Abdomen (Stomach) surgeries:
Best Stomach Specialist in Coimbatore:
ELCE Hospitals is the leading stomach specialist in Coimbatore provides the best gastro intestinal surgeries in India.
The field of Gastro-intestinal surgeries is a vast and growing field which has recently entered a new era with the advent of Laparoscopic surgery. This has even been surpassed now with the advent of Robotic surgery.
The main source of laparoscopic surgery is the use of an instrument called a laparoscope. It is a type of endoscope equipped with a light source, which enables visualization of organs and to introduce special equipments and perform surgeries inside the abdomen without need for extensive open incisions.
Few historical Milestones:
The greatest milestone was the discovery of anaesthesia for surgery in 1846. After this Ether anaesthesia made surgery a smooth and painless affair.
William Miles of England first wrote about his technique of abdominoperineal resection (APR Surgery) in 1908, the same year that FriedrichTrendelenburg attempted pulmonary embolectomy. William Mayo for his radical operation for carcinoma of therectum in 1910.ThomasDunhill of London was a pioneer in thyroid surgery. Earl Shouldice of Toronto first began to experiment with a groin hernia repair based on overlappinglayers brought together by a continuous wire suture duringthe 1930s.
In this section we shall explain about some of the common surgical conditions which are treated using lap surgery.
Some of the common surgeries done are:
Lap hernia repair
Lap diagnostic biopsy
Lap ovarian cystectomy
Major GI surgeries: Gastric cancer surgery, Hemi-colectomy, small bowel resections, Recto-sigmoid cancer, Gynaecological cancer surgery
Most Effective Stomach Specialist in Coimbatore:
COMMON ABDOMINAL SURGERIES- PART I
In this section we shall deal with the first two of the above
Lap Appendicectomy :
Appendicitis or inflammation of the appendix is a common surgical condition encountered in the population.
Appendix is a small, pouch-like sac at the beginning of the ascending colon. It can be found on the right lower side of your body in an area in your lower-right abdomen near the caecum of large intestine.
Appendicitis is caused by the infection or blockage of appendix followed by an invasion of bacteria into the wall of the appendix and subsequent inflammation which leads to treatment.The treatment can be done by ELCE Hospitals, the stomach specialist in coimbatore.
Common symptom of appendicitis is pain in your abdomen.Gets worse in a matter of hours, gets worse when you move around, is severe and often described as different from any pain you’ve felt before. The major complications of appendicitis are rupture, abscess, and peritonitis.
Typical pain in the central part of their abdomen that eventually moves over to the right lower quadrant
Loss of appetite is the major early symptom of appendicitis.
Nausea and vomiting may occur early along with illness or even later as the result of an intestinal obstruction.
Stomach pain is followed by nausea, vomiting, loss of appetite,
Low grade fever
Complicated appendicitis presents with:
Severe pain abdomen
All the symptoms of appendicitis is easily detected by our doctors the most dedicated stomach specialist in coimbatore.
USG Abdomen reveals thickening/inflammation of appendix and any associated features like abcess, dilatation of bowel loops etc
Images showing lap views of the steps of appendicectomy:
The procedure of laparoscopic appendectomy involves three incisions for lap ports , each about ½ an inch are made. One incision is near the umbilicus, or navel, and the another one is between the umbilicus and the pubis. One other incisionsis smaller and are on the right side of the lower abdomen. The surgeon then injects a camera and special instruments through these incisions. With the use of this equipment, the doctor visually examines the abdominal organs and identifies the appendix.
The appendix may sometimes be grossly inflamed and adherent to nearby bowel loops and these are freed carefully.
The appendix is then freed from all of its attachments and removed. The place where the appendix was formerly attached, the stump is ligated with sutures. Then the appendix is pulled through one of the incisions. The instruments are removed and then all of the incisions are closed. The surgery for appendix is given by ELCE Hospital’s doctors who are the stomach specialist in Coimbatore.
Differential diagnosis: Other diseases that may present with similar symptoms are – Ureteric stones (calculi), Ileitis, Crohn’s Disease, and Abdominal TB.
These need to be ruled out by careful evaluation of patient
Top Stomach Specialist in Coimbatore:
CalculousCholecystitis is the inflammation of gall bladder due to long standing gall bladder calculi. This may further lead to complications such as perforation, gangrene, obstructive jaundice.
In acute cholecystitis the most common presenting symptom is upper abdominal pain.
Patient may show Signs of peritoneal irritation may be present like radiating pain to right scapula
Pain begins in the epigastric region and then localizes to the right upper quadrant (RUQ)
Nausea and vomiting are present
Low grade fever – in severe cases
Physical examination may reveal the following:
Fever, tachycardia, and also tenderness occurs in the RUQ or epigastric region
Palpable gallbladder or fullness of the RUQ (30%-40% of patients)
Jaundice (~15% of patients) in cases of obstructive jaundice
Lab tests –
Leukocytosis with a left shift may be observed
The evidence of CBD obstruction is revealed by bilirubin and alkaline phosphatase.
Amylase/lipase assays are used to assess for pancreatitis
USG abdomen – Reveals the calculi in gall bladder and edematous wall and any surrounding fluid accumulation
Complications: Calculus may enter CBD and result in obstructive jaundice. Then ERCP needs to be done. ERCP visualises the biliary tree, CBD and pancreatic duct and looks for any calculus obstructing the passages.
ERCP and its use in therapeutic purpose have been dealt in an earlier blog. ELCE Hospitals, the stomach specialist in Coimbatore provides the complete diagnosis for the CalculousCholecystitis using latest technology.
Surgery – Lap cholecystectomy
Laparoscopic cholecystectomy, is a procedure which involves removal of gallbladder and the calculus within it using laparoscopy. Prior to the digestion process the gallbladder is responsible for storage of bile formed in the liver.
CBD Blockage by slipped gall stones
Leading Stomach Specialist in Coimbatore:
The standard technique is to use 4 ports. The pneumoperitoneum is achieved by closedVeress needle technique. A 10 mm telescope usually a 30 degree is used for visualisation. Three other working ports also placed appropriately .The gall bladder is usually found inflamed and edematous and adhesed to surrounding organs .The adhesions are released carefully
The anterior and posterior dissection is done and Calot’s triangle visualised and wide window is created. In order to prevent bile duct injury the critical view of safety is maintained. Clipping of the cystic duct and cystic artery is achieved from 10 mm epigastric port.
Gallbladder extraction is generally done from epigastric port site.
Drain is placed inside and kept for around 7 days for evacuation of fluid.
And is removed after that.
Elective cholecystectomy is usually straight forward and does not need drain placement. Get effective treatment for calculouscholecystitis from ELCE Hospitals who are the top stomach specialist in Coimbatore.