Dear Friends, I am Dr. Manish Kumar Gupta, I am consultant laparoscopic and robotic surgeon at Sir Ganga Ram Hospital. I have my own clinic with the name of New Life Clinic in Indirapuram, Ghaziabad. Friends, I will be talking about a very common problem today, which is Hernia. So we all sometimes hear about it that someone has got Hernia and got operated.
what is Hernia? Hernia is basically, whenever the content of the abdomen comes out through an opening, which is an abnormal opening or a normal opening and present as a swelling or a lump over the tummy. So whenever such sort of a swelling appears in the abdomen, patients get worried, what this type of swelling appeared over their abdomen. These hernia is usually present whenever patients walks, coughs, sneezes or strains, these swellings come out through these defects and whenever patients lie down these swellings go down into the tummy, so these are the initial symptoms and as the time passes these defects gets increases in sizes and more and more internal component like intestines or fat comes out through these opening and hernia swelling sizes keeps on increasing day by day.
What happens in hernia is that It can occur in any part of the abdomen, the most common site for developing these hernias are basically belly buttons and in the groin region. If a patient has undergone some surgery, some operation for some intestine or something like that in the abdomen, this is the weaker side and from this side a hernia can appear. So initially the symptom is like there is a lump, which comes out and goes in once you press or lies down.
The chances of complication can occur and the complication are initially irreducibility, it means that it doesn’t go inside the abdomen and remains there because there are some additions in between the content of the hernia and the abdominal wall and the second complication is the obstruction, it means, that intestine has come into the hernial sac and there is non passage of any content like food or any fluid through the intestine and patient gets started vomiting, there distinction of abdomen and pain, the third complication is that whenever the blood supply of this intestine gets disrupted then there is strangulation, it means that it can lead to gangrene of the intestine. So these complications are like an emergency complication and one has to go and get operated as early as possible so that one doesn’t develop any gangrene of the intestine.
The treatment for Hernia is basically surgery. Whenever one sees such hernial swelling, one should go and contact a surgeon so that he can advise you when to go for surgery but the earlier the better. One should not wait and watch to get the complications to occur.
Nowadays, the surgery for hernia is basically a laparoscopic surgery, it means that we make three holes which is like pencil size holes through which we put a mesh which is a polypropylene or a bio degradable mesh and put this mesh over the hernia defect and fix it with multiple tackers.
Nowadays, the chances for recurrence is quite less because of formation of application of these mesh over the hernial defect.
There are few precautions one can take. There are some precautions which a person can take, like one should not sneeze too much or cough too much so that these hernial swellings do not increase in size and don’t get impacted into the defect.
So friends i have told you about hernia swellings today and if you have such problems then you should go and meet a surgeon or if you want to come to me, you can come at Ganga Ram hospitals, which is in central Delhi or you can come to me and meet me at my clinic which is in Indirapuram, Ghaziabad or you can talk to me through Lybrate, you can chat me or you can text me through Lybrate.com.
Here are some treatments and symptoms of gall bladder stones
Symptoms and Treatments of Gallbladder Stones
Dear friends. I’m Dr. Manish Kumar Gupta. I’m a Consultant Laparoscopic and Robotic Surgeon in Sir Ganga Ram Hospital.
I have my own clinic with the name New life clinic at Indirapuram, Ghaziabad.
Today, friends, I’ll be talking about gall bladder stone which is a very common problem in North India.
The gall bladder is basically a pear shaped organ which is attached to the liver and the bile which is formed in the liver gets stored in the gall bladder which is later goes in to the intestine, and get mixed with the food to cause digestion of the food.
Whenever the component of the bile like cholesterol or bile pigment increases there is formation of gall bladder stones.
The symptoms of gall bladder stones are basically distension of abdomen after having heavy meals or discomfort or sometimes patient can have pain in the right side of the upper abdomen or which can radiate to the back and shoulder.
Sometimes, these gall bladder stones can be silent stones, and they lie in the gall bladder without causing any symptoms but if these stones are in patients having diabetes or if these stones are very large more than 2 cm in size then, the treatment is required.
The diagnosis of gall bladder stone is very simple. By a simple ultrasound abdomen, one can be easily diagnosed whether the patient is having a gall bladder stone or not and it is almost a confirmatory diagnosis. One does not need a very special investigation or test to get diagnosed these gall bladder stones.
The treatment for gall bladder stones is basically a surgery.
There’s nothing like, you can’t do anything to prevent gall bladder stones to form but yes, if you eat less oily or less fatty meals, the symptoms get relieved to some extent.
As I told you that the treatment is surgery. Nowadays, there is no big cut in the tummy to take out the gall bladder but what we do nowadays is a laparoscopic surgery.
In laparoscopic surgery, we make three or four pencil size holes in the abdomen and through these holes we operate. Through one hole, we put a cylinder like camera inside and by two or three ports, we put our instruments inside and get these gall bladder removed from the abdomen through a 10 mm port.
Nowadays, this type of surgery is basically a day care surgery and one can come to the hospital and get operated and can be discharged on the very same day if it’s an uncomplicated gall bladder.
Gall bladder can cause complications also other than these symptoms and if the stone gets slipped down and gets inducted in a common bile duct which is a channel which joins the gall bladder to the intestine and if the stone gets inducted in common bile duct, then, one has to take out that stone endoscopically through ERCP and then after that one has to go for gall bladder stone removal.
So, it is like a two stage procedure. So, one should not wait to get all these complications to occur because , if the stone gets inducted in the CVD then, the chances of jaundice, chances of acute pancreatitis can occur which can be dreaded complication .
So, friends I have told you about the gall bladder stones and if you have such problems, if you have gall bladder stones even though it is asymptotic or you have symptoms you should go to a surgeon or a physician who can guide you.
You can tell you what need to be done or if you want to meet me you can come to me at Sir Ganga Ram Hospital or at my clinic which is in Indirapuram with the name New life clinic or you can talk to me through Lybrate, you can chat with me, you can text me at the lybrate.com and I will be available 24 hours to you.
Thank you friends! Thank you!
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Kidney Stones Treatment
Removal Of Stitches Procedure
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Even though I was fit and fine, it was shocked when I got to know that I have gallstones. My previous experiences were not so good, but Manish K. Gupta has completely changed my opinion as he is very helpful and humble. I must say the hygiene was maintained very nicely in the New Life ClinicDuring the complete gallstones treatment program he always supported and motivated me. The New Life Clinic was equipped with various facilities. I feel so great after the completion of treatment. With great ease Manish K. Gupta explained us the problem and how the treatment will be carried out.
Due to my piles treatment i have bee better. Thanks to him I am much better now. It was an amazing experience as everyone in the New Life Clinic is so nice. I am really grateful as his piles treatment has give me a ray of hope. He is not just friendly, but also is very motivating. It's been so long, I have lost all hope, but then I met Manish K. Gupta and I am hopeful again that I will be fine. Manish K. Gupta has so much knowledge that for everything my family takes his reference.
I was suffering from hemorrhoids for such a long time. I read an article of Dr Manish in the paper and made contact. Not only he is very calm and composed, but is also a very understanding doctor. I was quite depressed due to my condition, but he guided me to change my attitude. I must say the hygiene was maintained very nicely in the New Life Clinic.
Initially the symptoms of swelling were not that severe but then it became worse. I am so much benefitted with Dr Manish's treatment, that i am perfectly fine now. Over the period of time the swelling treatment has helped me a lot. He definitely is aware about the latest and advanced ways to treat serious cases.
I am so thankful that drManish K Gupta has given me the best advice and I am now finally able to get back to my normal self. It's been more than a year now, and I have noticed considerable change in myself after cysts treatment by him. he canm be consulted at New Life Clinic in ghaziabad.
Thnaks to Dr Manish for treating my Varicose. I was quite worried about this problem but after consulting this doctor, I am so much relieved. He is not just highly qualified, but has years of experience in handling high risk cases. The New Life Clinic was equipped with various facilities.
I was suffering from Vitiligo, I am so thankful to Dr Manish has given me the best advice and I am now finally able to get back to my normal self. No matter how critical be the situation, he is always very calm. The friendliness of staff is the best in the New Life Clinic.
I found the answers provided by the Dr. Manish K. Gupta to be saved my life. Best Doctor In Gastro I have ever seen..He saved my brother's life ....No one can explain as he can No one can Simplify as he can...hats off
dr Manish K. Gupta did my treatment his at his clinic New Life Clinic in Noida for my problem of anal fissure.Overall Treatment was very effective. his advice and counselling has helped me immensely.
Good and comfortable.
The gallbladder is responsible for storing and releasing bile. This bile aids in digestion by breaking down fat cells. If the gallbladder does not function optimally, small crystals begin to develop within the gallbladder. These are known as gallstones and can range from being the size of a salt crystal to a golf ball. Gallstones can be extremely painful and do not go away on their own. Since the body can function without a gallbladder, a surgeon may advise removing this organ to treat gallstones. This is known as a cholecystectomy. Today, this surgery is usually performed laparoscopically.
What is a laparoscopic cholecystectomy?
This surgery is also known as a keyhole surgery. Unlike an open surgery, in this case, the surgeon makes a few small incisions through which instruments may access the gallbladder. The removal of the gallbladder is also done through one of these incisions. A laparoscopic cholecystectomy may also be performed if the gallbladder is inflamed or in the case of pancreatitis. There are a number of advantages to this type of surgery. Most important amongst them is that the patient recovers faster and has less scarring.
Laparoscopic Cholecystectomy Procedure
This surgery is usually performed while the patient is under general anaesthesia. The surgeon begins by making a number of small incisions in the patient’s abdomen. A tube is then inserted into one of the incisions. Carbon dioxide gas is passed through this tube to separate the underlying organs from the abdominal wall. A tiny camera is inserted into another cut. The feed from this camera is displayed on a large monitor. Clips are sued to cut off the arteries and ducts servicing the gallbladder. The gallbladder is them cut free and pulled out of the abdomen through one of the incisions. During the surgery, special x-rays may also be used to check for gallstones lodged in the bile ducts. The incisions will then be stitched and dressed. In most cases, patients may go home on the same day.
Recovery from Laparoscopic Cholecystectomy
This surgery has a high success rate and is considered relatively safe. However, there are some risks associated with the procedure. These include:
- Allergic reaction to anaesthesia
- Bleeding or clotting of blood
- Increased heart rate
- Injury to the small intestine or bile duct
Recovering from a gallbladder removal surgery usually takes a week. Unless there are any complications, extended hospitalization is not required. In the first few days after the surgery, patients may experience slight diarrhoea. Patients are advised to walk but should avoid lifting weights. Special antibacterial soaps should be used while bathing to avoid the onset of infections.
Obesity surgery is more commonly referred to as bariatric surgery. It is a surgery done on the stomach and/or intestines of a person with morbid obesity so that he or she loses weight. It is believed that as of now, bariatric surgery is the only option that almost always works to help overly obese people lose a lot of weight, which automatically makes the associated chronic conditions vanish.
How does this surgery work? Bariatric surgery works by changing the anatomy of the stomach and the digestive system (gastrointestinal tract) or by causing different physiologic changes in the body, which in turn changes the energy balance and fat metabolism. Technically, eating fewer calories than they are burned by the body, results in gradual and long-lasting weight loss. Bariatric surgery is the best option for people who have a body mass index (BMI) above 40. It can also be recommended for people with a BMI in between 35 and 40 and who have health problems such as type 2 diabetes, hypertension, or higher risk of heart diseases.
Types of obesity surgery: There are four types of bariatric surgical procedures that can be done to promote weight loss. This includes:
- Roux-en-Y Gastric Bypass Surgery – This is commonly known as gastric bypass. It is considered as the gold standard of weight loss surgery. This procedure is often considered to be highly effective and a more permanent one.
- Adjustable gastric band – This is more commonly referred to as band surgery. It is the most basic and easiest of surgeries to do.
- Sleeve Gastrectomy – This procedure is often called the sleeve. Studies show that the sleeve is as effective as the gastric bypass surgery in terms of weight loss and improvement of diabetes. However, the complication rates of the sleeve are on the higher side.
- Biliopancreatic Diversion with Duodenal Switch Gastric Bypass – Abbreviated as BPD/DS, it is a procedure with two components. It is considered to be the most effective surgery for the treatment of diabetes among all.
However, only a surgeon is able to decide which surgery will be the best for a patient. The decision is made after carefully considering the condition, requirement and manifestations of a patient. Moreover, the surgeon will also consider the advantages and disadvantages of each obesity surgery type before choosing the most suitable one for an individual.
Benefits of obesity surgery: Bariatric surgery continues to benefit people worldwide who fight against morbid obesity. Obesity is associated with impairment in the quality of life. In particular, obesity can cause increased physical limitations, body pain, fatigue, high blood pressure, and even diabetes. Bariatric surgery also acts as a preventive intervention against these serious health problems caused by obesity. Numerous studies have suggested that not just physical but many individuals have reported improvement in psychological functioning as well.
Bariatric surgery can help improve patient’s overall mood and psychological health. Patients who have undergone these procedures report decreased feeling of depression and anxiety, as well as an increase in energy to take up more active lifestyle post-surgery. Obese patients who undergo bariatric surgery not only live longer but also live much better.
Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.
Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient’s age, weight, overall health etc.
- Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
- Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient’s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
- Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
- Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Piles are a common ailment, albeit distressing, which can be treated with proper operative measures. Piles refer to hemorrhoids which have become swollen or inflamed. Comprised of vital tissues, blood vessels, elastic and muscle fibers, Hemorrhoids are masses and clumps of tissue cushioning and lining the anal canal. The inflammation occurs when there is a rise in the pressure in the small arteries that make up hemorrhoid causing them to enlarge and swell with blood.
Besides the fact that piles, also called as pathological hemorrhoids, can be extremely painful, not operating can give rise to severe health issues. There are different types of piles surgery procedures conducted according to individual needs as prescribed by individual doctors.
Surgery For Piles - What To Expect?
Piles are a common ailment, albeit distressing, which can be treated with proper operative measures. Piles refer to hemorrhoids which have become swollen or inflamed.
Comprised of vital tissues, blood vessels, elastic and muscle fibers, hemorrhoids are masses and clumps of tissue cushioning and lining the anal canal. The inflammation occurs when there is a rise in the pressure in the small veins that make up hemorrhoid causing them to enlarge and swell with blood. Besides the fact that piles, also called as pathological hemorrhoids, can be extremely painful, not operating can give rise to severe health issues other than severe anemia and weakness. There are different types of piles surgery procedures conducted according to individual needs as prescribed by individual doctors.
This procedure involves injecting a chemical into hemorrhoids. The chemical causes the hemorrhoids to contract and stop bleeding. Most individuals encounter little or no pain with the shot. In the case of small internal hemorrhoids, Sclerotherapy is shown to have the best benefit rates.
Stapled Hemorrhoidopexy, also commonly known as MIPH, is a form of surgery which requires 12 hours of hospitalization. This process necessitates general, regional, or local anesthesia. This kind of surgery is used to handle hemorrhoids that have already prolapsed. A surgical staple fixes the prolapsed hemorrhoid inside your rectum and cuts off the blood supply so that the tissue can contract. Recovery from hemorrhoidopexy is less painful and takes lesser time than the recuperation period of a hemorrhoidectomy.
Excision used to be prescribed for hemorrhoid sufferers. This therapy involves the surgical removal of the hemorrhoids with a cautery, laser or knife. Although these methods are slightly different, the outcomes are identical. Excision results in discomfort and pain in the perianal area that lasts from two weeks to two months. The pain during bowel elimination also lasts for approximately the same time.
Management of the hemorrhoids with proper medication, diet and workout is by far the safest way to go. Only in the case of lifestyle changes failing to solve the condition, surgical interference should be considered.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Laparoscopic Surgery, also known as Keyhole Surgery, is a minimally invasive technique in which operations are performed through small incisions made far from the location. Laparoscopic Surgery has many advantages over the traditional open surgery procedures. It is reliable, risk-free and reduces the chances of huge pain and hemorrhaging. Smaller incisions are made while performing this operation which enables a faster recovery.
How is it performed?
Laparoscopic Surgery is performed with the help of an instrument called Lparoscope. It has a thin tube-like structure and is extensively long. The camera at the front of a laparoscope is inserted into the body through a hole that allows doctors to perform surgery by watching real time video on the TV screen and it is much more convenient than open surgery.
Reasons Behind Performing Laparoscopic Surgery
Abdominal Problems are usually solved by using techniques such as MRI, CT scan, and Ultrasound technology. If these fail to provide enough information, then laparoscopic surgery is performed for a better diagnosis of the condition. It can also be performed in a case when the doctors need a sample of tissue from a part of the abdomen. Laparoscopic surgery is famous and most preferred in Bariatric Surgery and Gallbladder Removal.
This minimally invasive technique is widely common for weight loss.
Laparoscopic Surgery is safe and trusted by many surgeons worldwide, and it can be performed on patients who have undergone laparoscopy surgery beforehand as well. The only thing that is needed to be kept in mind is that the keyhole is to be made should be from a different site. Laparoscopic Surgery allows the patient to start having food normally after a couple of days of the surgery. It reduces hospital costs as minimal days are spent in the hospital, and it helps the patient to continue with their normal life early.
Types of Laparoscopic Surgeries
- Hand-assist laparoscopy: Hand Access Devices are new Laparoscopic devices which help the doctor perform various functions having their hand inside the surgical location. Such hand-assist surgeries are called the hand-assist laparoscopy and are used in surgeries like colon removal and kidney removal.
- Robot Assisted Surgery: This is the most commonly used laparoscopic technique which surgeons perform in a less invasive way. This computer based system is known as the Da Vinci system. The surgeon performs this type of surgery with the help of two masters which are similar to joy sticks. These masters control the two arm-like instruments which they insert into the body.
Preparing for Laparoscopic Surgery: There are no such preparations that are required to be taken before laparoscopic surgery as your doctor might help you out with everything. If you are taking any prescribed medicine, your doctor must know about it. Before laparoscopic surgery, blood test, urinalysis, ECG, and other required tests might be advised by your doctor. It is best not to eat or drink anything 8 hours before laparoscopy.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Your body needs proper care after a major surgery. You lose a lot of blood during the surgery, and thus your body becomes weak. It is essential to give proper nourishment to the body to recover completely. This is why you should consume enough nutrients and calories to bring back your body in good shape and order. If you know which food you should eat and which you should not, you can reduce the risk of any infection and also speed up the process of healing the incision. A proper diet not only keeps you healthy, but it gives you additional energy as well as strength.
Foods and nutrients that you should focus on: A proper diet will aid in healing the incision faster and minimize bruising, inflammation, or infections. You may also have digestive upset as a result of all the antibiotics that you are consuming. They also work wonders when it comes to preventing constipation. If you fuel your body properly, you will get back all the energy to get back to the routines of your daily life.
- Lean Protein: Collagen is found in the body in excess which plays a critical job of knitting the tissue. You should consume 0.8gm protein pe kg body weight, but after surgery, the protein intake should increase to 1.5gm protein per kg body weight. Proper intake of protein helps in repairing the incision faster.
- Fermented Dairy: There is no doubt to the fact that your doctor has prescribed you a series of antibiotics to heal fast. Antibiotics not only kill all the bad bugs, but they also destroy the useful gut bacteria that help in digestion. The digestive tract can be repopulated with gut bacteria by consuming the fermented dairy product that includes yogurt or kefir.
- Fiber: Pain killers, alteration in your diet, anesthetic agents used during the surgery, stress, or less physical activity work against the standard process of excretion. You should drink enough water and also pop prunes which will make the elimination of the waste products from the body regular. Prunes are very rich in not only the soluble fiber but also the insoluble fiber, which aid in adding bulk to the stool. Foods like beans, apples, oatmeal, etc. are also rich in fiber.
- Colored Fruits: Your body goes through a lot of stress and anxiety after surgery. This may result in the oxidative load on your body to increase, which is also referred to as the production of free-radicals. The body makes use of the antioxidants to get rid of the harmful molecules. Hence, it is vital to increase the intake of antioxidants after surgery. Colored fruits including the blueberries, raspberries, cherries, strawberries, pomegranates, and blackberries are an excellent source of antioxidants.
In some complex surgeries, you lose a lot of blood during the surgery, and thus your body becomes weak. Taking good care of your body is essential after surgery to get back to the normal life in a healthy manner.The diet that you will be maintaining will help in healing up the wound faster and make you completely fit.
Hernia is a small protrusion or escape of any structure or organ through nearby weak spot or muscle. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia. This hernia can be removed and relocated to its original position and secured with special type of hernia mesh to prevent the recurrence of hernia.
When hernia surgery is required?
Hernia is not a serious health issue that requires surgery immediately. But surgery is essential only during the following situation-
- Size of hernia is more than half an inch.
- Hernia causes severe pain and causes much physical discomfort.
- Hernia causes disfigurement.
There are two different methods used for hernia surgery:
- Open hernia repair: Open surgical incision is made near the herniated site and the surgical procedure is done and secured with a mesh work. This surgical procedure requires several preparatory measures to be done before surgery. There is also blood loss and recovery period after surgery is also more than other type of surgeries.
- Minimally invasive hernia repair: The surgery is done with a laparoscope which has small tiny camera, small synthetic hernia mesh and small tool with it. So the patient can return back to their normal routine earlier as the incision made is smaller.
Before undergoing hernia surgery:
- One week before surgery it is much essential to stop taking drugs that are causes the thinning of the blood. Drugs like aspirin should be stopped with the doctor’s advice.
- Stop herbal supplements and check the fitness of your cardio and diabetes
- Gain adequate knowledge about surgery and be prepared for the post surgical care
After hernia surgery:
Our endocrine glands work overtime to keep us healthy by secreting hormones which reach each and every cell in our body through the blood. These hormones evoke life changing responses in other cells to keep us alive and healthy. Endocrine surgery is a term for an operation in any one or more endocrine glands in your body.
Types of endocrine glands
- Thyroid gland: This is the most important endocrine gland in your body and it secretes thyroid hormone, which regulates metabolism.
- Parathyroid glands: There are 4 parathyroid glands and these are located behind the thyroid gland in the neck region. These glands secrete the parathyroid hormone which controls calcium levels in the body.
- Adrenal glands: These are located over the kidney. There are 2 adrenal glands and these secrete adrenaline, aldosterone and cortisol- the body’s fight or flight hormone. These also maintain salt levels in the blood and the blood pressure.
- Neuroendocrine glands of the pancreas: These are located in the pancreas behind the stomach. They work to control glucose levels and glucose metabolism.
- Pituitary gland is the master gland of the body: It secretes thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), and other important hormones that control ovaries, thyroid and other endocrine glands in your body.
Depending on the endocrine gland being operated upon, there are different types of endocrine surgeries. The most important ones are-
- Hypophysectomy: This is the surgical removal of the pituitary gland. It is a very sophisticated and critical surgery that surgeons resort to, if there is a tumor in the pituitary gland - especially craniopharyngioma tumors. It can cause atrophy of thyroid, adrenal glands and the ovaries as the pituitary secretes hormones to control their function. In addition, it can result in sterility and sometimes results in a non-functional reproductive tract in both men and women.
- Thyroidectomy: It is an operation that involves removal of the entire or parts of the thyroid gland in the neck. Trained ENT or endocrine surgeons perform this operation, which is indicated for thyroid cancer or hyperthyroidism, goiter or Graves disease. Sometimes it is done for treating an enlarged thyroid gland or obstructions in the neck region, causing problems in swallowing or breathing. In cases of total thyroidectomy patients will need life long thyroid hormone supplementation. Sometime patient can have change in voice which is usually temporary.
- Since the thyroid produces several hormones like thyroxine (T4), triiodothyronine (T3), and calcitonin, you will have to take oral synthetic hormones all your life post surgery. The thyroid is usually removed through an incision in the neck. These days there is the option of minimally invasive surgeries too.
- Adrenalectomy: It is the removal of one or both adrenal glands to treat tumors of the adrenal glands. It is done using an open incision or laprascopic technique.
- Pinealectomy: It is a surgical procedure in which the pineal gland is removed. If you wish to discuss about any specific problem, you can consult a General Surgeon.
At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as
- Midline Incision: It’s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
- Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
- Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
- Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
- Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron’s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
- Gridiron’s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
- Kocher’s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher’s incision. This however is different from the same named incision used for the thyroid gland surgery.
- Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.
You probably think many more things can go wrong during a surgery as compared to after a surgery. However, you are wrong. The chances of infection after a surgery are very high and it used to be the highest cause of unsuccessful surgery in the past before it was known just how deadly an infection is. A doctor, however, cannot monitor everything afterwards. Therefore, it is crucial you know and take care after the surgery. Here are some ways in which you can do so:
1. Keep it dry
It is crucial that you keep the incision dry for whatever period of time the doctor tells you to keep it dry as otherwise the chances of infection increase dramatically. Some of the things you should do to keep it dry is to not take a bath, scrub the incisions or put lotions on it. In fact, you should also not expose it to sunlight.
2. Keep the incisions
You must trust your doctor as the doctor is trained and usually knows better than you. Therefore, if the doctor tells you to keep the incisions then keep them. Do not scrub, rub or put powder on them either.
3. Check for signs of infection
This may be the easiest thing to do as there are many symptoms of an infection. These include a change in the color, size, or odor of the incision, fever, redness, hardening or heating of the surrounding area or in extreme cases more bleeding and pain than usual.
4. Changing a dressing
This is a major cause of infections among surgery patients and the only way to prevent it is to follow the doctor's instructions to a tee. Once again, trust your doctor and remember to wash your hands and put on medical gloves. Do not put alcohol, iodine or hydrogen peroxide either. If you wish to discuss about any specific problem, you can consult a doctor.