If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

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?

Colon cancer is a medical condition where malignant cancerous growths mainly originate in the colon or the large intestine. Believed to be the sixth most common type of cancer prevalent in India (As per the Rajiv Gandhi Cancer Institute & Research Centre), the colon cancer can metastasize and affect the other healthy body parts and organs.

The symptoms that may be indicative of colon cancer include:

Irritable Bowel Syndrome.
A person may suffer from anemia (triggered by iron deficiency).
Rapid and unexplained loss of body weight.
There may be rectal bleeding (blood may also appear in the stool). There may also be pain and discomfort during the bowel movement.
A person may experience extreme weakness and fatigue.
Frequent diarrhea or constipation.
A person may complain of abdominal pain and cramps.
There may be a change in the consistency of the stool.
Unfortunately, in most cases, the symptoms associated with colon cancer may not appear in the initial stages, thus complicating the situation.

Prevention and management of Colon Cancer
A little alertness on your part can help to prevent colon cancer.

Regular health checkups and screening: Whether the symptoms appear or not, health check-ups at regular intervals are a must. In addition to preventing colon cancer, regular health check-ups can also help to avert a host of other health complications. The screening tests for colon cancer are necessary for people who have a family history of colon cancer and also those who are above 50 years of age. The various screening tests for colon cancer include:
Colonoscopy (used to examine the inside of the colon for any abnormalities).
Fecal Occult Blood Test (FOBT)/Fecal Immunochemical Test (FIT) (These tests are carried out to detect the presence of blood in the feces).
The screening may also be done using Virtual Colonoscopy or Flexible Sigmoidoscopy.
Forget the unhealthy lifestyle habits: Smoking and drinking (excessive) can be the chief contributors triggering colon cancer. Limiting your alcohol intake and quitting smoking will not only keep you healthy but also keep colon cancer at bay.
Shed the extra pounds: The harmful effects of obesity are known to all. Obesity is considered to be one of the underlying factors that can trigger a colon cancer. A healthy body weight can go a long way in preventing colon cancer and keep you fit and active. Minimum 30 minutes exercise daily is all that you need to stay fit and healthy.
Make healthy changes in the diet: If you want to prevent colon cancer, make your diet as healthy as you can. Enrich it with fruits, vegetables and food items that are rich in fibers, minerals, vitamins, and antioxidants. Dietary fats (red meat or any other processed meats) are a strict no. Choose whole grain products over refined ones.

Colon Cancer - How To Prevent 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

On each side of the uterus, two ovaries are present. It is the size of an almond and produces ova or eggs in simple terms, along with the release of hormones like oestrogen and progesterone. When a cancerous growth or a tumour grows in the outer lining (epithelium) of the ovary, it is known as ovarian cancer. Ovarian cancer occurs in women who are aged above 65 years.

There are three types of tumour
Ovaries are made up of three kinds of cells and each kind is capable of developing different types of tumour.

Epithelial tumour- It develops from the cells that cover the ovary s outer surface.
Germ cell tumour- It develops from the cells that produce ova.
Stromal tumour- It develops from the tissue cell which is the structure holding the ovary together and produces oestrogen and progesterone.
Some tumours are non-cancerous and never spread beyond the ovary. Cancerous or ovarian tumours that are less malignant can metastasize to other body parts. The signs initially would be mistaken with premenstrual syndrome or poor bowel movement or a bladder problem, but if the problems are persistent then one must get an expert opinion. Ovarian cancer often goes undetected till it spreads within the abdomen or the pelvis. 

Causes of ovarian cancer
Cancer develops when the cells of the body divide and multiplies in an unregulated manner. Mutations that are genetic like BRCA1 and BRCA2 can be the cause often or if an individual is diagnosed with any other type of cancer before like breast, colon or uterine. There is a higher risk of being affected by this type of cancer if the person had undergone fertility treatment or is suffering from infertility. Hormone Replacement Therapy (HRT) is another cause of this type of cancer. Experts say that longer the HRT, higher the risk. Women who are obese or are overweight has more chances of being affected. Endometriosis or the disorder in which the growth of the tissue occurs outside the uterus, in such a case the risk is 30% higher.

The signs or symptoms of ovarian cancer differ from one woman to another. Some of the symptoms given below might as well be non-cancerous because since the ovaries are situated near the intestines and bladder, it might be often mistaken to be symptoms of gastrointestinal issues. It is advisable to consult a doctor if the symptoms are persistent.

Symptoms that occur at an early stage
Pelvic pain, Abdomen pain, Indigestion issues, Loss of appetite, Painful sexual intercourse, and Changed bowel movement are a few of the symptoms that occur during the early stages of the development of an Ovarian cancer.

Signs at a progressive stage
Loss of weight, Fatigue, Short of breath, and Nausea are the predominant symptoms when the Ovarian cancer has progressed more. Early diagnosis may lead to complete cure

Symptoms of ovarian cancer are similar to that of ovarian cysts. These ovarian cysts are often non-malignant but women with such cysts have a higher risk of being affected by cancer. Ovarian cancer can begin silently and are often detected at a later stage. Thus any individual undergoing these symptoms can avail medical assistance for further diagnosis.

Ovarian Cancer - Things You Need To Know!

Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

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