Menorrhagia refers to very heavy and prolonged menstrual bleeding or periods in women. The bleeding is abnormal in nature, and if this continues for a long time, a hysterectomy surgery needs to be carried out to solve the problem.

Bleeding during the night time and passage of large blood clots during menstruation are other symptoms of Menorrhagia.

Causes:

The various possible causes of this kind of heavy menstrual bleeding are:

Hormonal imbalance, specifically of estrogen and progesterone is a common cause, which is more likely in adolescents and in women nearing menopause. Dysfunction in the ovaries also causes hormonal imbalance.

Non-cancerous tumors or fibroids may also be responsible for menorrhagia.

Women suffering from a miscarriage or ectopic pregnancy are likely to experience heavy menstrual bleeding.

Using blood thinners may lead to menorrhagia.

An intrauterine device used for birth control measures can cause disturbance and may lead to heavy menstruation.

A condition known as adenomyosis, where the glands in the uterus lining get embedded in the walls of the uterus, also causes menorrhagia.

Pelvic inflammatory diseases, infection in the uterus or fallopian tubes are other common causes.

Heavy bleeding may occur in patients with ovarian or cervical cancer.

Diseases of the kidney, liver or thyroid diseases may also cause menorrhagia.

Diagnostic Tests:

Several tests and methods are carried out for the diagnosis of menorrhagia. They are:

A general physical examination.

Bleeding diary of the woman.

Blood tests to detect anemia or thyroid.

Pap Smear for the evaluation of cervical inflammation, infections or cancer

Ultrasound for evaluation of pelvic organs like uterus, ovaries and pelvis.

Hysteroscopy, where a camera is inserted into the uterus to observe the linings.

Sonohysterography, where a fluid gets instilled into the uterus along with an ultrasound test.

Treatment:

Certain drugs are used to treat menorrhagia. They include:

Iron supplements for treating anemia.

NSAIDS or non-steroidal anti-inflammatories for treating and reducing blood loss.

Tranexamic acid is used for reducing menstrual bleeding.

Several oral contraceptives are used for regulation of the menstrual cycle. Oral progesterone corrects hormonal imbalance and reduces bleeding.

Surgical procedures for treatment of menorrhagia include:

Hysteroscopy, dilation and curettage, where uterus lining is scraped and evaluated.

Uterine artery embolization treats menorrhagia with fibroids.

Focused ultrasound ablation enables the killing of the fibroid tissue.

Myomectomy, endometrial ablation and endometrial resection are other surgical techniques.

Hysterectomy surgery is the penultimate solution, where the uterus, cervix or ovaries are completely removed.

Menorrhagia is characterized by abnormally heavy menstrual bleeding in women. This is quite unhealthy and proper measures must be taken for curing the heavy bleeding.

Menorrhagia (Heavy Menstrual Periods) - A Common Indication For Hysterectomy

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!

The gall bladder is a very small organ located behind the liver. This organ stores the bile created by the liver and releases it whenever needed. We rarely pay attention to this organ until there is a problem and most gallbladder related problems are very painful. Unknowingly you may be harming your gall bladder by eating certain types of food like red meats and saturated fats. On the other hand, eating some types of food can improve your gall bladder health. Some such foods are:

Fiber-rich foods: Fruits and vegetables are rich sources of fiber and a must in a balanced diet. Fiber helps keep the gall bladder healthy and also helps prevent gallstones from developing. An easy way to add more fibre to your diet is to incorporate a salad with your lunch and dinner.
Water: Water not only helps hydrate the body but also helps maintain the water levels required in bile. Ideally, a person should drink 8 glasses of water a day. This should not all be drunk at one time but should be spaced out through the day. Drinking too much water at one time will result in the body expelling it in the form of urine instead of absorbing it.
Foods rich in Pectin: Pectin is a dietary fiber that binds cholesterol in the stomach and helps in its removal from the body. Since cholesterol is one of the major causes for gall stones, eating pectin-rich foods helps reduce the risk of gallstones. Some foods that are rich in pectin include citrus fruits, strawberries and apples.
Flaxseeds: Eating just one tablespoon of flax seeds a day can boost your health in a number of ways. One of the many benefits of including flaxseeds in your diet is a healthy gall bladder. Flax seeds contain mucilaginous fiber or fiber that forms a gel. This type of fiber aids in the liver s synthesis of bile acids and thus keeps the gall bladder healthy.
Omega 3 Fatty Acids: Not all fats are bad for the body. Omega three fatty acids play an important role in producing anti-inflammatory compounds. Some rich sources of omega 3 fatty acids include olive oil, avocados and flax seeds.
Citrus fruits: Citrus fruits are very rich in vitamins like vitamin C. a deficiency of this particular vitamin can cause gall stones. For this reason, eat plenty of citrus fruits and other fruits and vegetables such as bell peppers and broccoli that are rich in vitamin C. 

Gallbladder Health - Foods that Can Help maintain it!

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

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

A hernia occurs when a weakened area of muscle in the abdominal wall gives way and the internal organ/tissue bulges out through this weakened are or  defect'. This can happen in many different areas of the abdomen. A hernia that develops in the groin region is called "inguinal hernia". It may be very painful especially if a part of the intestine gets trapped in the bulge.

The only treatment option is surgical repair as the weakened area "defect" needs to be repaired and will likely need reinforcement by a prosthetic material called a "mesh". Doctors may resort to Open Surgery or Laparoscopic Inguinal Hernia Repair depending on his/her evaluation of the patient. 

Who is a candidate for Laparoscopic surgery?

Laparoscopic surgery is the preferred treatment option for most people with inguinal hernia. Special situations in which laparoscopic surgery is much superior to open are

  Failure of a previous open surgical repair. Laparoscopic surgery is performed from "behind" the hernia and abdominal wall in comparison to open surgery which is performed from "the front". So, in case of failure of the open surgery, laparoscopic surgery is done through a fresh, non-scarred area and is technically safer and easier than doing an open surgery once again.

  If there are hernias on both sides and both need to be repaired at the same time, laparoscopy has a great advantage as both the hernias can be tackled and repaired through the same three tiny cuts, and two separate large incisions need not be made. 

Who is Not a Candidate for Laparoscopic Surgery?

The person is not a candidate for Laparoscopic Surgery if he has:

  Some patients who have undergone previous Abdominal Surgery or prostate surgery may not be suitable candidates for laparoscopic inguinal hernia surgery.

  Some underlying medical conditions, that make him unfit for general anaesthesia, as usually laparoscopic surgery can only be done under general anaesthesia.

How Laparoscopic Inguinal Hernia Is Carried Out?

In a Laparoscopic Intervention, two to three small incisions are made in the lower abdominal area. The laparoscope is passed through one of these incisions and the surgical instruments are inserted through the other incisions. The abdominal cavity is inflated using Carbon Dioxide to help the surgeon visualize the lower abdominal area clearly. Using the laparoscope, the surgeon visualizes the Hernia and uses long instruments to operate on it. She covers the hernia with a mesh and may fix the mesh to abdominal muscles using either stitches or stapler-like instruments.

Benefits of Laparoscopic Surgery

1. Two or three tiny cuts (5-10 mm in size), hence there is less pain after laparoscopic surgery

2. Better cosmetic results

3. Quicker recovery

4. Early return to daily activities like walking, working, etc

5. Shorter hospital stay 

Role of Laparoscopic Surgeon In comparison to many other minimally invasive surgeries:

Laparoscopic Inguinal Hernia Repair is more demanding in terms of technical capability of the surgeon. In general, Laparoscopic Inguinal Hernia Repair is more difficult to carry out in obese people than others. However, if the doctor is well trained and technically advanced with long experience, he can carry out such minimally invasive surgeries smoothly irrespective of the BMI of the patient. Everybody is not a candidate for Laparoscopic Inguinal Hernia Repair.

It is the doctor who decides if a particular patient is suitable for such surgery or not. However, the conclusive factor in any such repair is the experience and expertise of the doctor. This is why there are not many Laparoscopic Surgeons who carry out Laparoscopic Inguinal Hernia Repairs. Owing to the complexity of this procedure, it is important to get it done from an expert surgeon only.

Laparoscopic Inguinal Hernia Repair !

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