Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

Laparoscopic Surgery For Cholecystectomy - Who Should Go For It?

The abdomen houses multiple organs and pain in the abdomen could indicate a problem with any of these organs. From a medical point of view, the abdomen and associated pain can be divided into nine areas or quadrants the right, middle and left sideways and the upper, middle, and lower quadrants from top to bottom. The doctor would usually ask the patient to point to the area of the problem for instance, right lower quadrant or upper left quadrant.

With a mental mapping of the organ in each of these quadrants, the diagnosis is arrived at, with confirmation by imaging if required. Some of the most common causes for lower abdominal pain are listed below, and the kidneys are important organs in this area.

Lower left abdominal pain is caused because of the problems in the large intestine, small intestine, spleen, left kidney, ureter, ovaries, fallopian tube, urinary bladder and their associated structures.
Some of the common issues in this area could be menstrual cramps, urinary tract infections (UTIs), left kidney stones, uterine disorders, intestinal obstruction, ectopic pregnancy, constipation, colon cancers, pelvic inflammatory disorder, Crohn s disease, inguinal hernia, and a ruptured spleen.
Lower right abdominal pain can be due to appendicitis, right inguinal hernia, UTI, right kidney stones, colon cancer, menstrual cramps, uterine disorders, intestinal obstruction, ectopic pregnancy, pelvic inflammatory disorders, diverticulitis, Crohn s disease, endometriosis, and lymph node inflammation.
As is evident from this list, many of these are related to the urinary tract and kidneys. Whether it is the kidneys per se, the urinary bladder, the ureters, or the associated nerves and blood vessels, UTIs are very common. And if one of these organs is affected, then the chance of the infection spreading to the surrounding organs is very high. There is a constant flow of urine through these structures, and so the infection can pass through easily.
A person who has had kidney problems would have very characteristic symptoms. The pain would be in the lower back, on either side of the spine, depending on which side is affected. While the pain experienced due to kidney stones is acute and can be stabbing in nature, the UTI would appear in bouts. The associated symptoms should always be kept in mind when identifying and treating kidney problems.
There could be nausea, diarrhoea, blood in the urine, fever, profuse sweating and severe fever, which could help in discovering the problem.
These should not be ignored and diagnosis should be confirmed with blood tests and imaging including X-rays and CT scans. The treatment would depend on the condition, and early identification of the problem leads to better prognosis and a simpler treatment.

Lower Abdomen Pain - Can It Be A Sign Of Kidney Problem?

Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

Measures to be taken before surgery for fast recovery from Abdominal Surgery.

Ancillary measures

Take regular walks several times daily to prevent blood clots and help the bowels moving.
Avoid climbing the stairs every day, at least for the first ten days. 
Avoid strenuous exercise such as lifting, carrying, pulling, or moving heavy objects (more than 5 pounds) until your surgeon advises as it may open the sutures due to pressure. Avoid lifting anything over a certain weight for at least six weeks after your operation.
Maintaining a good posture will help your wound heal correctly. Use a comfortable pillow while sitting to give rest to the operated site.
Take good sleep and proper rest for a quick recovery as most of the repair and healing occurs during sleep.
Avoid straining with bowel movements by eating a high-fiber diet or taking stool softeners to avoid constipation.
An abdominal binder can also help with the recovery process. These help keep everything in place and can decrease the possibility of a hernia.
A gradual return to work may be advised because sudden resume to work may cause opening of sutures and delay the process of healing.
Use table that easily wheels away from the bed but can also straddle the bed. This will allow you to read, use the computer, and eat without putting any pressure on your stomach or twisting around.
Cough and sneeze carefully by applying pressure to the incision with your hands or a pillow to avoid reopening of the surgical incision.
Improper dressing or not maintaining hygiene during dressing and keeping dressing unchanged for a longer period of time may lead to infection which may cause delayed healing. Thus, in order to prevent this a gentle wash with soap and water is required to avoid infection.
Dietary measures

A protein-rich diet should be consumed in order to hasten wound healing.
Have a liquid diet with lots of vitamins as vitamin C and zinc help with healing. Also, include B12 and Iron   as both aid bone marrow in forming new blood cells.
Intake of Fiber and probiotics help boost the immune system and also keeps your digestive tract moving along.
Have plenty of water-this will help the recovery process and removal of toxins from the body.
Try sitting in the sunlight as it will help with getting some extra Vitamin D.
Keep control over sugar levels if you are diabetic as increased levels of sugar in the blood helps bacteria to grow rapidly. This will further lead to infection and delay the process of healing.

Abdominal Surgery - Recovery Tips!

The outcome and the procedure of an abdominal laparoscopic surgery vary among patients. The extent of the surgery, the length of the procedure, the surgeon, the hospital nursing staff, and a number of other factors vary with each patient.

Moreover, the recovery or the healing time also varies among patients. What applies to one patient may not apply to another. Generally speaking, surgeons will tell you that it takes only a few days to recover from a laparoscopic surgery, but this is not true to specific cases as in many cases, the recovery time has been longer than expected. So, a laparoscopic surgery is subjective to the health of the patient and the extent of the procedure; however, there are some tips that may prove to be helpful for you to deal with a laparoscopic surgery and to improve your healing process.

Here are some useful tips that you can follow before the surgical procedure.

After you have consulted your doctor and made up your mind on the procedure, then it will be useful to watch some surgery videos and read about the procedure to prepare yourself mentally. The videos can be gory and hence discretion must be maintained.
You can read blogs by patients who have undergone laparoscopic surgery to get a better understanding of the procedure and its implications.
Eight hours prior to the procedure, do not drink or eat anything.
Ask someone to accompany you on the day of the procedure.
Make sure that you fix a pre-op appointment with the surgeon to clear any doubts about the surgery, anesthesia or any such concern.
You can shave the part of your body where the surgery will be performed by yourself or be prepared for someone else to do the same at the hospital.
Prepare your hospital bag with the necessary items and inform the person accompanying you about the items in your bag.
Here are some useful tips that you can follow after the surgery.

Keep yourself active after the procedure to enhance the healing process and to relieve any flatulence.
Stick to comfortable clothing and preferably loose clothes.
Avoid taking a bath for a week or as advised by your surgeon.
To avoid constipation and to stay hydrated drink at least 2-3 liters of water a day.
Hold a pillow against your stomach to lessen the pain while sneezing or coughing.
Don t get up straight from your bed. Roll sideways and use the support of your arm to stand up.
Avoid driving for at least 2 weeks.
Go for regular check-ups with your surgeon or doctor to ensure that the incisions are healing properly.

Tips To Deal With Abdominal Laparoscopy!

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