General & Laparoscopic Surgery - Diagnosis & Treatment At Fortis Hospitals Mumbai
General & Laparoscopic Surgery - Diagnosis & Treatment
The open sores that develop in the lining of the stomach or the upper section of the small intestine are Peptic ulcers. It occurs when the digestive acid wears away the digestive tract’s protective layer of mucus. This can be caused by infection with a type of bacteria called Helicobacter pylori and use of certain types of medication like non-steroidal anti-inflammatory drugs. The symptoms of peptic ulcers include indigestion-like pain, burning stomach pain, heartburn, fatty food intolerance, nausea, and weight loss. Medication like antibiotics, Proton pump inhibitors, acid blockers, and antacids can be administered to heal peptic ulcers. In severe cases, surgeries like Vagotomy, Antrectomy, and Pyloroplasty are used to manage these ulcers.
Morbid obesity (Bariatric surgery)
When the body mass index (BMI) is abnormally high (usually greater than 35), the condition is called Morbid obesity. It occurs when too much fat gets stored in the body due to the consumption of more calories than the body can burn. This condition can lead to serious health problems like stroke, type 2 diabetes, heart disease, gallstones, infertility, osteoarthritis, sleep apnea, urinary stress incontinence and certain cancers. This excess body fat can be removed by a type of surgery called Bariatric surgery, which involves making changes to the digestive system.
Benign tumours and cysts
Benign tumour of the liver is the noncancerous abnormal growth of cells in the liver. It does not meta-size to other parts of the body and causes no symptoms. Treatment for this involves a surgical intervention to remove the tumour. Liver cysts are abnormal sacs filled with fluid or a solid mass of cells in the liver. These cysts are often congenital, meaning they are present at birth. A small liver cyst causes no symptoms. However, as the cyst enlarges, symptoms may include bloating, abdominal pain, heartburn, protruding stomach, nausea and vomiting. The treatment for liver cysts involves draining the fluid from the cyst or surgically removing it.
Surgical shunts for portal hypertension
An increase in the pressure within the portal vein (the vein which carries blood from the digestive organs to the liver) is Portal Hypertension. This makes the large veins (varices) to become fragile and bleed easily. If the initial level of treatments through diet and medications does not control this variceal bleeding, surgical procedures can be performed to reduce the pressure within the veins. This includes Transjugular intrahepatic portosystemic shunt (TIPS) and Distal splenorenal shunt (DSRS) procedures. During a TIPS procedure, a stent, connecting the hepatic vein with the portal vein, is placed in the middle of the liver to reroute the blood flow in the liver and help relieve pressure in the vein.
Gallstones (laparoscopic cholecystectomy)
Gallstones are hard masses that form in the biliary tree, which includes liver, gall bladder and bile ducts. Gallstones in the gallbladder can block the flow of bile in the digestive system and cause abdominal pain, nausea, vomiting and bloating. This can be treated by removing the gallbladder through a minimally invasive surgical procedure called laparoscopic cholecystectomy. This surgery uses a thin tube called laparoscope to visualise the inner organs and removes the gallbladder by making several small incisions in the abdomen.
Benign biliary strictures
Benign Biliary stricture occurs when the bile duct becomes abnormally narrow. This narrowing can occur when the bile ducts are injured due to Post-operative or inflammatory problems. The stricture can block the flow of bile from the liver to the small bowel, which, in turn, makes food digestion difficult. This condition can be treated with two procedures namely Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography.
Minimally invasive pancreatectomy
A minimally invasive pancreatectomy is a surgical procedure that involves the removal of part or all of the pancreas through small incisions made in the abdomen. This procedure is performed to treat a number of conditions that affect the pancreas like tumours, inflammation, severe trauma, etc. when other treatment methods are unsuccessful. Minimal blood loss, shorter hospital stay, quicker recovery are some of the benefits of minimally invasive pancreatectomy.
Whipple procedure (minimally invasive pancreatoduodenectomy)
A Whipple procedure often called pancreatoduodenectomy, is a surgical operation to remove the head of the pancreas, the upper section of the small intestine (duodenum), the gallbladder and the bile duct. When this surgery is performed through a laparoscope or robotic-system, it is called minimally invasive pancreatoduodenectomy. Most often, this procedure is used to treat Pancreatic cancer, Pancreatic cysts, Pancreatitis, Pancreatic tumors, Bile duct cancer, Trauma to the pancreas or small intestine and small bowel cancer.
Pancreatitis is a condition in which the pancreas becomes inflamed. It can be acute or chronic and caused by many factors like gallstones, heavy alcohol use, certain medications, pancreatic cancer, abdominal surgery, infections and cystic fibrosis. Treatment for pancreatitis may include administration of antibiotics, Intravenous (IV) fluids, pain medication and low-fat diet. In severe cases, endoscopic retrograde cholangiopancreatography, Gallbladder surgery or Pancreas surgery may be performed depending on the cause of the Pancreatitis.
Open and minimally invasive splenectomy
A surgical procedure which involves the removal of the spleen is Splenectomy. It is performed to treat a ruptured spleen, enlarged spleen, blood disorder, infection or cyst or tumour in the spleen. This surgery can be carried out as a traditional open surgery or minimally invasive surgery depending on various factors. During minimally invasive splenectomy, the spleen is removed through four small incisions made in the abdomen. Open splenectomy involves removing the spleen through a single large incision in the middle of the abdomen.
Diverticula are small, bulging pouches that develop in the walls of the digestive tract. The development of Diverticula is called Diverticulosis. Infection or inflammation of the diverticula results in Diverticulitis. Belly pain or cramping, bloating, constipation and diarrhoea are some of its symptoms. It can be treated with dietary changes and medications, if it is not severe. In severe cases, surgery or needle drainage can be performed to drain an abscess of pus and treat the condition.
Obstruction and fistulae
A blockage in the small intestine is called obstruction. This obstruction can block the food or liquid from passing through the small intestine and also flowing onward to the large intestine, resulting in abdominal pain, loss of appetite, vomiting and swelling of the abdomen. If the small intestine is completely blocked, surgery may be needed to remove the blockage. A fistula occurs when an abnormal connection forms between the part of the small intestine and the skin or another organ, resulting in content leak out. The treatment for a fistula depends on part of the small intestine affected and how severe it is. In severe cases, surgical interventions may be required.
Diverticulitis of colon occurs when the pouches called Diverticula protruding through the muscular layer of the colon become infected and inflamed. It causes abdominal pain, nausea, vomiting, fever, and even urinary symptoms. This condition can be treated by administration of antibiotics, fluid diet, CT-guided percutaneous drainage of the abscess and sometimes surgery. The choice of the treatment depends on the cause of the infection or inflammation and the severity of the condition.
Appendectomy (open and laparoscopic)
Surgical removal of the appendix is appendectomy. Most often, it is performed as an emergency operation to treat appendicitis, a condition in which the appendix becomes inflamed. This surgery can be performed as an Open appendectomy or Laparoscopic appendectomy. In an open appendectomy, a single, large incision is made in the lower right-hand side of the abdomen and the appendix is removed. Laparoscopic appendectomy involves the removal of the appendix through 2 or 3 small incisions in the abdomen.
Hernia repair (open and laparoscopic)
An abdominal hernia occurs when internal tissue or an organ pushes through a weak place in one of the muscle walls that enclose the abdominal cavity. It is usually treated with surgery, which can be open or laparoscopic. During an open hernia repair surgery, an incision is made in the groin and the hernia is pushed back into the abdomen and the abdominal wall is strengthened with stitches. During a laparoscopic hernia repair surgery, the abdomen is inflated with a harmless gas for a better look of the organs and the hernia is repaired with mesh through a few small incisions that are made adjacent to the hernia.
Thyroid - nodules, cysts, hyperthyroidism
The solid or fluid-filled lumps that form within the thyroid are Nodules. If a nodule makes breathing or swallowing harder, surgery can be performed to treat it.
The fluid-filled sacs that develop in the thyroid are called cysts. When there are multiple large thyroid cysts or if the cysts have become symptomatic, thyroid surgery can be performed to treat it.
Hyperthyroidism is a condition that occurs when the thyroid gland produces too much of the hormone thyroxine. If medications and radioactive iodine therapy are not effective in treating hyperthyroidism, a thyroidectomy (surgical removal of all or part of the thyroid gland) can be performed.
Parathyroid: parathyroidectomy (open and minimally invasive)
Parathyroidectomy refers to a type of surgery that is performed to remove one or more Parathyroid glands. It can be performed as an open surgery or minimally invasive surgery. During an open Parathyroidectomy, an incision is made in the skin of the neck and the parathyroid glands that are damaged or affected are removed. Minimally invasive parathyroidectomy can be carried out as a radio-guided procedure, endoscopic procedure with gas insufflation or video-assisted procedure without gas insufflation.
Adrenal: Cushing syndrome, Adrenalectomy (laparoscopic), Adenoma (open and minimally invasive)
High levels of the hormone cortisol in the body for a long time cause Cushing syndrome. If the cause of Cushing syndrome is a tumor in the adrenal glands, it can be removed through a standard operation or minimally invasive surgical techniques.
Adrenalectomy is the surgical procedure to remove one or both of the adrenal glands. An adrenal mass or tumor is the common cause that triggers the need for adrenalectomy. Laparoscopic adrenalectomy is a minimally invasive technique which is safe and effective for the surgical removal of an adrenal mass. During this surgery, three small incisions are made in the abdomen and the diseased adrenal gland is removed.
Adenoma is a type of non-cancerous tumor that affects the adrenal gland. Adrenal Adenomas are usually treated with surgery, which can be open or minimally invasive. During open surgery, a single large incision is made in the abdomen and the tumor is removed. The Minimally invasive procedure involves using a lighted camera and special instruments to remove the tumor through small incisions in the skin.
Robotic surgery is a type of minimally invasive surgery that is performed using very small tools attached to the robotic arms. It benefits the patient directly with less pain, less blood loss, shorter hospital stay and quick recovery.
In the field of Gastroenterology, robotic surgery is performed to treat a wide range of cancers, tumors and other diseases that affect the digestive tract, which includes the esophagus, stomach, intestines, appendix, pancreas, liver, gallbladder, and bile ducts.
Hysterectomy, Myomectomy, Sacrocolpopexy, Radical hysterectomy, Surgery for complex endometriosis, Tubal anastomosis are some surgeries that are performed using Robotic technology in the field of Gynaecology.
In the field of Oncology, robotic techniques are used to perform complex surgeries for treating a wide range of cancers that affect various organs like colon, rectum, uterine, cervix, oesophagus, stomach, pancreas, kidney, urinary bladder, prostate, etc.
Partial nephrectomy, radical nephrectomy, Radical cystectomy, Pyeloplasty, Adrenalectomy, Radical prostatectomy, lymph node dissection for prostate cancer, Partial bladder resection are some of the urologic surgeries that are performed with robotic-assistance.