The  Roux en Y Gastric Bypass  surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the  Gastric Bypass  or the  Roux en Y Gastric Bypass . Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that  Is this possible . The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that,  Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?  The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card   The  Roux en Y Gastric Bypass  that helps the :

 Morbidly Obese  (BMI >37.5) to lose significant weight and reach their ideal weight.
 Obese  (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
 Type 2 Diabetics  (BMI > 27.5) to get Remission from type 2 Diabetes.
 Metabolic Syndrome  (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.
Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

Prostate cancer is one of the most common cancers that men are diagnosed with. It is accompanied by a number of difficulties of urination and ejaculation. It can also cause difficulty in achieving and sustaining an erection. If cancer advances and affects the bone structure and the spine, it can cause weakness in the limbs, and also result in urinary and fecal incontinence. If it is diagnosed in its early stages it can be treated quite easily before it spreads.

Treatment for Prostate Cancer-
Prostate cancer generally does not show any symptom in the early stage but progressively degenerates with time. If you suspect having any of the symptoms of prostate cancer such as urination difficulty, erectile dysfunction and discomfort in the pelvic region, then consulting an oncologist is the next step. Your doctor will perform certain diagnostic tests like digital rectal examination (DRE) and prostate-specific antigen (PSA) test. After the diagnosis of prostate cancer, doctors generally check the stage and rate of growth of a tumour by determining its Gleason score.



Once the extent of the prostate cancer is known, a treatment plan is devised by the doctor. If the cancer is localised and small, your doctor will either prescribe active surveillance or surgery. During active surveillance, there is a blood test, rectal examination, and biopsies on a regular basis to monitor the growth of a tumour. However, the tumour can also be deftly removed with surgical intervention in the form of Radical Prostatectomy. There are two types of radical prostatectomy- laparoscopic prostatectomy and robotic laparoscopic prostatectomy

Robotic Radical Prostatectomy-
A radical prostatectomy is one of the most common methods of treating prostate cancer. It involves the surgical removal of the prostate gland along with some of the surrounding tissues. This curtails the spreading of the cancerous cells to other parts of the body. A robotic radical prostatectomy is a minimally invasive procedure that involves the use of a robotic instrument that is controlled by surgeons to make the removal of the gland precise and efficient. The surgeon controls the robot by sitting at a console and makes several small incisions to enter the abdomen. This procedure reduces the risks of blood loss and any possible side-effect that includes erectile dysfunction and urinary difficulties.

Robotic Radical Prostatectomy For Cancer Prostate!

Ovaries are a part of a woman s reproductive system. The primary function of ovaries include producing  ova  or eggs and secreting hormones such as progesterone and estrogen. Cysts are fluid filled sacs that form the ovaries; they usually do not cause any symptom and are not painful.

There are primarily two types of ovarian cysts:

1. Follicle cysts: During a woman s menstrual cycle, the egg develops in a sac known as the follicle. Under normal circumstances, the sac breaks open and releases the egg. When this doesn t happen, fluids start accumulating in the follicle to form a cyst.

2. Corpus luteum cysts: Follicle sacs dissolve after releasing the egg, but in some cases, these sacs remain and the opening of the sacs gets sealed. It again results in fluid accumulation, leading to the formation of corpus luteum cysts.

Symptoms

Usually, cysts do not cause any symptom. If the size of the cysts increases, they may cause symptoms such as stomach pain, pain during bowel movements and sex as well as pelvic floor pain. The breasts may become tender and one may experience rapid breathing. Other symptoms of ovarian cysts are fever, nausea and dizziness. Usually, rupturing of a cyst leads to these symptoms surfacing; hence you would know when exactly to call the doctor.

Treatment

The treatment options for ovarian cysts are:

Laparoscopy: Laparoscopy is carried out if the cysts are small in size. An incision is made close to the navel, through which an instrument is inserted to get rid of the cyst.
Birth control pills: For chronic ovarian cysts, oral contraceptives are prescribed to stop the ovulation process in order to arrest the formation of cysts.
Laparotomy: In case of large cysts, this procedure is recommended. A relatively bigger incision is made in the abdomen, through which the cyst is removed.
Ovarian cysts, if left untreated, can certainly cause infertility. Pre-menopausal women and who suffer from frequent hormonal imbalances in the body are the most vulnerable to this condition.

Ovarian Cysts - 3 Ways it Can Treated

When dieting and exercising fail to help an obese person in managing his/her weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within the first 6 months following which there is a slower weight loss over the next 6 months.

A gastric sleeve surgery is a relatively safe and short duration surgery. Prior to the surgery, you would have been given a special diet to be followed, the duration varies between one week to two weeks. It is essential to follow this diet strictly. This surgery may be performed laparoscopically, through tiny keyholes. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. This surgery is not reversible. 

Recovery from a gastric sleeve surgery is quite smooth and varies from person to person. A certain amount of pain and discomfort is normal for the first and second day following the surgery. The patient is put on clear liquids for the first 2 weeks following surgery. Soft foods are introduced in week 3 and 4. You can get back to small amounts of your normal food in week 5. You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. In some rare cases, your food may also be emptied into the small intestines at a very fast rate. This is known as dumping syndrome. This may cause diarrhea and nausea and leave you feeling weak. It is essential to drink plenty of water to allow for smooth bowel movements and to prevent constipation.

On an average, this surgery can help people lose between 60 to 90% of their excess body weight. However, this requires control over your diet and the amount of exercise you do. At some point in time, your weight loss may plateau. This is normal to overcome this, you must make a change to your diet or exercise schedule. A dietician can also help you address the right number of meals needed by your body. It is very important not to fall back to your earlier unhealthy lifestyle and to maintain a positive attitude.

Gastric Sleeve - Understanding The Course Of It!

Hernia surgery is performed for the correction of a hernia which refers to the bulging of internal organs or tissues through an abnormal opening. It is easy to detect hernia through any pain or discomfort while lifting heavy objects, cough and strain during urination or bowel movements or during prolonged standing or sitting. It can be found in both men and women. The Hernia can be congenital or can be developed over a period of time. If it doesn t get better over time and also does not go away by itself, then surgery becomes the only option.

Types of Surgery
There are two types of surgery for hernia treatment. One is the conventional open method, which requires an incision in the skin directly over the hernia. The other one is the Laparoscopic hernia repair in which surgery is performed using a small telescope known as a laparoscope. In this type of surgery minimal invasions are made and the hernia is repaired with only small incisions adjacent to the hernia. Most hernia operations are performed on an outpatient basis, which means that you can go home the very same day.

Tips for early recovery

    Wear comfortable clothing with expandable waistbands.
    Keep yourself active by moving around as much as you can as it increases circulation, which further speeds up healing.
    Eat a diet rich in fibre, fresh fruits and vegetables.
    Drink lots of water and other fluids to avoid constipation.
    Do not lift any objects even if it is very light as it can bring back pain.
    Do not to pick up things from the floor as it will be difficult to bend.
    Hold a pillow against your stomach while sneezing or coughing to lessen the pain.
    Use stool softener for a few days before and after surgery to help you with your bowel movements.
    Avoid driving till the time you feel any pain and as long as you are taking narcotic pain medicines.
    Band-Aids which cover the incisions should be changed as and when needed.
    Refrain yourself from intercourse as it can be painful.
    Check with your doctor when to take a shower so as not to hurt your incisions, and make sure to gently dry your incisions and replace the Band-Aids after taking a shower.
    Do not consume any alcoholic drinks for at least 24 hours.

The tips mentioned above will definitely provide help to cope up with post surgery blues. However, in case of fever, excessive sweating, difficulty in urinating, bleeding or any prolonged pain consult your doctor immediately.

Hernia Surgery - 13 Tips to Help You Recover from it

Washing your skin with water is something that you probably do daily, but you may not know at what temperature the water should be. Using water at the correct temperature is advantageous for the skin. Water at extreme temperatures is harmful for the skin as your skin is not designed that way.

The temperature of the water should also depend on the purpose for which it is being used. Here are some tips on how to set the temperature of the water depending on the purpose: 

1. Showering: while showering, if you are using hot water, then it may strip your skin of its essential oils and make it vulnerable to dryness. This may cause various skin complications, such as cracked and rough skin. Hence, use lukewarm water while you shower.

2. Washing your hair: using hot water to wash your hair may lead to hair damage as it rids your hair of all the essential oils and makes it limp and dull. Lukewarm to normal water is recommended while washing your hair as it will allow the hair to retain its natural oils.

3. Brushing: the right temperature of water while brushing your teeth should optimally be lukewarm. Too cold or hot water can lead to teeth sensitivity and cause oral problems.

4. Washing your face: before you apply a cleansing agent on your face, use warm water to wet the face as it helps to open up your pores. After the cleansing agent is applied, then use cold water to wash your face. Cold water helps in closing the pores after the impurities are removed from the skin.

5. Shaving: if you are going to shave, then opt for warm water as it opens the pores up and thus makes it easier for the blade to glide through the skin. This also reduces the risk of razor burns on your skin.

6. Washing your feet: wash your feet with lukewarm water as it facilitates dead cell removal and also helps in getting rid of warts.

Hot vs Cold: Which Water Temperature is Best for Your Skin

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