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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.
Cancer is the one of the biggest threat to the young Indian population because of the factors that cause cancer, but also due to late detection. However, certain bad habbits and the factors increase the risk of cancer in India.
Causes of cancer in India:
- Overpopulation and the problem of nutrition: As per records, India is the world's third most populous country. However, it lacks in resources to feed the multiplying number of mouths. Nutrition plays a key role in deciding the quality of a person's life. Nutrition has therefore emerged as an essential branch of research and medical care in the last few decades. Lack of nutrition directly results in weakened immunity. Your body becomes prone to diseases, some of which can be fatal. To fight off cancer cells, one must have a strong immune system that comes from the right kind of nutrition.
- Smoking is a recurrent habit among children and adults: Smoking can cause cancer. Every cigarette packet reads the same warning messages but it doesn't actually deter smokers in any way. Smoking is prevalent among people of all age groups in India. From poor children to conscious educated adults, all are seen smoking.
- A Tropical country and its woes: Tropical countries are known to face the wrath of the sun. While most places in central, western, partly eastern and southern India experience extremes of temperature in summer, other places with moderately hot summers are not exempted from the harmful UV rays. Ultraviolet rays can be very harmful for one's skin, as it can cause skin cancer. Indians have a high amount of melanin, which protects them against sun rays, but the threat exists nonetheless.
- The concept of fast food: A global economy has opened avenues awaiting your attention in the realm of food. To suit the tones and moods of a fast life, fast food has been made available to you. We take pride in consuming things that can be prepared in an instant: instant noodles, soups and even curries. Packaged food and junk food are sources of cancer cells.
- Lack of awareness regarding the most common types of cancer: Breast and cervical cancer are the two most common types of cancer eating away the health of Indians. The problem lies in being unaware about the root causes, symptoms and treatment procedures related to these kinds of cancer. Social repression turns health concerns into matters of insignificance. Women fear social alienation after coming in the open with their problems.
I have back pain L4. L5 problem fast in 5 years. I want to reduce pain with out operation is possible. Please Inform
I am suffering from disk and Knee joint pains for the past 10 years I have already done panchakarma treatment. There is no result? What can I Do?
Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.
Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer.
- The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
- The discharge of bloody fluid material from the nipples.
- Sudden change of the size, shape and appearance of the breast.
- Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
- Appearance of an extra nipple which is inverted.
- If the darkened area around the nipples known as the areola is flaking or peeling off.
Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.
Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.
Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.
My wife is suffering from slip disc I already have consulted orthopedic surgeon now, will homeopathy be more effective than doctors medicine. Please advise.?
I am a student. Usually I used to sit more than 8 hours a day in chair. Now a days I am feeling very much pain on regions of backbone and neck. Is this a chance of disk failure?
Lung cancer occurs at slightly younger age in women than in men. Adenocarcinoma is the commonest type of lung cancer in women. It warrants testing for some molecular markers which form the basis of targeted therapies. Thus lung cancer in women behaves biologically and clinically different from that in men
Women should take care of their health, stay away from tobacco and think positive
I want to know about exercises being done in case of diffuse disc bulge at l1-l2 level indenting anterior the cal sac mildly with bilateral mild neural foraminal narrowing.
I am 51 yrs. I am suffering from neck pain and headache last two years. My mri report says that c5-6 disc shows diffuse asymmetric bulge[more towards left side], causing effacement of anterior subarachnoid space and indentation of bilateral c6 nerve roots[left>>right]. Along with posterior osteophytes, it constitutes hard disc. What should I do? please help me.
What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.
Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own.
Why ICU pateint put on ECMO?
Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.
ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.
When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.
This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.
How long can someone stay on ecmo?
That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.
What is the difference between ecmo and a ventilator (breathing machine)?
Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.
Uterine fibroids are referred to as benign, abnormal growths which tend to develop in the uterine walls of a woman. The size of such growths can range from a few centimeters to even excess of a few inches. As such, they can cause the uterus to increase to the size of a five month pregnancy. Although, the symptoms of fibroids are not always apparent, they often cause heavy bleeding and pain in women. A recent research concluded that around 60 to 75 percent women contract such fibroids by the age of 50, at least once in their life.
Depending on the site of formation, uterine fibroids are distinguished into different types. Intramural fibroids in the lining of the uterus and subserosal fibroids which develop outside the uterus are the most commonly observed fibroids.
What causes Uterine Fibroids?
Although, the exact reason for the formation of fibroids are obscure, medical professionals have determined certain factors that may affect their formation. Some of them are:
1) Hormones: Progesterone and estrogen, produced by the ovaries regenerate the uterine lining during each menstrual cycle and trigger the growth of fibroids.
2) Family history: If you have had a family history of uterine fibroids, then you're likely to develop the condition yourself as well.
3) Pregnancy: The production of progesterone and estrogen increases during pregnancy which increases the likelihood of fibroids.
What are the signs of the condition?
Depending on the location and size of the tumors, symptoms of such fibroids include:
1) Heavy bleeding and blood clots during periods
2) Pain in the pelvis
3) Frequent menstrual cramps
4) Pressure and pain in the lower abdomen
5) Swelling in the abdomen
6) Pain while intercourse
What is the procedure of the treatment?
Ultrasound and pelvic MRI are common diagnostic procedures to check for uterine fibroids. After diagnosis, depending on your age, size of the fibroid and your comprehensive health, the doctor would prescribe you with appropriate medications. Only after medications prove futile, doctors opt for minimally invasive surgeries. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Hello, I have very much pain in L5 S1 spine from last 2 months. MRI report says: "Annular tear of l5-s1 disc with diffuse posterior bulge, central & right para central prolapse & mild inferior migration of the prolapsed fragment causing compression of right exiting nerve root. Please suggest me what I do? Pain is very much. Should I go for surgery or any other option available. If surgery then how much time time required to recover & what is accuracy of surgery treatment. Thank you.
I have been diagonosed for Lumber region disc displacement/compression in L1-L2-L3-L4.Though I have been taking homeo medicine for past 8-9 months, the pain subsidise for some days but comes back again at lower back and down the right leg thighs,knee and calf muscles. Sometimes it is also on left leg side. Can I restart tretment again. Prescribe some medicines and other preventive treatment to correct this defect
Sir I am suffering from disc problem symptoms are: Hands and chest become pain and fire can I have solution.
Breast Augmentation is the most popular plastic surgery procedure performed worldwide.
Breast augmentation can enhance your appearance and your self-confidence, enlarging your breasts and making them more proportional with the rest of your body. Breast augmentation can also be used to correct differences in the size of your breasts or sagging breasts, which can occur after pregnancy and breastfeeding.
There are many choices and options in breast augmentation, which require careful planning to individualize what are the best options for you. All of these choices have advantages and disadvantages, which you should understand before you make a decision with your surgeon.
Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision.
Most patients choose silicone implants rather than saline implants because they have a more natural look and feel. Modern silicone implants are substantially different from the old type of silicone implants used in the 1970s and 80s. Another advantage of the cohesive gel silicone implants is that they are made in a variety of round and tear-drop shapes, which means it is easier to choose an implant to achieve the breast shape that you desire.
Misinformation emerged about silicone in the late 80's and early 90's. The effects of silicone implants have since been studied extensively these claims were made, looking at 100,000s of women with breast implants. In June 1999, The Institute of Medicine at the National Academy of Sciences in the U.S.A. released a report, which confirmed that there is no increased risk of the development of cancer, immunologic or neurological problems associated with the use of silicone breast implants, which had been claimed in the late 80's. Patients with implants can breastfeed normally as there is no effect on breast milk.
Breast augmentation surgery requires a general anaesthetic, with the operation taking 1-2 hours, and is usually performed as a day-stay or overnight-stay procedure.
Implants are placed either behind the breast tissue or under the pectoralis muscle on the chest wall. Breast implants placed underneath the muscle have a more natural shape, a lower chance of capsular contracture (hardening) of the implant, and it is easier for mammography. There is also a choice of incision - in the crease under the breast, under the areola or in the armpit, all of which have advantages and disadvantages, which you should discuss with your surgeon.
Following the surgery, it is important to have restricted light activities, with no lifting or heavy duties for 7-10 days. Most patients may drive again and return to work within 7 days after the surgery. Heavy activities and sport should not be undertaken for 3-4 weeks following the surgery. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Dear sir For last 1month I am suffering from severe pain in L5S1 region in lower back .done MRI also n compression is seen. Now what precautions should I take on daily basis as I m on bed rest for last one month..
Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.