights the importance of considering tropical parasitic infections in the differential diagnosis of urological symptoms, especially in patients with relevant travel or exposure history. This complex case demonstrates the multidisciplinary approach required for diagnosing and treating schistosomiasis, a condition that can often be overlooked in initial evaluations.

Patient Presentation

A 41-year-old male patient sought medical attention for persistent abdominal and right flank pain, accompanied by gross hematuria and intermittent nausea over several weeks. Notably, the patient reported a previous episode of gross hematuria two years prior that had spontaneously resolved without medical intervention. Despite these concerning urinary symptoms, the patient described himself as generally healthy with no significant medical history.

Initial Investigations

The diagnostic journey began with ultrasound imaging, which revealed dilation of the right renal pelvis. Further evaluation with CT scanning of the abdomen and pelvis identified:

• A 5 x 4 mm calculus in the distal right ureter
• A smaller calculus at the vesico-ureteric junction
• Diffuse bladder wall thickening
• Non-dependent isodense foci in the bladder lumen, suspected to be blood clots

These findings initially suggested a urolithiasis-related etiology for the patient’s symptoms, with possible secondary inflammation of the bladder wall.

Surgical Intervention and Unexpected Findings

Under the care of Dr. Humam Qaraschouli, Consultant Urologist, the patient underwent ureterorenoscopy (URS) for stone removal and further evaluation of the urinary tract. The procedure was supported by Dr. Maitham Badawy and Dr. Syed Abu Sayeed, Specialists in Anesthesia.

Upon cystoscopic examination, several concerning and unexpected findings were noted:

• Diffuse redness and irritation of the bladder mucosa
• Tumorous changes in the area of the bladder dome and base, raising initial concerns for malignancy
• Characteristic “sandy patches,” a pathognomonic finding in schistosomiasis

During post-operative discussion with the patient and his wife, a critical piece of medical history emerged: the patient had experienced schistosomiasis (bilharzia) during childhood, a fact not disclosed during initial consultations.

Multidisciplinary Approach

Following this revelation, a multidisciplinary approach was initiated:

1. The ureteric stones were successfully removed and a DJ stent was placed
2. Resection of the affected bladder areas was performed for histopathological examination
3. Dr. Maher Wassim Malaeb, Specialist in Gastroenterology and Medical Director, was consulted
4. Colonoscopy identified suspected areas of infection in the rectum and sigmoid colon
5. Biopsies from both the bladder and intestinal lesions confirmed the diagnosis of schistosomiasis, likely caused by Schistosoma haematobium

Treatment and Follow-up

After removal of the DJ stent, the patient was referred to the Infectious Diseases department for definitive treatment with Praziquantel, the antiparasitic medication of choice for schistosomiasis.

Clinical Significance

This case underscores several important clinical lessons:

1. The value of comprehensive history-taking, including childhood illnesses and geographic exposure
2. The importance of considering parasitic infections in the differential diagnosis of urological conditions
3. The need for multidisciplinary collaboration in complex cases
4. The potential for chronic, latent parasitic infections to manifest years after initial exposure

Understanding Schistosomiasis

Schistosomiasis, also known as bilharzia or snail fever, is a parasitic disease caused by flatworms of the genus Schistosoma. It predominantly affects tropical and subtropical regions, particularly in Africa, Asia, and South America.

The life cycle involves:

1. Parasite eggs released into water bodies through human excretion
2. Larval development in freshwater snails
3. Release of infective cercariae into water
4. Penetration of human skin during water contact
5. Migration to target organs where adult worms produce eggs

In urinary schistosomiasis (S. haematobium), eggs trapped in the urinary tract cause inflammation, scarring, and potential long-term complications including bladder cancer.

Conclusion

This case exemplifies the diagnostic challenges and successful management of schistosomiasis at Burjeel Royal Hospital Asharej. By maintaining awareness of tropical diseases even in patients without recent travel history, the medical team was able to identify and appropriately treat this chronic parasitic infection, preventing further complications and providing relief from the patient’s symptoms.

Experts

Introduction

Burjeel Medical City continues to lead in minimally invasive gynecological procedures with their advanced robotic surgery program. A recent case highlights how the Da Vinci XI Robotic Surgery System is transforming treatment options for women suffering from fibroid-related complications, offering faster recovery and improved outcomes.

Patient History

A 52-year-old patient with no previous medical or surgical history and two normal vaginal deliveries presented with a one-year history of challenging gynecological symptoms. Her primary complaints included irregular bleeding, heavy menstrual periods, persistent headaches, fatigue, and chronic pelvic pain that significantly impacted her daily activities. The severity of her condition had resulted in severe iron deficiency anemia requiring multiple blood transfusions (five units of packed RBCs) and intravenous iron therapy.

Clinical Assessment

Physical examination revealed a palpable suprapubic mass extending to the umbilicus. Speculum examination showed a normal cervix. Comprehensive diagnostic workup included:

• Blood tests showing hemoglobin of 11.00 g/dL and platelet count of 356 X10^3/μL
• PAP smear negative for intraepithelial lesion or malignancy
• Bilateral mammography classified as BI-RADS 1 (normal)
• Normal endometrial biopsy
• MRI pelvis with and without contrast

The MRI findings confirmed an enlarged, anteverted uterus measuring 15 cm x 10.5 cm x 11.2 cm with a normal 7 mm endometrium. The primary pathology was identified as a large posterior wall intramural fibroid (approximately 11.2 x 8.8 x 10 cm) showing heterogeneous enhancement with degenerative changes. Additionally, a small 1.5 x 1 cm submucosal fibroid was noted in the anterior wall.

Surgical Approach

The expert surgical team led by Dr. Aysha Almentheri, Consultant Gynecologist, and Dr. Jafaru A, Consultant Gynecological Oncology Surgeon, performed a robotic radial hysterectomy with bilateral salpingectomy using the Da Vinci XI Robotic Surgery System. Anesthesia was administered by Dr. Baby Thampuru Vamadevan.

The robotic approach offered several key advantages:

• Enhanced 3D visualization of the surgical field
• Greater precision through robotic arm instrumentation
• Minimal incisions resulting in less post-operative pain
• Reduced blood loss
• Faster recovery compared to traditional open surgery

The procedure successfully removed the uterus, fibroids, cervix, and both fallopian tubes, with the specimen weighing 950 grams. Blood loss was limited to 300 ml, and no intraoperative transfusion was required.

Pathology Results

Histopathological examination confirmed:

• Conventional leiomyomata (fibroids) in the myometrium
• Benign endometrial polyp with progesterone-related changes
• Chronic endocervicitis
• Unremarkable fallopian tubes with bilateral small benign para-tubal serous cysts

Robotic Surgical Technology at Burjeel

This case exemplifies the technological capabilities of Burjeel Medical City’s Da Vinci XI Robotic Surgery System, which provides surgeons with enhanced capabilities through advanced robotic arms and HD 3D visualization. The system represents Burjeel Holdings’ commitment to incorporating cutting-edge technology that results in precise, minimally invasive procedures with improved patient outcomes and recovery.

Conclusion

The successful robotic hysterectomy with bilateral salpingectomy demonstrates how advanced robotic technology at Burjeel facilities is transforming women’s healthcare across the UAE and Oman. By providing minimally invasive surgical options for complex gynecological conditions, Burjeel Holdings continues to improve patient experiences and outcomes through technological innovation and surgical expertise.

Experts

Introduction

In a testament to Burjeel’s advanced interventional capabilities, a complex endovascular procedure was successfully performed to treat a potentially life-threatening vascular complication. This case study highlights the cutting-edge techniques employed by our interventional radiology team to manage an inferior mesenteric artery pseudoaneurysm in a critically ill patient.

Patient Presentation

The patient presented with a complex medical profile including several critical conditions:

• Inferior mesenteric artery pseudoaneurysm
• Pseudomonas pneumonia
• Respiratory failure requiring tracheostomy
• Sepsis
• Gastrointestinal bleeding
• Additional comorbidities including moderate open-angle glaucoma, bilateral dry eye syndrome, and thyrotoxicosis

This constellation of conditions presented significant challenges for treatment, requiring a multidisciplinary approach and minimally invasive techniques to minimize procedural risk.

Procedural Technique

The interventional team, led by Dr. Mohamed Almarzooqi, Medical Director & Consultant in Interventional Radiology, with anesthesia support from Dr. Sivan Pillay Azhagappan, performed a selective mesenteric angiography with transcatheter coil embolization.

The procedure involved:

1. Ultrasound-guided vascular access via the right common femoral artery
2. Insertion of a 6F vascular sheath
3. Selective catheterization and angiography of multiple vessels:
   • Superior mesenteric artery
   • Right and left ileocolic arteries
   • Inferior mesenteric artery (IMA)
4. Identification of a pseudoaneurysm in the IMA, located a few centimeters from its origin
5. Navigation past the aneurysm using a micro-catheter and microwire system
6. Precise deployment of embolic coils to exclude the aneurysmal segment
7. Confirmation of successful treatment with post-procedure angiography showing no residual flow into the aneurysm
8. Hemostasis achieved using an Angio-Seal closure device

The patient tolerated the procedure well, despite the complex underlying medical conditions.

Clinical Significance

Mesenteric artery pseudoaneurysms represent rare but potentially catastrophic vascular lesions that can lead to life-threatening hemorrhage if left untreated. Traditional open surgical repair carries significant risks, particularly in critically ill patients with multiple comorbidities. Transcatheter embolization offers a minimally invasive alternative with reduced procedural morbidity while effectively treating the underlying vascular pathology.

Burjeel’s Endovascular Capabilities

This case exemplifies Burjeel’s commitment to providing advanced interventional services across its network. With state-of-the-art facilities including:

• 7 catheterization laboratories
• 1 bi-plane catheterization laboratory
• Hybrid operating rooms
• Advanced imaging systems

The healthcare network is equipped to handle complex endovascular procedures that require specialized expertise and cutting-edge technology.

Conclusion

The successful management of this complex case demonstrates the high level of interventional capability available at Burjeel facilities. Through the application of advanced endovascular techniques, the interventional team was able to effectively treat a potentially life-threatening condition while minimizing procedural risk in a medically complex patient.

Experts