Dr. Apoorv Goel

Noticed an unusual lump in the breast while in the shower? Then, the first thought you get might be cancer. But no need to hit the panic button though, as not all such lumps are cancerous. However, opting for immediate medical evaluation is necessary whenever one notices the presence of swelling or lumps in the breasts is found.

What are breast lumps?
The term breast lumps refer to localized swelling or bumps or bulges in the breast, which doesn’t feel as same as the breast tissues around them or like that of the normal breasts. There are a number of reasons that can cause breast lumps.

Who can develop breast lumps?
It is often the hormonal changes such as menstruation that is responsible for causing breast lumps, which usually disappears naturally in most cases. Both the boys and the girls may develop breast lumps that feel tender during their puberty. Such breast lumps are temporary and go within a few months. Increased levels of estrogen can also cause breast lumps in a baby, but that too disappears once the estrogen returns to normalcy.
But when breast lumps don’t go away even after puberty or after menstruation and continue to grow bigger, making the breasts appear bruised, turning the skin of the breast area like an orange peel or causing bloody discharge from the nipple, it’s time to visit a doctor immediately. Upon evaluation, a mastectomy might be advised.

What is mastectomy?
The term mastectomy refers to the surgical procedure of breast removal. There are five different types of mastectomy which are, total mastectomy, preventive mastectomy, partial mastectomy, the radical mastectomy and modified radical mastectomy. Depending on a person's age, size of the tumor, general health, tumor stage and grade, involvement of the lymph nodes etc., which type of mastectomy will be ideal is determined.

When mastectomy becomes necessary?
In situations where large lumps formed in the breasts, or the lumps being present in the middle of the breast or cancer has spread in more than one single area in the breasts, mastectomy becomes necessary. Plus, those, who already have gone through radiotherapy for their breast cancer are usually suggested to opt for mastectomy.

Remember, though popular and most effective, mastectomy is not the only way of dealing with breast lumps. Depending on the size, location, spreading and the type of lump, whether it's a tumor or spreading as cancer, the treatment may vary from person to person. Hence, it's a doctor who can best guide you by performing necessary medical evaluation and tests and help opt for a treatment option that is ideal. In case you have a concern or query you can always consult an expert & get answers to your questions!

What is an Appendectomy?

An appendectomy (which is sometimes referred to ‘appendicectomy’) is the surgical elimination of the organ known as the appendix. Appendectomy is mostly performed as an emergency surgical procedure, when patients suffer from appendicitis.

How is Appendectomy Performed?

Appendectomy can be performed both as an open operation as well as laparoscopically. An appendectomy is most often performed laparoscopically, if the diagnosis is in doubt, or if the patients feel that they need to hide their telltale surgical scars near their umbilicus or in the pubic hair line.

However, although laparoscopic appendectomy has its cosmetic advantages, and its recovery time is a little quicker, this procedure is more expensive than conventional open surgery.

Conventional Open Appendectomy

In the conventional open surgery, the surgeon makes an incision which is less than 3 inches in length in the lower right section of the abdomen. Once the infected appendix is identified, the surgeon separates the infected appendix from its surrounding tissues and removes it surgically from the cecum (an intraperitoneal pouch that forms the junction of the small and large intestine). After that, the cecum is closed and is returned back into the abdomen. In the end, the muscle layers and the skin are sewn together and the incision is closed.

Laparoscopic Appendectomy (LA)

While performing appendectomy laparoscopically, which is also known as LA, four incisions of 1 inch in length are made in the abdomen. One incision is made near the umbilicus, while another one is made in an appropriate region between the umbilicus and the pubis. The other two incisions, which are even smaller in size, are made in the right side of the lower abdomen. The surgeon then passes the camera and special laparoscopy instruments through these openings and after identifying, frees the appendix from its surrounding tissues. Next, the appendix is removed from the cecum and the site of its former attachment is sewed. The infected appendix is removed from the body of the patient through any one of the two 1 inch incisions. In the end, the laparoscopic instruments are removed and the incisions are sutured and closed. During this whole procedure, the intraperitoneal space is filled with medical grade carbon dioxide gas, to inflate the abdomen, which is released after the surgery.

Recovery Time For Appendectomy

The recovery time for appendectomy depends on and varies with the type of procedure and anesthesia used during the surgery. While laparoscopic appendectomy can be done on an outpatient basis so that the patients can recover back at home, an open surgical procedure will require an overnight or even longer hospital stay.

Normally patients after appendectomy can resume their normal daily activities within a few days. However, for full recovery, it may take four to six weeks. Patients are advised to avoid strenuous activities during this period of time.

Risk and Long Term Consequences of Removing the Appendix-

While wound infections are the most common complications of this surgery, formation of an abscess in the area of the surgical incision and also in the area close to the removed appendix has also been noticed as an aftermath of appendectomy.

Other rare complications may include lack of intestinal peristalsis (ileus), gangrene of the bowel, injuries to the internal organs and infections in the peritoneal cavity (peritonitis).

Major long-term consequences of appendectomy include increased risks of bowel obstruction, stump appendicitis (infection in the retained portion of the appendix still stuck with the cecum) and development of incisional hernia at the site of the scar.