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 tube that carries food to your stomach from your throat is called the oesophagus. When the muscular valve (lower oesophagus sphincter) in the oesophagus fails to relax and carry the food to the stomach, the condition is termed as achalasia.

Achalasia has a variety of causes, and can be difficult for your doctor to diagnose the exact cause. Some common causes of Achalasia include:
1. Hereditary predispositions
2. Autoimmune disorders (The immune system erroneously destroys healthy cells in the body)
3. Nerve degeneration in the oesophagus
There other medical conditions that often lead to symptoms identical to achalasia, such as oesophageal cancer and Chagas  disease (an infectious disease caused by a parasite).

Other symptoms of achalasia include:

The most prominent symptom of achalasia is dysphagia, which is characterised by swallowing difficulties or sensations of food stuck in the oesophagus. Dysphagia often triggers coughing and shortness of breath or choking on food.
1. Discomfort or pain in the chest
2. Weight loss
3. Heartburn
4. Intense discomfort or pain after eating

Some of the treatments include:

Most of the methods to treat achalasia focus on the lower oesophageal sphincter (LES). The treatments used can either permanently alter the sphincter s function, or reduce symptoms.
1. Oral medications such as calcium channel blockers or nitrates are prescribed, which can relax the LES to let food pass through with more ease. Your doctor may also treat the LES with Botox.
2. For a more permanent treatment, the sphincter can be dilated or altered. In dilation, a balloon is inserted into the oesophagus and it is inflated. This will stretch out your oesophagus to improve function.
3. To alter the oesophagus, oesophagomyotomy is performed. It is a kind of surgery where minimal incisions are made to gain access to the LES, and then it is carefully altered to improve flow of food to the stomach.

Unlike dilation, which can cause complications such as tears in the oesophagus, oesophagomyotomy has a greater success rate. However, certain complications may still arise, such as:
1. Acid reflux
2. Respiratory conditions that are caused by food entering your windpipe

Achalasia - Can Autoimmune Disorders be the Cause Behind it

If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

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

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!

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

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