What is an epidermal cyst?

Epidermoid cysts are small, noncancerous lumps under the skin. They can appear anywhere on the skin, but are more common on the face, neck, and trunk. Epidermoid cysts grow slowly and are often painless, so they rarely cause problems or need treatment.

Many people call epidermoid cysts “sebaceous cysts,” but they are different. True sebaceous cysts are less common. They arise from the glands that secrete fatty matter that lubricates the hair and skin (sebaceous glands).

What symptoms does it cause?

Signs and symptoms of epidermoid cysts include the following:

• A small, round lump under the skin; usually on the face, neck, or trunk.
• A small black dot that plugs the central opening of the cyst.
• A thick, yellow, foul-smelling substance that sometimes drains from the cyst.
• Redness, swelling, and tenderness in the area, if the cyst is inflamed or infected

How is it diagnosed?

Doctors usually make the diagnosis by looking at the cyst. Epidermoid cysts look like sebaceous cysts, but they are different. True epidermoid cysts result from damage to hair follicles or the outer layer of skin (epidermis).

What treatment options exist?

Generally, it is possible not to treat a cyst if it does not cause discomfort or cosmetic problems. If you seek treatment, talk to your doctor about these options:

• Incision and drainage. With this method, the doctor makes a small cut in the cyst and gently squeezes it to remove the contents. This is a fairly quick and easy method, but the cysts usually come back after this treatment. It is usually used when the cyst is complicated and the infection must be evacuated.
• Minor surgery. The doctor removes the entire cyst. Minor surgery is safe and effective and usually prevents the cysts from coming back. If the cyst is inflamed, the doctor may delay surgery.

What is cholecystectomy?

Cholecystectomy is a surgical procedure to remove the gallbladder, a pear-shaped organ that is located just below the liver, in the upper right part of the abdomen. The gallbladder collects and stores bile, a digestive juice produced in the liver.

A cholecystectomy is a common surgery and carries a small risk of complications. In most cases, you will be able to go home the same day as your cholecystectomy or the next morning.

Cholecystectomy is performed primarily to treat gallstones and the complications they cause. Your doctor may recommend a cholecystectomy if you have the following:

• Gallstones in the gallbladder (cholelithiasis).
• Gallstones in the bile duct (choledocholithiasis).
• Inflammation of the gallbladder (cholecystitis).
• Large polyps in the gallbladder.
• Inflammation of the pancreas (pancreatitis) due to gallstones.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a cholecystectomy, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A cholecystectomy is performed under general anesthesia, so you won’t be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe. Your surgeon will perform the cholecystectomy using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) cholecystectomy

During a laparoscopic cholecystectomy, the surgeon makes four small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the gallbladder.

Afterward, you may undergo an imaging test, such as an X-ray, if your surgeon is concerned about possible gallstones or other bile duct problems. The incisions are then sutured and you are moved to a recovery area. A laparoscopic cholecystectomy takes one to two hours.

A laparoscopic cholecystectomy is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) cholecystectomy.

During an open cholecystectomy, the surgeon makes an incision about 15 centimeters in the abdomen below the ribs on the right side. Muscle and tissue are retracted to reveal the liver and gallbladder. The surgeon then removes the gallbladder.

The incision is sutured and you are taken to a recovery area. An open cholecystectomy takes one to two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the gallbladder was. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 6 hours, you will begin with the intake of liquids and then solid foods. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised by nursing staff at all times.

If your surgery was performed in the morning and you have no previous illnesses, you may be discharged at the end of the day. If your surgery took place in the afternoon, you will usually leave the following noon.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs. Occasionally, you may need antibiotics for a few days if your gallbladder was infected during the procedure.

In relation to food, we recommend the first week to avoid copious and fat-rich meals. Subsequently, all types of food will be progressively reintroduced, with possible intolerance of some of them, so their intake will be suspended and they will be tried again in the following weeks. Occasionally diarrhea may appear that usually lasts a few days or a week in relation to the new situation of the digestive system without gallbladder.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery can take approximately two to three weeks for laparoscopic cholecystectomy. However, with open cholecystectomy, once at home, full recovery may take four to six weeks.

What are the risks of cholecystectomy?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

LESS SERIOUS AND FREQUENT RISKS:

Infection or bleeding from the surgical wound, phlebitis (inflammation of the veins), temporary digestion disorders. Pleural effusion. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

INFREQUENT AND SERIOUS RISKS:

Biliary fistula. Intra-abdominal bleeding or infection. Intestinal obstruction. Inflammation of the pancreas (pancreatitis). Cholangitis (infection of the bile ducts). Jaundice (your skin may turn yellow). Allergic reactions. Liver failure. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

In most cases, these complications are resolved with medical treatment (medications, serums, etc.), sometimes other tests are required (ERCP and/or drainage), but they may require a reoperation, usually urgently., and exceptionally death may occur.

Your risk of complications depends on your overall health and the reason you’re having a cholecystectomy.

Gallbladder stone surgery in East Delhi, also known as cholecystectomy, is a common procedure performed by experienced surgeons like Dr. Zahid to remove gallstones and alleviate symptoms. Gallstones are hard deposits that can form in the gallbladder, leading to pain and discomfort.

What are gallstones?

Gallstones are hard deposits of digestive fluid that can form in the gallbladder. The gallbladder is a small, pear-shaped organ located on the right side of the abdomen, just below the liver. The gallbladder contains digestive fluid called bile, which is released into the small intestine. Gallstones range in size from small, called biliary sludge, to large, like golf balls. Some people develop only one gallstone, while others develop many gallstones at the same time.

Those who have symptoms with gallstones usually need to have their gallbladder removed during gallbladder stone surgery in East Delhi. Gallstones that don’t cause signs or symptoms usually don’t need treatment.

What symptoms does it cause?

In the event that a gallstone becomes lodged in a duct and causes a blockage, the resulting signs and symptoms may include the following:

• Sudden and rapidly intensifying pain in the upper right side of the abdomen
• Sudden and rapidly intensifying pain in the center of the abdomen, just below the breastbone
• Back pain just between the shoulder blades
• Right shoulder pain
• nausea or vomiting

Gallstone pain can last from a few minutes to several hours.

Complications of gallstones can include:

• Gallbladder inflammation.  A gallstone that lodges in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.
• Obstruction of the common bile duct.  Gallstones can block the tubes (ducts) through which bile flows from the gallbladder or liver to the small intestine. Severe pain, jaundice, and infection of the bile ducts may occur.
• Obstruction of the pancreatic duct.  The pancreatic duct is a tube that leaves the pancreas and connects to the common bile duct just before it enters the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct.

A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes severe and constant abdominal pain and usually requires hospitalization.

• Gallbladder cancer: People with a history of gallstones are at increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is high, the chance of gallbladder cancer is still very low.

Request an appointment with the laparoscopic surgeon in Laxmi Nagar if you have signs or symptoms that concern you.

Seek immediate care if you develop signs or symptoms of serious gallstone complications, such as:

• Severe abdominal pain that you can’t find a comfortable position.
• Yellowish color of the skin and in the white part of the eyes.
• High fever.

How is it diagnosed?

The tests and procedures used to diagnose gallstones and their complications include the following:

• Abdominal ultrasound.  This test is the most commonly used to look for signs of gallstones. Abdominal ultrasound involves moving a device (transducer) back and forth across the abdomen area.
• Endoscopic ultrasound (EUS).  This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. During an endoscopic ultrasound, your doctor passes a thin, flexible tube (endoscope) through your mouth and digestive tract. A small ultrasound device (transducer) in the tube produces sound waves that create an accurate image of the surrounding tissue.
• Other diagnostic imaging tests.  Additional tests may include magnetic resonance cholangiopancreatography (MRCP), computed tomography (CT), or endoscopic retrograde cholangiopancreatography (ERCP) or a hepatobiliary iminodiacetic acid (HIDA) scan. Gallstones discovered by endoscopic retrograde cholangiopancreatography may be removed during the procedure.
• Blood test.  Blood tests may reveal infection, jaundice, pancreatitis, or other complications caused by gallstones.

What treatment options exist?

Most people with gallstones that do not cause symptoms will never need treatment. We’ll determine if treatment for gallstones is recommended based on your symptoms and diagnostic test results.

Treatment options for gallstones include the following:

• Surgery to remove the gallbladder (cholecystectomy).  Your doctor may recommend gallbladder stone surgery in East Delhi to remove your gallbladder, since gallstones often return. Once the gallbladder is removed, bile flows directly from the liver to the small intestine, instead of remaining stored in the gallbladder.

You don’t need the gallbladder to live, and removing it doesn’t affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

• Medications to dissolve gallstones.  Medications you take by mouth can help dissolve gallstones. However, dissolving gallstones in this way can take months or years of treatment, and gallstones are likely to reform if treatment is stopped. Gallstone medications are not used often and are reserved for people who cannot have surgery.

Frequently Asked Questions (FAQs):

Q1. Is gallbladder stone surgery risky?

A1. Gallbladder stone surgery in East Delhi is considered safe and routine, with low risks of complications. However, as with any surgery, there are potential risks, such as bleeding, infection, or injury to nearby organs.

Q2. How long does it take to recover from gallbladder surgery?

A2. Recovery time varies, but most patients can resume normal activities within a few weeks after laparoscopic cholecystectomy. Open cholecystectomy may require a more extended recovery period.

Q3. Will I need to change my diet after the surgery?

A3. After surgery, you may need to avoid fatty and greasy foods initially. Your doctor will provide specific dietary guidelines to follow.

Q4. Can gallstones come back after surgery?

A4. Once the gallbladder is removed, gallstones cannot return. However, in rare cases, some individuals may develop stones in the bile ducts.

Conclusion

Gallbladder stone surgery in East Delih, performed by skilled surgeons like Dr. Zahid, is an effective way to treat gallstones and alleviate related symptoms. The procedure can be either laparoscopic or open, depending on individual circumstances. It is essential to follow preoperative and postoperative instructions to ensure a smooth recovery. While the surgery is generally safe, it is natural to have questions and concerns, so do not hesitate to discuss any doubts with your doctor. With proper care and adherence to medical advice, most individuals can expect a positive outcome and improved quality of life after gallbladder stone surgery.

What is gastric bypass?

The Gastric Bypass Operation or Gastric Bypass Surgery is a technique that is performed by laparoscopy.

It consists of a reduction in the volume of the stomach creating a “short circuit” so that the food goes directly from the reduced stomach to the end of the intestine, “bypassing” a large part of the intestine to prevent the absorption of food.

How does Gastric Bypass work?

According to the survey carried out by the IFSO (International Federation for Surgical Obesity), gastric bypass is the most widely used technique to treat obesity given its great long-term efficacy.

This surgery generates an anatomical modification of the digestive system allowing obesity to be treated definitively and successfully.

Through the laparoscopic Gastric Bypass technique, only a small stomach is left that joins directly with the small intestine. Thanks to this, food does not pass through a large part of the small intestine, so the absorption of calories and nutrients is greatly reduced.

In addition, and naturally, the appetite decreases and the feeling of fullness arrives much earlier due to the small size of the stomach and the effect of the bypass. This is a complementary way of reducing weight by reducing the volume of food eaten.

These two mechanisms, both the fact that the absorption circuit is much shorter, and the fact that the volume of food ingested is considerably reduced, make gastric bypass one of the most effective techniques for weight control. long term and it is for this reason that it is widely accepted by most surgeons.

In which cases can a gastric bypass intervention be performed?

The gastric bypass technique is indicated for those people who have a Body Mass Index greater than 40 (BMI or body mass index is obtained by dividing weight by height squared).

It is also a technique indicated in cases of body mass index above 35 if there are associated risk factors such as hypertension, sleep apnea, heart disease or diabetes.

 What does the procedure consist of?

The use of laparoscopy allows recovery after the intervention to be very fast and with little pain. The intervention lasts approximately between 2 and 4 hours and a recovery of 2 to 3 days.

A specific diet after the operation is necessary during the first month or month and a half to then start with a normal life.

​What are some of the advantages and disadvantages of gastric bypass?

This bariatric surgery technique has pros and cons compared to others; we are going to list some of them.

ADVANTAGE

• With gastric bypass, the average weight loss is much higher than other procedures (between 60% and 70% of excess weight), such as gastric banding or vertical gastrectomy (gastric sleeve). It is also much faster if you follow the medical instructions on the diet to follow.
• Obesity – related diseases, such as type 2 diabetes, hypertension, gastroesophageal reflux, or sleep apnea, can begin to improve even before weight loss.
• Bypass is a reversible procedure. That is, it can be reoperated to return to the initial state. This does not happen with the gastric sleeve, which is irreversible since a part of the stomach is removed).
• Patients who undergo gastric bypass are able to greatly improve their quality of life and have very good health in general.

DISADVANTAGES

• The surgery requires more experience and technical skill than with the gastric sleeve or other procedures. However, the postoperative period is similar to other procedures, being a process with little pain and simple.
• Being a restrictive and malabsorptive technique, the ability to absorb some nutrients such as iron or some vitamins is selectively reduced. Because of this, the patient must take vitamin supplements for life.
• The patient will need to follow a diet low in sugar, simple carbohydrates, or starch. This is because these foods can give you dumping syndrome (sudden drops in blood sugar that cause dizziness and discomfort).
• Before any bariatric surgery, a detailed psychological evaluation must be carried out. It is important to detect if there is an anxiety disorder that the patient compensates with binge eating. If left untreated, the patient may develop a transfer of this “food addiction” to something else such as alcohol or drugs.

Finally, the important thing is that you put yourself in the hands of a team of specialists with a lot of experience. They will know which technique best suits your needs and will help and accompany you throughout the process. Go for it!

Piles (hemorrhoids) can be uncomfortable and cause distress, but they are manageable with various options for piles treatment in Laxmi Nagar, East Delhi and lifestyle changes. Maintaining a healthy diet, staying physically active, and avoiding straining during bowel movements are essential steps in preventing and managing piles. If you experience persistent symptoms or have concerns about piles, don’t hesitate to seek medical advice. Remember, early intervention and proper care can help you get relief and improve your quality of life.

What are hemorrhoids?

Hemorrhoids, also called piles, are swollen veins in the anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

It is a fairly common pathology among the population. Fortunately, there are effective options for treating hemorrhoids. Many people get relief from lifestyle changes.

What symptoms does it cause?

The signs and symptoms of hemorrhoids generally depend on the type of hemorrhoid.

EXTERNAL HEMORRHOIDS

They are located under the skin that surrounds the anus. These are some of the possible signs and symptoms:

• Itching or irritation in the anal area.
• Pain or discomfort in the anus.
• Swelling around the anus.
• Occasional bleeding.

INTERNAL HEMORRHOIDS

Internal hemorrhoids are found inside the anus. They usually cannot be seen, but straining or irritation during bowel movements can cause:

• Painless bleeding during bowel movements. You may notice small amounts of bright red blood on toilet paper or in the toilet bowl.
• A hemorrhoid that pushes through the anus (prolapsed or bulging hemorrhoid), causing pain and irritation.

THROMBOSED HEMORRHOIDS

If blood collects in a hemorrhoid and forms a clot (thrombus), it can cause:

• Intense pain.
• Inflammation.
• A hard lump near the anus.

How is it diagnosed?

Dr Zahid, surgeon in East Delhi, can diagnose external hemorrhoids on physical examination alone. Diagnosis of internal hemorrhoids may include examination of the anal canal and rectum.

• Digital exam. The doctor inserts a lubricated, gloved finger into the rectum. The professional will try to detect something unusual, such as tumors.
• Visual inspection. Since internal hemorrhoids are usually too soft to be detected during a rectal exam, your doctor may also examine the lower part of your colon with an anoscope or rectoscope.

Dr Zahid may want to examine your entire colon through a colonoscopy in these cases:

• Your signs and symptoms indicate that you may have another disease in the digestive system.
• You have risk factors for colorectal cancer.
• You are middle-aged and have not had a recent colonoscopy.

What options exist for Piles Treatment in Laxmi Nagar, East Delhi?

PREVENTION

The best way to prevent hemorrhoids is to keep your stools soft so they pass easily. To prevent hemorrhoids and reduce hemorrhoid symptoms, follow these tips:

• Eat foods rich in fiber. Eat more fruits, vegetables, and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid straining that can cause hemorrhoids. Add fiber to your diet progressively to avoid gas problems.
• Drink lots of fluids. Drink at least two liters of water or other liquids each day (not alcohol) per day to keep your stools soft.
• Consider adding fiber supplements. Most people don’t get the recommended amount of fiber (20 to 30 grams a day) in their diet. Studies have shown that fiber supplements improve the overall symptoms and bleeding of hemorrhoids.
• Don’t make efforts. Straining and holding your breath while you have a bowel movement puts a lot of pressure on the veins in the lower rectum.
• Go to the bathroom as soon as you feel like passing stool . If you wait to have a bowel movement and the urge wears off, the stool could dry out and be more difficult to pass.
• Do exercise. Stay active to prevent constipation and to reduce pressure on your veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that could be contributing to hemorrhoids.
• Avoid sitting for a long time. Sitting for a long time, especially on the toilet, can increase pressure in the veins of the anus.

HYGIENE RECOMMENDATIONS

You can often relieve the mild pain, swelling, and inflammation of hemorrhoids with lifestyle changes.

• Soak in a warm tub or take a sitz bath frequently. Soak the anal area in warm water for about 15 minutes two or three times a day.
• Avoid intense physical efforts.

MEDICINES

• Use topical treatments.  Apply creams for hemorrhoids or suppositories with hydrocortisone, the latter is not recommended beyond a week. These measures can temporarily relieve pain and itching.
• Take pain relievers by mouth.  You can use acetaminophen or ibuprofen temporarily to ease your discomfort.

THROMBECTOMY OF EXTERNAL HEMORRHOIDS

If a painful blood clot (thrombosis) has formed inside the external hemorrhoid, the laparoscopic surgeon in East Delhi may remove piles, which can provide immediate relief. This procedure, performed under local anesthesia, is most effective if done within 72 hours of a clot developing.

MINIMALLY INVASIVE PROCEDURES

If you have persistent bleeding or painful hemorrhoids, Dr Zahid might recommend one of the other minimally invasive procedures available. This piles treatment in East Delhi can be done in hospital or other outpatient setting and usually don’t require anesthesia.

• Rubber band ligation. The doctor places one or two small elastic bands around the base of internal hemorrhoid to cut off its circulation. Hemorrhoid weakens and falls off within a week.
• Injection (sclerotherapy). The doctor injects a chemical solution into the hemorrhoid tissue to shrink it. May be less effective than rubber band ligation.
• Coagulation (infrared, laser or bipolar). Coagulation techniques use laser or infrared light or heat. They make small, bleeding hemorrhoids hard and dry. Coagulation has few side effects and usually causes little discomfort.

SURGICAL PROCEDURES

Only a small percentage of people with hemorrhoids require surgery. However, if other procedures have been unsuccessful or if you have large hemorrhoids, your doctor might recommend one of the following:

• Removal of hemorrhoids (hemorrhoidectomy). The surgeon removes the excess tissue that is causing the bleeding. The surgery can be performed under spinal anesthesia or general anesthesia.

Hemorrhoidectomy is the most comprehensive and effective way to treat severe or recurrent hemorrhoids. Most people have some pain after the procedure, which can be relieved with medication.

• Hemorrhoid stapling. This procedure, called stapled hemorrhoidopexy, blocks blood flow to the hemorrhoidal tissue. It is typically used only for internal hemorrhoids. Stapling generally involves less pain than hemorrhoidectomy and allows for an earlier return to regular activities but has been associated with an increased risk of recurrence and rectal prolapse, which is when part of the rectum protrudes from the anus.

Frequently Asked Questions (FAQs)

Q1: Can piles be prevented?

A: Yes, piles can often be prevented by maintaining a healthy lifestyle, including a high-fiber diet, drinking plenty of water, and staying physically active. Avoid straining during bowel movements and take breaks from prolonged sitting or standing.

Q2: Are piles a serious medical condition?

A: While piles can be uncomfortable and cause inconvenience, they are usually not life-threatening. Most cases can be managed with lifestyle changes and conservative treatments.

Q3: How long does it take for piles to heal?

A: The time it takes for piles to heal varies depending on their severity and the chosen piles treatment in Laxmi Nagar, East Delhi. Mild cases may resolve within a few days to a week, while more severe cases may take several weeks.

Q4: Can I treat piles at home without medical intervention?

A: Mild cases of piles can often be managed at home with lifestyle changes, over-the-counter medications, and sitz baths. However, if symptoms persist or worsen, it’s essential to seek medical advice.

Q5: Can pregnant women get piles?

A: Yes, pregnancy can increase the risk of developing piles due to increased pressure on the pelvic region. Pregnant women should follow a high-fiber diet, stay hydrated, and consult their healthcare provider if they experience symptoms.

What is hiatal hernia surgery?

The diaphragm has a small hole (hiatus) through which the food tube (esophagus) passes before it joins the stomach. In a hiatal hernia, the stomach pushes up through this hole and into the chest.

A large hiatal hernia can allow food and acid to back up into the esophagus, causing heartburn. When medications do not help or if the hiatal hernia is of a significant size, surgery would be indicated.

The intervention consists of pushing the stomach down into the abdomen and reducing the size of the opening in the diaphragm. Sometimes it is necessary to use a mesh when the hole is very wide. Generally, a fundoplication must be associated to prevent gastroesophageal reflux disease. The surgeon wraps the upper part of the stomach around the lower esophageal sphincter to tighten the muscle and prevent reflux. This procedure is usually done with a minimally invasive (laparoscopic) approach.

Previous considerations.

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for hiatal hernia surgery, your surgeon may ask you to:

• Do not eat anything before surgery. You can have a sip of water with your medications, but avoid eating and drinking for at least eight hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Hiatal hernia surgery is performed under general anesthesia, so you will not be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe. Your surgeon will perform the intervention using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) surgery

During laparoscopic hiatal hernia surgery, the surgeon makes four or five small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to bring the stomach into the abdomen and wrap the upper part of the stomach around the lower esophageal sphincter, tightening the muscle and preventing Reflux. According to the studies carried out before the intervention, the surgeon will decide whether to perform a complete or partial fundoplication. The incisions are then sutured and you are moved to a recovery area. A laparoscopic hiatal hernia surgery can take an hour or two.

The laparoscopic route is not appropriate for all people. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) surgery

During open surgery to treat a hiatal hernia, the surgeon makes a 6- to 8-inch incision in the middle of the abdomen above the navel. Muscle and tissue are retracted to reveal the stomach. The surgeon then places the stomach in the abdominal location and performs the fundoplication by fully or partially wrapping the stomach around the esophagus.

The incision is sutured and you are taken to a recovery area. An open surgery takes one to two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 8 hours, it will begin with the intake of liquids and the next day, pureed food. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised by nursing staff at all times.

If your surgery goes uneventfully, you will usually go home the next day.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend eating a pureed diet for the first week until your esophagus and stomach adapt to this new situation. Subsequently, a soft diet with easy-to-digest foods will be reintroduced and meals will be divided into five times throughout the day and with less quantity. Three or four weeks after the intervention, you will reintroduce your usual diet.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery may take approximately three to four weeks for laparoscopic fundoplication. However, in open fundoplication, once at home, full recovery may take a little over four weeks.

What are the risks of gastroesophageal reflux disease surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and frequent risks: Infection or bleeding of the surgical wound, phlebitis. Difficulty burping, transient difficulty swallowing. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Bleeding or intra-abdominal infection. Viscera perforation. Stenosis. Significant difficulty swallowing. Reproduction of gastroesophageal reflux. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having surgery to correct your hiatal hernia.

What is inguinal hernia surgery?

An inguinal hernia occurs when a part of the intestine or fat protrudes through the opening of the abdominal muscles at the groin level. Inguinal hernias are more frequent in men due to the anatomy of said area in relation to the elements that go towards the testicle. The main complication of inguinal hernia is that its content is trapped, compromising the blood supply and requiring urgent surgery. Sometimes, it is manifested by the pain and sensation of a lump in the groin.

Inguinal hernia surgery is a common surgery and carries a small risk of complications. In most cases, you will be able to go home the same day or the next morning. This surgery is called inguinal hernioplasty, it is possible to repair the opening or muscular defect, using in most cases a prosthesis (mesh) that gives consistency to the tissue.

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for abdominal wall hernia surgery, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

Inguinal hernia surgery can be performed under general or spinal anesthesia. Numbing medications will be given intravenously in your arm or through a catheter in your spine. Once the medications take effect, the health care team will insert a tube down your throat to help you breathe if your case ultimately benefits from a general anesthetic. Your surgeon will perform the surgery using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) inguinal hernioplasty.

During laparoscopic surgery, the surgeon makes three small incisions in the abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to repair your muscle defect using a prosthesis (mesh). This intervention can take one or two hours. Laparoscopic hernioplasty is performed under general anesthesia.

A laparoscopic inguinal hernioplasty is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) inguinal hernioplasty

During open abdominal hernia surgery, the surgeon makes an incision over the affected groin. The muscle and tissue are retracted to reveal the defect, which will then be repaired with the use of a prosthesis (mesh). General or spinal anesthesia may be used for this procedure.

The incision is sutured and you are taken to a recovery area. An open hernioplasty takes one to two hours. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach or due to the characteristics of the hernia.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. He will spend a short period of time in an area called post-anesthetic recovery, before being taken to his room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 6 hours, you will begin with the intake of liquids and then solid foods. We recommend sitting down and starting to walk about 8 hours after the intervention. You will be supervised by nursing staff at all times.

If your surgery was performed in the morning and you have no previous illnesses, you may be discharged at the end of the day. If your surgery took place in the afternoon, you will usually leave the following noon.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may condition wound healing and prosthesis fixation (mesh) should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and sometimes the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend the first week to avoid copious meals. Subsequently, a usual diet.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery can take approximately two to three weeks in laparoscopic hernioplasty. However, in open hernioplasty, once at home, full recovery can take four weeks.

What are the risks of inguinal hernioplasty?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Infrequent and infrequent risks: Infection, bleeding or fluid collection in the surgical wound. Phlebitis. Acute urinary retention. Hematoma. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Prolonged postoperative pain due to nerve damage. Mesh rejection. Hernia reproduction. Testicular inflammation and atrophy. Vascular injury. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having abdominal hernia surgery.

What is colectomy?

Colectomy is a surgical procedure in which all or part of the colon is removed. The colon, also known as the large intestine, is a long, tube-shaped organ at the end of the digestive tract.

There are several types of colectomy operations:

• Total colectomy involves removal of the entire colon.
• Partial colectomy involves the removal of part of the colon.
• Hemicolectomy involves removal of the right or left part of the colon.
• Proctocolectomy involves removal of both the colon and the rectum.

Colectomy surgery often requires other procedures to reconnect the remaining parts of the digestive system and allow waste to pass out of the body.

Colectomy is used to treat and prevent diseases and disorders that affect the colon, such as:

• Uncontrollable bleeding. Heavy bleeding from the colon may require surgery to remove the affected part of the colon.
• Intestinal obstruction. A blocked colon is an emergency that may require a full or partial colectomy, depending on the situation.
• Colon cancer. Early-stage colon cancer may require removal of only part of the colon during colectomy. More advanced cancer may require removal of a larger portion of the colon.
• Crohn’s disease. If medications don’t help, removal of the affected part of the colon may offer a resolution of your signs and symptoms. Colectomy may also be an option if precancerous changes are found during a test to examine the colon (colonoscopy).
• Ulcerative colitis. Your doctor may recommend a total colectomy if medications don’t help control your signs and symptoms. Colectomy may also be an option if precancerous changes are found during a colonoscopy.
• Your doctor may recommend surgery to remove the affected part of your colon if your diverticulitis recurs or if you develop complications.
• preventive surgery. If you are at very high risk of colon cancer due to the formation of multiple precancerous colon polyps, you may choose to have a total colectomy to prevent cancer in the future. Colectomy may be an option for people with inherited genetic disorders that increase the risk of colon cancer, such as familial adenomatous polyposis or Lynch syndrome.

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

Normally you should be evaluated by Hematology before the intervention since they must draw blood to study your blood group and make a reserve of blood bags for the day of the intervention. In this surgery, bleeding is an important complication, so we must offer you maximum safety. For your peace of mind, most of our patients do not require a blood transfusion.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a cholecystectomy, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.
• Drink a solution to cleanse the intestine. Your doctor may prescribe a laxative solution to mix with water at home. Drink the solution over a period of several hours, as directed. The solution causes diarrhea to help you empty your colon. Your doctor may also recommend that you take enemas.

It is not always possible to prepare for a colectomy. For example, if you need an emergency colectomy for a blockage or perforation in your intestine, you may not have time to prepare.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A colectomy is performed under general anesthesia, so you will not be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, your health care team will insert a tube down your throat to help you breathe and place a catheter to monitor your urine.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

• open colectomy. In open surgery, a longer incision is made in the abdomen to access the colon. The surgeon uses surgical tools to free the colon from the surrounding tissue and cuts out a part of the colon or the entire colon.
• laparoscopic colectomy. In a laparoscopic colectomy, also called a “minimally invasive colectomy,” several small incisions are made in the abdomen. The surgeon inserts a tiny video camera through one incision and certain special surgical tools through the other incisions.

The surgeon watches a video screen in the operating room as tools are used to free the colon from surrounding tissue. The colon is then removed through a small incision in the abdomen.

Laparoscopic colectomy relieves pain and reduces recovery time after surgery. But not everyone is a candidate for this procedure. Also, in some situations, the operation may begin as a laparoscopic colectomy, but circumstances may require the surgical team to convert it to an open colectomy.

Once the colon has been repaired or removed, the surgeon will reconnect the digestive system so that the body can expel waste. Options include the following:

• Union of the remaining parts of the colon. Typically, the surgeon joins the remaining parts of the colon together to create what is called an “anastomosis.” In this way, the stool will leave the body just as it did before.
• Connection of the intestine with an opening created in the abdomen. The surgeon may connect the colon (colostomy) or small intestine (ileostomy) to an opening created in the abdomen. This allows waste to pass out of the body through the opening (stoma). You must use a bag outside the stoma to collect stool. This can be permanent or temporary.
• Connection of the small intestine with the anus. After removing the colon and rectum (proctocolectomy), the surgeon may use a part of the small intestine to create a sac that connects to the anus (ileoanal anastomosis). This allows you to pass waste normally, although you may have several liquid bowel movements every day.

As part of this procedure, you may need to have a temporary ileostomy.

The surgeon will discuss the options with you before the operation.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the node was. This tube will be removed prior to discharge home.

What happens after the surgery?

After surgery, the patient slowly awakens from the effects of the anesthetic drugs, so they may have a feeling of not remembering the process. You will be for a short period of time in an area called post-anesthetic recovery or Intensive Care Unit for greater surveillance if your situation requires it. You will then be transferred to your room.

HOW IS THE RECOVERY IN THE HOSPITAL?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 24 hours, you will begin with the intake of liquids and then solid foods in the following days. We recommend sitting down and starting to walk about 24 hours after the intervention. The catheter that is inserted into your bladder will be removed in 1 or 2 days. At all times you will be supervised and helped by nursing staff.

If the surgeon has finally performed a stoma, you and your companion will receive the necessary information and training for its management.

If your surgery progresses on the floor without any incident, you will remain hospitalized for between 5 and 7 days.

HOW IS THE RECOVERY AT HOME?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend a soft diet for the first week and avoid copious meals. Subsequently, all types of food will be progressively reintroduced, being fundamental those rich in fiber such as vegetables and fruit. You must be well hydrated so we recommend that you drink at least 1.5 liters of non-carbonated liquids. Occasionally diarrhea may appear that usually lasts a few days or a week in relation to the new situation of the digestive system.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

If you have had an opening from the intestine to your abdominal wall, we will facilitate contact with a specialized nurse (stomatherapist) in the management of the stoma who will help you and resolve all kinds of doubts.

Virtually full recovery can take approximately three to four weeks for laparoscopic colectomy. However, with open colectomy, once at home, full recovery may take four to six weeks. It will depend on your physical condition before surgery and the complexity of the operation.

What are the risks of colectomy?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications.

Less serious and frequent risks: Infection or bleeding of the wound, acute retention of urine, phlebitis. Increased number of stools. Prolonged pain in the area of ​​the operation. Laparoscopic surgery may cause gas extension to the subcutaneous tissue or other areas and referred pain, usually to the shoulder.

Infrequent and serious risks: Fistula of the anastomosis due to impaired healing that in most cases is resolved with medical treatment (medications, serums, etc.), but that sometimes requires a reoperation with the creation of an artificial anus. Intra-abdominal bleeding or infection. Intestinal obstruction. Reproduction of the disease. Due to laparoscopic surgery, there may be vascular injuries, injuries to neighboring organs, gas embolism and pneumothorax.

These complications are usually resolved with medical treatment (medicines, serums, etc.), but they may require a reoperation, usually an emergency, and in exceptional cases death may occur.

Your risk of complications depends on your overall health and the reason you’re having a colectomy.

Lipoma Surgery in East Delhi: A Guide to Safe and Effective Treatment

Introduction

Lipomas, though typically benign, can be bothersome and affect your confidence. If you’re in East Delhi and considering lipoma surgery, you’re in capable hands. This article provides a comprehensive overview of lipoma surgery in East Delhi, covering everything from understanding lipomas to the surgical procedure and recovery. Rest assured, you can trust in our skilled surgeons for safe and effective treatment.

Understanding Lipomas

Before delving into lipoma surgery, it’s important to understand the basics. Lipomas are noncancerous, soft, fatty lumps that form beneath the skin. They are usually painless but can grow and become noticeable over time.

Signs and Symptoms

1. Soft, Doughy Lumps: Lipomas typically feel soft and doughy to the touch.
2. Moveable Under the Skin: You can usually move a lipoma with your fingers when you press on it.
3. Painless: Lipomas are generally painless, but they can cause discomfort if they press on nerves or other structures.

When to Consider Surgery

While lipomas are typically harmless and may not require treatment, there are scenarios where surgery is advisable:

• Cosmetic Concerns: If a lipoma is in a visible or bothersome location, surgical removal may be desired for cosmetic reasons.
• Pain or Discomfort: Lipomas that cause pain or discomfort may be surgically removed.
• Rapid Growth: If a lipoma is growing rapidly, it may warrant surgical evaluation to rule out other conditions.

The Lipoma Surgery Process

Preoperative Assessment

Before surgery, you’ll undergo a thorough evaluation to assess your overall health and ensure you’re a suitable candidate for the procedure.

Surgical Techniques

Lipoma removal can be performed through various techniques, including:

• Excision: The surgeon makes an incision, removes the lipoma, and closes the wound with stitches.
• Liposuction: In some cases, liposuction may be used to remove smaller lipomas through minimal incisions.

Your surgeon will discuss the most appropriate technique for your specific case.

Recovery and Aftercare

After lipoma surgery, it’s important to follow postoperative instructions:

• Dressing Changes: You may need to change dressings and keep the surgical area clean.
• Pain Management: Pain is typically minimal, but pain medication may be prescribed.
• Activity Restrictions: Your surgeon will provide guidelines on resuming normal activities.

Frequently Asked Questions (FAQs)

Is lipoma surgery safe?

Yes, lipoma surgery is generally safe. Complications are rare, and the procedure is typically straightforward.

Will the lipoma come back after surgery?

The chance of a lipoma recurring after surgery is very low. Most patients enjoy a long-lasting solution.

How long does the surgery take?

Lipoma removal is a relatively quick procedure, often taking less than an hour, depending on the size and location of the lipoma.

Is lipoma surgery covered by insurance?

Insurance coverage may vary, so it’s advisable to check with your insurance provider regarding coverage for lipoma surgery.

When can I return to normal activities?

Recovery times vary, but most individuals can resume normal activities within a few days to a week after surgery.

Where can I find expert lipoma surgeons in East Delhi?

For top-notch lipoma surgery in East Delhi, consider consulting with [Hospital/Clinic Name]. Our experienced surgeons are dedicated to your well-being.

Conclusion

Lipoma surgery in East Delhi offers a reliable solution for those looking to remove bothersome lipomas. If you’re considering surgery for cosmetic or medical reasons, trust in the expertise of our skilled surgeons. With a focus on safety and effectiveness, you can look forward to a smoother, more confident future.

What is hepatectomy?

Surgery to remove part of the liver is called liver resection or hepatectomy. Surgery is carried out to remove the part of the liver that contains the tumor, both malignant and benign. Malignant tumors can include primary liver tumors or metastases from other organs. Among benign tumors, the doctor may recommend surgery for liver cysts, liver adenoma, focal nodular hyperplasia, or cavernous hemangiomas that grow to produce symptoms. Surgery may also be recommended to prevent complications or because of the possibility of malignancy.

The part of the liver that remains in the body after surgery regenerates and grows within two to three months after surgery.

Surgery may require removal of the bile duct. Drainage of bile from the liver is done using a loop of intestine sewn into the bile duct that remains in the liver.

Previous considerations

Before any surgery, an assessment should be carried out by the anesthetist where they will advise you which medication you should stop taking and which you should continue taking. Sometimes you must be evaluated by another specialist if you have underlying diseases.

In the case of anticoagulant treatment or treatment that facilitates bleeding, the anesthesiologist, haematologist, cardiologist or family doctor will inform about the attitude to follow.

Normally you should be evaluated by Hematology before the intervention since they must draw blood to study your blood group and make a reserve of blood bags for the day of the intervention. In this surgery, bleeding is an important complication, so we must offer you maximum safety. For your peace of mind, most of our patients do not require a blood transfusion.

In the case of smoking, the habit should be stopped because it facilitates anesthetic management, smoker patients have more complications than smokers in anesthetic procedures.

It is recommended to perform moderate-intensity exercise before any intervention, unless there is a specific contraindication, such as walking at least 60 minutes a day.

How is the preparation prior to the intervention?

FOOD AND MEDICINE

In preparation for a hepatectomy, your surgeon may ask you to:

• Do not eat anything before surgery. You may have a sip of water with your medications, but avoid eating and drinking for at least six hours before surgery.
• Discontinue certain medications and supplements. Talk to your doctor about all medications and supplements you take. You continue to take most medications as directed by your doctor. Your doctor may ask you to stop certain medications and supplements because they can increase your risk of bleeding.

How is the surgery performed? (type of incision, resection, type of drainage, anesthesia)

BEFORE THE INTERVENTION

A hepatectomy is performed under general anesthesia, so you won’t be conscious during the procedure. Numbing medications are given intravenously into the arm. Once the medications take effect, your health care team will insert a tube down your throat to help you breathe, place a catheter to monitor your urine, and place lines in your neck and wrist to administer drugs and learn about your heart function.

You may have an epidural catheter or injection into your spine, as well as local nerve blocks in your abdominal wall. These procedures allow you to recover with minimal pain and discomfort after surgery and help reduce the amount of opioid pain medication you’ll need.

Your surgeon will perform the hepatectomy using a laparoscopic or open procedure.

DURING THE PROCEDURE

Depending on your situation, your surgeon will recommend one of two surgical approaches:

Minimally invasive (laparoscopic) hepatectomy

During a laparoscopic hepatectomy, the surgeon makes four to six small incisions in the abdomen. He inserts a tube with a tiny video camera into his abdomen through one of the incisions. The surgeon watches a video monitor in the operating room while using surgical tools inserted through the other incisions in the abdomen to remove the diseased part of the liver.

One of the incisions will be enlarged to remove the piece of liver removed. The incisions are then sutured and you are moved to a recovery area. A laparoscopic hepatectomy takes between three and six hours. Very specialized instruments are used to prevent bleeding during the intervention.

A laparoscopic hepatectomy is not appropriate for everyone. In some cases, the surgeon may start with a laparoscopic approach and determine that a larger incision is necessary due to scar tissue from operations, previous complications, or an inability to safely continue with the procedure.

Traditional (open) hepatectomy.

During an open hepatectomy, the surgeon makes an incision about 20-25 centimeters in the abdomen below the ribs on the right side. Muscle and tissue are retracted to reveal the liver. Next, the surgeon removes the diseased part of the liver.

The incision is sutured and you are transferred to a post-anesthetic recovery area. An open cholecystectomy takes between two and four hours. Very specialized instruments are used to prevent bleeding during the intervention. It is usually performed when the procedure cannot be carried out with maximum safety through the laparoscopic approach due to the complexity of the case.

Sometimes it is necessary to place a tube or drain inside the abdomen with an outlet through the skin to allow the discharge of fluid from the area where the diseased part of the liver was. This tube will be removed prior to discharge home.

WHAT HAPPENS AFTER THE SURGERY?

After surgery, the patient is transferred to the Intensive Care Unit (ICU) where he will remain for 24 hours if there are no incidents. It is possible that the anesthesiologist will remove the connection to a breathing machine in the operating room or the doctor in charge of your surveillance in the ICU will do it. You will slowly wake up from the effects of the anesthetic drugs so you may have a feeling of not remembering the process. After your stay in this unit you will then be transferred to your room.

How is the recovery in the hospital?

It is possible to feel nausea or abdominal pain after the intervention but they will be controlled with the prescribed medication. After about 8 hours, he will begin with the intake of liquids and the next day solid foods. We recommend sitting down and starting to walk about 24 hours after the intervention. The catheter that is inserted into your bladder will be removed in 1 or 2 days. At all times you will be supervised and helped by nursing staff.

If your surgery progresses on the floor without any incident, you will remain hospitalized for between 3 and 7 days.

How is the recovery at home?

Our premise is to be active in recovery. For this reason, we encourage the patient to walk daily, we recommend walking at least 60 minutes each day both inside and outside the house. Important physical efforts that may affect wound healing should always be avoided.

When you are discharged home, you will be prescribed medication to make you feel as comfortable as possible. You will resume your previous medication following the surgeon’s recommendations, since some drug may not be recommended in the first days after surgery. Normally the taking of painkillers is indicated to control the pain and the injection of heparin to avoid the appearance of thrombi in your legs.

In relation to food, we recommend the first week to avoid copious and fat-rich meals. Subsequently, all types of food will be progressively reintroduced, with possible intolerance of some of them, so their intake will be suspended and they will be tried again in the following weeks. Occasionally diarrhea may appear that usually lasts a few days or a week in relation to the new situation of the digestive system.

You can wet your wounds when you wash yourself and then gently dry them with the application of any antiseptic (chlorhexidine, povidone-iodine, crystalmine…). These wounds should be evaluated by nursing around 7 and 10 days after surgery.

Virtually full recovery can take approximately three to four weeks for laparoscopic hepatectomy. However, with open hepatectomy, once at home, full recovery may take four to six weeks. It will depend on your physical condition before surgery and the complexity of the operation.

What are the risks of liver surgery?

The normal thing is that your intervention proceeds without incidents but you must know the potential complications. 

Less serious and frequent risks: Infection or bleeding from the surgical wound, phlebitis (inflammation of the veins), temporary digestion disorders. Pleural effusion. Prolonged pain in the area of ​​the operation.

Infrequent and serious risks: Dehiscence of the laparotomy (opening of the wound). Biliary fistula. Intra-abdominal bleeding or infection. Intestinal obstruction. Inflammation of the pancreas (pancreatitis). Cholangitis (infection of the bile ducts). Jaundice. Liver failure.

In most cases, these complications are resolved with medical treatment (drugs, serums, etc.), and sometimes other tests (ERCP and/or drainage) are required, but they may require a reoperation, usually urgently., and exceptionally death may occur.