APPENDICITIS LAPAROSCOPIC APPENDECECTOMY
APPENDICITIS is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. The appendix doesn't seem to have a specific purpose. Appendicitis causes pain in lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe. Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.
Symptoms Signs and symptoms of appendicitis may include:
• Sudden pain that begins on the right side of the lower abdomen Sudden pain that begins around your navel and often shifts to your lower right abdomen
Pain that worsens if you cough, walk or make other jarring movements
• Loss of appetite
• Low-grade fever that may worsen as the illness progresses
• Constipation or diarrhea
• Abdominal bloating
A blockage in the lining of the appendix that results in infection is the likely cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture.
Complications Appendicitis can cause serious complications, such as:
A ruptured appendix. A rupture spreads infection throughout your abdomen (peritonitis). Possibly life-threatening, this condition requires immediate surgery to remove the appendix and clean your abdominal cavity.
• A pocket of pus that forms in the abdomen. If your appendix bursts, you may develop a pocket of infection (abscess). In most cases, a surgeon drains the abscess by placing a tube through your abdominal wall into the abscess. The tube is left in place for two weeks, and you're given antibiotics to clear the infection. Once the infection is clear, you'll have surgery to remove the appendix. In some cases, the abscess is drained, and the appendix is removed immediately.
To help diagnose appendicitis, your doctor will likely take a history of your signs and symptoms and examine your abdomen. Tests and procedures used to diagnose appendicitis include:
A physical exam to assess your pain. Your doctor may apply gentle pressure to the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, signaling that the adjacent peritoneum is inflamed. Your doctor also may look for abdominal rigidity and a tendency for you to stiffen your abdominal muscles in response to pressure over the inflamed appendix (guarding).
• Blood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection.
• Urine test. Your doctor may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn't causing your pain.
• Imaging tests. Your doctor may also recommend an abdominal X-ray, an abdominal ultrasound or a computerized tomography (CT) scan to help confirm appendicitis or find other causes for your pain.
Treatment usually involves surgery to remove the inflamed appendix. Before surgery, you may be given a dose of antibiotics to prevent infection. Surgery to remove the appendix (appendectomy) Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches (5 to 10 centimeters) long (laparotomy).
LAPAROSCOPIC APPENDECTOMY , surgery can be done through a few small abdominal incisions During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix. In general, laparoscopic surgery allows you to RECOVER FASTER and heal with LESS PAIN and scarring. It may be better for people who are elderly or obese. But laparoscopic surgery isn't appropriate for everyone. If your appendix has ruptured and infection has spread beyond the appendix or you have an abscess, you may need an open appendectomy, which allows your surgeon to clean the abdominal cavity.
It is a type of surgery, which involves the usage of small tubes, surgical instruments and video cameras for operations through small incisions or cuts in your body.
Even though laparoscopy is a very popular form of surgery, there are quite a few myths associated with it, which are:
Though different people experience the surgery differently due to difference in health conditions, there are some points everyone should know about a laparoscopic surgery.
Gastric bypass is a kind of bariatric surgery, which helps in weight loss. This surgery aims to make changes so that your stomach becomes smaller than it used to be. This limits the amount of food you consume and effectively helps you to reduce weight.
Are you fit for the surgery?
Not everybody can go in for this surgery. Your doctor will recommend this surgery after careful evaluation. These are the parameters based on which your doctor will make a decision-
• Your medical history - If you suffer from sleep apnoea, heart ailments, liver diseases, kidney stones or if you have blood clots then you might have to undergo the surgery.
• Your psychological status - Sometimes obesity is the outcome of certain psychological ailments. A doctor will first ensure that these conditions are addressed before you go under the knife.
Gastric bypass operation is performed under general anaesthesia so you will be asleep for the entire duration of the surgery and it will be pain-free. The surgery is done laparoscopically. Tiny incisions are made through which scope and fine surgical instruments are introduced into the abdominal cavity. The camera guides the surgeon by providing live images from inside the body. Laparoscopic gastric surgery is advantageous because the wound heals faster and does not leave any marks.
Sometimes your surgeon might opt for an open surgery where she/he makes a large incision to reach the stomach.
There are two major steps to the surgery-
• The aim of the surgery is to make the stomach smaller so the surgeon divides it into two portions with staples. The food that you eat will go into the upper part (the pouch) of the stomach. The reduced upper stomach can hold at the most 28 grams of food so you are forced to eat less than usual. This will help you lose weight.
• The other step is the bypass surgery. After the pouch is created, the surgeon links it to the small intestine through the small hole in the pouch. This way, food will pass directly from the pouch to the small intestine. The surgery takes around 3-4 hours. You will be kept under observation for a couple of days and you will be released from the hospital in a week.
Gastric bypass operation is an effective and simple surgery that can help you reach your weight goals when you have a very high BMI and most other dietary restrictions have not been successful.
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
It might take some time for the wounds to heal, but in case of any prolonged pain do remember to consult doctor immediately.
Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.
The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.
What Causes Gallbladder Problems?
Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.
It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.
These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.
Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.
Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.
What are the Advantages of Performing Laparoscopic Gallbladder Removal?
Are you a Candidate?
Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.
Laparoscopic surgery is also called keyhole surgery or minimally invasive surgery. In traditional method of surgery, large incision is a major post-operative side-effect which results in longer recovery period. The alternative technique, laparoscopy also known as minimally invasive surgery or keyhole surgery, is a modern surgical procedure in which small incisions of about 0.5-1.5 cm are made far from the location of the operation.
Laparoscopic surgeries cause smaller, lighter scars once the surgery wound heals completely. However, as with any surgery, complications may occur during the course of Laparoscopic surgery.
Gallstones are a medical condition in which the formation of stones takes place in the bile duct or the gallbladder. One of the major factors responsible for the formation of gallstones is an elevated excretion of cholesterol by the liver, most of which remains undissolved by the bile. The undissolved cholesterol may crystallize resulting in the formation of gallstones (yellow cholesterol stones, a condition termed as Cholesterol Gallstones). In some cases, increased level of bilirubin in the bile (triggered by a liver problem, liver damage or other medical conditions), which doesn't undergo a breakdown, may lead to stone formation (known as Pigment Gallstones). Here, the stones appear black or dark brown in color.
Gallstones are common among women, especially those who are 40 years and more. Obesity, diabetes, liver disorders, unhealthy diet (rich in fats and cholesterol), certain medications (those containing estrogen) can also trigger the formation of gallstones. Gallstones left untreated and unattended can give rise to serious complications such as blockage of the pancreatic duct (resulting in Pancreatitis) or the bile duct. There may also be inflammation of the gallbladder. In extreme cases, a person may even suffer from something as serious as Gallbladder Cancer.
Laparoscopy to remove the gallstones
Laparoscopic Appendix Surgery
The appendix is a vestigeal organ, which means that it does not have a vital part to play in the body. While it may play a small role in immune function as it produces a class of antibodies known as immunoglobulin, it is not the only organ capable of doing this. If a person is suffering from pain due to infection and inflammation of the appendix, the doctor will, in all likelihood, recommend removal of appendix by surgery, called appendectomy.
However, an appendix surgery may involve postoperative pain, long hospital stays and protracted route to recovery. One can avoid all these if one opts for Laparoscopic Appendix Surgery. In fact, this Laparoscopy is the most preferred method of removing appendix.
Benefits of Laparoscopic Appendectomy
Common benefits include:
● Less postoperative pain
● Short hospital stays
● Quicker return to normal bowel function
● Quicker return to normal activity
● Cosmetically better results
Who Should Go for Laparoscopic Appendix Surgery?
A patient may develop sudden pain in upper/right abdomen, fever, vomiting, loss of appetite. These are signs and symptoms of acute appendicitis and usually diagnosis is confirmed by ultrasonography or CT scan. Most patients with acute appendicitis will require appendix removal surgery on an emergency basis. Other patients may have repeated episodes of upper/ right lower abdomen pain with occasional nausea and vomiting due to recurrent mild infection of appendix.
These patients with recurrent mild appendicitis may require removal of appendix if the episodes are frequent. Both sets of patients would benefit from laparoscopic removal of appendix. In fact laparoscopic surgery can be done even in cases of complications such as ruptured or perforated appendix, and formation of abscess.
In very, very rare instances such as excessive bleeding, or dense scarring resulting in inability to visualise the appendix, the surgeon may revert to traditional open surgery for the patient's safety.
How Is Laparoscopic Appendix Surgery Performed?
In laparoscopic appendix surgery, the laparoscopic surgeon usually makes 3 small incisions on the abdominal wall. Through one of these incisions, she will insert a cannula, and a laparoscope is then inserted through this cannula. With the help of the laparoscope, the doctor can get a magnified view of the internal organs on a television monitor. Through the other incisions, more cannulas are inserted, and surgical instruments are passed.
The surgeon visualised the enlarged images on television monitor and manoeuvers the instruments accordingly. This helps the doctor to work inside smoothly and take out the infected appendix. In case or rupture/perforation or abscess, a drain may be placed during the procedure to remove infected fluids from the body. Finally the recovery is much quicker after laparoscopic than open surgery with much less pain, less chances of infection and better cosmesis.
Today, both doctors and patient prefer minimally invasive procedures as compared to traditional open surgery. Such procedures are also known as laparoscopic procedures or keyhole surgeries. This procedure involves making a small incision through which a long, flexible tube is passed. The end that enters the body has a powerful light and a camera through which the surgeon can view the internal organs. To facilitate movement of the tube, carbon dioxide gas may also be pumped into the abdominal cavity. In case an organ needs to be operated upon, other incisions will also be made through which surgical instruments can be used.
Liver cancer is one of the conditions that can benefit from laparoscopic procedures. Laparoscopy can be used to diagnose liver cancer and determine the stage it has reached and to treat it accordingly. In order to confirm a liver cancer diagnosis, the surgeon will look for the presence of tumors in the lymph nodes and surface of the liver. In addition, tissue samples will also be collected. These will be sent to a lab to be biopsied in order to determine whether the tumor is malignant or benign.
Once a diagnosis is confirmed, surgery to remove the tumor is the most recommended form of treatment. This may be followed by chemotherapy and radiation. Small malignant tumors on the left lateral segment of the liver or anterior segment on the right side of the liver can be safely removed with laparoscopic procedures. Laparoscopy can also be used to remove multiple tumors on the liver. However large tumors and tumors that are located close to the suprahepatic junction or portal bifurcation should not be addressed laparoscopically. Laparoscopy may also be avoided if the patient has undergone open resectional procedures earlier that may have caused dense adhesions. In such cases, open surgery is preferred. However, even these procedures may be preceded by a laparoscopic exploratory procedure that allows the surgeon to get a clearer view of the tumor.
As compared to open surgery, laparoscopic surgery has a number of advantages. These include:
As with any other procedure, the skill of a surgeon plays an important role in the success of the procedure. In the case of laparoscopic procedures, this skill is critical. Hence, laparoscopic surgeries of the treatment of liver cancer are not very common.
Obesity is one of the biggest menaces that can jeopardize a person's happy life. From mood swings to fertility problems as well as a myriad of health complications, obesity can make life miserable. Children and young teenagers seem to bear most of the brunt. The situation turns extremely complicated when a person suffers from Morbid Obesity or severe obesity. Morbid obesity is a condition where a person's body weight is found to be nearly 100 pounds more than the healthy body weight. Morbid obesity, if not treated on time, can prove to be fatal.
Laparoscopic surgery comes as a blessing when most of the other weight loss programs fail to produce any positive outcome. There are many options available such as the Laparoscopic Gastric Banding, the Gastric Bypass as well as the Malabsorption operations to aid a severely obese person to lose weight effectively.
i) The Laparoscopic Gastric Banding
The Laparoscopic Gastric Banding is a surgical procedure extensively used to lose weight.
A surgeon may also carry out the gastric bypass through an open surgery, but the laparoscopic surgery is a much better option.
iii) A person can also opt for Laparoscopic Malabsorption surgery.