Category Archives: Laparoscopy

Laparoscopic Hernia Treatment

WHAT IS HERNIA

Laparoscopic Hernia is  a way of treating Hernia with least risk. A hernia is the protrusion of a viscus or part of it through an abnormal opening in the wall by which it is normally contained.

CLASSIFICATION OF HERNIA

Hernias can be broadly classified as internal or external.

External hernias can occur spontaneously as a result of congenital defect or following any surgical intervention when they are called incisional hernias.

Depending upon the site of external hernia they are classified as

  • Inguinal hernia which can be indirect or direct
  • Femoral hernia
  • Spigelian hernia
  • Lumbar hernia
  • Obturator hernia
  • Perineal hernias
  • Umbilical hernia
  • Epigastric hernia Approximately 75% of all hernias are inguinal; of these, 50% are indirect (male-to-female ratio, 7:1), with a right-side predominance, and 25% are direct. About 10% of hernias are incisional or ventral

Laparoscopic Hernia

ETIOLOGY OF HERNIA:

  • The etiology of most hernias can be explained on the basis of congenital defect in the body wall. However, any condition that increases the pressure in the intra-abdominal cavity may contribute to the formation of a hernia which includes the following:
  • Only 3-5% of hernias are femoral
  • About 14% of hernias are umbilical
  • Internal hernias mostly occur after abdominal surgical intervention.
  • Marked obesity
  • Heavy lifting
  • Coughing
  • Straining with defecation or urination
  • Ascites
  • Peritoneal dialysis
  • Chronic obstructive pulmonary disease (COPD)  

 

PRESENTATION OF HERNIA:

The typical presentation of an asymptomatic hernia is as follows:

  • Swelling or fullness at the hernial site with aching or dragging sensation
  • Enlargement of the swelling with increasing intra-abdominal pressure which can result from coughing or straining.

 

LAPAROSCOPIC HERNIA TREATMENT:

Surgery is the only definitive treatment for the management of hernia and it is mandatory in almost all hernias because of complications which can happen in any case of untreated hernia.

Hernia surgery can be done by Open or Laparoscopic approach. A number of studies have however shown Laparoscopic repair of inguinal hernias to have many advantages over conventional open repair which includes reduced postoperative pain and early return to work.

The term laparoscopic hernia repair can refer to any of the following 3 techniques:

  • Totally extraperitoneal (TEP) repair
  • Transabdominal preperitoneal (TAPP) repair
  • Intraperitoneal onlay mesh (IPOM) repair

 

COMPLICATIONS OF LAPAROSCOPIC HERNIA :

The complications of Laparoscopic Hernia Repair include haemorrhage, recurrence and adhesion formation.

Adhesion formation is more common in TAPP and IPOM. However the incidence of these complications is very low in expert hands.

For Further information on LAPAROSCOPIC HERNIA TREATMENT ask

Dr. Arvind Kumar

MBBS,MS(GENERAL SURGERY) Fellowship in Advanced Laparoscopy & Oncosurgery(AIIMS)

at SCI INTERNATIONAL HOSPITAL

Contact No. :   +91-9999446622

Hysterectomy Treatment

What is Hysterectomy Treatment?

A hysterectomy is a surgical procedure to remove a woman’s uterus from the body. After this, you no longer have menstrual periods and cannot become pregnant.

Why is Hysterectomy performed?

Hysterectomy is used to treat many women’s health conditions. A woman may have a hysterectomy for different reasons, including:

  • Uterine prolapse
  • Uterine fibroids
  • Severe Endometriosis
  • Heavy vaginal bleeding (which is not controlled by other treatment methods)
  • Chronic pelvic pain
  • Abnormal uterine bleeding
  • Cancer (or precancer) of the uterus, ovary, cervix, or endometrium (the lining of the uterus)

Hysterectomy-Treatment

Types of Hysterectomy Treatment?

Type of Hysterectomy depends upon the reason for this procedure. The surgeon may choose to remove all or only part of the uterus depending upon the condition of the patient. Types of hysterectomies are mentioned below:

  • Total Hysterectomy: The Surgeon removes the whole uterus and the cervix. This is the most common type of hysterectomy.
  • Partial or Subtotal or Supracervical Hysterectomy: The Surgeon removes only the upper part of the uterus. The cervix is left in place.
  • Radical Hysterectomy: It is most often used to treat certain types of cancer, such as cervical cancer. In Radical Hystrectomy the Surgeon removes the whole uterus, cervix, the tissue on both sides of the cervix, and the upper part of the vagina.

Methods for Hysterectomy Treatment?

Surgical Techniques for Hysterectomy

There are two methods to surgery – a traditional or open surgery and surgery using a minimally invasive procedure.

The methods are selected depending upon the surgeon’s experience, the reason for the hysterectomy, and a woman’s health. The hysterectomy technique will partly determine healing time and the kind of scar, if any, that remains after the operation.

Open Surgery Hysterectomy

An abdominal hysterectomy is an open surgery. This is the most common approach to hysterectomy, accounting for about 65% of all procedures.

To perform an abdominal hysterectomy, a surgeon makes a 5- to 7-inch incision, either up-and-down or side-to-side, across the belly. The surgeon then removes the uterus through this incision.

On average, a woman spends more than three days in the hospital following an abdominal hysterectomy. There is also, after healing, a visible scar at the location of the incision.

How long does the procedure last?

The procedure lasts 1 to 3 hours. The amount of time you spend in the hospital for recovery varies, depending on the type of surgery performed.

What is the recovery time required after Uterus Removal?

Hysterectomy is a major surgery, so recovery can take a few weeks but the patient is discharged within 2-3 days when stabilised.

Does it come under health insurance?

Yes, this process is covered under mediclaim provided policy has completed 2 years.

Will the ovaries needs to be removed in Hysterectomy?

Ovaries may be removed during Hysterectomy to lower the risk for ovarian cancer. However ovaries are removed during hysterectomy depends upon the reason for the procedure.If both ovaries are removed during the hysterectomy, patient will no longer have periods. The decision to keep or remove your ovaries is one you can make after talking about the risks and benefits with your doctor.

Are there any side effects after Hysterectomy/Uterus removal?

Changes that can be expected after a hysterectomy include:

Menopause. The patient may experience  menopause symptoms if ovaries are removed during the hysterectomy. These may include:

  • Hot Flushes
  • Anxiety
  • Weepiness
  • Sweating
  • Bowel and bladder disturbances
  • Vaginal discharge

Does Hysterectomy affect sexual function?

A woman’s sexual function is usually not affected after hysterectomy . Some women have vaginal dryness or less interest in sex after a hysterectomy, especially if the ovaries are removed.

After a hysterectomy, many women also experience an initial loss of sexual desire (libido). It is generally recommended not to involve in sexual activities until the scars have healed and any vaginal discharge has stopped.

How much pain should I expect  after having a Hysterectomy/Uterus Removal?

The amount of pain and scarring also depends on what exactly is removed during your hysterectomy. Most women with a laparoscopic or vaginal hysterectomy experience pain for two to three weeks. Some women have less pain after laparoscopically assisted vaginal hysterectomy than they do after a basic vaginal hysterectomy,with abdominal hysterectomy, pain may last for three to five weeks.

What are the risks involved in hysterectomy?

A hysterectomy is generally very safe, but with any major surgery comes the risk of complications. While most women don’t have health problems during or after the surgery, risks may include:

  • Infection
  • Excessive bleeding
  • Blood clots
  • Pain during sexual intercourse
  • Damage to your urinary tract, bladder, rectum or other pelvic structures during surgery, which may require further surgical repair
  • Adverse reaction to anesthesia

What are the other alternatives to hysterectomy?

A hysterectomy is only one way to treat problems affecting the uterus. For certain conditions, however, hysterectomy may be the best choice. But sometimes you can try other treatments first.

These include:

  • Watchful waiting for uterine fibroids which tend to shrink after menopause
  • Medicine.  Over-the-counter pain medicines to be taken during your period also may help with pain and bleeding.
  • Vaginal pessary. A pessary is a rubber or plastic donut-shaped object, similar to a diaphragm used for birth control. The pessary is inserted into the vagina to hold the uterus in place in case of uterine prolapse.
  • Exercises. Pelvic floor exercises help restore tone to the muscles holding the uterus in place in case of prolapse uterus.
  • Surgery. You and your doctor may choose to try a surgery that involves smaller or fewer cuts than hysterectomy. The smaller cuts may help you heal faster with less scarring. Depending on your symptoms, these options may include:

For Further information on UTERUS REMOVAL/HYSTERECTOMY

Contact No. :   +91-9999446622