Surgery - Treatment, Procedure And Side Effects

Following are the most common foot conditions which require surgery:

1. Plantar fasciitis: It is one of the most common causes of heel pain which is aggravated in the morning with initial few steps. Too much pressure on feet can damage or tear the ligaments because of which the plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
2. Rheumatoid arthritis: It is an autoimmune condition that affects the joints and causes swelling of the joint lining (synovium). It commonly affects the small joints of the hands and feet. Surgery is required when the condition leads to deformity or cartilage loss.
3. Sesamoiditis: It is a condition where there is a pain on the bottom of the foot at the base of the great toe. Excision of the chronically inflamed sesamoid is required.Ankle arthritis: It is usually caused by osteoarthritis where the cartilage covering the ends of bones gradually roughens and becomes thin and the bone underneath thickens. This leads to pain, swelling, and occasional deformity of the joint. 
4. Fracture: Healing fractures require immobilizing the foot with a boot and sometimes even surgery.
5. Bone spurs: An excessive growth of bone is causing pain or limitation of movement. These spurs develop at the edge of the joint causing pain, tenderness, and difficulty in walking. Surgery is required to remove these excessive growths.
6. Gangrene: It is one of the most common conditions requiring amputation where the death of the tissue occurs.
7. Clubfoot/Talipes Equinovarus: It is a foot deformity in newborns where the foot is rotated inwards (varus) and downwards (equinus).
8. Claw Toes/Hammer Toes: It is a condition affecting the toes in people as they age causing difficulty and pain while walking. The affected joints require replacement with artificial joint or fusion (surgical stiffening). 
9. Morton's Neuroma: The patient presents with pain in the forefoot, in the “ball” of the foot causing irritation of one or more of the small nerves, just before they travel into the toes.
10. Hallux Valgus/Bunion: It is one of the most common conditions, especially seen among women, where bony lumps develop on the side of the foot and at the base of the big toe causing malpositioning of the foot. For some people, it is only a cosmetic problem. Bunionectomy is a surgery performed to remove the bony prominence.
11. Hallux Limitus/Rigidus: It is an arthritic condition of the big toe joint leading to pain and loss of motion.
12. Diabetes mellitus: It affects circulation and blood supply causing delayed healing. Ulcerations, infections, and sometimes severe infections require amputations.
13. Cysts and ganglions: These are painful lumps that cause pressure and rub on the shoe while walking. If a change in the footwear doesn’t solve the problem, surgical removal of the cyst or ganglion is done.

When a person is told of the need to undergo surgery, one of the first things that comes to mind is the pain after the procedure. Is it going to be very painful? How long is it going to last? How to manage it? These are some questions that doctors are repeatedly asked and they spend quite a bit of time trying to put the patient at ease.

The talk about post-surgery pain management should begin well ahead of surgery so that the patient can plan accordingly and be mentally prepared. There could be cases where the patient may need to have a caretaker when back home so that they can assist in daily chores and manage pain. Read on to know some of the tips to manage pain.

1. Expect the pain: Talk to your doctor well in advance so that you are mentally prepared for the pain that will come post the surgery. The type of pain, duration, radiation to surrounding areas, etc., will help to plan in pain management. While back surgery produces spasms, abdominal surgery can cause cramps in the stomach. If you have pre-existing conditions like chronic pain, the pain is likely to get worse.
2. Beat the pain: After surgery, take the pain medication before the anesthetic effect wears off. This gives enough time for the medication to kick in before the effect of anesthesia wears off. Else, there could be a period of intense pain, which can be quite difficult to manage. Though some people avoid pain medications, take them if you need. Also, if you had side effects with any, let your medical team know so that an alternative medicine can be prescribed.
3. Emotional management: A surgery comes with a lot of anxiety and depression. This could be due to social, financial, physical, and emotional reasons. Pain is a lot more emotional than physical, so preparing for pain helps in dealing with it better. Talking to friends and family can be really help you deal with the entire situation and If required, you can reach out to social workers or counsellors so that you are at ease with other issues and manage pain better.
4. Alternative therapies: For some, in addition to the painkillers, therapies like mild yoga, acupressure, meditation, music, and other relaxation techniques work wonders. They soothe the mind and make sure pain is lot reduced. They also improve blood circulation and thereby promote healing. Quicker healing promotes pain relief, making it further easy.
5. Types of pain relief measures: Depending on the severity of the postsurgical pain, one of the following may be used
   • PCA or patient-controlled analgesia: The patient can program the amount of pain medicine via a small pump.
   • Nerve blocks: This is useful to control pain over a specific area supplied by a nerve.
   • Oral pills: In mild to moderate cases, tablets are given to control pain. Depending on their duration of action, repeat doses are planned. Narcotics could be used initially before switching to non-narcotic painkillers.

​​In case you have a concern or query you can always consult an expert & get answers to your questions!

Hernia refers to the condition when an organ or fatty tissue inside the body begins to protrude from its location. Hernias are mostly detected in the groin, belly, or the stomach region. They occur because of muscle weakness in the said region where it is detected but they can be treated with surgery. In most cases, a surgery is prescribed and laparoscopic hernia repair is a very popular surgical procedure that has proven to be successful in most of the cases. This is why a growing number of patients decide to go for it.

Laparoscopic hernia repair: procedure: In this surgical procedure, a laparoscope (an instrument with a high-resolution camera and high-intensity light) is passed inside the abdomen through small incisions that varies between 0.5 and 1.5 inches in length. When the laparoscope moves inside the abdomen, it sheds light on the hernia and sends the images to the monitor connected to it. The surgeon views the hernia on the monitor and then the abdominal cavity is made to swell with carbon dioxide so that the surgeon can find enough space to operate the hernia. Once this is done, the surgeons operate the hernia with tiny surgical instruments. Once the hernia is removed, space or the hole is covered with a mesh from inside the abdomen.

Advantages of laparoscopic hernia repair: The laparoscopic procedure is popular because it is comfortable for the patient in many ways. They have to endure lesser post-operative pain as compared to open surgery, which means the recovery is quicker. They require lesser drugs for healing and the patient can get back to work in fewer days. It is an advanced form of surgery and thus, gives better results.

Disadvantages of laparoscopic hernia repair: While the non-invasive laparoscopic surgery has several advantages, it also comes with some drawbacks. It is lengthier in comparison to open surgery and also costs more. It cannot be performed by all the surgeons and only those who are skilled in this type of surgery can do justice to the different cases of a hernia. 

Recovery after laparoscopic hernia repair: The patient takes one to two weeks after the surgery to return to light activity and daily routine. Nevertheless, heavy exercise and strenuous activity should be avoided until four weeks after the surgery. The full recovery time differs from patient to patient depending on their age, gender, and health condition but one month is the average time for full recovery.

555 Manish Technique for inguinal hernia repair:

Totally extra-peritoneal (TEP) repair of inguinal hernia is now a standard surgical technique. A 12 mm incision in infra-umbilical region for Hasson trocar is must for TEP repair of inguinal hernia. This is the only technique known to laparoscopic surgeons. We have innovated a "555 Technique" for completing Mini TEP repair of inguinal hernia by using all three 5 mm ports.

555 Technique" is a feasible option without compromising the principles of TEP repair for inguinal hernia. Innovation of simple "Manish Retractor" is the key in completing Mini TEP repair. This technique is simple, less invasive, less morbid, and cost effective as it avoids dependence over costly Hasson trocar with better cosmetic results. In case you have a concern or query you can always consult an expert & get answers to your questions!

Weight loss surgery or bariatric surgery helps lose weight in those people who are about 100 pounds (male) and 80 pounds (female). It helps individual resolve obesity-related medical problems.

Types of Weight Loss Surgeries-

1. Gastric Band

A band is put around stomach tightly which divides the stomach into two sections, namely smaller upper and larger lower which is connected through a small tube by which emptying of the upper part becomes slow. Since less food is required to fill this pouch; there is no need to eat much. The band is connected to a device under the skin. It can be tightened after 4-6 weeks after surgery.

Merits: Simpler method. Recovery is faster leaving a small scar.

Demerits: Lesser weight loss than other surgeries. The band might slip out. Vomiting can occur after overeating food quickly.

2. Sleeve Gastrectomy

In this procedure, a larger portion of the stomach is cut off, and the remaining smaller part is attached to the intestine. Smaller the stomach, lesser is the production of appetite-regulating hormone ghrelin. As a result, less food is taken in.

Merits: It is a simple method. As it does not involve intestines, the process of absorption takes place smoothly, and the patient does not fall short of nutrients.

Demerits: It is an irreversible process. It can cause infection and leaking of sleeve might take place.

3. Duodenal Switch with Biliopancreatic Diversion

In this procedure, a larger part (70%) of the stomach is cut off leaving the duodenum. The surgeon cuts the middle part of intestine attaches it to the duodenum. It is called duodenal switch. The leftover part of the intestine is again attached to the last part of intestine allowing pancreatic juices and bile to flow into that part. This is biliopancreatic division. Food passes directly into the small intestine limiting absorption of nutrients and calories, ultimately resulting in weight loss.

Merits: It is a fast method to lose weight, and the patient can eat large amounts of food.

Demerits: Nutritional deficiencies are seen.

4. Gastric Ballooning

A small balloon filled with salt and water is placed in the stomach through a thin tube via throat.Merits: The patient feels full and will not be able to eat much.

Demerits: It is a temporary method, which can last only for 6 months.

5. Gastric Bypass

In this procedure, the surgeon divides the stomach into two parts, namely upper and lower. Here, the upper part of the stomach is directly connected to the last part of the intestine.

Merits: More than 50% weight loss take place, as much weight gets reduced, and conditions, such as diabetes and blood pressure come under control.

Demerits: As less of nutrients are absorbed, the patient might land up into anemia and nutritional deficiency. The patient might need to take supplements after surgery to maintain balance. In case you have a concern or query you can always consult an expert & get answers to your questions!

The thyroid gland is located on the front base of the neck and its shape is like a butterfly. The thyroid gland plays a significant role in our body by secreting several hormones that are collectively called as thyroid hormones. These hormones regulate different processes throughout the body such as influencing the metabolism, body temperature and keeping the other organs to function properly. Sometimes, the thyroid gland is affected by various disorders such as goiter (enlargement of the thyroid gland), hyperthyroidism (over-production of thyroid hormone), hypothyroidism (insufficient production of thyroid hormone), and thyroid cancer. Thyroid surgery is also called, thyroidectomy and is used to treat thyroid disorders.

Here are some common reasons why thyroid surgery is advised:

1. Thyroid cancer: Cancer of the thyroid gland is one of the most common reasons to perform the thyroid surgery. Depending on the conditions and stage of cancer, removal of most of the part of the thyroid gland, if not all, is considered as the treatment option. Surgery is considered an imperative option when small nodules or tumors are present in the gland and some of these nodules are precancerous or cancerous.
2. Hyperthyroidism (overactive thyroid): The second reason of thyroidectomy is hyperthyroidism. Hyperthyroidism is the condition in which thyroid gland produces a large amount of thyroxine hormone (it is the main hormone of the thyroid gland). If the patients don’t respond to the other treatment options such as anti-thyroid medications or if they don’t want to undergo radioactive iodine therapy, thyroid surgery may be a right option.
3. Goiter (enlargement of thyroid gland): Another reason of thyroidectomy is the enlargement of the thyroid gland. The condition, in which thyroid gland swells or enlarges, is known as goiter. In the condition of goiter, the benign nodules become large enough to cause different problems. Thyroid surgery is the right option for the treatment of these problems that include difficulty in eating, breathing or speaking; the patient feeling uncomfortable, and the overproduction of thyroxine hormone.

Types of thyroid surgeries:
Although there are different types of thyroid surgeries the most common types are:

1. Lobectomy: It involves removing one of the two lobes of thyroid gland when the inflammation or nodule affects only half of the gland.
2. Subtotal thyroidectomy: It involves removing the thyroid gland but the surgeon leaves a small amount of thyroid tissue behind.
3. Total thyroidectomy: It involves removing the complete thyroid gland and thyroid tissue. It is done to treat cancer or when the inflammation affects the entire gland.

Conclusion: 
Thyroid disorders can be treated with various treatment options but it is better to have a thyroid surgery if the underlying thyroid disorder becomes severe. In case you have a concern or query you can always consult an expert & get answers to your questions!