Surgeons perform the Laparoscopic Cholecystectomy Procedure when there is an obstruction to the flow of bile from the gallbladder to the digestive system. This may happen due to the formation of stones in the gallbladder. 

In case there is stone in the gallbladder, it calls for the removal of gallbladder. If the gallbladder is not removed, it may give rise to abdominal pain, nausea, vomiting, pain in the shoulder, arms, etc. It may also lead to jaundice and infection and put the pancreas in difficulty. The gallbladder removal procedure can be carried out through the Laparoscopic Cholecystectomy.

In this procedure, the gallbladder is removed from the abdomen through small incisions using a laparoscope and other surgical instruments. A total of five incisions are made into the abdomen.

Role of Gallbladder and Why Laparoscopic Cholecystectomy is Needed?

The gallbladder is a pear-shaped organ located at the right side of the liver. It helps the digestive system of the body. The gallbladder stores the bile juice made by the liver. This bile juice helps in digesting the fat. If there are stones in the gallbladder, it can block the flow of bile fluid, which affects the functionality of digestive system. This problem is known as Gallstones. A Laparoscopic Cholecystectomy is performed when there is a stone in the gallbladder.

What Is a Laparoscope and How Is It Used?

A laparoscope is a narrow tube-like structure that carries a camera in front of it. This instrument is inserted through a small incision and the doctor manipulates it to view the targeted area clearly. He can view the area clearly on the monitor. Surgical instruments are then inserted through other incisions, and the gallbladder is removed.

The Procedure:

Before the procedure, the patient is administered with general anesthesia. This relaxes the muscles and prevents pain. The patient falls asleep and the doctor carries out the procedure. Carbon dioxide is inserted into the abdomen to inflate it. After this, a small incision is made in the navel and the laparoscope is inserted through it. The surgeon may also perform an X-ray to confirm the existence of stones in the common bile duct. Once he is confirmed about the existence of stones, he inserts surgical instruments through other incisions. The surgeon removes the gallbladder through these incisions.

What Are the Benefits of Laparoscopic Cholecystectomy Procedure?

There are many benefits of Laparoscopic Cholecystectomy over open gallbladder removal:

The patient suffers less discomfort compared to regular surgery.

The patient also needs to stay in the hospital for a lesser number of days as compared to open surgery.

The patient also suffers smaller tears as compared to open surgery.

Risks of Laparoscopic Cholecystectomy:

The risk of complications is low in a laparoscopic procedure. However, there are still some risks, that include:

Infection

Business

Injury to the common bile duct

Shoulder Pain

Leakage of Bile

Conclusion:

Laparoscopic cholecystectomy has become a popular option for patients suffering from gallbladder stone. Surgeons often suggest this procedure so that patients can recover quickly and there is minimal bleeding. However, the laparoscopic surgeon must be experienced to perform this type of surgery. An experienced laparoscopic surgeon can ensure that there are minimal bleeding and little risk of other side effects during the procedure. The patient must be able to recover quickly and get back to his routine.

Laparoscopic Cholecystectomy Procedure!

The prostate is a vital organ that located between the penis and the bladder. The prostate is involved in the release of the prostate fluid that keeps the sperm properly nourished. Prostate cancer, as the term indicates, is characterized by the abnormal and uncontrolled growth of cancerous cells in the prostate. Though the incidences of prostate cancer are low in India, necessary precautions and diagnostic steps should be carried out to prevent the condition from jeopardizing our lives.

Prostate screening includes two tests known as the Digital Rectal Exam (DRE) and Prostate-Specific Antigen test (PSA). PSA combined with DRE helps to identify prostate cancer at a very early stage. If any of the tests show an abnormality, a doctor might prescribe an ultrasound such as MRI Fusion or Prostate Biopsy to confirm the diagnosis.

Immediate treatment may not be necessary
For low-risk prostate cancer, doctors often recommend active surveillance that includes periodic blood tests, rectal exam, and biopsies.
Active surveillance helps a doctor to continuously track the growth of cancer cells and the possibility of their spread to other areas of the body.
Surveillance is fit for those who are already suffering from a serious condition or for those patients who are above the age of 60.
A surgical procedure to remove prostate cancer
Surgery is considered when the cancer has metastasized to surrounding tissue and the lymph nodes. There are two kinds of surgeries that a patient can go through- a Robot-Assisted surgery and a Retropubic surgery.
Radical Prostatectomy might have risks involved. It is, therefore, wise to discuss the pros and cons of the surgery with the doctor well in advance.
Understanding the treatment options

Radiation therapy: Radiation therapy involves the use of high-powered and high-frequency energy beams to kill cancer cells. Radiation therapy is often used to shrink the size of the cancer cells. There could be two types of radiation therapy-Brachytherapy and External beam radiation. Radiation therapy too can have its side effects. Doctors prescribe several medicines during therapy.
Hormone therapy: Hormone therapy helps to stop the production of a male hormone known as testosterone. This treatment option includes medication that completely stops the production of testosterone, the medications may also block the flow of testosterone on the cancer cells, and surgery to remove the testicles. Hormone therapy is used in advanced cancer stages.
Chemotherapy: Chemotherapy is a drug that goes into the body and kills rapidly growing and metastasizing cancer cells. It is administered through IV (intravenous), or orally as pill or both. This treatment option is employed when cancer spreads to a remote body location and does not respond to hormone therapy.
Biological therapy: Biological therapy involves the usage of the body s immune system to fight cancer. A type of biological therapy known as the sipuleucel-t is used to treat patients with advanced cancer stage and recurring cancer as well.

Prostate Cancer - How Biological Therapy Will Help?

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

Bathing soap vs. Body wash: what's better when you take a shower?

The most important part of skincare is keeping your skin cleansed and fresh. But before that, it is imperative to find the right product for the same. Skin type varies from person to person, and hence finding skincare goods most suited to your skin makes all the difference.

Bathing habits directly affect the quality of your skin, which involves picking the appropriate cleanse; i. E. Choosing between a body soap and body wash. Each has a different set of characteristics and comes with its own set of advantages and disadvantages. Let's find out which one is better for your skin.

Why you should choose bathing soap bar:

 it is more effective in removing dirt through deep cleansing

 it is suited to skin that is excessively oily in nature as it contains ingredients that are highly effective in stripping off excess oil from the skin

Why you should not choose bathing soap bar:

 it tends to strip the skin of its natural oils and moisture, making it dry and flaky

 it is unhygienic in case of sharing between individuals as soaps tend to accumulate the dirt from your skin due to direct body contact

Reasons to pick a body wash:

 it has a very mild and gentle effect on the skin in comparison to soaps

 it keeps the skin moisturized by preserving natural oils

 it is more hygienic than bar soaps in case of interpersonal sharing

 it is the most suitable option for dry skin

Reasons to ditch a body wash:

 it contains a large amount of artificial additives and preservatives that can do more harm to your skin than good, giving rise to allergic reactions in some cases

So, who's the winner of the two?

You must certainly base the choice on what's best for your skin type. Body soap is more compatible with oily skin while dry skin is better suited for body wash. A body wash, however, is much more gentle on your skin. 

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Soap Vs Hand Wash - What Should You Wash Your Hands with?

Bathing Soap vs. Body Wash: What's Better When You Take a Shower?

Breast examination is a way of detecting early changes that help in detecting lumps or other growth in the breast. This is a manual form of examination that may be carried out by the doctor or even by the patient. This kind of examination helps in detecting the onset of breast cancer and helps in successful treatment of the same. It is an essential screening strategy that all women must go through. Let us cast a glance on the various details regarding this examination, and also how frequently it must be conducted.

Age: Women who have reached the age of 18 are said to have matured physically and sexually. They should perform this examination once they have reached the said age in order to detect any anomalies in the way the physical changes occur in the breast tissue.
Procedure: One should begin by looking at one's reflection in the mirror to find any rashes or dimpling in the breasts. The shape, size and colour of the breasts and nipples must also be studied so as to check for any anomalies. Inverted nipples, redness and soreness must also be reported to the doctor. Once you are done checking the visuals, you can raise your arms and look for any changes. Then, you will need to lie down and feel your breasts by using a circular motion. The finger pads must be used in order to check for any lumps. One must start from the centre and move the breasts sideways. Any wet and slippery feeling must be reported to the doctor immediately.
Pressure: During the breast examination, you must use light pressure for the skin and tissue that lie beneath the breasts, while medium to moderate pressure should be used for the middle portion of the breasts. One must use a firm hand to check the tissue that lies at the back of the breasts, near the rib cage.
Frequency: One must get into the habit of conducting a breast examination at least once a fortnight or once a month, without fail. You can also go to the gynaecologist for an examination in case you are not confident of conducting it on your own with proper movements and accuracy. You may also journalise your breast examination findings.
Menstrual Cycles: When you are going through your menstrual cycle or period, it is important to remember that your breasts can become tender just before or after the start of the cycle. So, do not panic if you think you have found a lump or any other growth at this time. It is best to check again after a week and then visit the doctor about checking the same.

How Frequently Should a Breast Examination Be Done?

Ovarian cysts are fluid-filled sacs that develop on a woman's ovary. A patient might experience abdominal and pelvic pain, abnormal bleeding, menstrual irregularities, pain during intercourse or irregular bowel movements. These symptoms indicate an ovarian cyst developing inside you. Ovarian cysts are common in women and may develop during menstruation. In many cases, symptoms are not observed, and you may get ovarian cysts without knowing. Usually being harmless, ovarian cysts may sometimes lead to severe health conditions.

Here are 7 important things you should know about ovarian cysts:
1. You should know the reason behind the formation of ovarian cysts. When the follicle does not release the egg, it may grow bigger in size and take the form of a follicular cyst. A corpus luteum cyst may also develop, which is a cavity that gets formed after the egg is ruptured and released from the follicle. The cysts may bleed and cause pelvic pain.

2. It is important for you to know if you have an ovarian cyst. Many ovarian cysts do not show symptoms and go away by themselves. Follicular cysts do not change your menstrual cycle, but corpus luteum cysts may cause bleeding.  

3. You should know how to detect an ovarian cyst. You should visit a gynecologist regularly for diagnosis. Bigger cysts can be diagnosed via a pelvic examination. Ultrasound is also used for detection.  

4. You should have an idea about all the symptoms associated with ovarian cysts. These include fever, nausea and vomiting. These symptoms indicate that you have an infection. Sometimes, a cyst might twist an ovary, which may cut off blood supply to the ovary, causing permanent damage.

5. In case you are at a risk of twisting of the ovaries, you have to undergo a surgery. Surgery is also considered when the cyst lasts longer than three menstrual cycles and it is bigger than four inches in size. The cyst may also pose the risk of being a tumor. The common surgical procedures for ovarian cysts are laparoscopy and laparotomy.  

6. You can prevent ovarian cysts be taking birth control pills, which help in suppressing ovulation and prevent the formation of a cyst. Birth control pills may help only if you are not pregnant.

7. Ovarian cysts are more common in premenopausal women. However, these are possible in postmenopausal women as well, especially in the early postmenopausal stage.  

Sometimes, there might be chances of an ovarian cyst being cancerous in nature, which may lead to ovarian cancer. The risk of cancerous ovarian cysts increases with age. It is recommended to consult a gynecologist for the proper diagnosis and treatment of ovarian cysts in women. Pain medications and heating pads are used as alternative treatment methods for less serious ovarian cysts.

7 Things You Should Know About Ovarian Cysts

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