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!

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

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

The body receives its source of energy and nutrition through the blood, which is the transport medium. The blood runs through a highly complex network of blood vessels, with the aorta being the largest one. It originates in the heart, the left ventricle precisely and supplies oxygenated blood to all parts of the body. Coarctation is a condition where there is a narrowing of the aorta. The heart, therefore, has to exert extra pressure to push out blood so that blood supply to the target organs is not affected.

The exact cause of aortic coarctation is not known, though it often develops at birth and so is known as a congenital disorder. Depending on the severity of the narrowing, symptoms develop at various times in life. While some infants demonstrate symptoms, some may not show any symptoms well into adulthood. Infants with severe narrowing may manifest the below symptoms quite early in life.

Difficulty in breathing may gasp
Difficulty in feeding
Be extremely irritable
Profuse sweating
Pale skin
When these symptoms are not noticed and treated in time, the child may have heart failure or even die. If the symptoms do not manifest early in life, the infant can grow into childhood quite normally. Symptoms may then manifest which would be different, as below.

Increased blood pressure
Headaches (frequent)
Weakness in the muscles
Nosebleeds
Chest pain
Frequent fainting spells
These are generic symptoms and it is difficult to suspect coarctation of the aorta. Therefore, further imaging would be required to rule out coarctation of the aorta. There are some risk factors, most related to the heart, which puts one at increased risk of developing aortic coarctation.

Bicuspid aortic valve
Aortic valve stenosis and/or regurgitation
Mitral valve stenosis and/or regurgitation
Patent ductus arteriosus
Treatment: Diagnosis is the first step in treating coarctation of the aorta. This would include a series of imaging tests including an echocardiogram, electrocardiogram, chest x-ray, CT scan, and MRI.
Surgery is often the most definitive mode of treatment, and the approach chosen depends on the severity and stage of identification. The most common approach is to open up the narrowed portion and keep it from collapsing again, so that blood flow is restored. This is known as a balloon angioplasty and stenting. Some of the other procedures used include:

Resection with end-to-end anastomosis
Bypass graft repair
Subclavian flap aortoplasty
Patch aortoplasty
In all affected individuals, after surgery, medications are prescribed to maintain blood pressure levels, which is often increased. In addition, lifestyle changes including exercise and healthy eating habits have to be developed.

Coarctation of the Aorta - Symptoms and Treatment

What is adrenal gland tumour? Let's answer this question by first knowing the meaning of what a tumour is.

When many tissues grow in the body, some tissues start to grow abnormally and it forms a clot thing in the blood. These clots do not allow the body to function properly and hence, it is called a tumour.

Adrenal gland tumour is the type of tumour when some tissues join together and grow abnormally in the adrenal parts of the endocrine system. It forms a cyst there hence resulting in the swelling of that body part and is called as adrenal gland tumour. This tumour can be cancerous or maybe non-cancerous, depending on the functioning of the cells.

Adrenal glands are an important part of the body. These glands are present on the top of our kidney and are in triangular shape. It releases all kinds of hormones which are important for the metabolism of the human body. These hormones help the human body in many ways.

Causes of Adrenal Gland Tumour:

One of the main causes of adrenal gland tumour is the normal behaviour of any tumour. The tumour grows in the body and does not allow other organs to work properly, which results in many problems inside the body.

The tumour grows and grows and becomes a regular part of metabolism. It suppresses the other glands by not letting them do their work and obviously forming a cyst.

The other reason of these kinds of tumours can be that they release hormones which affect the body and may also result in cancer. These hormones are generally the androgens and estrogens which result in the early growth of many people.

Symptoms of Adrenal Gland Tumour:

People experience many symptoms before they get diagnosed with this tumour. These symptoms are clearly visible and one should take care of all the symptoms. If a person notices any of the symptoms, they should be directly admitted to the hospital.

The symptoms which are visible in a person having adrenal gland tumour are:

They might experience high blood pressure with a low potassium level.

They may experience heart palpitations, anxiety, or panic attacks.

The major signs are that they may experience abdominal pain, weakness, weight loss, or weight gain.

Other symptoms include abdominal stretch marks, excessive hair growth, changes in their genitalia, unusual acne, and also changes in libido.

Treatment for Adrenal Gland Tumour:

The adrenal gland tumour is mainly treated by surgery. The surgery is done by a specialist called endocrine surgeons. The surgery not only consists of many steps performed together by multidisciplinary team. They do the surgery and remove the cyst out of the body and also ensure that it does not return.

The surgery is known as Adrenalectomy, which removes a tumour from the adrenal gland. There is a team of endocrine surgeons who have come together to clear this tumour from the body.

Conclusion:

The adrenal gland tumour should be detected at an early stage so that it can be treated properly and cured at the right time. However, it is always advisable to consult the doctor or specialist before opting for any treatment or medicines.

Adrenal Gland Tumour - What Should You Know?

Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.
Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you.

Bariatric Surgery For Type 2 Diabetes - Does It Help?

Don't wait any longer, manage your Robotic Surgeon online with a Lybrate doctor today

Consult for Robotic Surgeon - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES