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Laparoscopic Surgery Tips

Laparoscopic Treatment For Different Types Of Hernia Repair!

Dr.Amitava Chakraborty 89% (13ratings)
MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
General Surgeon, Kolkata
Laparoscopic Treatment For Different Types Of  Hernia Repair!

Laparoscopy surgery is a very vital component of the hernia repair. Studies have shown that many patients have a better outcome when they opt for laparoscopic surgery. Candidates eligible for this mode of surgery include those with bilateral inguinal hernias, ventral hernias, and recurrent hernia. People associated with athletics and other outdoor sports prefer to go for a laparoscopic hernia surgery as it ensures a speedy recovery and minimal tissue invasion (due to small incisions).

Laparoscopic hernia repair- inguinal 
Laparoscopic surgery requires an incision of 1-2 cm at the belly (at the lower end). Two small punctures are done near the umbilicus. The punctures are done to make room for the cameras so that the surgeon is able to view the abdomen clearly. The smaller incisions allow the operating instrument to enter into the stomach.

The Procedure:
A balloon is placed in between the abdomen and the overlying muscle so that the peritoneum can be separated. When space is successfully made, the camera comes into the action to view the condition of a hernia. A hernia is pulled from its hole into the abdomen. Once the hole is detected, the defect of a hernia is fixed.

Laparoscopic hernia repair- incisional/ventral: Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia, ventral hernia, recurrent umbilical hernia, epigastric hernia, etc. Just like an inguinal hernia, A camera is placed into the abdomen through the muscles. Two small incisions are made for the operating instruments to get through. This is followed by the cutting of the tissue that is placed between a hernia and the intestine. The hole thus gets exposed. Through one of the laparoscopic ports, the hernia mesh gets rolled and is placed into the abdomen. A hernia is then pulled up and the mesh gets secured with 4 sutures. A special device is used to fix healthy muscle.

Tension-free repair: “Tension-free” repair is often used to symbolize hernia surgery. A hernia is often triggered by the weakened muscles. Few surgeons endeavors to sew the muscle around the area of a hernia. Since the muscles surrounding the hernia are weak in the first place, they pull apart causing a recurrence of a hernia. To avoid this, most surgeons use a mesh to strengthen the cells around the hernia region. This procedure ensures that the muscles aren’t sewn but the mesh placed over the hole can prevent the muscle to push through the walls of the abdomen.

The use of mesh: There are some reservations about using the mesh in hernia surgery. However, this is the safest and most appropriate way to perform a hernia laparoscopic surgery. The use of a mesh also negates the risk of open incisions and recurrence of a hernia.

1742 people found this helpful

Esophagectomy - Know New Method Of Tackling It!

Dr.Atul Mishra 87% (27ratings)
MBBS, MS General Surgery, FRCS
General Surgeon, Ludhiana
Esophagectomy - Know New Method Of Tackling It!

Esophagectomy is a procedure of removing a part of the esophagus and reconstructing the same using another organ of the body. The oesophagus is the tube that connects the stomach and the mouth. This procedure is often performed in an advanced stage of esophageal cancer and Barrett’s esophagus. This procedure removes the cancer cells from the esophagus and gives relief from the symptoms. The organs from where the reconstructing tissues are taken are generally large intestine and stomach.

Many esophagectomy surgeries are performed with minimally invasive techniques. The latter is commonly known as laparoscopic surgery. This is a procedure where numerous small incisions are made in order to perform the surgery. This procedure results in faster recovery and reduced pain as compared to conventional surgery.

Newer methods such as Robotic surgery are being adopted by many doctors these days. Procedures like these can access the oesophagus through places such as the throat, collarbone and abdomen. They make a minute incision to get to the exact location of cancer and treat them with improved precision, unlike conventional surgical methods.

An important aspect of treating this condition is to determine the procedure that is going to be implemented. To determine this, doctors use imaging techniques such as PET scan, CT scan and an MRI scan. A doctor might also prescribe other tests such as FNAC and endoscopic ultrasound. Heart evaluations are also conducted before the surgery to ensure that there are no complications involved while performing the surgery.

Before Esophagectomy

Unless the cancer is detected at a very early stage, most doctors recommend radiation or chemotherapy or both. These treatments help to shrink the size of cancer and make for an effective oesophagectomy. Both chemotherapy and radiation have their set of side effects, which include loss of appetite, fatigue, hair loss, vomiting and skin discolouration.

After Esophagectomy

Post the procedure, a patient cannot directly consume food. He is required to consume food through a pipe for a duration of four-six weeks. Adequate nutrition is required during this phase to recover quickly. Once the patient is able to resume a normal diet, it should be ensured that he takes food in reduced quantities to make up for the reduced stomach size.

Follow-up

Almost 90% of patients who have gone through this procedure report an improved life quality. While lifestyle related adjustments have to be made, there could be regular follow-ups to ensure the below-mentioned complications do not arise:

1. Breathing-related problems

2. Swallowing problem

3. Effectively managing heartburn and ensuring the pain is under control

4. A thorough review of the nutritional diet to be consumed by the patient to counter sudden weight loss.

2313 people found this helpful

Laparoscopic Surgery & Ovarian Cysts - How Can Former Tackle Latter?

Dr.Chitrangada Gupta 88% (15ratings)
MS - Obstetrics and Gynaecology, MBBS, Fellowship In Reproductive Medicine
Gynaecologist, Lucknow
Laparoscopic Surgery & Ovarian Cysts - How Can Former Tackle Latter?

Ovarian cysts are fluid-filled sacs in the ovaries, often in multiples, which are very common in women. This is absolutely different condition from polycystic ovaries. Most of them are benign and not indicative of an underlying problem. They produce no specific symptoms and even if detected, can be watched over a period of time. Treatment may be required only if there are serious symptoms or there is higher possibility of cancerous nature of the cyst. Read on to know more. 

Types 

  1. Functional: There are two types in this. The follicular variety is when the egg that is ready for fertilization does not completely shrink and stays for a few more days before it disappears. Another variety, the luteal ovarian cysts are formed when after the release of the egg, there is blood filling up in the corpus luteum. 
  2. Pathological: There are many types here – dermoid, cystadenomas, endometriomas, cancerous cystadenocarcinomas etc. These are worrisome and need to be treated. Both varieties, once identified, should be monitored. The functional variety, though may not cause a problem, can cause infertility and so necessitate treatment. 

Symptoms 

Any ovarian follicle larger than 2 cm can be called as an ovarian cyst. They are usually benign and do not produce any symptoms. However, if they turn pathologic or grow in size, they can cause various symptoms such as: 

While cysts are often quiet and do not produce any symptoms, they can cause intermittent, nonspecific symptoms like above. If there is a family history of ovarian cancers in mothers, maternal aunt, Sisters, Grandmothers etc then women should have regular Gynaecological checkups to have a check done for ovarian cysts. 

Why go for laparoscopic surgery? 

  1. Laparoscopic surgery is considered to be one of the most effective ways of treating the condition of ovarian cysts. During the surgery, problem causing non-cancerous cyst can be removed without harming the ovaries. In the case of cancer, both ovaries along with uterus etc may have to be removed. This decision is taken by the operating surgeon depending upon age of the patient, characteristics and nature of the cyst and future fertility desires of the patient. 
  2. The patient is given general anesthesia during the surgery. After the surgery, one is suggested to rest for a day and may be permitted to return to normal activities within a day’s time. However, one needs to avoid any strenuous activity for almost a week. 
  3. While some cysts can be watched for years, others need treatment. This would be specifically true in cases where the couple is facing infertility issues or if there is a higher possibility of cancerous cysts. Such cysts need urgent intervention and should be monitored by a gynecologist with an experience in oncology. There are few blood tests that are needed to be done to know the nature of the cyst if it is benign or cancerous.
1359 people found this helpful

Laparoscopy & Endometriosis - How Can Former Help Latter?

Dr.Seema Saxena 85% (10ratings)
MBBS, MS - Obs & Gynae (Gold Medalist)
Gynaecologist, Delhi
Laparoscopy & Endometriosis - How Can Former Help Latter?

Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis. 

How does the procedure go? 

Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure. 

How is the procedure performed? 

The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give clear visibility to a surgeon. The laparoscopic camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis. 

Why is laparoscopy done? 

  1. If the endometriosis pain has returned after a hormone therapy 
  2. If there is a growing endometriotic cyst 
  3. If the scar tissue found on the pelvic wall poses a threat to fertility 
  4. If the endometriosis interferes with other organs such as the bladder etc. 
  5. If the pain during menses ( dysmenorrhoea) refuses to subside 

Duration of hospital stay: 
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery. 

Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization, intake of fertility drugs, insemination etc. If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay.

1462 people found this helpful

Types Of Hernia - Can Laproscopy Help You Manage Them?

Dr.Gaurav Bansal 91% (2301ratings)
MBBS, MS-General Surgery , FMAS, FIAGES
General Surgeon, Gurgaon
Types Of Hernia - Can Laproscopy Help You Manage Them?

Laparoscopy surgery is a very vital component of the hernia repair. Studies have shown that many patients have a better outcome when they opt for laparoscopic surgery. Candidates eligible for this mode of surgery include those with bilateral inguinal hernias, ventral hernias, and recurrent hernia. People associated with athletics and other outdoor sports prefer to go for a laparoscopic hernia surgery as it ensures a speedy recovery and minimal tissue invasion (due to small incisions).

Laparoscopic hernia repair- inguinal

A laparoscopic surgery requires an incision of 1-2 cm at the belly (at the lower end). Two small punctures are done near the umbilicus. The punctures are done to make room for the cameras so that the surgeon is able to view the abdomen clearly. The smaller incisions allows the operating instrument to enter into the stomach.

The Procedure:

A balloon is placed in between the abdomen and the overlying muscle so that the peritoneum can be separated. When space is successfully made, the camera comes into the action to view the condition of a hernia. A hernia is pulled from its hole into the abdomen. Once the hole is detected, the defect of a hernia is fixed.

Laparoscopic hernia repair- incisional/ventral: Laparoscopic hernia repair is suitable for all types of a hernia such as an umbilical hernia, ventral hernia, recurrent umbilical hernia, epigastric hernia etc. Just like an inguinal hernia, A camera is placed into the abdomen through the muscles. Two small incisions are made for the operating instruments to get through. This is followed by the cutting of the tissue that is placed between a hernia and the intestine. The hole thus gets exposed. Through one of the laparoscopic ports, the hernia mesh gets rolled and is placed into the abdomen. A hernia is then pulled up and the mesh gets secured with 4 sutures. A special device is used to fix the healthy muscle.

Tension free repair: “Tension free” repair is often used to symbolize hernia surgery. A hernia is often triggered by the weakened muscles. Few surgeons endeavors to sew the muscle around the area of a hernia. Since the muscles surrounding the hernia are weak in the first place, they pull apart causing a recurrence of a hernia. To avoid this, most surgeons use a mesh to strengthen the cells around the hernia region. This procedure ensures that the muscles aren’t sewn but the mesh placed over the hole can prevent the muscle to push through the walls of the abdomen.

The use of mesh: There are some reservations about using the mesh in a hernia surgery. However, this is the safest and most appropriate way to perform a hernia laparoscopic surgery. The use of a mesh also negates the risk of open incisions and recurrence of a hernia. 

1525 people found this helpful

Laparoscopic Cholecystectomy - Know Merits Of It!

MBBS, MS - General Surgery, Fellowship in Minimal Access Surgery, DNB - General Surgery, Fellowship in Surgical Gastroenterology
General Surgeon, Lucknow
Laparoscopic Cholecystectomy - Know Merits Of It!

Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

995 people found this helpful

Benefits Of Laparoscopic Surgery!

MCh - Surgical Gastroenterology/G.I. Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
Surgical Gastroenterologist, Delhi
Benefits Of Laparoscopic Surgery!

Benefits Of Laparoscopic Surgery!

Minimally Invasive Gastrointestinal Surgery - Know In Depth About It!

MBBS, MS (General Surgery), Fellowship in Surgical Gastroenterology
General Surgeon, Cuttack
Minimally Invasive Gastrointestinal Surgery - Know In Depth About It!

Minimally invasive gastrointestinal surgery, also identified as laparoscopic surgery or hand-assisted laparoscopic surgery (HALS), deals with minimally invasive methods where only one small keyhole incision is made in the abdomen in order to treat diseases originating from the gastrointestinal tract. This is, however, in contrast to traditional modes of open surgery, which generally work on the colon or on other parts of the intestine. These keyhole incisions are only about 5mm to 10mm in size and are therefore less harmful, in addition to boosting recovery time.

Need for minimally invasive gastrointestinal surgery -

Laparoscopic surgery is capable of treating the following conditions -

1. Crohn’s disease

2. Diverticulitis

3. Gall Bladder Stone

4. Gall Bladder Removal

5. Abdominal hernia

6. Hiatus hernia

7. Surgery for Hernia

8. Ulcerative colitis

9. Colorectal cancer

10. Familial polyposis

11. Rectal prolapse

12. Chronic severe constipation

Procedure -

Firstly, keyhole incisions are made to pave the way for access ports. It is through these access ports that your surgeon will insert the laparoscope and other surgical tools to begin the operation. With the help of the laparoscope, your doctor can view the transmitted pictures that will be displayed on the video monitor.

This kind of surgery can perform the following operations -

  1. Proctosigmoidectomy
  2. Total abdominal colectomy
  3. Abdominoperineal resection
  4. Total proctocolectomy
  5. Ileocolectomy
  6. Fecal diversion
  7. Rectopexy

Self-recovery -

After surgery, you may steadily resume daily activities after a few days. Walking is an essential necessity for faster recovery. In a matter of weeks, you will be fit to perform mild exercises to regain strength. Lifting heavy objects, however, is not advisable as it may cause back problems or cause the stitches to tear loose.

1348 people found this helpful

IVF Vs Tubal Reversals - Which Is Best?

Dr.Pranay Shah 90% (73ratings)
MS - Obstetrics and Gynaecology
IVF Specialist, Ahmedabad
IVF Vs Tubal Reversals - Which Is Best?

In vitro fertilization (IVF) includes empowering the woman with medicines, taking various eggs from her ovaries, fertilizing them with her partner’s sperm, and inserting a portion of the subsequent embryos into her uterus with the trust that one will form into a fetus. 

Tubal ligation reversal, on the other hand, requires a laparotomy, which needs a much bigger entry point on the abdomen, usually around four to six fingers long. Since the skin, each of the muscles, and different tissues of the stomach must be sliced through, there is extensively more uneasiness and longer recovery time required after the surgery, when compared with laparoscopic surgery, for example, with a tubal ligation. 

Here are a few common differences: 

  1. Sperm quality: The male partner needs a sperm test before basic procedures of either of the two. In case that the sperm quality is great, then the couple could consider proceeding. In case that the sperm quality is poor, in vitro treatment is the better alternative. With IVF, poor sperm quality is effectively overcome. 
  2. Tubal status: The length of the remaining tubal stumps after tubal ligation is an important aspect. The more extended the two remaining stumps are on each side, the better and more effective is the pregnancy. The shorter the stumps, the lower are the odds for pregnancy. 
  3. Status of other pelvic conditions: Pelvic endometriosis or any scar tissue in the range of the tubes or ovaries would diminish the chance for accomplishment after tubal ligation reversal. Although, IVF pregnancy achievement rates are usually not influenced by these conditions. Along these lines, in vitro fertilization is most likely a superior alternative in women with noteworthy endometriosis or pelvic scar tissue. 
  4. Female age: Chances for pregnancy with either tubal ligation or IVF decrease in the mid to late thirties and significantly reduce at the age of thirty-eight. By age forty-three or forty-four, not many women will have the capacity to have a baby using either approach. 
  5. Egg amount and quality: A few women have a decrease in either egg amount or quality prior in life than anticipated. In this manner, the woman’s ovarian capacity needs to be tested before a choice is made in regards to whether to continue with either tubal ligation or in-vitro fertilization. AMH levels, ovarian antral follicle number, and day 3 FSH levels are generally done to evaluate ovarian capacity or hold. 
  6. Doctor intervention: The greatest favourable position of tubal ligation reversal over IVF is that once the woman has experienced the surgery she ideally will not require any medication through the doctor, for example, medications or systems, keeping in mind the end goal to get pregnant.
2329 people found this helpful

Knowing Details About Laparoscopic Surgery!

Dr.Nalla Seshagiri Rao 88% (64ratings)
DNB (General Surgery)
General Surgeon, Visakhapatnam
Knowing Details About Laparoscopic Surgery!

Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside our belly. It is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder.

The gall bladder is a small organ that sits right under the liver and is credited with bile storage, which can help the body in breaking down various kinds of fats that enter it. So, what all do you need to know about this operation? Read this list.

Reasons for Gall Bladder Operation: The gall bladder is not a very efficient organ. It can lead to blockages and choking as the bile it stores can become very thick and difficult to handle. Also, this bile can start to harbor deposits that are hardball like substances, usually known as gall bladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

Further, these gall bladder stones can cause infections which can lead to symptoms like nausea, vomiting, bloating and more. Another reason can also be the gall bladder disease known as cholelithiasis, which can cause abdominal pain. Inflammation in the pancreas, also known as pancreatitis, can lead to gall bladder open removal surgery.

Risk: While the gall bladder removal surgery is usually considered a safe one, with little or no complications, there are risks attached to this surgery too. These include sudden and excessive bleeding and the creation of blood clots, allergic reactions to the drugs used as well as anaesthesia, blood vessel damage, accelerated heart rate which leads to an increased risk of contracting a heart attack or heart disease, infections, inflammation or swelling in the pancreas, and injuries caused to the bile duct during surgery.

You might also need this type of surgery if you have the following:

1. biliary dyskinesia, which occurs when the gallbladder doesn't fill or empty correctly due to a defect
2. choledocholithiasis, which occurs when gallstones move to the bile duct and potentially cause a blockage that prevents the gallbladder from draining
3. cholecystitis, which is an inflammation of the gallbladder
4. pancreatitis, which is an inflammation of the pancreas

Laparoscopic surgery is preferred over open cholecystectomy surgery because the smaller incisions that are made reduce your risk of infection, bleeding, and recovery time.

Preparation: To prepare for your gall bladder removal surgery, the doctor may ask you to have a prescription fluid so that your bowels are flushed clean. You may also be asked to fast for at least six hours before the surgery so that there is no hindrance to the same. Also, the use of antibacterial soap to bathe is usually prescribed so that the risk of contracting infections decreases.

While this surgery can be a simple one, you will have to take due care after the surgery to ensure that the recovery is fast and virtually pain-free.

1052 people found this helpful
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