Dr. Ashok Gupta

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

1. Ultrasound is most commonly used to find gallstones.
2. In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.

Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

1. Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
2. Patients usually have minimal post-operative pain.
3. Patients usually experience faster recovery than open gallbladder surgery patients.
4. Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.

Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.
 

Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). The hernia may be Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. The hernia can also originate from an incision (Incisional Hernia). The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the bellybutton. This results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm. Of all the hernia types, the Inguinal Hernia is the most common. 

Severe strain and muscle tear or weakness can result in hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of hernia. In case of hernia, the affected area tends to protrude or bulge out. If left untreated; hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.  

The severity of the hernia depends upon its size. In case the hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be Open or Laparoscopic. In open surgery, hernia is identified through an incision. Once located, the hernia is removed from the adjacent tissues. In Laparoscopic Repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.  In such repair, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chances of a recurrence.

Certain factors needs to be well addressed before performing hernia operation-

1. Hernia operations, Laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
2. Laparoscopic hernia operation should be avoided in case a patient has adhesions from previous surgery.
3. Extreme care should be taken while performing a hernia operation in infants and children.
4. In some cases, hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men.

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

How Smoking Impacts Your Organs

As you inhale cigarette smoke, about 7000 carcinogens stir the crevices of your body. In India, about 3,00,000 people die every year due to smoking-related issues.

Here's a list of 5 such organs, which are the most affected by cigarette smoke.

1. Your lungs - Your lungs are probably the first organs to bear the wrath of cigarette smoke. Majority of the lung cancer cases are due to smoking. Other diseases include bronchitis and emphysema. This smoke paralyzes the cilia lining the inner walls so much so that it overproduces mucous. When the mucous builds, respiration suffers. Asthma and cancer follow.

2. Your Skin - Your skin also gets affected up to a huge extent if you smoke. You could have deep circles under your eyes, wrinkles on your skin, and stretch marks, if you continue smoking over time. Also, there lies the risk of major health issues like skin warts, psoriasis, skin cancer, and wounds, which may take longer to heal.

3. Your Penis - Studies revealed that you can take longer for an erection and find it difficult to maintain it if you are a heavy smoker. Studies have also revealed that men who quit smoking had longer and firmer erections.

4. Your Liver - Smoking increases the chances of you suffering from liver cancer dramatically. According to studies, half of the liver cancer cases are due to smoking. Obesity can also take place if you're a heavy smoker.

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

Hi everybody!

I’m Dr. Rojy, physiotherapist. I’m in physiotherapy department. Today I’m going to talk about the osteoarthritis of the knee. Osteoarthritis of the knee is very common for arthritis. And we will discuss about the difference of the osteoarthritis means what is the differences between the osteoarthritis of the knee. So osteoarthritis of the knee is the degenerative disease of the joints and another it is called arthritis. In this conditions the natural connecting between the joints cartilage becomes worse to worse.

So when it happens bones between the joints means the bones of the joints becomes rough against one another. So that roughing reasons in pain, stiffness, sometimes results in the osteoarthritis formations. And sometimes it results in the decrease in the joints mobility. So the types next the types of osteoarthritis are 2 types of osteoarthritis are there. One is tibia fibula osteoarthritis second is the patellofemoral joints arthritis. The causes for the osteoarthritis is first is the age.

Age is the major risk factor for the osteoarthritis of the knee. Second hereditary, then weight, then repetitive strain injury. Then arthritis like rheumatoid arthritis and some other illness like metabolic disorder. These are the causes for the arthritis of the knee. Then next is what the symptoms of the osteoarthritis of the knee area. First is the pain, second swelling then warmth filling of warmth in the joints then stiffness and the other symptoms are the decreased mobility of the joints and sometimes deformity also and then sometimes creepy also. So, these are the symptoms of the osteoarthritis of the knee.

Second is the diagnose next step is the diagnosis. Diagnosis is based on the history and the physical examination. Other diagnoses are X-ray and MRI. So on MRI, some changes can see on MRI. The changes involved are one is osteophytes formation that is the bone spur then narrowing of the joint space. Then what is the treatment for the osteoarthritis of the knee means the physiotherapy is the treatments for the osteoarthritis of the knee. So first that is discussed is the aim and goal of the physiotherapy treatments. First the aim, one is the reduced the pain and the inflammation. Second, normalize the range of the motion.

Third is the strengthen the knee muscle especially quadriceps and hamstring. Then improve the functions, then improves the balance, then improves the particular alignment and some functions. These are the aims and the goals of the physiotherapy. Then next come to the treatment for the physiotherapy. First is the race, second cold therapy, we can apply the ice in the knee joints to reduce the pain. Next thermotherapy, thermotherapy includes soluble diathermy, paraffin wax bath and hydro collator pack.

This thermotherapy means this modality we can use according to the conditions. Next electrotherapy. Electrotherapy includes IFC, ultra Sony and the TENS. These also we can use according to the patient’s conditions. Next exercises. Exercises are very important in the cases of osteoarthritis. Basically, exercises have to strengthen the muscles, improves the flexibility, to improve the range of the motion. Next water reduction. Next aerobic like cycling, walking then tapping then supporting device like braces we can also use. These are the physiotherapy treatments. So if you are suffering from osteoarthritis of the knee you can get this physiotherapy and physiotherapy. And if you have any investigations you can contact on lybrate.com

Diabetes is a gnawing problem that affects millions throughout the world. It is a disorder that if overlooked can lead to serious diseases; cardiovascular ailments, problems related to vision, kidney problems and many more. While medication tries to regulate your blood sugar levels, it is not always unfailing. Medication along with changes in your diet and lifestyle can still not improve your condition in certain cases. At times it is hard to increase the insulin production in a person's body even after administering medicines solely known for their efficacy. Such kind of diabetic patients can therefore benefit from a Bariatric surgery.

What is a Bariatric surgery?

Bariatric surgery doesn't refer to a single operative method. It involves a host of surgical procedures conducted on a person to rid him or her of obesity. Obesity in combination with diabetes can make a person's life miserable. The treatment of one can come in the way of curing the other. A diabetic patient who also suffers from obesity usually finds it hard to lose weight in spite of exercising or being on diet. Surgery comes to their rescue. This kind of surgery should be fallen back upon as the lender of last resort that is to say when other solutions have not helped. Bariatric surgery is always performed under skilled supervision. It might include reduction of the size of your stomach, removal of a portion of the stomach, or even gastric bypass surgery.

How does Bariatric surgery help reduce Diabetes?

Diabetes can be of three basic kinds;

Type 1 diabetes in which the body produces no amount of insulin.

Type 2 diabetes in which the body produces an insufficient amount of insulin or Gestational diabetes that pregnant women tend to contract.

Bariatric surgery proves to be very advantageous for patients of Type 2 diabetes:

1. Surgery lowers blood sugar levels considerably. Research shows people with acute diabetes made huge improvements after having undergone a Bariatric surgery. Their blood sugar levels dropped by a noticeable percentage and they felt healthier. Reduced blood sugar is an almost immediate effect in some while for others it does take some time.

2. Bariatric surgery exercises a control over cholesterol, blood pressure and triglyceride levels.

3. The impressive benefits of this operation for a Type 2 diabetes patient are not superficial or temporary. If the patient adheres to the lifestyle prescribed by a doctor, takes medication regularly and follows the basics of post- operative care he or she is likely to remain beyond the ambit of this metabolic disorder.

4. It successfully takes care of ailments resulting from diabetes.

5. Bariatric surgery can eliminate the need for medication or it can reduce the dosage of medicines you take.   

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

Type diabetes

Hi, I am Dr Ashok Gupta, practising since last 37 years as a general surgeon, Laparoscopic surgeon and Gastroenderoscopist. Today we are going to discuss the most common problem that is Anal Fissure.

Anal Fissure is such a problem which is very prevalant in our community, may be the raeson of the pattern of the diet, constipation, inactivity, Obesity Diabetes and other inactive way of diet. Anal fissure is the breech in the skin which are there from the anal walls to the rectum in lower part. This is about 2-3 cm in size and this anoderm is more sensitive and lacking in sweat glands and hairs. Once the hard motion is being passed or the person is constipated, there occurs a breech in the skin which leads to severe pain while passing the stool sometime otherwise also. This linear breech is not going to heal by any chance, it mostly requires medical interference. Medical treatments are responsive at times but once it get failed, then surgery is only the answer.

The surgery is very simple in this case. We just relax the sphincter because sphincter always give the spasm to the fissure which is not allowing it to heal and it always gives the problem in later times. The surgery being done under general anaesthesia and spinal anaesthesia, just to relax the sphincter.

After the cure is there, so it is not going to create problems. But the complicated anal fissure has to be dealt with the "fissure act me" in which the fissure is being removed.

If you have nay query or if you want to contaact me, you can come to my clinic Tirupati Medical Centre in Malviya Nagar. Also, you can contact me through Lybrate.

I am Dr Ashok Gupta, practising since last 37 years as a general surgeon, laparoscopic surgeon and Gastroenderoscopist. Today, we are going to discuss about Gall Bladder Stone disease.

In my carrier of 37 years, I have operated the maximum number of cases of Galstone diseases. Gallstone disease is a very much prevalant in this part of the country. The reason of the Gallstones are many but the diet factor, the inactivity, obesity, diabetes or metabolic disease difference are there. The clinical features of this disease are;

• Patient complaint for pain in the upper abdomen
• Extention of the abdomen
• Vomiting

And this leads to many complications with times.

The diagnosis of this disease is very siple which is the ultrasound. ULtrasound is the main stage in the treatment which helps in diagnosing this disease. If the gall bladder disease is complicated further, then few more investigations like CT Scan, MRI Scan are neded.

The treatment of this disease is very simple these days by the way of Minimal Access Surgery. Initially we used to give 5-7 inches horizontal incision in the adbomen which gives the very ugly scar later. Now there is a Minimal Access Surgery which is called Laparoscopy Cholecystectomy in which the small hole is made and the chip camera is intrioduced and the gall bladder is disacted very easily. 

The post surgery period is uneventful in most of the cases and the person can go home on the same day or on the next day. The complications are very few of this procedure.

If you want to contact me, I am Ashok Gupta at Tirupati Medical Centre in Malviya Nagar. You can also contact me through Lybrate.

Gallstone removal surgery is mainly of two types i.e. keyhole surgery and open surgery. In the case of the former, the patient is not required to stay in the hospital after the surgery, but in the case of the latter, the patient cannot be immediately discharged. Even though after the surgery the amount of bile that is necessary is made by the liver, still patients sometimes feel difficulty in digesting foods with fatty acids. But there are some steps which you can undertake that will give you relief from the complications that arise after the surgery.

1. A proper diet: A proper diet is very necessary for the fast recovery of your gall bladder. So, introduce different food groups gradually. To start with you can have liquid foods like broth or gelatin and then progress to solid foods. You should avoid fatty foods and fried foods as much as you can. Maintain a low-fat diet. Hence, the food items which you must discard from your list includes pizzas, creamy soups, burgers, chocolate, spicy foods, meat gravies and oily foods. And probably after a month, you can start eating the high fiber foods like nuts, legumes, whole-grain bread, broccoli, cabbage and others which would help prevent constipation.
2. Do some mild exercise: Exercise is essential in improving body condition in any circumstance, and gallstone removal surgery is no exception. Heavy exercise that will place stress on your wounds is not recommended. You can go for a walk or indulge in such mild workouts. Any physical activity that causes discomfort should be stopped immediately.
3. Increase your fluid intake: Don’t let your body be dehydrated. Drink water from time to time. Dehydration will slow down the recovery process and also result in fatigue. Drink fruit juices too as they will not help in restoring the nutrients in your body but also prevent dehydration.
4. Take care of your incision area: Taking care of the cuts is very important otherwise they might get infected. So take care of your incisions and change the bandage regularly. Wash the area carefully, and you can apply any antiseptic too but only with the advice of the doctor. You must avoid swimming pool or warm water or bathtub till the incision is completely healed.
5. Take pain medications if it becomes unbearable: If you experience too much after the surgery, then you can ask your doctor to prescribe some pain medications that will help you with the pain. However, don’t panic as the pain is completely normal in the initial days and you may even feel pain in other portions of the body like your shoulders as well.

With these points in mind, you will be able to recover very fast and resume your normal day-to day activities in no time. If you wish to discuss about any specific problem, you can consult a General Surgeon.

Any type of surgery is stressful for your body and you will need to take extra care of yourself in order to heal well. Any procedure that is performed on the stomach, liver, gallbladder, intestines, appendix, pancreas or spleen can be categorised as an abdominal surgery.

Here are ten tips to speed up the healing process after such a surgery.

1. Be prepared: While preparing yourself for surgery, also prepare your home for your return after surgery. Stock up your fridge with soft foods and keep loose, comfortable clothes easily accessible. Ideally, finish your laundry and house cleaning before the surgery and move away furniture and other things that could trip you.
2. Understand your medication: After the surgery, you are likely to be prescribed medication to relieve the pain and help with the healing process. Understand the dosage of these medications as well as any possible side effects that you should watch out for.
3. Get out of bed: The more you move around, the faster your incision will heal. Moving about also aids in the digestive process and helps the bowel work efficiently.
4. Avoid lifting heavy weights: Do not lift anything heavier than 500 grammes without your doctor’s consent. This includes your pets, laundry baskets, grocery bags etc. also, avoid vacuuming for a while.
5. Get some light exercise: It may be a few months before you can get back to your regular workout routine but ensure that you get a little light exercise every day. Walking is a great way to start.
6. Keep plenty of pillows at hand: Holding a pillow between your knees or against your stomach can help relieve abdominal pain and discomfort. You may also feel better by propping yourself up on a few pillows when sitting on a chair.
7. Drink plenty of water: Keeping your body hydrated is crucial to the healing process. Water aids in circulation and ensures that adequate nutrients reach all parts of your body. Ideally, one should drink 8 to 10 glasses of water a day.
8. Care for your incision: Keep your incision clean and dry by washing it with soap and water daily and thoroughly drying it afterwards. Do not apply any ointment or cream on the area unless advised so by the doctor.
9. Take a close look at your diet: For the first few days, it is advisable to eat only soft or semi-soft foods that are easy to digest. You may gradually change to normal food as your body’s tolerance levels increase.
10. Get plenty of sunshine: Exposing yourself to a little sunshine on a daily basis can make the recovery process less painful and make you more cheerful. If you wish to discuss about any specific problem, you can consult a General Surgeon.

Even Roald Dahl faked having appendicitis in his famous book, but, what exactly is appendicitis? Wouldn’t it be a little interesting, to say the least, to find out what causes it and what treatment a person can expect to undergo in the case of getting it?

Quite simply, appendicitis is the name of the condition when the appendix swells up. Under normal circumstances, it is about three and a half inches in length. The ironic part about this is the fact that though appendicitis may cause tremendous pain and warrants surgery, no doctor is really aware of the reason why the appendix exists, in the first place! As a matter of fact, it is fully possible to live without an appendix and many people have not experienced any health problems after having their appendix removed.

While the appendix does not serve any properly defined function, this really does not mean that appendicitis is something that is not all that serious. In fact, if there is an explosion of the appendix, a person can die without very strong levels of medication in a time bound manner!

So, what is the cause behind this scary prospect? Simply said, when the appendix gets blocked, the result is appendicitis. What blocks it? Well, it could be cancer, a foreign body or even stool! That being said, it is to be kept in mind that this is not the only reason as to why appendicitis exists. If there is an infection in the body, in response to it, the appendix may end up getting inflamed.

With the exception of a very small minority of cases in which very strong antibiotics are made use of in order to treat appendicitis, a surgery to remove the appendix is usually a given case scenario when a person has appendicitis. As a matter of fact, it is treated as an emergency and the doctors go ahead and start the treatment as soon as possible to avoid the possibility of the rupture of the appendix.

It usually takes about two or three weeks before a person can get back to normal activities though some gentle movement can be undertaken within about twelve hours since the end of the operation. There are two types of surgery. If a laparoscopic surgery is being performed, the recovery is relatively straightforward but if an open surgery is performed, the recovery can take more time and would require a greater amount of care. If you wish to discuss about any specific problem, you can consult a General Surgeon.