Dr. Nandakishore Dukkipati

 The gallbladder is a very important organ in the human body. This is a pear-shaped organ which is used for storing the bile. Bile is a fluid which helps in digesting your food. When the gallbladder does not function well, then hard fragments will form in the gallbladder and they are calledgallbladder stones. The size of these stones differs from person to person. For a few people, they are just the size of a small rice grain and for few, it can be as large as a golf ball.

When gallbladder stones are formed, they will not vanish by themselves. They will cause pain and many other symptoms which are unbearable. You need to consult a doctor and you may have to get the gallbladder removed. This kind of gallbladder removal surgery is called cholecystectomy.

How are gallbladder stones removed?
More than 80 percent of people with gallbladder stones will need a cholecystectomy. This surgery can be performed in two different ways.

• Open gallbladder surgery: In an open gallbladder surgery, a 5-inch incision is made in the abdominal area which is not required for a laparoscopic surgery. Nowadays, people are opting for laparoscopic surgery for any kind of surgery as it is safe, less painful, requires a shorter stay at the hospital and there are fewer scars.
• Laparoscopic gallbladder surgery: In a laparoscopic gallbladder surgery, 4 small incisions are made in the abdominal area. A small tube with a very small camera and light will be inserted into the abdomen through one of the incisions made. Equipment required for the removal of the gallbladder is also inserted through the other incisions and the surgery is performed.

Before performing the laparoscopic gallbladder removal surgery, you will have to undergo a few tests such as blood test, complete physical test, gallbladder imaging tests and a review of your past medical history. After going through the reports of all these tests and checking all other medications that you take, your doctor will decide if you need gallbladder surgery or not.

Post Gallbladder surgery: Post-surgery, you may see some symptoms, but they are rare and mild. One of the common symptoms experienced after the surgery is diarrhea. You can start walking as soon as you start feeling better. But you should talk to the doctor in order to get back to your normal routine.

Regarding your diet, you will have to start with a liquid diet and make sure that you do not take heavy and fatty food. Your body will take some time to get back to digesting a normal diet and hence you will have to take good care.

Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

1. Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
2. Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
3. Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.

Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you. In case you have a concern or query you can always consult an expert & get answers to your questions!

Rectal cancer is the growth of cancerous cells in the rectum, which is the colon’s lower part of the colon, connecting the large bowel and the anus. The basic function of the rectum is to collect the stool that is formed inside the human body before it is eliminated from the body. The cancer starts as a polyp, which is precancerous, and slowly develops and turns cancerous. This cancer will start spreading and penetrates into the walls of the rectum causing rectal cancer.

Surgery is the most common treatment available for rectal cancer. Depending on the location of the cancer and the type of cancer, there are different types of rectal cancer surgeries available. One of the important things that are considered before deciding which kind of surgery is required is the location of the tumor from the anus.

Types of Surgeries for Rectal Cancer:
Here are different types of surgeries available for different stages of rectal cancer.

1. Low Anterior Resection Surgery: When the cancer or the tumor is located above the anus, then low anterior resection surgery is the best surgery. The rectal cancer, adjoining rectal tissues and the lymph nodes are removed. This surgery is done by making an incision in the lower part of the abdomen. This surgery is used for stage 1 cancer.
2. Abdominoperineal Resection Surgery: Abdominoperineal resection surgery is preferred when the tumor is close to the anus. It can be used for treating stage 1 cancer and also can be used for stage II and stage III as well. The rectal cancer, the anus, adjusting rectal tissues and the lymph nodes are removed.
3. Local transanal resection: When the cancer is in its early stage and is not far from the anus, your surgeon will opt for local transanal resection surgery. Usually, the tumor has to be small for performing this surgery.
4. Proctectomy with colo-anal anastomosis: You may have to remove the entire rectum if the tumor is present in the middle or lower part of the rectum. This is usually in stage II or stage III. This kind of situation requires proctectomy with colo-anal anastomosis.
5. Transanal endoscopic microsurgery: When the tumor is above the rectum and is in its early stage, transanal endoscopic microsurgery is the best method. But for performing this surgery, experts with special equipment are required.
6. Pelvic exenteration: When the rectal cancer starts growing to the organs near to rectum, pelvic exenteration is required. This is a time consuming major surgery. Usually, along with the rectum, other organs such as the bladder, uterus or prostate is also removed. The patient will take months to recover from this major surgery.

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