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Surgery Health Feed

Anterior Cruciate Ligament (ACL) - 3 Treatment Options For It!

Dr. Umesh Kulkarni 88% (20 ratings)
MBBS, MS - Orthopaedics, Diploma In Orthopedics
Orthopedist, Nashik
Anterior Cruciate Ligament (ACL) - 3 Treatment Options For It!

The anterior cruciate ligament is one of the most delicate yet vital ligaments that holds the knee bones in place and stabilizes the movement. Injury to the ligament, on account of a sprain, can prove to be a cause of severe distress. This may lead to a partial or a complete destabilization of the knee joints and impair the normal movements to a great extent.

Causes
Some of the most common causes of this sort of a ligament tear are accidental injuries during a sporting activity, unexpected collision or incorrect body postures. This is a fairly common occurrence among the athletes. However, the physiological and neuromuscular controls make women more susceptible to damage to the Anterior Cruciate Ligament than men.

There are two cruciate ligaments in our body, i.e. the anterior and the posterior cruciate ligaments. They run in crosses to connect the insides of the knee joints. They regulate the back and forth movement of your knees. They therefore, may incur substantial damage through sudden movements like jerks or an abrupt change of direction; the degree of tear may vary from minor strains to complete detachment. Accordingly, treatments are available to cure the distress. The treatments may either be surgical or nonsurgical, depending about the extent of the injury as well as the age of the patient. A complete tear in the ligament necessitates surgery for recovery. However, one may choose to opt for other non - surgical methods to minimize the damage.

Some of the most effective treatments for a tear in the anterior cruciate ligament have been enlisted below:
1. Bracing: Wearing a brace or using a crutch for the purpose of movement can accord the knees with some stability. It also keeps the joints intact and alleviates pain.
2. Physiotherapy: Once the inflammation reduces, you may opt for physiotherapy to restore movement and reduce the pain. Heat and Ice therapies work as ideal adjuvants to physiotherapy in such cases.
3. Surgery: Regrowth of the anterior cruciate ligament may be possible through a surgical process of grafting. This enables the tissues to repair themselves. Knee caps and adequate rest accord better rehabilitation. The recovery is faster and steadier in this process.

Revision Joint Replacement - Do You Need It?

Dr. Niranjan T J 88% (10 ratings)
DNB - Orthopedics, D ( ORTHO), MBBS
Orthopedist, Trivandrum
Revision Joint Replacement - Do You Need It?

Thousands of people are affected with a painful knee which troubles their lives directly. Due to a weak or inflated knee, they cannot continue to carry on with their activities which they do have been doing regularly. A total knee replacement is required in many such cases, which is one of the most popular and successful ways to provide relief from chronic knee pain.

But in many cases, a successful total knee replacement is not possible due to various reasons and in that case, the people need to undergo another replacement, called Revision Joint Replacement.

What is Revision Joint Replacement?

As we mentioned in the above section that total knee replacement is successfully carried out in most cases but there are also many in which it is not possible. Other than that, even if a successful total replacement is made, overtime different problems related to it may arise like wearing of thr implant or adjustment of the original parts as well. So, another replacement is recommended to fix these problems and this is popularly known as Revision Joint Replacement.

Revision joint replacement is often much more complicated than total knee replacement. This is because the process deals with bringing changes to the already replaced knee and therefore, any kind of mishandling can lead to serious knee problems. Let us have a look at the different reasons because of which revision knee replacement is carried out.

Why Revision Knee Replacement Done?

The reasons because of which a revision joint replacement may need to be performed include:

● One of the very important reasons is worn out implants. Even though implants are designed to support the knees for a long time, due to various reasons and activities of the individual, these implants gets worn out and needs to be replaced.

Infection is one of the biggest risks in joint replacement surgery which will seriously affect the whole health of the person. If over time any kind of infection is likely to develop due to improper care or negligence of any initial infection symptoms around the postoperative area, revision replacement is done to help the individual.

● If it is found out that the implants are becoming unstable with time, you must understand that you will need a revision joint replacement. When the implants are not occupying a proper position or have been dislocated due to some reason, the implants will need to be placed in the right area once again.

So, these are the various reasons because of which revision knee replacement is important. If you read the article carefully you will understand that even though revision replacement has its risks, it is quite beneficial and convenient for the people too carry on with their activities.

Liver Transplant Surgery - Post Surgery Care!

Dr. Akhter Ahmad Ganai 90% (10 ratings)
MS, Fellowship in Minimal Access Surgery, Fellowship of Indian Association of Gastrointestinal Endo Surgeons (FIAGES), FALS(Fellow Advanced Laparoscopic Surgery)
General Surgeon, Srinagar
Liver Transplant Surgery - Post Surgery Care!

A liver transplant surgery involves surgically substituting a problematic liver with a healthy liver from a different person. Usually, the healthy liver is taken from a person who has recently passed away. In some cases, a living person may also give away part of the liver. Usually, living donors are members of the family or someone who has a good blood type match. The liver regenerates lost tissues after a surgery; hence, the donor’s liver becomes normal within a few weeks of surgery.

You may require a liver transplant if your liver does not function optimally, owing to the below mentioned conditions:

  1. Cirrhosis: This is a chronic disease of the liver wherein, scar tissues replace healthy tissues in the liver, thus, not allowing the liver to function optimally.
  2. Metabolic disease: Disorders that modify the activity of the chemicals in the body
  3. Acute hepatic necrosis: This is a disorder that causes the healthy tissues in the liver to die
  4. Autoimmune disorders or liver cancer: Autoimmune disorders can cause healthy tissues in the liver to die as the immune system in the body starts attacking healthy tissues. Formation of malignant tumors in the liver can impair liver functioning.

Procedure

You have to undergo certain procedures before the surgery is conducted; a general health exam, imaging tests, blood tests and a psychological exam are conducted before the surgery. Based on the functioning of the liver and some other factors, your suitability for the transplant will be determined.

The procedure begins with general anesthesia, following which an incision is made in the abdomen. The liver is then removed and replaced with a healthy one. Once the procedure is completed, the surgeon closes the incision with stitches.

Aftercare

Once the procedure is done with, you are kept in the intensive care unit for a few days. The doctor will monitor your progress and put you on medications. After the recovery, you will have to undergo check-ups at regular intervals. You may also have to take medications such as immunosuppressant to prevent your immune system from attacking the liver.

Know About Care Necessary Post A surgery!

Dr. Mahesh Sinnarkar 86% (21 ratings)
MBBS, MS - General Surgery
General Surgeon, Pune
Know About Care Necessary Post A surgery!

You probably think many more things can go wrong during a surgery as compared to after a surgery. However, you are wrong. The chances of infection after a surgery are very high and it used to be the highest cause of unsuccessful surgery in the past before it was known just how deadly an infection is. A doctor, however, cannot monitor everything afterwards. Therefore, it is crucial you know and take care after the surgery.

Here are some ways in which you can do so:

1. Keep it dry

It is crucial that you keep the incision dry for whatever period of time the doctor tells you to keep it dry as otherwise the chances of infection increase dramatically. Some of the things you should do to keep it dry is to not take a bath, scrub the incisions or put lotions on it. In fact, you should also not expose it to sunlight.

2. Keep the incisions

You must trust your doctor as the doctor is trained and usually knows better than you. Therefore, if the doctor tells you to keep the incisions then keep them. Do not scrub, rub or put powder on them either.

3. Check for signs of infection

This may be the easiest thing to do as there are many symptoms of an infection. These include a change in the color, size, or odor of the incision, fever, redness, hardening or heating of the surrounding area or in extreme cases more bleeding and pain than usual.

4. Changing a dressing

This is a major cause of infections among surgery patients and the only way to prevent it is to follow the doctor's instructions to a tee. Once again, trust your doctor and remember to wash your hands and put on medical gloves. Do not put alcohol, iodine or hydrogen peroxide either.

Robotic Unicondylar Surgery - All You Should Know!

Dr. Hrushikesh R.Saraf 86% (10 ratings)
MBBS, DNB - Orthopedics, MS - Orthopaedics
Orthopedist, Pune
Robotic Unicondylar Surgery - All You Should Know!

Robotic Unicondylar surgery, also known as Partial Knee Replacement surgery, with the assistance of a robotic arm. In this surgery, only one part of the damaged knee is replaced either inside (medial) part, the outside (lateral) part, or the knee cap of the knee.

Surgery to replace the whole knee is known as Total Knee Replacement Surgery.

Description of Robotic Unicondylar Surgery

In this surgery, damaged tissue and the bone of the knee joint are removed. This is done when arthritis is active in only one part of the knee. The areas are exchanged with a man- made implant, called prosthetic. The rest of the knee is preserved. Under this surgery, mostly small incisions are done, hence shorter recovery time.

Anesthesia used before the surgery is as follows:

  1. General Anesthesia: Patient is asleep and pain free during the procedure.

  2. Regional (spinal or epidural) Anesthesia: Patient is numbed below the waist and is also given medicine to relax and make them feel sleepy.

During the surgery, the surgeon makes a cut over the knee about 3 to 5 inches long.

In the knee joint, a small 3D camera and a tiny surgical instrument is placed.

Camera enables the surgeon to see a zoomed in view of the operative area in 360 degrees.

Then after, using the device hand and foot controllers, the surgeon can move the robotic arm slightly, which is attached to the surgical instrument.

Now another surgeon places the operation table in the correct position to verify the alignment of the operative area and the surgical instrument.

Risks Involved in Robotic Unicondylar Surgery:

There are several risks involved while having and after a Robotic Unicondylar Surgery:

  1. Blood Clots: In procedures like these, blood clots are likely to happen. Blood clots typically occur within two weeks of surgery. However, it can be easily cured in a few days.

  2. Infections: The chances of getting an infection after the surgery are very low. If the operative area gets any exposure during surgery and proper precautions are not taken by the surgeons, then the chances of getting an infection increase. This can happen in very rare cases.

  3. Allergy to the Metal Components: A few patients may suffer from a reaction due to the metal used for the artificial knee joint. The metal used in this type of surgery is generally made from cobalt-chromium-based alloy or titanium. People usually know if they have a metal allergy. This risk can easily be avoided by telling your surgeon about the allergy.

  4. Knee Stiffness: Following the postoperative instructions may lower the chance of knee stiffness. This problem can also be easily resolved with the help of physiotherapy and regular exercise. Serious cases of stiffness are known as Arthrofibrosis, which may demand a follow-up procedure so that scar tissue can be broken up and the knee can be adjusted.

Benefits of Robotic Unicondylar Surgery:

There are a number of benefits for Robotic Unicondylar Surgery:

  1. High Accuracy.

  2. A More Natural Knee Motion.

  3. Small Incisions.

  4. Less Pain.

  5. Minimal Blood Loss.

  6. Quick Recovery.

  7. No need to remove Stapes.

  8. All 4 stabilizing ligaments remain intact.

Conclusion:

A Robotic Unicondylar surgery is so minimal that in most cases patients walk within hours of surgery. It is always advisable to consult a doctor before going for surgery.

Hernia - How To Treat It?

Manavta Hospital 88% (30 ratings)
ENT Specialist, Faridabad
Hernia - How To Treat It?

When an organ residing in a cavity such as the abdomen tries to push through the muscular layer it resides, it is called as hernia.

Though said to be genetic, hernias can be caused by things such as improper heavy lifting, incorrect posture, or chronic constipation and as a result of surgical complication or injury. Factors like obesity, pregnancy, smoking, chronic lung disease aggravate the severity of the hernia. It is believed that about 27% of all males and 3% of females can have a hernia during their lifetime.

Types of hernias:

Inguinal hernia - The groin is the most common area, where the abdomen pushes through a weak spot in the lower abdominal wall, causing a protrusion into the inguinal canal. More common in men than women.

Hiatal hernia - The abdomen has the diaphragm separating it from the thoracic cavity in the upper border. When it pushes through the diaphragm, a hernia is caused and there is almost always associated food reflux in these cases. Though the most common cause is associated old age, due to muscle weakness, there also are cases of congenital hiatal hernias.

Umbilical hernia - The abdomen finds a weak layer along its length and protrudes through the skin on the stomach. Most commonly seen in babies around the bellybutton, it gradually corrects itself on its own. Quiet rare in adults, seen during pregnancy and in chronic obese people.

Incisional - These are post-surgical, and happen when the organ protrudes through the weakened wall due to surgery. The abdomen is again the most common area and the hernia can happen either onto the external surface or internally, when they are called ventral hernias.
These are the most frequent types, though hernia affects other organs like the spine, brain, appendix, etc.

Treatment - This includes a combination of constant monitoring followed by a decision to do surgical treatment. Hiatal hernias and umbilical hernias can be monitored for a while before deciding on surgery. Inguinal hernias may require surgery earlier in the stage. Post-surgery, a mesh is placed to hold back the tissue in its corrected place. The umbilical hernia in children could be self-limiting. If it does not get auto-corrected in the first year of life, that also would qualify for a surgical treatment.

Dependent on each patient, hernias need to be managed under medical supervision.

Colorectal Surgery - Everything You Should Know!

Dr. Saket Goel 94% (2190 ratings)
MS, MBBS, Clinical Fellow Pancreatic Surgery, FMBS
General Surgeon, Delhi
Colorectal Surgery - Everything You Should Know!

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:

  1. Anal cancer
  2. Colorectal cancer
  3. Severe complications related to constipation
  4. Anal injuries
  5. Inflammatory conditions of the gastrointestinal tract
  6. Congenital defects
  • Procedures: The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopysigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:
  • Colectomy: This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.
  • Colonic polypectomy: An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.
  • Strictureplasty: Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.
  • Colostomy or Ileostomy: A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.
  • Hemorrhoidectomy: This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.
  • Anoplasty: Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

Cholecystectomy - Know More About It!

M.Ch - Paediatric Surgery, MBBS, MS - General Surgery
Pediatric Surgeon, Hyderabad
Cholecystectomy - Know More About It!

Cholecystectomy is an operation performed to remove the gallbladder. The gallbladder is a kind of a small sac found just below the liver, on the right hand side of the abdomen. The gallbladder stores a liquid known as bile. Bile is made in the liver and it gets released into the intestine along with the meals. The importance of bile lies in the fact that it helps to digest the fat in foods.
As gallbladder is not really an essential organ, so a child would do well after cholecystectomy. Once the gallbladder gets removed through this pediatric surgery, bile will continue to get released from the liver right into the intestine along with meals.

What is the necessity behind cholecystectomy?
The necessity for performing this surgery of Cholecystectomy can be outlined as follows:

  • The main reason behind the surgery is gallstones and pain.
  • Gallstones are small rocks, which form inside the gallbladder
  • These stones prevent the release of bile out from the gallbladder.
  • This blockage results in pain as well as jaundice
  • If a child comes across these problems, he or she would be recommended by his or her primary doctor to visit a paediatrician.
  • A paediatrician can get rid of the gallstones by removing the gallbladder through performing the surgery if Cholecystectomy.

How is the surgery performed?
The surgery is performed in the following manner:

  • A Cholecystectomy is performed on most of the occasions by way of laparoscopy.
  • A small telescope and tiny instruments are placed through very small incisions made on the abdomen.
  • The surgery normally gets completed within two hours.
  • When a child gets hospitalized, he or she receives intravenous fluids, antibiotics as well as pain medication.
  • As and when a child feels well, he/she would be allowed to eat, drink and also take pain relievers through mouth.
  • Cholecystectomy surgery involves very less loss of blood. Only in a rare case, when there is an emergency, a child needs to receive blood.
  • Children are released from hospital, one or two days after the surgery as and when they are able to eat, drink and be comfortable about themselves.

Homecare needed after the surgery
There are certain guidelines which parents must follow when their children get back home after the surgery. They include:

  • Pain management: The pain medication prescribed by the paediatrician is not required at a routine basis after discharge from the hospital. Most of the children only require Acetaminophen (Tylenol) or Ibuprophen once they are at home.
  • Healing ridge: Once the small incisions get healed, children would be able to feel a firm ridge just below it. It would last for few months, slowly get softened and then disappear.

All You Should Know About Bariatric Surgery!

Dr. Manish K. Gupta 91% (76 ratings)
F.I.A.G.E.S , MNAMS (Membership of The National Academy) (General Surgery), DNB (General Surgery), MBBS, IAGES
General Surgeon, Delhi
All You Should Know About Bariatric Surgery!

Obesity and a shapeless body are problems that plague many people around the world. Besides leading to an appearance that is less than ideal, it can also lead to severe health problems including heart failure, heart disease, diabetes and more. While there are many ways to combat being overweight with the help of exercise, a proper diet and even medication, very severe cases of obesity can also be fixed with a surgical process known as Bariatric Surgery. So, here's everything you need to know about it.


* Affecting the Digestive Process: As per the normal digestive process, the food moves into the digestive tract while its nutrients get collected with the help of a well functioning system that includes digestive juices and enzymes. This food moves through the digestive tract, passing through the oesophagus before it goes down into the stomach where it meets the strong digestive acids which break it down, and then it enters the small intestine. While the stomach can hold three pints of food at a time, there is a chance that some of this food may not get properly digested in the small intestine. In this case, the food enters the large intestine. Now, Bariatric Surgery helps in restricting the amount of food that a person can have and hold in the first place.


* The Process: This surgical procedure may be carried out by cutting open the stomach and removing a portion of the same. This procedure can also reroute the small intestine into the gastric pouch or the small stomach pouch. This process can also be done with laparoscopic invasion where a few small incisions will be used to insert a tiny camera and instruments for the process.


* Ideal Candidates: If your BMI or body mass index is more than 40, then you can opt for this kind of surgery, as mere dieting and exercising will not help you in your weight loss endeavor. This surgery can also help in preventing the onset of type 2 diabetes mellitus. The patient also has to have reached the normal adult height in order to qualify for this surgery. 


* Side Effects: After the surgery, the patient may experience a few side effects including leakages and bleeding. An incisional or an internal hernia may also occur after the surgery. Also, for patients who have a poor diet, there may be complications after the surgery due to less intake of necessary vitamins and minerals.
 
Once you undergo the surgery, it is important to commit to a proper diet with less food intake and proper exercise on a lifelong basis. n with us. 

Diseased Uterus - Can It Be Replaced?

Dr. Sandeep Talwar 89% (31 ratings)
MBBS, DNB - Obstetrics and Gynecology, Fellowship In Reproductive Medicine
IVF Specialist, Delhi
Diseased Uterus - Can It Be Replaced?

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.

Who requires a uterus transplant?

This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

What is the procedure?

Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?

Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

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