General and Laparoscopic Surgery

A Laparoscopic Cholecystectomy refers to minimal invasive surgical removal of the gall bladder. The surgery is carried out under general anesthesia. The procedure involves three to four (sometimes more) small incisions on the abdomen, allowing the surgeon to insert a narrow tube to fill the abdomen with gas to make space and have clarity. The surgeon then inserts a tube camera through one of the cuts, which in turn, allows the doctor to see the internal organs, clearly on a larger screen placed in the operation theatre. Once the surgeon has a clear idea, he gently removes the gallbladder through one of the incisions.

The incisions are then stitched with dissolvable stitches and the patient is kept in recovery until he/she regains conscience.

Benefits of Laparoscopic Cholecystectomy

• Smaller incision, each less than one inch instead of the seven to eight-inch cut that is done for open surgery.
• Less pain post-surgery.
• Quick recovery as compared to open surgery. Sometimes the patient can walk back home the same day.
• Less blood loss

Surgery is the only effective treatment for hernias. It is the most common procedure in the world and can help to relieve pain, restore hernia affected abdominal organs to their place and, strengthen the weak muscle area.

 Areas of weakness in the abdominal wall where hernias are commonly found include the groin (Inguinal hernia), belly button (umbilical hernia), where you have a surgical scar (incisional hernia), and hiatus hernia.

Inguinal Hernia: This type of hernia occurs when the intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin area.  This type of hernia mostly occurs in men due to area sensitivity, and almost 90% of all groin hernias are inguinal. 

Umbilical Hernia: It occurs when a part of the small intestine, passes through the abdominal wall near the navel. It is common in newborns, and also in women who have had many children.

Incisional Hernia: It occurs when the intestine pushes through the spot of previous abdominal surgery. The root cause of this type of hernia is inactivity, commonly in obese and elderly people who lack regular exercise post-surgery.

Hiatus Hernia: This type of hernia occurs in the hiatal opening in the diaphragm through which the esophagus passes. In this type of hernia, the stomach squeezes through the hiatus causing discomfort and digestion-related health problems.

The process for laparoscopic surgery of hernia is as follows:

• The surgeon makes three or four ¼” to ½” incisions in your abdomen. One is near your navel and the others lower down.
• A laparoscope is inserted through one of the openings, allowing the surgeon to visualize the area on a TV monitor.
• The surgeon performs the procedure using tiny surgical instruments inserted through the other openings while viewing it on the TV monitor. The hernia is then reduced and the defect is covered by a mesh that is positioned and fastened in place with sutures or staples.
• The instruments are removed and the holes are closed with a stitch or with surgical tape.

Option for open surgery for hernias is also available and depends entirely on the patient condition and requirement.

While open hernia repair may be done under general, regional (spinal), or even local anesthesia with sedation, laparoscopic hernia repair is always done under general anesthesia.

Majority of patients undergoing laparoscopic surgery go home the same day after pain administration is done and they are able to tolerate food and liquids without nausea or vomiting.

Appendicitis is one of the most common health problems that affects almost one out of every 2,000 people in the world during their lifetime. Appendectomy is usually performed as an emergency procedure to treat acute appendicitis. Treatment can be done through minimal invasive surgery.

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each 1 to 1inch) while watching an enlarged image of the patient’s internal organs on a television monitor.  

The appendix is separated (mobilized) from adjacent organs and is ligated and divided, later the surgeon removes the infected appendix with the help of endobag via one of the 10mm incisions. All the holes are then closed with absorbable sutures.

Benefits of Laparoscopic Appendisectomy

• Smaller incision, each size 5-10mm instead of the seven to eight-inch cut that is done for open surgery.
• Less pain post-surgery.
• Quick recovery as compared to open surgery. Sometimes the patient can walk back home the same day.
• Results in restoring better bowel movement soon

Colectomy, the surgical removal of the colon, entirely, or a part of it is done to treat digestive diseases, bowel obstruction, bowel perforation, cancer of the colon, etc. It is also called bowel resection. The colon is part of the digestive system and helps in absorbing nutrients and minerals while separating the waste. The waste then is passed on to the small intestine, and eventually evacuated, through the anus.

The colon can be removed by a laparoscopic procedure in which multiple small incisions are made, and a tube with a camera is inserted through one of the cuts, other medical equipment enters through other cuts to carry out the minimal invasive surgery. However, not all patients are candidates for laparoscopic colectomy, some might have to undergo an open surgery for the procedure, depending on the stage of disease and the condition of the patient. Also, in some situations, the operation may begin as a laparoscopic colectomy, but circumstances may force your surgical team to convert to an open colectomy.

Splenectomy refers to the surgical removal of the spleen partially or wholly. The spleen is an integrated part of our system, situated in the upper left side of the abdomen, and helps in purifying blood and fights infection. It helps the flow of blood to the liver. The spleen is removed in case it gets affected with cancer or the patient has hereditary spherocytosis, in addition to other spleen-related diseases.

In most cases, the spleen can be removed through a laparoscopic procedure, by making small incisions on the abdomen. Through one of the incisions, a tube with a camera is inserted, once the spleen is identified, medical instruments are inserted through other incisions, and then the spleen is separated and pulled out.

The laparoscopic procedure enables minimal blood loss which is not possible in open surgery, especially in the case of splenectomy. However, the doctor will decide to keep in mind the condition of the patient as to which procedure will be beneficial for him/her.

Ingrown toe nails are very painful and cause severe infections if left untreated. It occurs when the top corner of the toe nail grows into the flesh next to it. The most common site for ingrown toe nail is the big toe. Though, commonly ingrown toe nails can be treated at home easily, some cases require special attention and timely surgery. Part of the toe nail or the entire toe nail may have to be removed depending on the severity of the infection. The surgery is done under local anesthesia and is a day care procedure.

Thoracoscopy is a minimal invasive procedure which allows the surgeon to scan the lining of the lungs, and the surface of the lungs. The footage obtained from this procedure helps the surgeon determine the signs of pleural mesothelioma, such as, inflammation, pleural plaques and pleural thickening. It is also used to diagnose or treat conditions of the chest (pulmonary, mediastinal, chest wall). Most major procedures, traditionally performed with open thoracotomy, can be performed using smaller incisions with video assistance. During the procedure, the surgeon can also conduct a biopsy to ascertain the disease.