Dacryocystorhinostomy (DCR)
Steps Involved in IVF:
Procedure Description
Dacryocystorhinostomy (DCR) is a surgical procedure designed to treat nasolacrimal duct obstruction, which is a blockage in the tear drainage system that leads to excessive tearing (epiphora) or recurrent eye infections. This obstruction can be due to congenital abnormalities, chronic infections, trauma, or inflammation. DCR creates a direct passage between the lacrimal sac (tear sac) and the nasal cavity, bypassing the blocked duct and allowing for normal tear drainage.
During the DCR procedure, the surgeon makes a small opening in the bone between the lacrimal sac and the nasal cavity. This allows tears to drain directly into the nasal passage. The procedure can be done through two primary approaches: external DCR and endoscopic (or endonasal) DCR. The external approach involves a small incision on the side of the nose, while the endoscopic approach is performed entirely through the nostrils, leaving no external scars.
External DCR is considered to have a high success rate due to the larger opening created for tear drainage. However, the endoscopic approach is less invasive, causes less tissue trauma, and typically leads to a faster recovery. The choice between these methods depends on patient-specific factors such as anatomy, the underlying cause of the obstruction, and the surgeon's expertise.
Procedure Duration
The duration of a DCR procedure typically ranges between 30 to 90 minutes, depending on whether an external or endoscopic approach is used and the complexity of the case. The phases of the procedure can be divided into preparation, surgery, and recovery.
Preparation: Before the surgery, the patient undergoes a comprehensive eye examination, including tests to confirm the site and cause of the obstruction. The patient is given local anesthesia (sometimes combined with sedation) or general anesthesia, depending on the approach and the patient's overall health condition. The preparation phase is crucial to ensure that the procedure proceeds smoothly.
Surgical Phase: In an external DCR, a small incision (approximately 1-2 cm) is made on the side of the nose to access the lacrimal sac and create a passage to the nasal cavity. In an endoscopic DCR, the surgeon uses a tiny camera and instruments inserted through the nasal passages to perform the same function internally. In both cases, a stent may be temporarily placed to keep the new passage open during the initial healing phase.
Recovery: Recovery time after a DCR is relatively short, but it varies depending on the surgical approach. For external DCR, patients may experience mild discomfort and swelling around the incision site, which typically subsides within a week. The nasal stent, if used, is usually removed after a few weeks to months. For an endoscopic DCR, recovery is often quicker, with minimal external swelling and faster return to daily activities. Full recovery and optimal function of the tear drainage system may take several weeks.
Benefits of DCR
- Restores Normal Tear Drainage: DCR effectively relieves excessive tearing by bypassing the blockage in the nasolacrimal duct.
- Reduces Recurrent Infections: By reestablishing proper drainage, the procedure helps prevent recurring eye infections or dacryocystitis.
- High Success Rates: Both external and endoscopic DCR have high success rates, making it a reliable procedure for tear drainage issues.
- Minimally Invasive Option Available: The endoscopic approach offers a less invasive alternative with no visible scarring.
- Improved Quality of Life: The elimination of chronic tearing and infections significantly improves comfort and daily activities.
Potential Destinations for DCR
- India: With a strong medical infrastructure and highly skilled ophthalmologists, India is a popular destination for DCR surgery. The affordability of high-quality treatment and extensive expertise in both external and endoscopic techniques make it an attractive choice for medical tourists.
- Turkey: Known for its state-of-the-art medical facilities and experienced surgeons, Turkey offers DCR procedures at a fraction of the cost compared to many Western countries. The country also has a rich culture and tourism appeal, making it a great destination for combining medical treatment with sightseeing.
- Thailand: A hub for medical tourism, Thailand boasts modern hospitals with advanced technology and internationally trained specialists in ophthalmology. With its welcoming approach to international patients and competitive pricing, Thailand is a top choice for those seeking DCR surgery.
- Mexico: For patients from North America, Mexico provides a convenient option for DCR procedures. High-quality care, shorter travel distances, and lower costs make it an appealing choice for those seeking efficient and cost-effective treatment close to home.
- United Arab Emirates (UAE): The UAE has made significant investments in healthcare, with world-class hospitals offering a range of ophthalmic procedures, including DCR. With a reputation for luxury medical services and expert care, the UAE is an excellent option for those looking for premium treatment.
Risks & Considerations
- Bleeding: As with any surgical procedure, there is a risk of bleeding during or after the operation. Most cases are mild, but careful monitoring is required.
- Infection: Post-operative infection is a potential risk, though it is rare. Preventive measures include using antibiotic eye drops as prescribed.
- Scar Formation: For external DCR, there may be a small scar on the side of the nose. However, it usually heals well and becomes barely noticeable over time.
- Stent-Related Complications: If a stent is used to keep the new passage open, it may cause discomfort or occasionally become dislodged, requiring repositioning or removal.
- Re-stenosis (Re-blockage): There is a chance that the new tear drainage passage may narrow or close over time, requiring revision surgery.
How to Choose the Right Doctor and Hospital
Selecting the right doctor and hospital for DCR is essential for a successful outcome. Start by researching ophthalmologists or ENT specialists who have extensive experience in performing both external and endoscopic DCR procedures. Look for board-certified surgeons who have specialized training in lacrimal and nasal surgeries, as their expertise ensures a higher success rate and safer procedure.
When choosing a hospital or clinic, prioritize facilities that are accredited by internationally recognized healthcare organizations. Ensure that the hospital has advanced equipment for endoscopic procedures and a dedicated team of professionals for pre-operative and post-operative care. Additionally, it is crucial to check reviews, patient testimonials, and outcomes for similar procedures to gain confidence in your choice.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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