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Dr. Arvind M. Jain

Radiologist, Mumbai

Dr. Arvind M. Jain Radiologist, Mumbai
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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
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Dr. Arvind M. Jain is a renowned Radiologist in Mumbai, Mumbai. You can visit him at Samadhan Diagnostic Centre in Mumbai, Mumbai. Book an appointment online with Dr. Arvind M. Jain and consult privately on Lybrate.com.

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Shop No.5, Sitabai Chawl, Dattaram Lad Marg, Nr.Western India Mill, Kalachowki, MumbaiMumbai Get Directions
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How to Reduce Urea Levels in Blood Naturally

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
How to Reduce Urea Levels in Blood Naturally

All healthy individuals will always have some amount of urea in the blood. Yet, when the urea level in the blood becomes too high, that means there is a malfunction in some part of the body due to which the body is not being able to remove this excess urea successfully. This urea can be formed in the liver when there is a process in terms of the protein metabolism's chemical balance. This urea is then transported to various parts of the body until the kidney cleans it out as urine. But when this urea does not get cleaned out properly, the urea gets concentrated in the blood and signifies a problem with the kidneys and other internal organs as well as the blood flow to the kidneys. 

The cause may include burns, heart failure, renal artery embolism, vomiting and loose motions as well as more serious ailments like Diabetes. This can lead to long term kidney damage and symptoms like thirst, fluid retention, headaches, fatigue, dizzy spells, accelerated pulse, restlessness in limbs, pain in the abdomen and more. Here are the best ways to reduce the blood urea levels in a natural manner.

Herbal Medicines:

Ayurveda is an ancient science that can be used for the benefit of many patients suffering from chronic and painful ailments like diabetes, kidney failure, cardiovascular ailments and more. One of the mainstays of Ayurveda includes the use of herbs to create medicines and concoctions that will help in giving relief with their 100% natural elements. Medicines like Mutrakrichantak Churna, Punarnava Mandur, Varunadi Vati and many others can be used to avoid dialysis and bring down the urea levels in the blood by aiding better functioning of the kidneys.

  1. Punarnava: The name of this herb has been derived from two words - Puna and Nava. While Puna means again, Nava means new and together they help in renewed functioning of the organ that they treat. This herb helps in flushing out the excess fluid in the kidneys by reducing the swelling without any side effects. This herb is basically a kind of hogweed.
  2. Varun: This is the common caper which can be used to break down the stones present in the renal region and even as a cure for urinary tract infection. This herb helps in removing any element that may be obstructing the urinary tract and finally removes the excess fluid build up and inflammation.
  3. Gokshur: This is a diuretic that can be used as a herbal tonic to give strength to the weak kidney cells for regeneration.

Other aspects of Ayurvedic treatment for this condition include proper protein intake and better hydration along with massages and Yogic postures.

3266 people found this helpful

I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solution?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solu...
Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall.
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Hello doctor. I am I 32 years female and I have slip disc problem from last two years .I have 2 years baby vd normal delivery. I am not able to sleep properly because when I sleep suddenly I awake 2-3 times at night nd I try to sleep again but I sleep after 30 to 40 min. Now I am gaining fat and weight also. I take proper meal and I don't take more junk food also. Please tell me what to do? My all checkup report are normal & thyroid also.

BAMS, MD (Panchkarma)
Ayurveda, Mumbai
Hello doctor. I am I 32 years female and I have slip disc problem from last two years .I have 2 years baby vd normal ...
Hello lybrate user, thanks for writing. If you want fast, permanent weight loss, you can try our research oriented holistic medicines for assures results. You can lose up to 10 kg weight per month, without crush dieting, with out side effect, without gym, without surgery. Tips for you: 1. Eat plenty vegetable and fruits. 2. Drink 9 glass of water per day. 3. Avoid dieting for weight loss. 4. Avoid oily thing. 5. Have 5to 6 servings of food per day. If you have any questions you can contact us by lybrate.
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Lumbar Herniated Disc Pain - 3 Hamstring Stretches for it

MD, FIPP
Pain Management Specialist, Kolkata
Lumbar Herniated Disc Pain - 3 Hamstring Stretches for it

The sciatic pain caused due to a lumbar herniated disc can radiate down your legs and may make you immobile. It is quite common for a herniated disc to press against a nearby nerve and inflame, leading to pain radiating along the length of the affected sciatic nerve. For getting relief from lumbar herniated disc pain, you need to become active. Daily hamstring stretches are considered to be an effective way to tackle such pain if you do them regularly.

Here are three important hamstring stretches which will help you in strengthening your hamstring muscles:

  1. Seated chair stretches: This stretch is perfect for people whose mobility is limited or for those who have unusually tight hamstrings. It is carried out in a sitting position. While performing this stretch, you have to sit on a chair with another chair placed across. By resting one foot on the ground and the other on the second chair, you need to straighten your back and lean forward over the leg which is extended. Once you feel a stretch in the upper and rear thigh, you should be in that position for at least 30 seconds. You should switch legs and repeat the stretching exercise thrice for each leg.
  2. Towel hamstring stretch: If you like stretching while lying down, this stretch is an ideal option for you. For performing a towel hamstring stretch, you have to lie down on the floor and keep one leg flat. Tighten your abdominal muscles while you lift the other leg and keep it straight. You should wrap a belt around the elevated leg’s instep and use it for pulling back the leg towards you. Hold the position for around 30 seconds when you feel a stretch.
  3. Wall hamstring stretch: This stretch is for people who find the towel hamstring stretch hard to execute. For such people, extra stability can be attained by taking help of a solid surface such as a door jamb or a wall. You can rest the raised leg against the wall for support. You need to lie on the floor near a wall corner and leave one leg straight while placing the other against the wall. Your hips should be on the floor.

While you do stretches of any kind, you should only stretch as far as you are comfortable. You must not stretch to a point which causes pain. These hamstring stretches are quite safe, but you should avoid them in case of any sudden, acute pain.

1 person found this helpful

I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in the foot ,slip disc or something else.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in...
Do Take IFT and laser Therapy for pain relief for 12 days followed by strengthening exercise from physiotherapist and need to be with Clinical examination.
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Sir I am 25 years old I am suffering L1L2 Disc degeneration I am unable walk speed and left leg jerks please help me.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), DYA (DIPLOMA IN YOG & AYURVED), D.I.H.M (DIPLOMA IN INDUSTRIAL HEALTH MANAGEMENT)
Ayurveda, Nashik
Sir I am 25 years old I am suffering L1L2 Disc degeneration I am unable walk speed and left leg jerks please help me.
1) do massage with warm sesame oil or suitable oil for 15 min. Afterwards take hot fomentation for 10 min. 2) start natural calcium supplement. 3) do regular stretching exercise 4) in yoga do bhujangasan, halasan & suryanamaskar. Life-style correction 1) correct your sitting posture. 2) take small pillow or back rest for lower back. 3) foot should rest to floor easily. 4) take small break after 1 hr & walk few steps. 5) do neck & upper back extension, give feedback after 4 days. Best treated with ayurved & panchakarma procedures. 1) massage + steam 2) pinda swedan 3) agnikarma you must start ayurvedic medicines to 1) strengthen bones & muscles. 2) stop further degeneration of joint. 3) healing of joint. 4) release muscular spasm even chronic. 5) reduce swelling & pain.
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Breast Cancer - 4 Common Symptoms

MD, MBBS, Advanced Infertility
Gynaecologist, Jalandhar
Breast Cancer - 4 Common Symptoms

Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.

1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.

2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.

3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.

4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.

However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

4701 people found this helpful

I am suffring from slip disc, hernited disc problem sence last 1 year.Please do help

MBBS, MS - Orthopaedics
Orthopedist, Delhi
This is quite a common condition rule out diabetes & vit. D deficiency. Sleep on a hard bed with a soft bedding on it. Use no pillow under the head. Any way take caldikind plus 1 tab daily for 10days paracetamol 250mg tds x 3 days contact me after that. Make sure you are not allergic to any of the medicines you are going to take. It may have to be further investigated.
1 person found this helpful
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5 Ways to Decrease The Chance of Breast Cancer

Royal College of Obstetricians and Gynaecologists (MRCOG)
Gynaecologist, Alwar
5 Ways to Decrease The Chance of Breast Cancer

While you cannot cure breast diseases, family history and maturing, but there are some hazards or risks that you can control. Keeping in mind the fact that there is no certain approach to forestall breast cancer, there are things you can do that may bring down the hazard. Here are five approaches to ensure your breast's well-being:

  1. Watch your weight: Being overweight or hefty expands breast cancer chances. This is particularly true after menopause and for women who have put on weight as grown-ups. After menopause, the vast majority of your estrogen originates from fat tissue. Having more fat tissue can heighten your chances of getting breast cancer by raising the estrogen levels. Additionally, women who are overweight have a tendency to have more elevated amounts of insulin, than other hormones. Higher insulin levels have been associated with a few tumors, including breast cancer.
  2. Exercise routinely: Many reviews have found that exercise is the sign of having a healthy breast. Studies show that one to two hours of energetic walking each week, lessened a woman’s cancer risk by eighteen percent. Walking ten hours seven days decreased the hazard all the more.
  3. Constrain liquor: Women who have two to five mixed beverages every day have a higher danger of breast cancer than women who have just one drink a day or none . As much as three to six glasses of wine seven days have been found to somewhat increase breast cancer chances. It is not clear how or why liquor raises the hazard. In any case, constraining liquor is particularly essential for women who have other hazard variables for breast cancer, like, breast cancer running in their families.
  4. Restrain time spent sitting: Research has shown that sitting time, regardless of how much exercise you get when you are not sitting, increases the probability of growing cancer, particularly for women. Women who sit six hours or more a day outside of work have a ten percent more serious risk for breast cancer compared to the ladies who sit under three hours a day, and an increased hazard for other cancer types as well.
  5. Stay away from or confine hormone substitution treatment: Hormone Replacement Treatment (HRT) was utilized frequently in the past to control night sweats, hot flashes, and other troublesome manifestations of menopause. In any case, specialists now realize that postmenopausal ladies who take a blend of estrogen and progestin might probably create breast tumors or cancer. Breast cancer disease seems to come back within five years in the wake of ceasing the blend of hormones. Therefore, get a breast cancer test even if you feel a small lump. If you wish to discuss about any specific problem, you can consult a gynaecologist.
4273 people found this helpful

My dad has a disc problem and in morning time he suffers from stiffness in lower back area. What should he do?

MS - Orthopaedics
Orthopedist, Chennai
My dad has a disc problem and in morning time he suffers from stiffness in lower back area. What should he do?
He should not bend down, avoiding bike riding and sitting for long time and lifting heavy weights. He should gentle back toning exercises. If not alright he might need surgery.
3 people found this helpful
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Diseased Uterus - Can it be Replaced?

Health and Medical ARC Fertility
IVF Specialist, Chennai
Diseased Uterus - Can it be Replaced?

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant. Learn more about having healthy pregnancy.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus. This is a reason why IVF is a popular procedure.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

3818 people found this helpful

I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.
If it's small disc bulge then it's treated with medication, exercises, physiotherapy. If no much relief then needs epidural steroid injection. Last resort with no improvement then needs discectomy.
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Cervical Lordosis Straightening Treatment

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Cervical Lordosis Straightening Treatment

Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

Reversal of cervical lordosis explained

The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

Reversal of cervical lordosis causes

The spinal curvature in the neck is constantly in flux to some degree.

Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

Scoliosis can affect the normal lordotic curvature in the neck.

Cervical spondylolisthesis is a major source of reversed lordotic curvature.

Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post whiplash
Post head injury
Stomach sleeping
Poor sitting/working postures
Congenital spinal curvatures
Osteoporosis
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine

Anatomy: straight vs. Curved

I've always heard that it was good to stand up straight.

stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

Diagnosis
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.

2 people found this helpful

Health Tip

Doctor Of Physical Therapy (DPT), Bachelor of Physical Therapy
Physiotherapist, Bangalore
Health Tip

Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.

5 people found this helpful

Lupus Disease

MD - Bio-Chemistry, MF Homeo (London), DHMS (Diploma in Homeopathic Medicine and Surgery), BHMS
Homeopath, Kolkata
Lupus Disease

This is a form of epithelial cancer and is a lose called eating cancer
Symptoms:- it first appears on the nose as a hard, dusky red sore and spreads in ulcerative form destroying the tissues till the bones are exposed. This affect women 10 time more than men. It usually appears in women between the age. Nausea, vomiting and abdominal pain may accompany. It is an ulcerative skin disease and requires a very long-term treatment. Sensitivity to sunlight is usually present. Lupus is caused by disruption of body waste disposal system from failure of special enzyme d nasil, which fails to remove wastes from the body.
Diagnostic tests
The disease is easily noticeable as it is outside the body on the the skin and biopsy is performed to confirm it.
If possible, the affected portion of the body is cut out.
I suggest homoeo doctor consult and homoeo treatment best.

2 people found this helpful

I have small disk. And my lift leg paining I went doctor he proscribed me some pain lure and nerve medication but still my leg paining. How I can get well and don't take medication. Thanks.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
I have small disk. And my lift leg paining I went doctor he proscribed me some pain lure and nerve medication but sti...
if the disc is small then its unlikely to cause nerve root irritation. other causes of leg pain like inflammatory arthritis, vascular causes and Vit D levels have to be checked.
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Myth: Brain Damage is Always Permanent

M.Ch, MBBS
Neurosurgeon, Bikaner
Myth: Brain Damage is Always Permanent

Myth: Brain damage is always permanent.

Fact: The brain can repair or compensate for certain losses, and even generate new cells.
People once believed that we were born with a finite number of brain cells, and that was it for life; if you damaged any of them you could never get them back. Similarly, many scientists believed that the brain was unalterable; once it was" broken" it could not be fixed. 

Now, of course, we know that the brain remains plastic throughout life, and can rewire itself in response to learning. It can also generate new brain cells under the right circumstances.

Know All About Gynae Laparoscopy Surgery

Panchkula & Delhi
Mother and Child Care, Panchkula
Know All About Gynae Laparoscopy Surgery

Q1. What exactly is Laparoscopy?

Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.

Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?

Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.

Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?

Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.

Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?

Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.

Q5. Will there be much pain or discomfort after Laparoscopic Surgery?

There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.

Q6. When can I be discharged from hospital?

Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.

Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?

Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.

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I want to know about exercises being done in case of diffuse disc bulge at l1-l2 level indenting anterior the cal sac mildly with bilateral mild neural foraminal narrowing.

Diploma in Radio-Diagnosis
Radiologist, Shimla
If pain is there no exercise indicated, after relief mild passive exercises, lumber exercise, lumbo-sacral exercise, mild lumber extension exercise; click on private quastion in my name for any clarification.
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