Lybrate.com has top trusted Radiologists from across India. You will find Radiologists with more than 39 years of experience on Lybrate.com. You can find Radiologists online in Pune and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. Vikram Chohan
Diagnostic X- Ray
Bone Densitometry Procedure
Uterine Artery Embolization
Interventional Diagnostic Procedures
Angiography Radial Approach
Submit a review for Dr. Vikram ChohanYour feedback matters!
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.
I am 54 year old male having MRI [LS-SPINE]. Finding Reveal Annular Tear, circumferential Disc Bulge With Small Posterocentral Protrusion at L4-L5 level, Causing No Significant Neural Compression Or Canal Stenosis" I have no pain anywhere since 5 months only difficulty in standing or on walking without pain. Become tired for few seconds, then start again walking. Ortho. Says no need to worry it will heal naturally. Spine Surgeon says need of "DISC FIX" treatment required. Getting confuse. WHAT TO DO.'
Herniated disk l3-14 mm L4-11 mm L5-10 mm S1-8 mm My age 23 /M Dr. suggest for surgery but I didn't want that any chances for normal.
Dear doctor, One of my relative suffered due to minor brain stroke She gave birth to baby by cesarean just a week before the stroke. Is there any relation between delivery and stroke. Kindly let me know. Note She is 30 years old female.
Fibroids are non-cancerous growth that develop in the uterus in varying sizes. Fibroids do not usually show symptoms, but if they are large they may cause severe pain in the abdomen, heavy menstrual bleeding, bloating, infertility or complications during pregnancy. Several factors may lead to the formation of fibroids, including hormones, family history, and pregnancy.
What is myomectomy?
Myomectomy is the surgical procedure which is used for removing fibroids from the uterus. It is a safe method that allows women to become pregnant in future. Gonadotropin-releasing hormone analogue therapy, performed before myomectomy helps in lowering the estrogen level and also controls anemia by stopping uterine bleeding. The different surgical methods for myomectomy include:
- Hysteroscopy, involving the insertion of a lighted viewing instrument into the uterus
- Laparoscopy, involving the insertion of a lighted viewing instrument and one or more incisions in the abdomen
- Laparotomy, involving a larger incision made in the abdomen
Why is the surgery performed?
Myomectomy treats fibroids while preserving the uterus. It is a viable option for those who have:
- Anemia which cannot be controlled with medicines
- Pain which cannot be tackled with medicines
- A fibroid that can cause infertility or increases the risk of miscarriages
How well does it work?
- Pregnancy: myomectomy is the only treatment for treating fibroids that improve your chances of having a baby. The method is effective for treating submucosal fibroid. A cesarean section is required for delivery after performing a myomectomy.
- Recurrence: recurrence of fibroids after myomectomy is really low. It is possible in rare cases, depending on what the original fibroid problem was. Large and numerous fibroids have a greater risk of recurrence. Consult an expert & get answers to your questions!
My MRI report says, Mild posterior broad base protrusion of L4-L5 intervertebral disc resultant mild central and lateral canal narrowing causing mild compression over thecal sac and right traversing L5 nerve root. I am doing bed rest from 10 days, what's the report says.
MY WIFE RECENTLY HAD A CT SCAN & THE IMPRESSIONS ARE AS FOLLOWS: * Bilateral vocal cord palsy (more prominent on left side) * Few enlarged left supraclavicular lymph nodes * ~3 x 2 cm irregular mass in medial aspect of right upper lobe of lung, infiltrating the mediastinal pleura-suggestive of malignancy (metastases - known carcinoma of left breast) * I11 defined soft tissue rind measuring ~1 cm in thickness in superior mediastinum, encasing the mediastinal structures- suggestive of malignancy (spread from pleura / metastatic lymphodes) * ~2 cm right perihilar mediastinal lesion. * Multiple nodules measuring about 2 mm to 5 mm in both lungs- suggestive of metastases. * Moderate pericardial effusion. * Thin layer of left pleural effusion. I KNOW IT IS RELATED TO CANCER, BUT I WANT TO KNOW EXACTLY WHAT TYPE OF CANCER IT IS & WHAT IS THE SURVIVAL CHANCE (PERIOD) FOR PATIENT TAKING TREATMENT & PATIENT NOT TAKING ANY TREATMENT. KINDLY GIVE YOUR VALUABLE SUGGESTION. Thanks & Regards
Ayurveda is a form of medicine that has been practiced for thousands of years and has many effective cure for some of the most complex diseases. Cancer, in this day and age, is one such complex disease and its incidence is increasing rapidly. It is always recommended to consult a Ayurveda specialist for severe cancer. Some of the common ingredients for treatment of uterine cancer through Ayurveda are mentioned here.
- Turmeric: Already a staple spice in many Indian dishes, turmeric as a herb in raw form and as a spice in powdered form, is touted the new wonder herb all across the world. It has been used as a traditional healing herb in India since ages. It has also been seen to be a very effective anti-inflammatory agent and thus it is very effective in stopping the growth of cancer cells.
- Green tea from the Camellia Sinensis plant: Green tea has been known to be effective in treating multiple types of cancer, aid in weight loss and also facilitate detoxification. Regular consumption of green tea from the Camellia Sinensis plant is known to fight the growth of cancer cells within the body; thus is a very effective in treating uterine cancer as well.
- Ashwagandha: This herb is not only used in Ayurveda, but has also been adopted by homeopathy as conventional medicine to make extracts. Ashwagandha is an adaptogen, which means it can adapt to the requirements of the body and then make the changes to provide support to the necessary areas. It is also very good at preventing the growth of cancer cells.
- Garlic: This spice is known to be good for multiple forms of cancer as it contains allicin, which is being hailed as one of the best fighters of inflammatory diseases. It also contains other types of phytochemicals and thus helps in detoxifying the body. It is very effective in fighting cancer cells and can arrest the growth of cancer within the body.
- Ginger: Ginger is extremely effective in the treatment of many ailments, if consumed regularly in controlled amounts. It has been known to be very effective in the treatment of colon cancer. Due to its properties, it is also known to be effective in the prevention of uterine and many other forms of cancer.
Ayurveda, an enigmatic yet enthralling science offers numerous treatment methods for uterine cancer. Here are a few:
- Matra Basti: Matra Basti is a special treatment in traditional ayurveda for chronic constipation, low back pain, rheumatoid arthritis, obesity, and various neurological disorders like multiple sclerosis, epilepsy, dystrophy and atrophy of nerves and muscle. In this treatment, certain herbal oils and herbal extracts are applied through the rectum on a daily basis. Matra Vasti has a lubricating, balancing, nourishing, strengthening and pacifying effect. It also works as rejuvenator, immune-modulator and nutrient and subdues elevated vata dosha. The treatment lasts for a period of 3 to 7 days.
- Pichu Dharanam for Soothing at Advance Stages of Uterine Cancer: It is a special treatment modality in Ayurveda where sterile medicated cotton swab is kept inside the vagina for a specific period of time. This comes under local treatment modalities specific to gynaecological diseases in females and is also done in ante natal care. Pichu means “cotton ball”. Yoni pichu is the application of a sterile cotton swab soaked in medicated oil or ghee in the vagina.
- Abhyanham: Abhyanga is a form of Ayurvedic medicine that involves massage of the body with large amounts of warm oil. It’s a complete body massage and really effective. The Abhyangam massage therapy is very beneficial and prevents degeneration and ceases the aging process. This therapy needs more positions to massage and comparing to other massage therapy, Abhyangam is very special. It usually involves oils prepared with specialized Ayurvedic herbs and essential oils for lymph drainage, detox, and relaxation. It has seven positions and it treats the whole body. It assures new healthy physical changes.
- Nasyam: Nasyam or errhine therapy is an Ayurvedic treatment excellent remedy for chronic sinusuitis, headache, throat diseases, epilepsy, catarrh, migraine, voice constraint, eye diseases and cervical spondylitis. In Ayurveda, the application of medical oils or powders through the nostrils is called Nasya. It is said in classical texts that the nostrils are the doorway to the brain. Nasya is an important method of treatment for illnesses of the cranial region. Nasya treatment - the forehead and neck regions of the patient are gently massaged with a suitable oil to induce sweating. Thereafter the patient is made to lie down on his back with his head bent slightly back. Warm oil is then dripped into both nostrils which the patient draws in.
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.
Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.
Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.
Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.
- A lump in either of the breasts or armpits
- Change in size, shape, or contour of either breast
- Redness of your breast or nipple
- Discharge of clear or bloody fluid
- Thickening of breast tissue or skin that lasts through a period
- Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
- One area on the breast that looks very different from the other areas
- Hardened area under the breast skin
Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.
Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.
- Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
- Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
- Age: Women over 50 are at higher risk of developing breast cancer.
- Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
- Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
- Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
- Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.
Stages: Starting from stage 0, higher stages indicate advanced disease.
- Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
- Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
- Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
- Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
- Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.
Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.
- Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
- In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
- Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
- Ultrasound screening can also be given in addition to mammograms.
- Breast MRI is another way to screen for breast cancer if the risk is greater.
Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.
- Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
- Tamoxifen is used in women who are at high risk for breast cancer.
- Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
- In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).
Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.