General Surgery

Thyroidectomy

Thyroidectomy is the surgical removal of all or part of the thyroid gland. Thyroid is a butterfly-shaped gland positioned at the base of your neck. It generates hormones that controls every aspect of your metabolism, from heart rate to how fast you burn calories.

Thyroidectomy can be recommended for conditions such as:

  1. Thyroid cancer.
  2. Overactive thyroid (hyperthyroidism).
  3. Noncancerous enlargement of the thyroid (goiter).
  4. Indeterminate or suspicious thyroid nodules.

Procedure

During a Thyroidectomy, surgeon will make an incision in the middle of the neck. Once you're unconscious, the surgeon makes an incision low in the center of your neck. It can be inserted often within a skin crease where it is difficult to spot after the incision heals. Depending on the reason of surgery, complete or part of the thyroid gland is removed.

If the thyroidectomy is post diagnosis of thyroid cancer, the surgeon may examine and eliminate lymph nodes round your thyroid.

Thyroidectomy usually takes 1-2 hours. It might take more or less time, which is based on the extent of the surgery required.

Mastectomy

A mastectomy is an operation to remove tissues from one or both breasts. The purpose of the operation is to eliminate or prevent the spread or growth of breast cancer in men and women. It may take four to six weeks to recover after mastectomy. The operation usually takes about 90 minutes, and most people are discharged the following day.

A mastectomy may be recommended in the following conditions:

  1. Cancer is in a large region of the breast.
  2. Spread of cancer throughout the breast.
  3. The breast is full of pre-cancerous cells.

Procedure

Mastectomy is performed under general anesthesia so you will be asleep when its carried out. During the mastectomy, a diagonal or horizontal incisions are done across the breast, based on the tissue that has to be removed. The amount removed may be based on the mastectomy type you're having. The surgeon places one or two drainage tubes in place to block fluid which builds up in the breast space. These may be left in for a few days.

Types of mastectomy

Main types of mastectomy are:

  1. Standard mastectomy.
  2. Skin-sparing mastectomy.
  3. Subcutaneous mastectomy.
  4. Radical mastectomy.
  5. Modified radical mastectomy.

Usually, the operation includes removing most of the breast tissue, skin and the nipple.

Laparoscopic Cholecystectomy

A cholecystectomy is commonly done by placing a tiny vide camera and special surgical tools through 4 small incisions to look inside your abdomen and dispose of the gallbladder. Doctors call this a laparoscopic cholecystectomy. A cholecystectomy is commonly done to treat with gallstones and the complications caused by them. Your doctor may suggest a cholecystectomy when you have:

  1. Gallstones in the gallbladder (cholelithiasis).
  2. Gallstones in the bile duct (choledocholithiasis).
  3. Gallbladder inflammation (cholecystitis).
  4. Large gallbladder polyps.
  5. Pancreas inflammation (pancreatitis) due to gallstones.

Laparoscopic Appendectomy

Appendectomy is the surgical elimination of the appendix. This process is mostly done as an emergency operation because the appendix has been swollen and there is a need to be eliminated. If it’s not removed, it may burst and could cause infection called peritonitis in the abdomen.

A laparoscopic appendectomy is a minimally invasive surgery to eliminate the appendix through tiny incisions. Recovery time from the lap appendectomy is fast and short.

Patients, who are undergoing other abdominal surgical operation for other reason, can have their appendix removed prophylactically so that appendicitis doesn’t grow in the future.

Appendicitis takes place when the appendix gets blocked, often through poop, foreign body or cancer. Blockage may additionally result from infection; the appendix can swell in response to any contamination in the body.

Appendicitis symptoms

If you have got appendicitis, you could experience subsequent signs and symptoms:

  1. Ache for your upper abdomen or around your bellybutton.
  2. Ache within the lower right side of your stomach.
  3. Loss of appetite.
  4. Indigestion.
  5. Nausea.
  6. Vomiting.
  7. Diarrhea.
  8. Constipation.
  9. Abdominal swelling.
  10. Inability to bypass gas.
  11. Low-grade fever.

Laparoscopic Release of Adhesions

NandanaMulticare Hospital performs a laparoscopic lysis of adhesions, a minimally invasive surgery to take out the scar tissue.

Procedure

Scar tissue happens predominantly inside the abdomen and pelvis and will result from post-operative recovery or from infections consisting of endometriosis, diverticulitis, appendicitis, and Crohn's ailment. Scar tissue is frequently painful and can lead an array of complications inclusive of bowel obstruction and sometimes infertility.

The surgical procedure is done with the usage of a laparoscope, a small lighted camera that could see in the body, and with other small devices placed through a few small incisions in the abdomen. While the patient is under general anesthesia, the doctor will cautiously cutthe scar tissue and remove it via one of the small incisions. Once all the scar tissue has been taken away, the doctor will sew the small incisions closed. The surgical procedure takes about one to a few hours.

Incisional hernia repair with mesh

Open repair of an incisional hernia with mesh includes re-opening the old incision to enable dissection and reduction of the hernia sac. The mesh may then be inserted over the defect, onlay repair, or deep to it, sublay repair, and must overlap the defect by several centimeters to decrease the risk of recurrence.

Epigastric Hernia Repair

A hernia takes place while the inside layers of the abdominal muscle have weakened, that results in a bulge or tear. In the similar way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened region of the abdominal wall in formation of a small balloon-like sac. This enables a loop of intestine or belly tissue to push into the sac. The hernia can lead to severe ache and other serious problems that need emergency surgery.

There are few choicespresent for a patient who has an epigastric hernia. Most epigastric hernias need a surgical procedure at some point in time. The open approach is done from the outside via an cuts over the palpable mass. The incision will extend through the skin, subcutaneous fat, and enable the surgeon to get to the level of the defect. The defect is usually tiny and can often be closed with sutures. This procedure is usually done under local anesthesia with sedation.

For small epigastric hernias,the laparoscopic approach cannot be used because there is no visible peritoneal sac from inside the abdomen. This approach can be used in large epigastric hernias with a peritoneal sac. It needs several tinycuts away from the epigastrium for the operative trocars. A piece of mesh is inserted in the abdomen via one of the trocar sites and is held in place with sutures through the muscle layers and surgical tacks round the mesh edges.

Umbilical Hernia Repair

Umbilical hernia repair is a surgical procedurewhich fixes umbilical hernias. An umbilical hernia includes a pouch or bulge that forms in the abdomen. This kind of bulge takes place whilst a segment of the intestine or abdominal cavity tissue presses through a weak spot inside the belly wall near the belly button. It develops in young children and adults.

Umbilical hernias don’t always need surgical repair. Surgery is required when the hernia:

  1. Is larger than half an inch.
  2. Causes pain.
  3. Is strangulated.

Inguinal hernia repair

Occurrence of an inguinal hernia is when soft tissues protrude through a region of weakness or a defect in your lower abdominal muscles. It is often in or near the groin area. Any individual can be affected by hernia but It is common more in men than women.

The bulging tissues are pushed back into the abdomenwhile stitching and reinforcing the portion of the abdominal wall that contains the defect during inguinal hernia repair. This procedure is also called as inguinal herniorrhaphyor open hernia repair.

Surgery is not always required, but hernia doesn’t improve without it generally. In some cases, an untreated hernia can become life-threatening.

Femoral Hernia Repair

Femoral hernia repair is a procedure used to repair a hernia near the upper thigh or groin. A femoral hernia is tissue that surges out of a weak spot in the groin. Usually this tissue is part of the intestine.

In open surgery:

  1. General anesthesia is given to the patient where this medicine keeps you asleep and pain-free. Or, regional anesthesia is given which numbs you from the waist to your feet. Or, your doctor may decide to give you local anesthesia and medicine for relaxation.
  2. In your groin area, surgeon makes a incision
  3. The hernia is found out and is separated from the tissues around it. Some of the extra hernia tissue may be eliminated. The remaining hernia contents are gently pushed into your abdomen.
  4. The weakened abdominal muscles are closed with stitches by your surgeon.
  5. To strengthen your abdominal wall, a piece of mesh is also sewn into place. This repairs the weakness inside the wall.
  6. The cuts are stitched closed at the end of the repair.

In laparoscopic surgery:

  1. 3 to 5 small incisions are made in your groin and lower belly by your surgeon.
  2. A medical device called a laparoscope is placed through one of the incisions. The scope is a thin, lighted tube with a camera on the end. It enables the surgeon to view inside your belly.
  3. Other tools are placed through the other incisions. The surgeon uses these tools to repair the hernia.
  4. The similar repair will be done as in open surgery.
  5. The scope and other tools are eliminated. The cuts are stitched closed at the end of the repair.

Intestinal Obstruction of small Bowel

Small bowel obstruction is a partial or entire blockage of the small intestine, which is an crucial part of the digestive system. Small bowel obstruction can be as a result of many things, along with adhesions, hernia and inflammatory bowel issues.

Symptoms of small bowel obstruction may include the following:

  1. Abdominal (stomach) cramps and pain.
  2. Bloating.
  3. Vomiting.
  4. Nausea.
  5. Dehydration.
  6. Malaise (an overall feeling of illness).
  7. Lack of appetite.
  8. Severe constipation. In cases of complete obstruction, a person will not be able to pass stool (feces) or gas.

Treatment

Surgery: If you are healthy and fit for surgery, you may require the area inflicting the blockage to be eliminated. The doctor also will take away any tissue to your bowel that has died because of lack of blood flow.

Stent: This is the more secure alternative for people who are too sick for emergency surgical operation. A stent made out of wire mesh is placedwithin the bowel at the site of the blockage to pressure the bowel open. This will permit matter to skip through again. Some people may not require anything greater than a stent. Others might also be in needof surgical operation after they end up being stable.

Intestinal Obstruction of Large Bowel

Large bowel (intestinal) obstruction may arise when there is a blockage in the large bowel which prevents food and gas from passing through.

The blockage stops blood supply to the bowel and a part of it dies. When this happens, the pressure leads to a leakage spreading bacteria into the body or blood. The most common symptoms involves not being able to pass gas or have a bowel movement, vomiting, nausea, bloating, abdominal swelling and pain.

If you have a short-term and sudden bowel obstruction, it will be treated by:

  1. Fluid replacement therapy: Is a treatment to bring back the fluids in the body to normal amounts. Intravenous (IV) fluids may be provided and medicines may be prescribed.
  2. Electrolyte correction: Is a treatment to bring the right amounts of chemicals in the blood, such as potassium, sodium, and chloride. Fluids with electrolytes may be given by infusion.
  3. Surgery: Surgery may be performed if serious symptoms doesn’t get relieved by other treatments.

If you have a long-term bowel obstruction, it will be treated by:

  1. Surgery: The obstruction is eliminated to relieve pain and enhance quality of life.
  2. Stent: A metal tube placed into the bowel to open the region that is blocked.

Hemicolectomy

A hemicolectomy is a surgical procedure that involves removing a segment of the colon. It is typically performed to treat colon cancer or a bowel disease, such as Crohn's disease or severe diverticulitis.

Laparoscopic procedure: When a laparoscopic surgery is done, a surgeon makes tiny incisions in the abdominal wall and places a thin scope. This scope consists of lens and light for viewing purposes.

The surgeon places surgical instruments through the tiny cuts in the abdomen.

Open surgery is done if the procedure can not be performed laparoscopically.

Open surgery: In open hemicolectomy, longer cuts are made to access the colon. Recovery may be longer as the cuts are larger with an open procedure.

The colon is composed of three parts: the ascending colon, which connects to the small intestine, the descending colon, which connects to the rectum, and the transverse colon, which is in between the ascending and descending colon.

AP Resection

Abdominoperineal Resection is a procedure done primarily for cancer of the rectum and, on rare occasion, in modified version, for some traumatic injuries to the rectum.

Most Abdominoperineal Resection Surgical procedure is performed as an elective procedure. This is a very huge surgery which includes elimination of the rectum, anus and varying amounts of the lower part of the colon (sigmoid colon), based upon the disease extent or injury, and creating a permanent colostomy.

After the procedure, you will have to stay in the hospital for 3-5 days. Rarely, an emergency Abdominoperineal Resection surgery is required, if there is a perforation, or hole in the lower part of the colon and/or extensive injury to the rectum and sigmoid colon.