Welcome to  CardioThoracic and Vascular surgical subspecialty of Dhulikhel Hospital.

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Radiofrequency Ablation for Varicose veins: Started in Dhulikhel Hospital on August 2013:
See details of the first patient series: 
https://www.ncbi.nlm.nih.gov/pubmed/27180370

Open Heart Surgery at Dhulikhel Hospital

See how we started: 

https://www.youtube.com/watch?v=LN2Iu19SePo


Open heart surgery first started in Dhulikhel Hospital on February 18, 2014 with open heart surgery of 6 years female with Atrial Septal Defect. This milestone was achieved by help of many national and international partners. Professor W.H.Kim and his team from Seoul National University, Korea gave lot of time and effort for training of our staff and help in the first cardiac surgical camp on February 2014.


Since July 2015, months after joining of senior Cardiothoracic surgeon, Dr. Mohan Devbhandari, open heart surgery started to be in regular basis with 2-3 cases every month.

(Photo on left: Dr. Mohan, with colleagues and team members from Cardiostart international performing open heart surgery), Photo courtesy: Parker Hilton Photography.


For this another milestone, cooperation from Nepali cardiac surgical team (Anesthesia, perfusion, surgeons, intensivist, nurses) from Shahid Gangalaal National Heart Center, Bansbari and Manmohan Cardiothoracic Vascular and Transplant center made a lot of positive impact. Our anesthesiolist Dr. Sangina Malla, cardiologist Dr. Rajendra Koju, Dr. Sanjaya Humagain, pediatric cardiologist Dr. Anish Joshi helped in each step of patients journey. Our perfusionists, scrub nurses, Cardiac ICU team and all the operation theater team are also important part of this team. 


In November/December 2015, Cardiostart international visited Dhulikhel Hospital for help in the open heart surgical program.  In December 2016, another senior Cardiothoracic surgeon, Dr. Sampurna Man Tuladhar was also associated with this program and with this growth, the program also started to grow in even rapid basis.  As of current date (Aprial 2016), the hospital has already performed 19 open heart surgical cases with very good results.On March/ April 2016, five team members of this unit visited Seoul National University of Korea for capacity building training program. 

Patient recovering from Open Heart Surgery in Cardiac Intensive Care Unit(CICU). CICU nurses along with incharge Rashmita Byanju have got on the job specialized training in Gangalaal National Heart Center, Nepal, Seoul National University, Korea and Glenfield hospital, UK.


Photo courtesy: Parker Hilton Photography.

Permission taken from the patient.

Members of Dhulikhel Hospital Cardiac surgical team and infection control with Prof. Dr. W.H. Kim (Center in the front) and Matron Bishnu Singh (Right in the front) during capacity building training at Seoul National University, Korea helped by Raphael international and J.W.Lee center of Global Health.

Left from behind are Asmita Bhuju (Perfusionist), Ashmita Shrestha (Scrub), Binita Paudel (Scrub), Roshani Shrestha (Perfusion) and Bedana Mahajan (Infection Control).  

Varicose vein treatment, state of the art at Dhulikhel Hospital


Of the many vascular ailments, one of the commonest condition is varicose vein which are prominent dilated veins usually in lower limb and more common in people with history of prolonged standing in their daily works.


Varicose vein, most recent surgical management: Radiofrequency ablation


Radiofrequency ablation (RFA) of great saphenous vein (GSV) has been found to have excellent results to conventional saphenofemoral junction ligation and segmental stripping in terms of long term disease free state. RFA works by causing  target tissue destruction by causing tissue necrosis by heating of the targeted tissue via the RFA probe.  RFA is done with catheter pull back technique with heating segment slightly longer than the pull back distance ensuring adequate overlapping. This is started about 2cm distal to saphenofemoral junction in the groin to the level usually just below knee. This procedure which has just started in Nepal since August 2013 in the tertiary level hospital, has already attained some popularity due to prompt recovery, less pain, less hospital admission days than conventional surgical procedure.  

Examples of presentations of varicose vein patients-->
Pigmentation and ulceration occurs in untreated patients

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dhulikhel hospital

OPD schedule

Every Monday and Wednesday

10-4, OPD no 5,

Dhulikhel hospital

011-490497

Hotline: 9801002478

The procedures are performed by trained vascular surgeon. This is done in operation theatre with the help of portable ultrasound machine. The catheters and radiofrequency generators are extremely advanced medical devices. The usual procedure time is about an hour. After taking rest for overnight, patient can be discharged the next day and can resume normal activities in 3-4 days.

Radiofrequency generator and catheter

Usual technique of burning of diseased vein
The catheter is inserted just below knee region.

State of the art P300 portable ultrasonography machine used during the operation

One week after the operation (permission for photography duly taken)