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Laparoscopic Surgery Health Feed

Advancement In The Surgery - Know About It!

Advancement In The Surgery - Know About It!

Large incisions were required for performing any kind of surgery in the past. In recent years, long incisions and large cuts can be avoided through minimally invasive surgical techniques such as Single Incision laparoscopic surgery. As this surgery helps the patients to recover faster and face lesser discomfort, it is rapidly replacing the traditional open surgery methods.

In this process, the doctor performs the surgery through a single entry point - usually in the abdominal region. Unlike older methods, it leaves only a small scar. This surgery has led to the development of surgical instruments that can be inserted into a small incision - about 10 mm long.

Process

The surgery is performed by inserting a thin tube through the belly button of the patient. The incision is made near the navel so that it can be easily hidden and a lighter scar is left behind. Using the surgical tool, a surgeon is able to check abnormal growths in the abdominal region, gynecologic issues like pelvic inflammatory disease or fibroids and endometriosis.

Organ removal processes like gallbladder, uterus, or the ovary can be carried out through the procedure. Hernias are also treated through this method.

Benefits of Single Incision laparoscopic surgery

The various benefits of the process are as follows:

  • Due to the single incision, the patient feels less pain during the surgery and it reduces the chances of infections. Most patients undergoing this surgery are satisfied in terms of cosmetic results

  • Fewer chances of visible scarring

  • Patients have a shorter stay at the hospital and recover faster than traditional methods

  • Less blood loss

  • It also reduces the chances of nerve injuries that are commonly observed in open surgeries and laparoscopy

  • It is very useful for treating liver cancer for patients who need a second surgery. The surgeons make a longer cut – similar to the ones made in the traditional methods. This helps them get a better look at the patient’s intestine. This significantly reduces the risk of adhesion, where intestinal parts get attached or stuck together

Who is the ideal candidate for the procedure?

The technique is the best option for patients undergoing the following surgeries:

  • Gallstone removal surgery

  • Biopsies in the abdomen region

  • Removal of tumours in the pelvic area or the belly

  • Bariatric surgery

  • Colon resection

If you have undergone multiple abdominal surgeries before, and have severe inflammation in the region or are diagnosed as obese, the doctor may ask you to opt-out for the Single Incision laparoscopic surgery. Therefore, before opting for this surgery, consult a specialist and discuss all your current health conditions.     

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Hernia Surgery - Everything About It!

Hernia Surgery - Everything About It!

Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). The hernia may be Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. The hernia can also originate from an incision (Incisional Hernia). The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the bellybutton. This results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm. Of all the hernia types, the Inguinal Hernia is the most common. 

Severe strain and muscle tear or weakness can result in hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of hernia. In case of hernia, the affected area tends to protrude or bulge out. If left untreated; hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.  

The severity of the hernia depends upon its size. In case the hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be Open or Laparoscopic. In open surgery, hernia is identified through an incision. Once located, the hernia is removed from the adjacent tissues. In Laparoscopic Repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.  In such repair, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chances of a recurrence.
     Certain factors needs to be well addressed before performing hernia operation
-    Hernia operations, Laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
-    Laparoscopic hernia operation should be avoided in case a patient has adhesions from previous surgery.
-    Extreme care should be taken while performing a hernia operation in infants and children.
-    In some cases, hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men.
 

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Laparoscopic Colon Cancer Surgeries!

Laparoscopic Colon Cancer Surgeries!

Cancer, in any form, is a deadly disease that requires immediate attention and treatment. Colon cancer is a common form of the disease, with over 10 lakh people reportedly affected in India each year.

In some cases, surgery is the only remedy for colon cancer. Depending on the progression of your cancer, if surgery becomes necessary, you should consider undergoing laparoscopic surgeries.

What is a laparoscopic surgery?

While most surgeries are open, where a large incision is made on the body to operate on the internal organs and tissues, it’s not the same with laparoscopic surgery. Here very small incisions are made on a particular body part to carry out the surgery. The procedure gets its name from the equipment used in the operation. A laparoscope is a tube-like instrument that has a camera on one end. During the surgery, this laparoscope is inserted in the patient’s body and the image relayed back by the camera is used to perform the surgery.

In case of laparoscopic colon cancer surgeries, the surgeon uses the same method to reach your the cancerous mass in your colon and remove it.

Why choose laparoscopic colon cancer surgeries?

As a person affected by cancer, you have already endured substantial pain and discomfort. You do not need additional discomfort from your surgery. This is why laparoscopic surgeries are so popular when it comes to colon cancer. Here are some benefits of the procedure over the standard surgery.

• Less pain after the surgery
• Limited stay at the hospital post surgery
• Allows you to return to a solid food diet sooner after the surgery
• Allows normal bowel function to resume quicker
• Less scaring from the procedure
• Faster return to a normal lifestyle

Not everyone is eligible for open surgery to treat colon cancer. For instance, open surgery on elderly people can be extremely dangerous. For them, laparoscopic surgeries are a better alternative.

Are you eligible for laparoscopic surgery?

Before you opt for laparoscopic surgery to treat your colon cancer, consult an expert. The surgeon will help you understand whether you meet the requirements for laparoscopic surgeries. Your doctor will evaluate your case and let you know which procedure will have the maximum impact on your long-term recovery from cancer.

Is laparoscopic surgery as effective in treating colon cancer as open surgery?

According to a study performed by a Canadian team of researchers, the laparoscopic procedure is just as useful in treating colon cancer as the standard surgery. However, each case of colon cancer is different and the outcome of surgery may vary from person to person.

Laparoscopy - Does It Help In Gynaecological Cancers?

Laparoscopy - Does It Help In Gynaecological Cancers?

Minimally invasive surgery or laparoscopic surgery is increasingly becoming popular in all fields of surgery including gynecological oncology. Given its many advantages, it is easy to see why people prefer this form of surgery. The use of laparoscopy in the field of gynecological oncology began in the late 1980s. The first laparoscopic-assisted hysterectomy was performed in 1989.

Laparoscopy and Endometrial Cancer:

The endometrium refers to the lining of the uterus. Endometrial cancer is rare are usually affect women over the age of 55 years. A hysterectomy is one of the forms of treatment for this condition. If detected in its early stages, this hysterectomy may be performed laparoscopically. As compared to traditional surgery, this reduces the hospital stay required and is associated with fewer postoperative complications. Laparoscopy may also be used to restage patients who have already undergone a hysterectomy.

Laparoscopy and Cervical Cancer:

The lowermost part of the uterus is known as the cervix. A pap smear can help in the early detection of cervical cancer. This can be treated surgically in the form of a lymphadenectomy or a radical hysterectomy. One of the factors crucial to the management of this type of cancer is an evaluation of the lymph nodes.

This is where laparoscopy is very useful. As in the case of endometrial cancer, laparoscopy may also be used for a hysterectomy procedure. A laparoscopic lymphadenectomy may also be performed to investigate the extent to which the cancer has spread. Advanced stages of cervical cancer can be treated with chemotherapy and radiation. In such cases, the role of laparoscopy may be limited to staging the patient before treatment.

Laparoscopy and Adnexal Masses:

Adnexal masses refer to ovarian abnormalities and development of masses in the fallopian tubes, uterus and other organs in the pelvic cavity. Laparoscopy is routinely used to treat benign Adnexal masses. It can also be used in the management of malignant adnexal masses. However, its role is less clearly defined in such cases. When using laparoscopic procedures to address adnexal masses, it is important to identify benign masses beforehand.

Laparoscopy and Uterine Cancer:

Laparoscopy can be used in a number of ways when it comes to the management and treatment of uterine cancer. These include staging apparent early stage cancer, determining the extent of the disease and resectability potential and to reassess a patient in cases of recurrent cancer. A hand assisted laparoscopy may also be used to resect the disease in some cases. 

Laparoscopy Surgeries & Infertility - How Former Can Help Latter?

Laparoscopy Surgeries & Infertility - How Former Can Help Latter?

Almost every woman wants to lead a healthy life with their loved ones and experience the joy of motherhood when the right time comes. However, as much as you detest it, the last decade or two has seen a steady rise in gynecological problems. While some of the gynecological conditions are minor and can be easily treated and taken care of, others may give you a hard time. From PCOS to Endometriosis, left untreated, some of these problems may trigger infertility, complicating things further.

Open surgeries have long been the only surgical option to deal with such critical problems. However, the advent of Laparoscopy has brought about a much-needed relief benefitting millions of women with gynecological problems worldwide. Based on the latest technology and being minimally invasive, laparoscopy comes with a lot of benefits. In addition to surgically treating a condition, laparoscopy also ensures an accurate and better diagnosis. In this article, we will discuss the laparoscopic surgeries to deal with infertility and other related gynecological issues.

Infertility and Laparoscopic surgery

Identifying the underlying factor(s) responsible for infertility can go a long way to treat the condition successfully. Some of the factors that contribute towards infertility include

  1. PCOS: Polycystic Ovarian Syndrome is a medical condition whereby formation of a cyst(s) take place in one or both the ovaries. These cysts affect the ovulation process as the eggs either do not mature or the ovary fails to release the mature eggs. To deal with this situation, a surgeon often performs the Laparoscopic Ovarian Drilling or Ovarian Diathermy.
    • Here, the surgeon makes small cuts in the abdomen (belly button).
    • To inflate the stomach, the surgeon inserts carbon dioxide gas inside the stomach.
    • The Laparoscope along with the surgical instruments are next inserted inside through the incisions.
    • Parts of the ovary that are being affected are destroyed using Electrocautery.
  2. Ovarian Diathermy plays a significant role in normalizing the ovulation process, which was affected by PCOS.
  3. A blocked fallopian tube can also trigger infertility. In this case, Laparoscopic Fimbrioplasty (performed when there is a scar or a blockage in the part of the fallopian tube that is adjacent to the ovary) comes in handy. It is a laparoscopic reconstructive procedure that helps to open the tubal blockage, thereby restoring the fimbriae (finger-like projections located at the tube ends that aids in the transportation of the matured eggs from the ovary into the uterus).
  4. Endometriosis: This is a medical term used to define a condition whereby the endometrial cells grow outside the uterus, often in the ovary or the fallopian tube resulting in pain and infertility. Here also, laparoscopy comes as a savior, getting rid of any scarred tissues, endometrial implants or endometrioma (endometriosis cyst that forms in the ovary), thereby improving the condition.
  5. Laparoscopy can also be used to treat ovarian cancer, removal of fibroids (uterine myomas or uterine tumors), hysterectomy (uterus removal).
  6. Laparoscopy plays a significant role in reversing the tubal ligation (closure of the fallopian tube to prevent pregnancy).

Can Laparoscopic Surgery Help In Dealing With Endometriosis?

Can Laparoscopic Surgery Help In Dealing With Endometriosis?

Laparoscopy is one of the most common procedures for diagnosing and treating endometriosis. Instead of giving a big incision, this procedure of surgery uses a lightweight instrument through a few small holes or incisions. 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 in pain associated with the endometriosis. If a cyst is found in the ovary, the 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 anesthesia is given during such procedures. A person specialized 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 with a scope is then pushed through an incision to examine the internal organs. If endometriotic lesions are found then a doctor can use one of the several laparoscopic techniques such as electrocautery, excision, etc to destroy the same. Post-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. To diagnose endometriosis.
2. Infertility associated with Endometriosis.
3. If there is an endometriotic cyst more than 4 cm.
4. If the endometriosis interferes with other organs such as the bladder, rectum, etc.
5. If the pain during menses ( dysmenorrhoea) does not subside with medication.

Duration of hospital stay -

Operations such as these are done as daycare procedures as these are less invasive. Patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalization may also be required. One can successfully return to normal work within 1 week of the surgery.

Post-surgical treatment -

Once the laparoscopic diagnosis is made and lesions treated, treatment depend upon the symptoms and age of the patient. If the patient is desirous of pregnancy then accordingly ovulation induction and either IUI or IVF is done. If the patient does not desire for pregnancy then she can be put on hormonal therapy.

Bariatric Surgery - Regimen To Adhere To!

Bariatric Surgery - Regimen To Adhere To!

Bariatric surgery refers to the procedure by which excess fat is removed gradually within few months from an individual’s body after modification in size of stomach and modification in gut pathway and length by laparoscopically (keyhole surgery).

The diet that must succeed a bariatric surgery changes with time. A post-bariatric surgery diet will tentatively look like:

  1. Initial stages: At the initial stage, eating solid food should be strictly avoided. A liquid diet with added protein can is a feasible option as long as it does not have any solid particles. The doctor may also prescribe regular and intermittent consumption at the beginning.
  2. Intermediary stages: The diet must be changed post second till the sixth week as the meal is made thicker. However, solid food must still be expelled. Due to the surgery, it is only normal that you would feel full after small consumption thereby, necessitating regular intake of food within a short span of time.
  3. Final stages: Post sixth week, incorporating solid food in the diet is generally allowed by the doctors. With the introduction of fuller meals, regular intake of food should be reduced and four meals a day should be the norm.

Along with a fixed diet chart, you may also practice certain exercises to expedite the process of recovery. Some of them are:

  1. Light exercise: Depending on the condition, few patients may be prescribed exercises every week for an hour.
  2. Multiple exercises: Few, on the other hand, may be prescribed by the surgeons to exercise twice every week, generally for an hour.

Gall Stone Surgery - What Should You Know?

Gall Stone Surgery - What Should You Know?

What is gallstone surgery?

It is surgical removal of the gallstone from the gallbladder. It is also known as cholelithotomy.

What are the Statistics of the surgery?
Approximately 90% of patients who seek treatment undergo surgery to remove the stones and the gallbladder.

What is the role of gallstone surgery?
Gallstones which are asymptomatic generally don’t need surgical removal. Treatment depends on the size and location of the gallstones. Surgery to remove the entire gallbladder with all its stones is usually the best treatment, and it is done in patients who can tolerate the procedure.

What are the indications for gallstone surgery?
Indications for gallstone surgery are as follows:

  • Stone lodged in the pancreatic duct
  • If the stone is causing severe pain, vomiting
  • Chronically obliterated cystic duct due to gallstone
  • Nonfunctioning gallbladder due to obstruction
  • Calculi greater than 3 cm in diameter
  • Acute infection of gallbladder (acute cholecystitis) due to gallbladder obstruction
  • Chronic infection of gallbladder due to gallbladder obstruction

How is the surgery performed?
The following surgeries are done in patients who are found to have cholelithiasis and choledocholithiasis:

  1. Extracorporeal shock wave lithotripsy: A special machine which generates sound waves is used to break the stone. It is only done in the people who are having a small, and soft stone. This procedure doesn’t require any anesthesia, and repeated shock wave therapy is required for complete removal.
  2. Laparoscopic cholecystectomy: It is a procedure where a laparoscope (a small, thin tube) is put inside the body through a tiny incision made just below the umbilicus, and another probe is inserted to remove the stone.
  3. Open gallbladder surgery: It is done to remove the gallbladder when it is infected, or inflamed, or has large gallstones, or when complications are found during laparoscopic surgery.
  4. Percutaneous cholecystostomy guided by computed tomography (CT), or ultrasonography (USG) to remove the gallbladder.
    • Contact dissolution of gallstone can be done where direct catheter of a chemical solvent is introduced by the percutaneous way. It is best for cholesterol stone and, is best at removing any size of the stone.
    • Endoscopic retrograde cholangiopancreatoscopy (ERCP) is used to remove the stones which are in bile duct through the mouth, throat, esophagus, stomach, duodenum, and biliary system without any surgical incisions.

What are the complications of surgery?
Following are the most common complications of surgery:

  • Bile leakage leading to biliary peritonitis
  • Infection of gallbladder due to improper aseptic precautions
  • Abscess formation around the gallbladder, or over adjacent structures
  • Death due to rapidly spreading peritonitis causing septicemia
  • • Raised liver enzymes, jaundice, and severe pain
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Minimally Invasive Gastrointestinal Surgery - What Should You Know?

Minimally Invasive Gastrointestinal Surgery - What Should You Know?

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.

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Hernia (Inguinal Or Ventral) - Which Are The Best Surgical Ways To Treat It?

Hernia (Inguinal Or Ventral) - Which Are The Best Surgical Ways To Treat It?

Hernias are quite common and occur more in men than in women. When left untreated, the condition gets very painful, and sometimes become life-threatening. Hence, ignoring a painful hernia is a bad idea, and seeking medical assistance is necessary. To know more about the condition and the treatment available, read on.

What is a hernia?

A hernia refers to an abnormal exit of an organ or tissues. When a fatty tissue or an organ squeezes or penetrates through a weak spot of the surrounding connective tissues or muscles, the condition hernia appears. Though there are various types of a hernia, it is an inguinal hernia and the ventral hernia that are two of the most common types.

Inguinal hernia:

When the bladder or the intestine protrudes into the groin's inguinal canal or extends through the abdominal wall, it is referred to as an inguinal hernia. Around 96% of the groin hernias that occur are usually inguinal hernia. It is due to the weakness in the groin area of men that men commonly suffer from this kind of a hernia.

Ventral hernia:

A ventral hernia is a type of a hernia that develops in the abdominal wall's front. Usually, it occurs at the weak areas of the abdomen such as the location of a previous surgery. Varying in sizes, it may be small to complex and large, these hernias may appear weeks or months or sometimes years after surgery. The various types of a ventral hernia are an epigastric hernia, umbilical hernia, incisional hernia, Spigelian hernia and parastomal hernia.

Complications, if left untreated...

If left untreated, your hernia may grow and become more painful. A portion of your intestine could become trapped in the abdominal wall. This can obstruct your bowel and cause severe painnausea, or constipation. An untreated hernia can also put too much pressure on nearby tissues. This can cause swelling and pain in the surrounding area. If the trapped section of your intestines doesn’t get enough blood flow, strangulation occurs. This can cause the intestinal tissue to become infected or die. A strangulated hernia is life-threatening and requires immediate medical care.

Treatment Options--

Open surgery:

Open surgery for treating hernia is the most traditional and old surgical practice. To perform this common type of hernia surgery, spinal anesthesia is required, while an incision of around 4 to 5 cm is made in a hernia affected area. Even the most complex and large hernias can be easily treated through such surgeries. Open hernia surgery usually takes 30 to 45 minutes.

Laparoscopic surgery:

Compared to the open surgery, laparoscopic surgery requires more time, around an hour or so and is one of the modern surgical processes. Though long-standing or chronic or large hernias cannot be removed through laparoscopy as easily as in open surgery, still, when it comes to smaller incision and quicker recovery time, it is definitely the laparoscopic hernia surgery that is chosen by many. But the costs for laparoscopic surgery is a bit higher than that of the open surgery.

Remember, both women and men can get a hernia at any age. People can even be born with a congenital hernia or develop a hernia over time. A hernia neither goes away all by itself, nor it gets healed over time. Getting operated, in the majority of cases, is usually considered to be the best option to get rid of this condition.

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