Dr. Elbert Khiangte is a reputed General Surgeon in Guwahati who has an experience of 17 years in treating his patients. He is an Endocrine Surgeon, Thyroid Specialist, Surgical Gastroenterologist, Anorectal Surgeon, Colorectal Surgeon, General and Laparoscopic Surgeon and an expert in Minimal Access Surgery and Vascular Surgery. He completed his MBBS from Gauhati University in 2000. Dr. Elbert Khiangte is known for rendering valuable services like Laparoscopic Treatment Procedures, Pancreatic Surgery, Kidney Stones treatment, Male Breast Reduction treatment, Piles treatment, treatment of Accidental Injuries, Gastric Bypass Surgery, Gastroscopy Procedure, Prostate Laser Surgery, Thyroplasty Procedure, Urinary Incontinence Surgery, Stem Cell Transplant, Post Induction Therapy, Varicose Vein Laser treatment, Dressings of wounds, Corn Removal Procedure, Cerebrovascular Surgery, Hernia Repair Surgery, Arterial Thrombosis treatment, Microvascular Surgery, Proctoscopy Procedure, Intra-arterial Thrombolysis Procedures, treatment of Deep Vein Thrombosis and Vascular Trauma treatment.
Dr. Elbert Khiangte is available at the International Hospital, G.S. Road, Christian Basti, Guwahati, Monday-Saturday, 10 AM-12 PM and 6 PM-7 PM.
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Kidney Stones Treatment
Removal Of Stitches Procedure
Corn Removal Procedure
Dressings Of Wounds Procedure
Varicose Vein Laser Treatment
Hernia Repair Surgery
Urinary Incontinence (Ui) Treatment
Stitching Of Wounds Procedure
Treatment Of Deep Vein Thrombosis - Dvt
Male Breast Reduction Treatment
Prostate Laser Surgery
Gastric Bypass Surgery
Vascular Surgery Treatment
Accident Injuries Treatment
Stem Cell Transplant
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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?
- 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.
- 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.
- 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
- Lobectomy: This procedure calls for partial removal of the lobes when a nodule or an inflammation affects just half of the thyroid gland.
- Subtotal Thyroidectomy: Here, a small proportion of the thyroid tissue is left behind even after the elimination of the thyroid gland.
- Total Thyroidectomy: Through this procedure, the entire thyroid gland is taken out along with the thyroid tissue. Consult an Expert & get answers to your questions!
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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. 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 cesarean section (c-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. If you wish to discuss any specific problem, you can consult a general surgeon.
Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.
Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:
- Relax you,
- Block pain,
- Make you sleepy or forgetful,
- Make you unconscious for your surgery.
Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.
Other’s are as listed below:
- Airway Obstruction
- Inadequate inspired oxygen delivery
- Endobronchial Intubation
- Premature Extubation
Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.
Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:
- Pulse Oximetry
- Combination of Both
Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome.
Laparoscopic surgery is also known as minimally invasive surgery. It leads to a lesser amount of pain after the surgery, and therefore requires less medication also. It reduces the possibility of hemorrhage, thereby, lowering the possibility of requiring blood transfusion. The smaller length and depth of the incision also means that the patient recovers from the surgery faster than usual. There is also a lesser chance of contracting infections because a larger number of organs remain unexposed and therefore uncontaminated. Laparoscopic surgeries also cause smaller, lighter scars once the surgery wound heals completely.
However, as with any surgery, complications may occur during the course of laparoscopic surgery.
- Wound infection: Even though laparoscopic surgery is minimally invasive and the possibility of contracting infections is considerably less, the wound is capable of getting infected. Hence, it is essential to maintain the cleanliness and hygiene recommendations provided by the concerned medical staff. It is also assumed that the surgeons would prevent this possibility by maintaining strict protocols regarding this issue on their part.
- Bruising: After surgery, depending on the type and duration of the procedure, the patient is always advised to follow certain restrictions regarding mobility and restriction of normal day to day functioning. These rules must be followed in order to prevent the possibility of bruising after a laparoscopic surgery.
- Hematoma formation: A hematoma is an accumulation of blood outside the blood vessel. This is not normal at all and requires urgent inspection and treatment. This is a relatively common complication that happens after a laparoscopic surgical procedure. Precautions are taken by surgeons to avoid this but it may still occur. It needs to be diagnosed early, and then the bleeding vessel needs to be emobilized selectively in order to reduce any further complication of this type.
- Anesthesia related complications: To prevent anesthesia related complications during laparoscopic surgery, it is essential that procedures related to the airways, ventilation, analgesia, antimetics are followed in the preoperative state.
- Injury: Any injury that may be inflicted on the blood vessels present in the walls of the abdomen or on the sidewall in the pelvic region, as well as injuries in the bowel area and the urinary tract. Proper protocol must be followed by the doctor to avoid such complications as much as possible. If you wish to discuss about any specific problem, you can consult a general surgeon.