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Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
In the CT chest scan they found ground glass opacities in lower libs of the both lungs. And the possibility are INFECTIVE ETIOLOGY/PNEUMONIA/pulmonary HEMORRHAGE. Is it leads to lung cancer?
Are you experiencing excruciating headache? you probably didn't know but you could be suffering from brain aneurysms. It is described as bulge formation in the blood vessel in the brain. It is a totally asymptomatic condition as one does not display any symptoms until the bulge vessel ruptures which may result in blood releasing in the skull which may further lead to a stroke. The bulge is often formed in the gaps between the tissues covering the brain and brain itself.
Most common treatment options for ruptured aneurysm
There are two common treatment options for a ruptured brain aneurysm endovascular coiling and surgical clipping. Both these procedures have certain risk factors, therefore it is best to discuss the details with a neurologist. The endovascular coiling is a less invasive process where the surgeon inserts a hollow tube or catheter into an artery and threads it through the body to reach an aneurysm. Then a guide wire is sent to push a soft platinum wire through the catheter. This coils up and disrupts the flow of blood into the aneurysm and leads to blood clotting. The clotting is essential in sealing off the aneurysm from the artery.
The surgical clipping is a process used for closing off the aneurysm, and a section of the skull is required to be removed for assessing the affected part. It also helps in locating the blood vessel that is responsible for the problem. Finally, a metal clip is placed on the neck of the aneurysm to stop the flow of blood. Though endovascular coiling is less invasive and said to be safer, adequate post-treatment care is necessary to minimize risks.
To treat larger aneurysms, a treatment called flow diverters may be useful. Since, the treatment is decided based on the size, location, apperance and your health condition, your doctor will be the best person to take the final call.
Other procedures to treat symptoms
Other than the surgical procedures several treatments might be prescribed to treat the symptoms and to manage complications. A few commonly advised treatments are:
- Pain relievers: To manage headaches
- Calcium channel blockers: One of the most common complications that may arise with an aneurysm is calcium entering the walls of blood vessels which may result in narrowing of walls. Calcium channel blockers are medications may be prescribed by the doctors to deal with the complication
- Anti seizure medications: Medications such as levetiracetam, phenytoin, valproic acid, and others are prescribed to treat seizures associated with aneurysms
- Procedures to prevent stroke: An insufficient blood flow may result in a stroke and to prevent it, the drug vasopressor is injected intravenously, or angioplasty is performed.
- Rehabilitative therapy: Damage to the brain may require the patient to undergo several physical and occupational therapy.
If you suffer from the condition, it is advised to keep a check on the blood pressure and quit smoking as they can help in reducing the risks associated with aneurysms.
In case you have a concern or query you can always consult an expert & get answers to your questions!
We are planning for PLDD surgery for my mother. I wanted to know if it's safe and a lifetime surgery. Also what's the cost included in this if it's done in india.
Breast cancer is the form of cancer that occurs from breast tissues in women. Signs of breast cancer may include a lump in the breast, changes in the shape of the breast, dimpling of the breast skin, a fluid coming out of the nipples or development of red scaly patches on the skin. There might be pain in the bones, swollen lymph nodes, shortness of breath, or the skin turning yellow and pale.
Breast cancer is a fatal mode of cancer in women, and one must try to abstain from this cancer in all possible ways. Here are 5 ways you can decrease the risk of breast cancer.
- Keeping a check on your weight: Although the process is tough to maintain, keeping up a sound and healthy weight is a critical objective for everybody. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause in women. Exercise is very important for maintaining a healthy body and lifestyle. Women who exert physically regularly are fitter than others and are at a much lower risk of acquiring diseases of any kind. Regular exercise decreases the chance of getting breast cancer and also keeps the body weight in check.
- Maintaining a healthy diet: Maintaining a healthy and balanced diet is a key for keeping away from any kind of cancer or major health problem. Include a sufficient amount of fresh fruits and green vegetables in your daily diet to ensure the supply of all vital nutrients to your body. This would increase your immunity.
- Avoid smoking and consume less alcohol: Smoking is a very unhealthy and harmful habit. Smoking lowers the quality of your life, and causes numerous diseases. Heart diseases, stroke and many kinds of cancer, including breast cancer can be caused from smoking. If you drink alcohol, you should moderate your drinking habits and drink less, as drinking in excess may lead to breast cancer.
- Practice breast feeding: Breast feeding your children for a span of one year or more is likely to reduce the risk of breast cancer.
- Avoid taking birth control pills: Birth control pills, in spite of having several benefits are associated with risk factors as well. Birth control pills have got worse effects in younger women than older aged women. Using birth control pills may cause breast cancer and these pills should be avoided.
There are many ways, adapting which you can lower the chances of getting breast cancer. If you wish to discuss any specific problem, you can consult a gynaecologist.
The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.
The causes of uterine prolapse are varied and include:
- Delivering a large baby
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area
Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.
Symptoms of moderate or severe prolapse are:
1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels
Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Lung cancer is the cancer killer of both men and women in the U.S. When you think of risk factors for lung cancer, what comes to mind? Most of us think about the risk associated with smoking cigarettes, but did you know that air pollution can also cause lung cancer? Overwhelming evidence shows that particle pollution in the outdoor air we breathe—like that coming from vehicle exhaust, coal-fired power plants and other industrial sources can cause lung cancer. Particle pollution increases the risk of dying early, heart disease and asthma attacks, and it can also interfere with the growth and function of the lungs.
What is particle pollution?
Particle pollution is a mix of tiny solid and liquid particles in the air and can be made up of a number of components, such as acids, organic chemicals, metals, soil and dust particles. It can be emitted directly from wood stoves, forest fires, vehicles and other sources, and it can also form from other types of pollution that come from sources like power plants.
Why does particle pollution harm our bodies?
While breathing in larger sizes of particle pollution can be harmful to our health, smaller particles are more dangerous. Bigger particles can irritate your eyes, nose and throat, but our natural defenses help us to cough or sneeze them out of our bodies. Unfortunately, those defenses don't keep out smaller particles, which get trapped deep in the lungs and can even get into the bloodstream, causing damage to our health.
Who is most at risk?
As for who is at risk for health problems from breathing in particle pollution. Those who live where particle pollution levels are high is at risk. Some people face higher risk, including children, the elderly, people with lung and heart disease and diabetes, people with low incomes, and people who work or exercise outdoors.
How do we protect ourselves from particle pollution?
Check the air quality index forecast for the day and limit your activity if pollution levels are high. Avoid exercising along heavily traveled highways regardless of the overall forecast.
As individuals, we can play our part in reducing air pollution levels by trying to avoid creating more of it. Choosing ‘active travel’ options where possible, like walking and cycling, can help reduce pollution levels from transport and is also a great way to be more active, which is linked to a reduced risk of cancer and other diseases.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.
Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A fragmented prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.
Risks: The risks of this condition are many and have been enumerated as follows:
- Complicated delivery during pregnancy
- Weak pelvic muscle
- Loss of tissue after menopause and loss of common estrogen
- Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
- Being overweight
- Obesity causing extra strain on the muscles
- Real surgery in the pelvic zone
Symptoms: Some of the most common symptoms of prolapse involve:
- Feeling of sitting on a ball
- Abnormal vaginal bleeding
- Increase in discharge
- Problems while performing sexual intercourse
- Seeing the uterus coming out of the vagina
- A pulling or full feeling in the pelvis
- Bladder infections
Nonsurgical medications include:
- Losing weight and getting in shape to take stress off of pelvic structures
- Maintaining a distance from truly difficult work
- Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
- Taking estrogen treatment especially during menopause
- Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
- Indulging in normal physical activity
Some specialists use the following methods to diagnose the problem:
- The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
- Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
- An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves. If you wish to discuss about any specific problem, you can consult a Gynaecologist.