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

Brain injury can happen as a result of trauma, infection or degeneration with old age. Whatever be the reason, injury on the head can result into brain dysfunction and should be given required medical diagnosis. In these cases, occupational therapy can be a major help.

It helps in improving health, providing rehabilitation and educational service to enable people to participate in things they are interested in and manage their daily activities. Occupational therapy can be used to manage issues relating to memory, organization and attention span, behavior and emotion control, safety issues and issues which contribute to society. Depending on expectations, different therapies can be sought. Read on to know a little more about how occupational therapy can help adults with brain injury. 

The person's skills and what they want to do are to be assessed and accordingly a daily plan that can be easily followed is made. Where possible, use technology like smart phone or voice recorder to manage this plan. The therapist can train the person to use these tools, review progress and make changes as necessary.
The therapist will also teach ways to do things on their own like cooking and small shopping, so they become independent and are therefore less frustrated.
Patients in need of anger management, the therapist will help them to identify what induces anger or frustration and support in managing those before it turns into actual anger. This will help the person relax and be more positive.
This could also be done using small roleplays, wherein they are taught ways to respond and be more relaxed and calm.
If you are keen on participating in social events or volunteering opportunities, then the therapist can recommend options for you based on your areas of interest. The therapist can also work with the identified organization (school, NGO, or workplace) to inform them of the kind of support required by you. Work behavior and social behavior can be taught to help the affected person succeed.
If the affected person happens to be alone, then they need to be assessed for ability to judge (e.g., self-awareness, impulsivity, and reliability), even while doing daily activities like bathing and dressing. Driving is permissible only if cleared for it by the therapist.
The home needs to be assessed for safety. You may have to make some safety modifications, for instance replace power tools with hand tools. Else, shared housing options, where independence and having someone close by is possible, should be evaluated.
So, with a brain injury, not all is lost. Occupational Therapy can definitely help restore function to a large extent, so use it to reap maximum benefits.

Adults With Brain Injury - Know How Occupational Therapy Can Help You!

A fracture requires quick and careful medical attention to ensure proper healing and alignment of the bone. Most fractures usually recover within six weeks but that is only half the problem. A lot of other tissues get damaged in the process when there is enough stress placed in the body to fracture a bone. Additionally, when you are unable to move that bone, you will have joint stiffness and significant muscle weakness.

After a fracture, physiotherapy might be recommended to guarantee that you come back to your ideal capacity. You might have to go for regular appointments to your physiotherapist in order to achieve full recovery. Usually, your physiotherapist will try to prevent your post-fracture stiffness in the nearby joints and muscles after the initial six weeks while you are recovering from your fracture. After six weeks or later, if x-rays show that the bone has not been fully healed, your physiotherapist can take a shot at recovering full movement of the joints and muscles near the affected area. 

Here are five ways in which physiotherapy helps heal post-fracture:

Physiotherapy after a fracture can help you enhance your muscle movement. In case you have fractured your leg, your physiotherapist can help you improve your walk and help you decide whether you need to take the support of a walking stick, crutches or a cane. In case you have broken an arm or shoulder, exercises focused on reaching and grasping are included.
Modalities might be used to help with the pain and swelling. Your physiotherapist may choose to use ice, heat or whirlpool baths.
Electrical stimulation can also be used to improve your muscle movement. You need to keep in mind that while inactive treatments like electrical stimulation or ultrasound might be used, you also need to keep your muscles physically active to better your movement and strengthen your bones.
If you have had surgery to join the fractured bone, you may have surgical scar tissue. Scar massage can decrease scar attachments and increase movement around the scar.
Exercise to improve the scope of movement and strength can also be started. Particular focus points need to be treated in the joints around the fractured area. If you have fractured a bone close to your elbow, exercises need to be included for your elbow, wrist, and shoulder. Moreover, a fracture in the shin needs to include exercises for the knee, lower leg, and hip. Exercise can guarantee that your bone can endure the load during daily routine work. Make sure to consult with your physiotherapist to learn the correct exercises for your condition.
A fracture can be very painful and might lead to a disability or problem in movement. Depending on the seriousness of the damage, the loss may be temporary or permanent. Physiotherapy can help you come back to your optimum function as quickly as possible.

Physiotherapy - 5 Ways It Can Help Post Fracture!

If you are concerned about breast cancer, you should know about the steps you can take to prevent the condition. Breast cancer is a type of cancer developing from the breast tissue. Symptoms such as a lump in the breast, fluid flowing from the nipple, changes in the shape of the breast and occurrence of red scaly patches on the breast denote breast cancer.

You need to make certain lifestyle changes in order to prevent breast cancer. The ways you should adopt include the following:

Limit your alcohol intake: The more you consume alcohol, the more you put yourself at the risk of getting breast cancer. It is recommended for you not to drink more than one drink per day. Small amounts of alcohol increase the risk of breast cancer as well.

Abstain from smoking: There is a direct link between tobacco smoking and breast cancer, and the risk is even more in premenopausal women. You should quit smoking to reduce the risk of breast cancer along with many other conditions, which can develop because of the ill-effects of smoking.

Control your weight: Obese women are more prone to breast cancer when compared with women with a healthy weight. This is especially true when obesity occurs at a later stage in life, after menopause.

Keep physically active: Regular physical activity is essential for you to maintain a healthy weight, which is important for preventing breast cancer. 150 minutes of moderate aerobic exercises or 75 minutes of vigorous exercises are recommended along with strength training.

Breastfeed: Breastfeeding plays an important role in preventing breast cancer. The more you breastfeed your baby, the more protected you are from breast cancer.

Limit the dosage and duration of hormone therapy: If you undertake combination hormone therapy for more than three to five years, you are at a higher risk of developing breast cancer. In case you are taking hormone therapy for menopausal symptoms, you should talk to your doctor about alternative options such as non-hormonal therapy and medications. If you still require hormonal therapy, you must use the lowest dose that will be effective.

Avoid exposure to radiation and pollution: Certain medical imaging procedures like computerized tomography involves radiation of high doses. There is a link between breast cancer and radiation exposure. Thus, you should abstain from getting exposed to radiation and avoid taking such tests if it is not very urgent.

Maintaining a healthy diet also helps in reducing your risk of developing breast cancer. You should include food items which are plant based in your regular diet, such as fruits, vegetables, nuts, whole grains and legumes. Also, consume healthy fats such as olive oil instead of red meat and butter.

How Can You Prevent Breast Cancer?

Peripheral arterial disease or commonly known as PAD is a common cardiovascular disease. Despite having the power to cause painful symptoms and severe health risks, it is overlooked by many. This particular arterial disease may lead to life-threatening consequences if left untreated for long. Read on to know more about the condition.

What is PAD?
PAD refers to the situation where in the peripheral arteries to the arms, head, stomach, and legs become narrow. Often referred to as the peripheral vascular disease, here, the arteries start to grow narrower due to the slow but constant buildup of fatty deposits on the artery walls. Though it can affect all the arteries in a person s body, except those that supply blood to the heart, in the majority of cases, it affects the arteries in the leg.

What are the threats it poses?
PAD is indeed a life-threatening disease, as the blockages, it creates in the peripheral arteries prevent normal blood circulation to the different organs, legs, and brain. And when the blood flow is restricted, or the vital organs of the body fail to receive necessary blood flow, then the legs, brain and all the vital organs suffer severe damage. And when PAD continues to harm the blood flow for a long time, then it leads to tissue infection or tissue death, which is known as gangrene.

Additional health issues it causes
PAD also creates various other health concerns, such as atherosclerosis. Atherosclerosis is a chronic disease of fatty materials  build up. In the case of atherosclerosis, the entire blood circulatory system gets damaged, including the arteries leading to the heart. The risk of blood clot build ups and vascular inflammation are also common additional threats posed by the fatty deposits.

Probable symptoms
Depending on the part of the body that is affected, the PAD symptoms vary from one to another. However, painful cramping in the muscles of one s legs is the most common symptom of this condition. The pain, originating in the legs often goes up to the muscles in the thighs or hips too. Except this, weakness or numbness in the legs, ulcers or open sores on the feet or legs, skin color changing into bluish or pale are some of the other symptoms of PAD.

Possible treatments
The peripheral arterial disease can be diagnosed easily, painlessly and straightforwardly under proper medical attention. Both prescribed medications and a lifestyle change are considered to be the best treatment for controlling PAD. Including a healthy diet and adopting a healthy lifestyle have often been successful in preventing PAD in its early stage.

The moment any signs or symptoms of PAD is noticed one should not be late in seeking immediate medical attention.

Peripheral Arterial Disease- A Serious Threat To Life Worth Being Concerned About!

Any kind of bleeding from the uterus, which is not normal, can be termed as abnormal uterine bleeding. This refers to bleeding between periods or before periods, bleeding after having sex, spotting, abnormally heavy bleeding or bleeding after attaining menopause. If you are suffering from any of these issues, you need to check with the doctor. 

Diagnosis
It is very important to diagnose abnormal uterine bleeding. There are several examinations and tests that have to be carried out, depending on age. For irregular spotting, a pregnancy test can be undertaken in case you think you could be pregnant. If your uterine bleeding is very heavy, a test has to be performed to check blood count. This is done to observe whether you have anemia. An ultrasound test of the pelvic region will also be advised by your doctor to know the cause of the bleeding. Several hormonal tests and thyroid function tests are required as well.

Other diagnostic tests include:

Sonohysterography: When fluid is placed within the uterus and ultrasound images of the uterus are taken. An image of the pelvic organs is obtained.
Hysteroscopy: It can be carried out when a device is inserted via the vagina and enables the doctor to examine the uterus internally.
Magnetic resonance imaging: This is also used to get images of the organs.
Endometrial biopsy:  It involves insertion of a catheter to take out a tissue which is microscopically observed. 
Treatment
There are different types of treatment for abnormal uterine bleeding depending upon factors such as the cause of bleeding and the age of the patient.

Medications: Several medicines are used to treat abnormal uterine bleeding. Sometimes hormonal medicines are used. Birth control pills are also used to improve the regularity of periods. Hormonal infections, vaginal creams and an IUD device releasing hormone can be used. Non steroidal anti-inflammatory drugs are also used to control bleeding. Several antibiotics may also be prescribed.
Surgery: In some cases of abnormal uterine bleeding, a woman has to undergo a surgery for the removal of growth such as polyps and fibroids, which results in bleeding. While some fibroids can be removed via hysteroscopy, others require different techniques for treatment.
Endometrial ablation: It can be undertaken to control bleeding. This mode of treatment aims at reducing the bleeding permanently. In case all treatment methods fail, hysterectomy has to be carried out. This is a serious surgery and after it is performed, a woman does not have periods anymore and will not be able to conceive a child.
Abnormal uterine bleeding is a serious health condition, which may lead to severe complications. Immediate diagnosis and appropriate treatment methods should be undertaken in case of any abnormal uterine bleeding.

Abnormal Uterine Bleeding - 3 Ways to Treat it!

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