Appendicitis

Appendicitis

Appendix is a 3.5-inch-long tube of tissue that stretches out of the large intestine. When this appendix has an inflammation then it is called as Appendicitis. It calls for prompt medical attention as soon as it is detected. If ignored, an inflamed appendix can become life threatening as it can burst and spill infectious materials into the abdominal cavity. It can be caused by-

  • A stomach infection that has reached the appendix
  • Infection caused by the bacteria due to the hard stool that got stuck in the appendix

Symptoms

  • Nausea
  • Vomiting
  • Fever
  • Constipation
  • Diarrhea
  • Loss of appetite
  • Worsening lower right side abdominal pain
  • Painful sneezing or coughing
  • Abdominal swelling
  • Pain around navel

Cure

When an inflamed and swollen appendix is surgically removed, then the procedure is called as Appendectomy. Appendix requires immediate treatment as it can also become life-threatening- it occasionally bursts within a day of symptoms showcase.

The surgeons perform two kinds of surgeries for the same-

Open Appendectomy- The traditional way of removing the infected appendix from large intestine. After the incision is made, the infected appendix is located and then cut from the large intestine and removed from the body post which the incision is sewed with stitches.

Laparoscopic Appendectomy- A minimally invasive technique in which several small incisions are made in the abdomen through which the camera and other surgical instruments are inserted so that the surgeon can view the area on a computer screen. The doctor then performs the surgery based on the video. Laparoscopic Appendectomy has several benefits over open appendectomy as it helps in faster recovery and allows the patient to leave the hospital on the same day. Moreover, he can also resume his normal day-to-day activities in a very short time.

Gall Bladder Stone

Laparoscopic Gall bladder Surgery in Jaipur

 

What are Gall Stones?

The stones that develop in the gallbladder or bile ducts are gallstones. These stones can range from microscopic to more than an inch in size. When cholesterol levels in the bile are too high, then that excess cholesterol turns into what is called as gallstone. They are usually green or yellow in color. Another type of gallstone is pigment stones, which are mostly made up of bilirubin and are smaller and darker. Cirrhosis (a liver disease) or blood diseases such as sickle cell anemia, triglycerides (a type of blood fat), fasting, obesity, genes and diet can be some of the reasons of gall bladder stones.

Your doctor may recommend surgery if:

  • You have repeated gallstone attacks
  • The pain from the attacks is severe
  • In case of inflammation of the gallbladder or the pancreas
  • You have an impaired immune system

Symptoms of Gall Stones

  • Nausea and vomiting
  • Fever or chills
  • Constipation
  • Jaundice
  • Chest pains
  • Heartburn, indigestion, and excessive gas
  • Stools of an unusual color (often lighter, like clay
  • Pain in the upper abdominal area, either in the upper right or middle
  • Severe abdominal pain
  • Pain that worsens after eating a meal, particularly fatty or greasy foods
  • Headache over eyes, especially right

Cure

  • Minimally invasive (laparoscopic) surgery or Cholecystectomy requires only 3-4 small incisions in the abdomen instead of five to seven inch incisions. If there are significant symptoms of gallstones, then laparoscopic surgery is the best cure for it. First, general anesthesia is given to the patient post which small incisions are made to insert a few instruments with which the gallbladder is removed. It has various advantages over other methods such as minimal post-operative pain, faster recovery, same day return to home etc.
  • Traditional or open surgery which takes few days to recover
  • Medicines

Consequences of untreated gallstones

  • Jaundice
  • Pancreatitis which is inflammation of the pancreas
  • Empyema which is pus in the gallbladder
  • Gallstone Ileus is the condition that arises when a gallstone blocks the intestine.
  • Perforated Gallbladder is a life- threatening condition and is most common in people with diabetes
  • Gangrene or Abscesses
  • Fistula
  • Infection in the Common Bile Duct (Cholangitis)
  • Gallbladder Cancer

Hernia Surgery

Laparoscopic Hernia Surgery in Jaipur

What is Hernia?

Hernia is a bulge or swelling in the abdomen, specifically the groin due to forceful push of some contents such as fat or bowel in your abdominal wall muscle. An amalgamation of pressure and weakness of muscle or fascia pushes the tissue through the opening and thereby gives rise to hernia. Such muscle weakness may be present at birth or occur later in life. Anything that causes an increase in pressure in the abdomen can cause a hernia, including:

  • Lifting heavy objects
  • Relentless coughing or sneezing
  • Diarrhea or constipation
  • Poor nutrition, over exertion, obesity and smoking can also cause hernia.

Types of Hernia

  • Hiatal (upper stomach)
  • Femoral (outer groin)
  • Inguinal (inner groin)
  • Umbilical (belly button)
  • Incisional (resulting from an incision)

Symptoms of Hernia

  • Swelling beneath the skin of the abdomen or the groin; it may disappear when you lie down
  • A heavy feeling in the abdomen grouped by constipation or blood in the stool
  • Discomfort in the abdomen or groin when lifting or bending over
  • Weakness, pressure, burning, or pain in the abdomen, groin , or scrotum
  • Pain when straining, lifting, or coughing
  • The feeling that something has ruptured
  • Unable to have bowel movement
  • Nauseated

Cure

  • Laparoscopic hernia surgery in which two to four small incisions are made in the abdominal wall through which laparoscope and other surgical instruments are inserted in the abdomen to treat the hernia. Most hernias can be cured by laparoscopic surgery including Inguinal, Para-umbilical, Umbilical and Incisional. It is also preferred in bilateral inguinal hernia as both the sides are operated by similar incisions and in recurrent hernia after open surgery. It is definitely much better than open surgery because it is time effective, does not demand longer hospital stays and has lesser post-ops.
  • Medication such as antacids, H-2 receptor blockers, and proton pump inhibitors. Although, it may vary according to different hernia types.
  • Open surgery in which a long incision is made and then the hernia is pushed inside, tied down or even removed depending on the patient.
  • Avoiding heavy meals and not lying after a meal are some ways with which it can be cured, if it is detected at an early stage.
  • Losing weight and giving up cigarettes

Rectal Prolapse

What is Rectal Prolapse?

When rectal tissue abnormally stretches and protrudes from the anus, then rectal prolapse occurs. This condition is developed because of various reasons such as-

  • Chronic diarrhea
  • Constipation
  • Weakening of the anal sphincter
  • Injury to the anal or pelvic areas
  • Damage to nerves
  • Other diseases and infections
  • Long-term history of straining during bowel movements

Symptoms

  • Feeling of a bulge or the appearance of reddish-colored mass that extends outside the anus
  • Pain in the anus and rectum
  • Rectal bleeding from the inner lining of the rectum
  • Fecal incontinence referring to leakage of mucus, blood or stool from the anus
  • Develop an ulcer on the part of your rectum that sticks out

Cure

  • Abdominal repair approaches
  • At an initial stage, your doctor may offer bulking laxatives, such as Fybogel
  • For children, the doctor may recommend an injection of a substance called a sclerosant
  • Minimally Invasive Rectopexy uses smaller incisions and is much more advantageous to other procedures.
  • Rectal (perineal) repair approaches, which can further be categorized into-
    • Altemeier Procedure
    • Delorme Procedure

Pilonidal Sinus

What is Pilonidal Sinus?

A Pilonidal Sinus (PNS) is an inflammatory condition in which small cyst or abscess occurs in the cleft at the top of the buttocks. Infection along with severe pain can be caused by it. Although the exact cause of this condition is not known, but changing hormones (because it occurs after puberty), hair growth, and friction from clothes or from spending a long time sitting can be some of the reasons.

Symptoms

  • Pain when sitting or standing
  • Swelling of the cyst
  • Reddened, sore skin around the area
  • Pus or blood draining from the abscess, causing a foul odor
  • Hair protruding from the lesion
  • Formation of more than one sinus tract, or holes in the skin

Cure

The following cures can be considered based on sensitivity of disease:-

  • Antibiotics, if diagnosed at an early stage.
  • Lancing
  • Phenol injections
  • Surgery: It is suggested in case of recurrent PNS, wherein the surgeon opens the lesions, removing all of the pus and debris. Once this process is complete, the surgeon will stitch the wounds closed.

Fistula

What is Fistula?

A small channel with its internal opening in the anal canal and its external opening in the skin near the anus is anal fistula. An infection near the anus causing abscess in the nearby tissue, Crohn’s disease, diverticulitis, infections from Tuberculosis (TB) can be reasons of anal fistula.

Symptoms

  • Skin irritation
  • Swelling and redness around anus
  • Bowel incontinence
  • High fever
  • Constant pain that may be worse when you sit down, move around, have a bowel movement or cough etc

Cure

  • Fistulectomy is a common mode of surgery in which fistula tract is cut out to cure the disease.
  • VAAFT or Video Assisted Anal Fistula Treatment is used for healing of intricate fistulas and their reappearances. This technique comprises two phases: a diagnostic one and an operative one. The advantages of VAAFT treatment are-
    • No surgical wounds
    • Complete certainty in the localization of the internal fistula opening
    • Complete destruction of fistula from the inside
    • No damage is caused to the anal sphincters
    • Risk of postoperative fecal incontinence is excluded

Anal Fissure

What is an Anal Fissure?

A crack or tear in the lining of the lower rectum (anal canal) is called as anal fissure. It can be very painful and may occur while passing large and hard stools, repeated diarrhea or strains during childbirth. Anal fissures are of two types- Acute and Chronic.

  • a) Acute do not last longer than 6 months and can be self-cured
  • b) Whereas chronic last longer than 6 weeks and need medication or even surgeries to heal.

Symptoms

  • Stinking and burning sensations during bowel moments.
  • Itching
  • Dark red blood mixed with stool may be a sign of a more serious problem.
  • Pain after bowel movements that can last up to several hours
  • Visible crack in the skin around the anus

Cure

  • Increasing intake of fiber and fluids
  • Soaking oneself (Anus area) in warm water for 15-20 minutes several times a day
  • Topical anesthetic creams or nitroglycerin can be applied externally for some relief in pain.
  • If the medication remains ineffective then minimally invasive surgical procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing is recommended by the surgeons. Its advantages involve faster recovery time, smaller incisions and lesser time in hospital.

Piles

What are Piles?

Also called as Hemorrhoids, Piles are caused due to excessive swelling that arises inside and around the back passage (anus) and the anal canal. Situations that can develop piles are constipation, pregnancy, ageing, hereditary factors, heavy lifting or even chronic cough.

Symptoms

  • Bright red blood after a bowel movement
  • Itchiness around anus
  • Lump in or around your anus
  • Mucus discharge when emptying the bowels
  • Pain while defecating

Cure-

Most piles don’t need surgery. Surgical treatments for piles are an option if you have severe piles, other treatments haven’t worked, or your piles keep bleeding. There are different types of surgeries, including the ones below.

  • In haemorrhoidectomy, any piles causing problems are carefully removed by making incisions around the haemorrhoid. The patient can usually go home in a day in this surgery.
  • In stapled haemorrhoidopexy or Minimally Invasive procedure for hemorrhoids (MIPH), the area of tissue with piles is stitched higher up your anal canal. This means your piles won’t come out from your anus anymore and will shrink. The advantages of MIPH over conventional surgery are minimal pain, faster recovery, short procedure, minimal blood loss, no external cuts and lowest recurrent rate.

Anorectal Surgery

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Anorectal disorders are the painful conditions like Fissures, Fistulas, Piles and PNS that affect the anal region. Surgeries that are undertaken to treat these conditions in anal and rectal regions are known as Anorectal surgeries. Depending on the disease, there can be various causes and symptoms associated with it such as pain and itchiness around anus, uneasy bowl movements etc.

Excessive /Morbid Obesity (Bariatric Surgery)

Bariatric Surgery in Jaipur

 

Excessive /Morbid Obesity (Bariatric Surgery)

Bariatric Surgery is a procedure adopted on people who have obesity. By reducing the size of their stomach through various minimally invasive laparoscopic techniques, the surgeons restrict the amount of food stomach can hold. This is done by either removing a part of the stomach or by gastric banding.

Accompanied with weight loss are various other advantages of this surgery such as relief from hypertension, sleep apnoea, diabetes, acid reflux, migraine, asthma, cardiovascular disease, menstrual dysfunction in women, non-alcoholic fatty liver disease etc.

Eligibility- Those who have tried other weight loss plans without long-term success in past and have BMI ≥ 40 or BMI > 35 with significant obesity-related co morbidities are eligible for this surgery.

Advantages of Laparoscopic Bariatric Surgery-

  • Rapid recovery
  • Shorter stay at hospital
  • Minimal risks
  • Lesser post-ops
  • Cure of various other weight related problems

Procedures followed-

  • Laparoscopic Sleeve Gastrectomy is a surgical process of about 2 to three hours in which the stomach is reduced by 75% of its original size leaving just a narrow ube like space. The process just involved reduction in the size of stomach which limits food intake that can be taken at once. After the first surgery, the patient loses approximated 40-70% of the excess weight.
  • Laparoscopic Gastric bypass- Another Laparoscopic Bariatric surgery is Laparoscopic Gastric bypass which is also called as “Roux-en-Y gastric bypass” (RYGB). In this procedure, the surgeon makes 4-6 small incisions in your abdomen after which the stomach is divided into two parts. The upper part which is also called as the pouch carries the food you eat and is as small as a walnut. This ensures less intake of food and hence helps in weight reduction.
  • Laparoscopic Gastric Banding- One of the least invasive surgical method for weight reduction in which the silicone ring with an expandable balloon is implanted in the center of top part of the stomach. This leaves a small pouch for the food you intake ultimately cutting the consumption of food as compared to earlier circumstances.
  • Mini Gastric Bypass (MGB) – It is a short and reversible weight loss procedure. It only takes 30 minutes for the procedure to complete and requires a shorter stay of a day in the hospital. In this procedure, a laparoscopic stapler is used to divide the stomach in a short tube like structure. The larger part of the stomach is no longer attached to esophagus and hence won’t take any food which becomes the actual reason of weight reduction.
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