Kidney transplantation is a major surgery. In this surgery, doctors will remove your damaged/malfunctioning kidney and replace it with a healthy kidney from a donor. A successful kidney transplantation surgery will greatly increase your life expectancy if doctors have diagnosed you with chronic kidney disease.

However, some kidney transplantation surgeries have a better outcome than others do. This is mainly due to some factors that can affect the chances of success before and after the surgery. Here is a look at what these factors are.

Pre-surgery:

You may not be able to control what happens before the transplantation surgery, but here are some things that can affect your chances of a healthy life:

1. Age of the donor and the recipient: Younger people have healthier bodies and easily recover from surgery. Therefore, to achieve the best results in kidney transplantation surgery, it is important for the kidney donor to be young. Kidneys from a younger donor are likely to be healthier and function better for a longer time. For instance, if donor A is 60 years old and donor B is 30 years old, the outcome of transplant will be better if you receive the kidney from donor B. Similarly, if you are too old, your body may reject the transplanted kidney. However, your body will easily adjust to the transplant if you are young.

2. Living donors are better: If you receive a kidney from a living donor, the surgery is much more likely to be successful. In most cases of living donors, a friend or family member donates the kidney to the patient. Therefore, if you have a friend or relative willing to donate a kidney to you, you should opt for that instead of waiting for a kidney from a dead donor.

Post-surgery:

When you undergo a kidney transplant, you can develop heart diseases. Here are some things that will help you prevent that-

1. Keep blood pressure low

Some medications for your kidney disease can lead to an increase in blood pressure. Therefore, you should consult the doctor and report the elevated blood pressure, so that he/she can change the medicine. Additional medication may be required to keep your blood pressure under check so that you do not develop cardiac conditions.

2. Keep cholesterol levels in check:

To prevent organ rejection after the transplant surgery, doctors prescribe immunosuppressants. These drugs can increase cholesterol levels in the blood, which leads to blood and heart disorders. Therefore, you need to reduce cholesterol intake through diet. Ask your doctor about exercises that you can do to reduce cholesterol build up in the body.

Lastly, maintaining proper body weight is also essential after kidney transplantation surgery. Taking these measures will keep your overall body healthy while keeping heart disease and other problems at bay.

How To Achieve Best Results In Kidney Transplantation?

A laparoscopic cholecystectomy may sound like a very complex medical procedure. Well, that should not come as a surprise because that is pretty much what it is. In any case, however, would it not be more than a little interesting to get to know more about this complex sounding procedure?

The cholecystectomy is required when there is a need to remove the gallbladder. When it comes to the surgery itself, there are two options from which a person can choose, in consultation with the doctor. There is the traditional sort and there is the laparoscopic cholecystectomy. The traditional way of performing the surgery requires that there is a cut made along the right side of the person s body, from which the surgeon removes the gallbladder.

When a person goes for a laparoscopic cholecystectomy, there is no need for a long cut of the body or anything of that sort! In its stead, there are a few very small incisions which are made of the abdomen of the patient and even a video camera is inserted through one of these incisions!

The use that is served by the camera is that it provides the surgeon with the view required inside the abdomen to perform the surgery without having to cut open much of the abdomen. Using the tools at his or her disposal, the surgeon can perform the same operation. Now, does that sound seem to be a lot better?

One of the great advantages about the laparoscopic cholecystectomy as compared to an open cholecystectomy is the fact that the recovery time is so much shorter! While the open surgery takes about an hour or two for the procedure itself and generally two to three whole days after it to recover, a laparoscopic cholecystectomy means that the patient can generally go home the same day, after spending about just ten hours at the hospital! That being said, in some cases, the doctors recommend that a night is spent at the hospital so that everything is stable.

Taking this into consideration, the time it takes for a person to get back to normal and do anything and everything that he or she wants is a lot less when the surgery was of the laparoscopic variety. Care needs to be taken though, but within a week to ten days, everything should be just fine.

Pain in the gallbladder, unfortunately, affects some people, but laparoscopic is the way to go!

Gallbladder Removal Surgery - Tips To Help You Recover!

What are Different Types of Bariatric Surgeries? 

Bariatric Surgery is one of the most popular options for obese people looking for a way to control their weight. To get bariatric surgery, one has to qualify for certain criteria like BMI (Body Mass Index), associated comorbidities like Diabetes, Hypertension, sleep apnea, infertility, hypercholesterolemia etc. There are many kinds of bariatric surgeries or weight loss surgeries, different surgeries work differently in order to give the desired effect, which is why it is important to understand these surgeries thoroughly. 

Weight loss surgeries are divided into different categories like - 

  Restrictive surgeries: Some bariatric surgeries are focused on limiting the amount of food that can be stored in the stomach. This allows a person to eat less than they used to, because of the limited capacity of the stomach. Sleeve gastrectomy, Adjustable gastric banding, Gastric imbrication, Gastric balloon surgery are examples of restrictive procedures. In sleeve gastrectomy, the stomach is divided into two halves first, then one half of the stomach is completely removed. The remaining part of the stomach is formed into a tube-like structure. This tube-like structure cannot hold enough food and restricts excessive food intake. It also limits the secretion of an appetite hormone called Ghrelin which limits the desire of a person to eat. 

  Malabsorptive procedures: In this procedure, a large segment of the small intestine is bypassed i.e the food is not allowed to enter a large segment of the small intestine and hence malabsorption will be there. Duodenal switch is a malabsorbtive surgery. 

To Summarize: The weight loss procedures that suit our Indian population are the Roux en Y gastric bypass and the sleeve gastrectomy. We do not come across any sign of malnutrition in patients who have undergone these procedures. For successful outcomes, vitamin, calcium and protein supplements are required. 

There are certain myths about bariatric surgery --- life will never be normal after the surgery, pregnancy is a problem after this surgery, one will never be able to eat after this surgery, marriage is a problem after this surgery etc. All these are incorrect as one live a better life after the surgery as one has shed the extra kilos, one is cured of existing problems like diabetes, high cholesterol, hypertension, obesity induced infertility and sleep apnea extra. IN FACT, the quality of life is phenomenal after this surgery. CHOICE of surgery depends on the existing BMI, existing associated problems and results of the investigations that are done prior to the surgery. Your surgeon is the best to decide the right procedure for you. As the procedure which your friend has undergone might not be good for you. Choice of procedure and proper follow up are the key points for a successful surgical outcome. 

  Combination of restrictive and Malabsorptive surgeries: In these procedures, the surgery is done on the stomach as well as the small intestine. It involves creating a small stomach pouch which is attached to the small intestine, thus bypassing a small segment of the small intestine to get the desired effect if the person has diabetes associated. The rest of the stomach produces important digestive juices and is also connected to the intestine so that it can transfer these digestive juices in it. As a part of the stomach and few centimetres of the small intestine are bypassed i.e food does not enter this part, the surgery is called the gastric bypass. The Roux en Y gastric bypass and the Mini Gastric bypass surgeries are examples of these combination procedures.

Bariatric Surgeries - Know Forms Of Them!

A hysterectomy is a surgical procedure that is done to remove your uterus. Robotic hysterectomy is a more preferred procedure than open surgeries because:

They cause minimal discomfort.
They have better recovery options.
Loss of blood is minimized
The pain associated with the usual surgical procedures are less compared to other options.
This is one of the best procedures that have been designed after years of research in the field of robotics. It is true that they are safe, but it does not mean that there are immediate recovery options. The bottom line is that it is a procedure to remove the uterus and you have to give due importance to the recovery procedures that come along with such robotic surgeries. Let us have look at them.

Recovery
The recovery period depends on the type of surgery you had and also depends on a case to case basis. However, you might be asked to stay overnight in the hospital for observation. You would be constantly monitored during this period and any complications that might arise are given utmost care.

Pain medications and medicines to prevent infections that might arise due to the surgery are given during this period.
You may experience a light vaginal bleeding for a few days. However, this is normal and will gradually ease out. In case the ovaries are removed, the recovery period is extremely crucial. You will no longer have menstrual periods and your body would immediately start adapting to the menopause cycle.
During this transition, the hormonal changes start to occur and you might be experiencing mood swings and hot flashes. You may also experience periods of night sweats. However, all these factors are common occurrences and your body would gradually adapt to these changes. The exact recovery period can range from a week to about six weeks. During these times, you would be given the following advice:

Take plenty of rest and limit your activities.
Do not lift any weights or do any rigorous tasks during these periods.
Any sorts of sexual intercourse must be avoided till you heal completely. Talk to your doctor about this and get to know more about the recovery options.
Never miss a periodic check-up during these times.
Always take the prescribed medications on time.
There can be some sense of loss of your uterus during this period. For some women, this can mean that they would not be able to bear a child. These are some of the common stress factors that come into play during the recovery period. Watch out for them and get emotional support guidance from the counsellor, if the need arises.

Underwent A Robotic Hysterectomy? Here Are Some Recovery Tips!

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications.

Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood.

Read on to know some of the emerging conservative alternatives to hysterectomy:

Myomectomy: Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus.

Uterine endometrial ablation: In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms.

Uterine artery embolization: In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method.

Laparoscopy and endometriosis excision: In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy.

Vaginal pessary: In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely.

In all these, medical management (painkillers and hormone replacement), stress and weight management, quitting smoking, reducing alcohol are also essential.

Hysterectomy - Know the Emerging Conservative Alternatives to it?

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