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Institute for Bariatric & Minimally Invasive Surgery
Bariatric and Minimally Invasive Surgery
Minimal Invasive Surgery
has revolutionized the way surgeries are performed conventionally. In this technique, surgeons use a small telescope to see a magnified view of the area to be operated on screen and through another small puncture introduce special instruments to perform the final surgery.Artemis Institute for bariatric and minimally
invasive surgery
is one of the best centers specializing in this form of surgery.The centre is also well equipped to facilitate all forms of minimally invasive surgeries, ranging from Gastric Bypass for weight loss, Lap Band surgery, sleeve surgery, Gallstones surgery, Hernia Repair, Appendix, gastro intestinal and cancer surgeries,
WHAT ARE THE ADVANTAGES OF PERFORMING THE PROCEDURES LAPAROSCOPIALLY?
Rather than a five to seven inch incision in conventional surgery, the laparoscopic operation requires only four small openings in the abdomen
Patients usually have minimal post-operative pain with better cosmosis
Patients experience faster recovery than open surgery patients
It may be performed as a day care procedure. Most patients go home within one day and enjoy a quicker return to normal activities
Laparoscopic Gastrointestinal Surgery
Laparoscopic GI surgery, in the modern era, is done by minimal invasive technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5cm) as compared to larger incisions needed in traditional surgical procedures.
The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system that is usually connected to a video camera. Also attached is a fibre optic cable system connected to a 'cold' light source to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or Trocar to view the operative field. The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. The gas used is CO2, which is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.
HIATUS HERNIA
What is a Hiatal Hernia?
A hiatal hernia happens when the diaphragm, the muscle that divides the chest from the abdomen, has a weakness or defect. This weakness allows the stomach, and potentially other organs and tissue, to bulge into the chest cavity. Normally the esophagus, or food tube, passes through a small hole in the diaphragm where it connects with the stomach.
You will not be able to see a hiatal hernia, unlike many other types of hernias. Small hiatal hernias that do not cause symptoms may only be discovered when testing is being done for another purpose. If a hiatal hernia is suspected, testing must be done to determine the type and severity, as the doctor will not be able to visualize the hernia until surgery begins otherwise.
Many patients who have a hiatal hernia do not realize that it is present, as the symptoms can be vague and are often dismissed as an upset stomach or heartburn.
Symptoms of a Hiatal Hernia
Most hiatal hernias are asymptomatic. Each patient can experience a different set of symptoms when they have a hiatal hernia. In some cases, there may be no notable symptom except heartburn, in other cases a patient can have problems eating, sleeping and feel chest pain on a regular basis.
Symptoms of a Hiatal Hernia:
- Chronic heartburn (reflux)
- Frog in the throat sensation
- Chest pain, especially after eating
- Nausea, especially after eating
- A feeling of fullness without eating
- Inability to swallow (rare)
When is an Hiatal Hernia an Emergency?
In rare circumstances, this type of hernia can become an emergency situation if the esophagus becomes “kinked” making it impossible for food to travel from the mouth into the stomach. This complication is rare, but is considered an emergency, requiring surgery to be performed quickly.
Hiatal Hernia Surgery – The Nissen Fundoplication
Hiatal hernia surgery is typically performed using general anesthesia and can be done on an inpatient or outpatient basis. Once anesthesia is given, surgery begins with an incision on either side of the hernia. A laparoscope is inserted in to one incision, and the other incision is used for additional surgical instruments. The surgeon then locates the stomach and the defect in the diaphragm. If necessary, the stomach is pulled down through the diaphragm, out of the chest cavity and into the abdominal cavity.
The top part of the stomach is then “wrapped” around the end of the esophagus, and stitched or stapled in place. If the defect in the diaphragm is very large, it may be stitched closed or a mesh graft may be put in place, but this is not necessary in most cases.
Recovering From Hiatal Hernia Surgery
Most hernia patients are able to return to their normal activity within two to four weeks. The area will be tender, especially for the first week. During this time, the incision should be protected during activity that increases abdominal pressure by applying firm but gentle pressure on the incision line.
SPLENECTOMY
A splenectomy is the surgical removal of the spleen. There are two types of splenectomies -- the traditional open approach, using a full size incision, and the laparoscopic approach, which uses several very small incisions. Laparoscopic surgery is often referred to as minimally invasive surgery.
The laparoscopic procedure is the more common of the two splenectomy procedures. The procedure uses several small incisions. Due to the incision size, the laparoscopic approach minimizes both the pain of recovery and the risk of infection.
A splenectomy, or spleen removal surgery, may be unavoidable in specific circumstances. In the majority of cases where a splenectomy is performed emergently, or to save the patient’s life, the spleen has been damaged by trauma.
Some conditions that may require spleen removal are:
- Diseases or disorders of blood cells
- Idiopathic thrombocytopenia purpura (ITP),
- Hereditary spherocytosis,
- Thalassemia,
- Hemolytic anemia,
- Hereditary elliptocytosis.
- Trauma to the spleen
- Blood clot (thrombosis) in the blood vessels of the spleen
- Sickle cell anemia
- Abscess or cyst in the spleen
- Lymphoma, Hodgkin's disease, and leukemia
- Other tumors or cancers that affect the spleen
- Cirrhosis of the liver
- Hypersplenism
- Splenic artery aneurysm (rare)
While the vast majority of surgeries remove the entire spleen, it is possible to have a partial splenectomy, a procedure where only a portion of the organ is removed.
The surgery begins with the administration of anesthesia. Once the patient is unconscious, the surgery begins, typically with the introduction of five small incisions approximately 2 to 3 centimeters in length below the ribs on the left side. A tiny camera called a laparoscope is inserted into one of the incisions. The other incisions are used for the insertion of surgical instruments and the actual performance of the surgery. During the surgery, the surgeon views the space being operated on with the camera, as the incisions are too small to allow the surgeon to view the surgery directly.
When you wake up from your surgery, you will probably feel some pain on your left side in the area of your stomach. You will also have a tube, called a nasogastric tube (NG), which goes in your nose, down your esophagus and into your stomach. This tube prevents the build up of stomach acid, minimizing nausea and vomiting after your procedure. The tube is usually removed a day or two after surgery.
The average patient is able to go home from the hospital 48 to 72 hours after surgery if the splenectomy was performed laparoscopically. An open procedure may require a longer stay, often up to a week, before being discharged. Most patients are able to resume their normal activities 4 to 6 weeks after surgery.
Once you have had a splenectomy, you will be more prone to infections and your body will not fight them as easily. You will need to be diligent about seeking medical care for conditions that you may not have immediately sought treatment for in the past, such as sore throats, fever, sinus and ear infections, and other common infections.
Your doctor will probably recommend that you receive the vaccine to prevent pneumonia and may suggest additional vaccines, such as the meningitis vaccine. Your resistance to infection will likely improve within two years of your surgery, but it is unlikely that it will ever return to preoperative levels.
If you are seeing a new physician or being treated for an unrelated problem, be sure to let the doctor know that you do not have a spleen.
Team of Specialists: