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

Dyspepsia is an uncommon word, but a very common problem. This medical condition is more commonly known as indigestion of the stomach and small intestine. The symptoms of this condition include abdominal pain, bloating, belching, nausea and a loss of appetite. They come and go varying terms of frequency and intensity. 

Some of the common causes of dyspepsia are lactose intolerance, anxiety, regurgitated stomach juices, stomach ulcers, irritable bowel syndrome and excessive caffeine or alcohol intake. In most cases dyspepsia can be easily treated with home remedies. 

Here are the 5 best ways to treat it.
1. Lemon juice: Lemon juice cleanses the digestive system by flushing out waste material and undigested food. It also inhibits the formation of acids in the stomach and boosts appetite. Dilute the juice of 1 lemon in a glass of water to avail its benefits. You could also add half a teaspoon of fresh ginger juice to this. Ginger also aids in digestion and prevents flatulence.

2. Buttermilk: Buttermilk has cooling properties and helps calm the stomach and intestines. It is also suitable for people who are lactose intolerant. Drink a glass of buttermilk immediately after a meal to improve your digestion. You could also flavor it with roasted cumin powder or mint. Mint also helps in relieving indigestion and prevents buildup of gases in the stomach while cumin stimulates the secretion of pancreatic enzymes.

3. Yogurt: Yogurt is the best remedy for any stomach bug. It is rich in probiotics that help restore balance healthy gut bacteria and stabilize digestion. Yogurt can be had as an accompaniment to your meals or mixed with steamed rice to make it a meal in itself.

4. Fenugreek: Fenugreek boosts appetite and helps relieve indigestion. This herb is known for its soothing properties that cleanse the digestive system. Fenugreek leaves can be bitter and unpalatable. Hence, to benefit from this, boil the leaves and then lightly fry them in butter before eating them.

5. Pomegranate juice: Pomegranate juice is an excellent way to treat indigestion and diarrhea. Its antioxidant properties also make it a good remedy for heartburn. To benefit from pomegranate juice, dilute the juice of a pomegranate in a glass of water along with a tablespoon of honey.

Along with this, also take a look at your eating habits. Avoid eating on the move and chew your food properly. Eat only when you are hungry and control your portion sizes. Lastly, make the time to exercise for half an hour or so every day.

What Is Dyspepsia? 5 Best Ways to Treat It

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!

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

Drug therapy and medication become ineffective.
Without undergoing surgery, the condition might increase the risk of developing cancer.
The colon has the risk of getting ruptured if surgery is not performed on time.
There could be excessive bleeding.
Toxic megacolon might set in.
Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery. 

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

There could be an excessive bowel movement.
There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
There could be a situation of intestinal blockage from adhesion due to surgery.
There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

Ulcerative Colitis - What You Need To Know?

Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Infection is generally understood as the invasion into the body tissues by certain foreign bodies, such as bacteria, parasite and virus. They are transmissible diseases and can be transmitted from one person to the other via sneezing, coughing or physical contact. They can be mild, moderate or severe.

1. They can be acute that is can last for a short time or chronic that lasts for a long time or a latent infection that may not cause any symptoms at first but reactivates and resurfaces over a period of time.

2. Although each infection has its own distinct symptom, generally these symptoms include fever, swelling, redness, inflammation, burning, cough, diarrhea, fatigue, muscular pain, nausea, vomiting, rapid pulse or rapid breathing.

3. If the patient has severe headache, difficulty in breathing, painful swelling, and unexplained prolonged fever or cough, he or she should immediately consult a doctor.

Conventional drugs that are given to treat infections like antibiotics, antiviral, antihistamines and steroids have many side effects on the human body . They, on one hand hampers the digestive power of the system and on the other hand lower the immunity power of the body. In the long run, these medicines can have adverse effects on the body. Though conventional drugs suppress the disease for some time, the disease tends to resurface in future.

However, Homeopathy has been found to be a great success in treating both acute and chronic infections. The best part is that, there are no side effects of this treatment and the disease is cured permanently. Homeopathy also boosts our immune system so that the body naturally develops the strength to fight against infections in future, when foreign bodies invade. Homeopathic medicines have also proved to be effective as preventive measures against infections.

Some of the homeopathic medicines for the treatment of most common infections are discussed below:
1. Throat infections - Belladonna, Lachesis, Lycopodium, Phytolacca, and Mercurius are most commonly administered to cure throat infections.
2. Skin infection - Common homeopathic remedies are Sulphur, Calendula, Hypericum, Silica, and Hepar sulfuris.
3. Bladder infection - Berberis, Chimaphila, Hydrastis, Apis, Cantharis, and Sarsaparilla are commonly prescribed.
4. Stomach infection - Arsenic album, Nux vomica, Carbo veg, Lycopodium, and Pulsatilla are commonly recommended
5. Sinus infection - Kali bichromicum, Pulsatilla, Mercurius, Natrum muriaticum, and Allium cepa work well in cases of sinus infections.

Note: Although, the names of the medicines have been mentioned here, still it is strongly recommended that no medicine should be consumed without consulting a homeopathic doctor. The  potency and dosage of the medicine will vary from person to person and can only be decided by a trained practitioner.

Homeopathy Treatment for Infection  - Effective Alternatives

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