Dr. Apoorv Goel

Obesity is unarguably one of the most regularly discussed topics around the world. A major section of the world's population is suffering from a variety of obesity related problems. There are a number of natural methods to check obesity; however, several medical surgeries are gaining popularity among the masses with instant results to reduce weight.

Here is a list of the most common types of weight loss surgeries:

1. Gastric sleeve surgery: This surgery is performed where removal of a large part of the stomach takes place. A long pouch is created, which connects the small intestine with the oesophagus. The pouch gets stapled and after that the other parts of the stomach are reduced. In some cases, an additional step is taken for reinforcement of the staple line.

Gastric sleeve reduces the size of the stomach and a patient will feel full after eating lesser amount of food. Because a portion of the stomach is reduced, lesser amount of hunger causing hormones are produced. The patient will therefore feel less hungry.

2. Gastric bypass surgery: This is another effective weight loss surgery, which reduces the patient's stomach size, resulting in reduced appetite. The intestines are rearranged, which makes the body absorb fewer minerals. While performing this surgery, the stomach is cut and stapled to create a pouch. 

The remaining stomach is attached to the small intestine's top portion, and the small intestine is cut and attached to the pouch as well. After this, the end portion of the small intestine is connected with the non-pouch part of the stomach and is attached to the roux limb bottom. This makes the stomach's digestive juices to meet the food present in the intestines.

3. Duodenal switch: This surgery reduces the stomach size in patients, which leads to decreased appetite or craving for food. Fewer hormones, which cause hunger, are secreted and the rearrangement of the intestine causes the body to absorb minimal minerals or calories.

A part of the stomach is removed and a pouch is created. The small intestine's top portion is cut off, but the duodenum is kept attached to the stomach. The small intestines are cut, and the part attached to the large intestine called colon is connected with the duodenum. Finally, the loose end of the small intestine gets attached to the small intestine to enable digestive juices to mix with food.

4. Lap band surgery: By this surgery, a band is wrapped around the upper middle section of the stomach which squeezes the stomach. Thus a smaller section of the stomach is created above the band which fills up very quickly while having food. The patient feels full by eating less. A laparoscopic adjustable gastric band is used.

There are many different weight loss surgeries. Most of them aim at reducing the capacity of the stomach, so that the person eats less food.

Gallstones are actually hard deposits or lumps that are formed in gallbladder. Gallbladder is a pear shaped, sac-like structure that is located in the upper right part of the abdomen that stores bile. Many people have gallstones present in their bladder but they never know it. This can be an alarming situation for people who have it.

What Causes Gallstones?

There may be several reasons, including:

1. Your genes
2. Your weight
3. Problems with your gallbladder
4. Diet
5. Bile can be part of the problem. Your body needs bile, but if it has too much cholesterol in it, that makes gallstones more likely.
6. It can also happen if your gallbladder can’t empty properly.

Who Is at Risk for Gallstones?

While your body produces cholesterol naturally, you can also take in excess cholesterol through your diet. Many risk factors for gallstones are related to diet. These include:

1. being overweight or obese
2. eating a diet that’s high in fat or cholesterol
3. rapid weight loss within a short period of time
4. eating diet that’s low in fiber
5. having diabetes mellitus

What are the treatments available for this?

1. Surgery: One of the famous treatments include surgeries. The famous surgery is Cholecystectomy (Removal of gallbladder) that further includes Laparoscopic surgery and Open cholecystectomy.
2. Medications: The patients who cannot undergo surgeries can also use drugs like ursodiol and chenodiol . But this can take months or years to remove stones from bladder.

You can reduce your risk of gallstones if you:

1. Don't skip meals. Try to stick to your usual mealtimes each day. Skipping meals or fasting can increase the risk of gallstones.
2. Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week.
3. Maintain a healthy weight. Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continuing to exercise.
    

Abdominal Laparoscopy is a surgical diagnostic procedure, which is used to examine the organs inside the abdomen. It is an invasive procedure, but only small incisions are made.
The procedure is usually done in the hospital and the patient is given general anaesthesia to make the procedure pain free.

The laparoscope is inserted through an incision in the abdominal wall. As it moves along, the image of the inside of your abdomen is then seen on the monitor. After the exam, laparoscope and instruments are removed and the cuts are closed. Laparoscopy is usually done as an outpatient procedure. This means that you will be able to go home the same day.

Why Is laparoscopy performed?
Laparoscopy is often used to identify the source of abdominal pain. It is usually performed when x-rays or ultrasound are unable to determine the root cause of the problem. Laparoscopy allows your doctor to see inside your body in real time and helps to diagnose or help discover what the abdominal problem is.

Tips to deal with laparoscopic surgery

Before Surgery

1. The first and the foremost thing is to prepare yourself for the surgery by watching some videos and going through some blogs on it as doing so will help you clear your doubts
2. Do not eat or drink anything 8 hours before the procedure
3. Make sure someone accompanies you on the day of the surgery
4. Fix your Pre Op appointment to ask any questions or address any concerns regarding the surgery, anaesthesia, etc
5. Shave the area where the surgery will be performed. This will substantially reduce itchiness
6. Lastly, prepare your hospital bag and discuss it with the person who is going to accompany you so that he/she knows what all you packed

After Surgery

1. Don’t lie down in bed all the time. Keep yourself active by moving every two hours as it promotes healing and helps eliminate gas pain
2. Wear comfortable clothing
3. Do not take bath for a week. However, you can take a shower 24 hours post surgery
4. Drink at least 1.5 to 2 litres of water per day to prevent constipation. If constipated, take a stool softener.
5. While sneezing or coughing, hold a pillow against your stomach to lessen the pain
6. Roll onto your side and sit up using your arms for support and then stand up
7. Don’t drive for two weeks
8. Refrain yourself from intercourse, douching, and swimming
9. Make sure to visit your doctor 2 to 3 weeks post surgery to make sure your wounds are healing

It might take some time for the wounds to heal, but in case of any prolonged pain do remember to consult doctor immediately.

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:

1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastrointestinal tract
6. Congenital defects
7. Haemorrhoids (Piles)
8. Anal Fissure
9. Fistula-In-Ano

• Procedures: The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:
• Colectomy: This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.
• Colonic polypectomy: An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.
• Strictureplasty: Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.
• Colostomy or Ileostomy: A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.
• Hemorrhoidectomy: This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.
• Anoplasty: Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

Thyroid is a small butterfly shaped gland, which is present at the lower frontal region of the neck, right beneath the voice box. It produces hormones which regulate metabolism (the breakdown of food by the body to convert it into energy). It even plays a pivotal role in boosting organ functions as well as in helping the body to sustain heat.

However, too much of hormone production by the thyroid gland might yield structural problems, for instance, growth of nodules (abnormal tissue growth) or cysts (non-cancerous sac-like structures containing fluid) and swelling. Hence, a thyroid surgery is a must once these problems occur. The surgery, administered with general anesthesia, eliminates the thyroid gland either wholly or partially.

Why do you need surgery?

1. The presence of tumors or nodules on one’s thyroid gland is one of the reasons why one should go for the surgery. Although most of the nodules are benign, few can be pre-cancerous or cancerous too. Also, those benign nodules can spell trouble, if they expand in size, thus obstructing the throat. They can be problematic as well if they cause the thyroid gland to overproduce hormones, giving rise to a condition known as hyperthyroidism.
2. Hyperthyroidism can be corrected through surgery. It is often an outcome of Grave’s disease, an autoimmune disorder wherein the body misidentifies the thyroid gland as a foreign body, thereby creating antibodies to combat it. The thyroid gland gets inflamed in the process, resulting in the overproduction of hormones.
3. Another reason is the enlargement or swelling up of the thyroid gland, termed as goiter. Similar to large nodules, goiter too can clog the throat, thus interfering with one’s breathing, speaking and eating.

Types of Surgery

1. Lobectomy: This procedure calls for partial removal of the lobes when a nodule or an inflammation affects just half of the thyroid gland.
2. Subtotal Thyroidectomy: Here, a small proportion of the thyroid tissue is left behind even after the elimination of the thyroid gland.
3. Total Thyroidectomy: Through this procedure, the entire thyroid gland is taken out along with the thyroid tissue.

Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process. Here are a few things to keep in mind.

1. Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
2. Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
3. Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
4. Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
5. Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
6. Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring.