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M/s Dr G Parthasarathy - Nursing Homes / Clinics / Hospitals of laparoscopic rectal prolapse surgery services, laparoscopic bile duct exploration service & laparoscopic splenectomy surgery services in Hyderabad, Telangana.

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Nursing Homes / Clinics / Hospitals

Laparoscopic Rectal Prolapse Surgery Services
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Laparoscopic surgeries have become the best option for treatment of most abdominal surgical problems.Rectal prolapse is a condition when the patient’s rectum is no longer in the same position as before and slides out of the abdomen and protrudes out like a hand coming out of a shirt’s sleeve.
The patients often face a frequent change in their bowel habits. Mucus drainage and bleeding from the rectum are also some of the most common symptoms of a rectal prolapse. The patient may also suffer from a condition in which he or she cannot control their stool called incontinence


What is laparoscopic rectal prolapse surgery?
The laparoscopic rectal prolapsed surgery, as you can understand from the name, is used to treat a rectal prolapse. This surgery is also known by the name of laparoscopic rectopexy. The rectum shifts from its original position in this problem and hence the surgery helps to restore the rectum to its original position. When the rectum is restored, it would not be able to form a protrusion and come out of the anus. Now, this surgery is of laparoscopic type, which means, a small camera will be placed inside the abdomen to see everything inside it and it this camera is inserted through minute keyhole like incisions. The instruments used for performing this is surgery are also inserted through those incisions.
What happens during a laparoscopic rectal prolapse surgery?
Firstly, you will be given an anesthesia and once you are fully unconscious, the surgeon will make a 1cm slit at a position near your bellybutton. Through this cut, the laparoscope will be inserted. Now, with the help of this laparoscope, the surgeons will be able to see everything clearly inside your abdomen on a screen. Depending on your built and some other factors, a number of small incisions like the one used for inserting the laparoscope will be made and their positions are determined by the surgeon. Through these incisions, the surgeon will reposition your rectum and restore it back to its original position. The rectum is placed in the locations firmly with the help of stitches and sometimes with a mesh.
How is the post-operative recovery after laparoscopic rectopexy?
The patient usually is made to walk on the same evening of the surgery.Oral liquids are started on the next day.The patient is discharged one or two days following the operation.It is advisable to avoid straining at stools after the operation and a stool softener is usually prescribed.

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Laparoscopic Bile Duct Exploration Service
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This is an advanced laparoscopic procedure done for clearing of the stones blocking the bile duct.
What are CBD stones(common bile duct)?
The common bile duct is a tube which carries the bile produced in the liver to the intestine.The bile is an important digestive juice which helps in digesting fat.When stones form in the gallbladder or rarely in the bile duct itself they can block the free flow of bile.This can cause stagnation of the bile in the liver and later cause jaundice.Sometimes these stones can also obstruct the duct of the pancreas and cause life-threatening inflammation of the pancreas called acute pancreatitis.

How to diagnose CBD stones?
CBD stones are usually diagnosed with the help of blood tests and certain imaging modalities.
A liver function test is a blood test which can give a clue to the presence of bile duct stones.
An ultrasonography can diagnose the presence of bile duct stones in most cases.In doubtful cases and when further information is required an MRI scan called an MRCP can clearly define the presence of CBD stones.
How are CBD stones treated?
In most cases, CBD stones are cleared without surgery.This is done by a procedure called ERCP.Here an endoscope is passed into the mouth and into the intestine and the bile duct entered with a wire and the stones are pulled out.
In certain situations when the stones are very large or hard ERCP may fail.In such cases, a surgery is needed to clear the CBD stones.In the earlier times, this was done by opening the abdomen through a 15-20 cm long incision and opening the bile duct, clearing out the stones and closing it back.This is usually combined with a removal of the gallbladder also because the stones are usually produced in the gallbladder and slip into the bile duct.

What is Laparoscopic bile duct exploration?
In the recent years, most of the CBD stones which need surgery are treated laparoscopically.The advantage of this being a scarless operation with early recovery.Also, there is avoidance of problems of a regular operation like wound infection and hernia formation.
This procedure is best done in the hands of experienced laparoscopic surgeons.The laparoscopic ports are similar to a gall bladder operation with a few extra ports.
The surgeon uses a special endoscope called a choledocoscope which is inserted through the skin and the bile duct is cleared.
The patient recovers in a day or two and can be discharged early from the hospital.Compared to an open operation there is a minimal pain, minimal scar and early return to normal activities of life.

 

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Laparoscopic Splenectomy Surgery  Services
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Splenectomy is the surgical procedure where the spleen is removed. The position of the spleen is just under the left rib cage. It is present near the stomach. The main function of the spleen is to combat the infections and filter out the old and damaged blood cells and numerous other functions. Now, you must be thinking that if it is such an important organ then why to remove it. Well, the main reason behind spleen removal is when there is a disease involving the spleen, or if the spleen is ruptured due to trauma and is bleeding inside.
This procedure can be done by a key hole technique called laparoscopic splenectomy.

Why is laparoscopic splenectomy done?
The main reasons because of which laparoscopic splenectomy is done are as follows:

  • If you somehow get hurt in your abdomen and accidentally rupture your spleen, then doctors usually advise going for a splenectomy to stop the internal bleeding.
  • Sometimes, people experience an abnormal condition in which the spleen enlarges and becomes bigger than its normal size. This causes blood abnormalities and pain. A splenectomy will give you relief from all such problems.
  • There are certain blood disorders which can be cured if your spleen is removed. However, spleen removal should be your last option and you should go for it only if all other treatment procedures have failed. Some of those blood disorders include sickle cell anemia, idiopathic thrombocytopenic purpura, thalassemia and polycythemia vera.
  • Sometimes a large amount of pus accumulates around the spleen leading to an infection which causes inflammation. Splenectomy can treat the condition.
  • There are some cancers which have the probability of being treated for the removal of the spleen. Some of those cancers are Hodgkin’s lymphoma, chronic lymphocytic leukemia, hairy cell leukemia and non-Hodgkin’s lymphoma.
  • Formation of tumors or cysts inside the spleen also requires splenectomy.

 

What happens during a laparoscopic splenectomy?
After you have been given an anesthesia, the surgeon will insert the laparoscope into your abdomen by making an incision. Through another incision, carbon dioxide gas is inserted into the abdomen so that the surgeon gets some space to work. After that, the spleen is disconnected from the neighboring organs and is removed. After the completion of the process, the incisions are closed.Sometimes a drain tube may be left to allow for drainage of fluid from the surgical site.This is usually removed in a few days.
What are the post-operative precautions after splenectomy?
Laparoscopic splenectomy is generally a safe operation if done for elective indications.In an emergency setting like in a trauma with massive bleeding, it is done as a life-saving procedure.
The spleen plays an important role in the development of immunity.SO splenectomy is generally avoided in children unless absolutely essential.The patient is given certain vaccines one week prior to the operation.After the removal of the spleen, one has to be careful about minor infections like a sore throat and fever, These can flare up suddenly.This is usually important in children.In adults, the chance of such serious infections is quite rare.

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Laparoscopic Hernia Surgery  Service
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Generally, laparoscopic hernia is the process of repairing by using an instrument called the laparoscope. Two or four very small incisions are made through the abdominal wall through which this device called the laparoscope is inserted which is basically a very thin telescope with a light on one end. As the incisions are very small so the entire process is also known as keyhole surgery. It is then that the hernia is viewed from the other side of the wall of the abdomen. Hernias are basically bulges in the belly of a person where abdominal fat and the intestine come out from under the skin due to certain defects. They become more prominent if and when the concerned person is coughing or is in a standing position.

What is the treatment procedure of laparoscopic hernia?

The space or the cavity of the abdominal region is inflated with the use of carbon dioxide to help the surgeon to get adequate space to operate inside the patient. The operation is done with long instruments. Then the hernia defect or the hole is covered with mesh from inside the abdomen then the entire thing is stapled into the tissues of the muscle so as to properly fix them in a patch. The procedure of this treatment is extremely less painful and problem free as they are pain-free stitches free and also bloodless. Though the treatment does not come very cheap yet the results are excellent. It has to be kept in mind that treatment as soon as possible is very essential as if left neglected, it might give rise to many serious problems in the patient and might even become fatal.

What is the recovery process from laparoscopic hernia?

Some immediate consequences of the operation are nausea, dizziness, pain and fatigue. But these will pass quickly. The patient’s throat might also bloat up and remain so for few days after which it will lessen. But it is as quick as three hours that the patient will be able to walk properly. The pain medicine that will be given might have certain light side effects but they too will be gone after few days. Very light exercise is prescribed initially and the concerned patient will be able to join work as early as one week.

What are the complications of laparoscopic hernia?

In case if you are suffering from inguinal hernia, it is technically very demanding for the surgeon as it is really difficult to master the process. A very efficient surgeon needs to be consulted as otherwise, the results could be severe. There remains a risk of major organs getting heavily damaged in these cases due to even a slight mistake. The surgery that concerns the laparoscopic hernia is generally done under general anaesthesia which might be really problematic if the patient has other history medical conditions. The hernia on both the sides, that is, bilateral hernia has to be repaired simultaneously. You must consult the doctor at once when you feel any discomfort.

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Laparoscopic Appendicectomy Surgery  Services
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Laparoscopic Sleeve Gastrectomy is a weight loss methodology in which the abdomen is reduced to about 15% of its initial size, by surgically removing a large segment of the belly along the greater curve.

This sleeve gastrectomy is an easier and simpler operation than the gastric bypass process as it does not involve the diverting of or reconnection of the intestines. This surgery also does not require the use of a banding tool to be embedded around a portion of the stomach, unlike the Lap-band. As far as the weight loss is concerned, it is generally faster with the sleeve than with the gastric band.The other advantages in the list are less food intolerance and lower surgical risk than with the gastric bypass while weight loss is similar.

The procedure of the surgery :

One will acquire general anaesthesia prior to this surgery. This is a medicine that keeps a patient asleep and pain-free for few hours or so.

The surgery is usually done using a tiny specialized video camera that is placed in the belly. This type of surgery is called laparoscopy and the camera is called a “laparoscope”, this allows the surgeon to view inside the belly during the operation with the help of the video monitor in the operative room.

Post these processes, the surgeon makes 2 to 5 small cuts called “incisions” in the abdomen through which the necessary instruments that are needed to perform the surgery are inserted.

A harmless gas is pushed into the belly to inflate it. The stomach wall thus gets lifted up from the small intestine and other organs giving the surgeon enough space to work. The surgeon removes most of the part of the stomach at least about 75% of the belly, hence creating a long vertical tube or banana-shaped stomach.No intestines are extracted or bypassed during this operation.

The leftover portions of the stomach are joined together using surgical staples. The tools are removed and then the cuts are stitched closed.

The surgery takes approximately 60 to 90 minutes.

This surgical procedure is primarily used as part of a staged access to weight loss. The patients who have a very high body mass index “BMI” or who are at risk for undergoing anaesthesia or suffers from heart problems may benefit from this staged approach. In patients who undergo “LSG” as a first stage procedure, the second stage i.e. gastric bypass is carried out 12 to 18 months later after the occurrence of significant weight loss and then the risk of anaesthesia is much lower as the liver also decreases in size. Though this approach involves two procedures yet it is safe and effective for selected patients.

 

Benefits:

The patients undergoing this surgery can expect to lose weight varying between 40% to 70% of their surplus body weight that they had earlier in the first year after operation.

Many obesity-related disorders improve after bariatric surgery. Diabetes, hypertension and other related diseases. Abnormal cholesterol levels get cured in more than 75% of patients undergoing “LSG”. Though wider study has not been done relating to this particular topic yet the weight loss that occurs after LSG results in drastic improvement in these medical conditions in the first year after surgery.

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Bariatric Surgery Service
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Bariatric surgery is an operative method applied for the highly obese people aiming reduction of weight. This surgery is made on the stomach and also sometimes on intestine with an objective to limit the patient’s food intake. It results in a change in the anatomy of the digestive system of the concerned patient. The outcome of the surgery focuses a significant effect in the perspective of long-term stability of weight loss and also other benefits like an improvement of cardiovascular risk factor and recovery of patients with diabetes.

What is bariatric surgery?

Bariatric surgery is an option to make changes in the anatomy of your digestive system with an aim to lose your body weight by limiting how much food you can eat or by controlling the absorption of nutrients into the body, or both. Bariatric surgery is generally of three type’s namely gastric bypass, gastric band, and gastric sleeve. Most surgeons prefer gastric bypass surgery due to its fewer complications than other surgical methods.

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Metabolic Surgery
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Metabolic Surgery

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Several conventional procedures of bariatric surgery and novel gastrointestinal operative methods induce long-term relief of type 2 diabetes mellitus (T2DM). These surgical procedures are also strikingly progressing in other metabolic dysfunctions such as hypertension and hyperlipidemia in patients without or with obesity. Many shreds of evidence compiled that these metabolic outcomes are not merely the results of substantial weight loss and reduced calorie intake but might be assignable in part to change of endocrine that derived from operational manipulation of the gastrointestinal tract. The outcome of such surgical intervention termed as metabolic surgery. It is becoming popular in today’s medical practice because of the reason that gastrointestinal tract is the key player in the management of glucose homeostasis and obesity.

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Sleeve Gastrectomy
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Sleeve Gastrectomy

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Sleeve gastrectomy for weight loss for morbid obesity was first demonstrated by Marceau in the year 1993 as a constituent of biliopancreatic diversion. After weight reduction surgery, more problems were observed in case of super-morbidly obese patients with higher rates of failure. Therefore, a two-step proposition comprised of laparoscopic sleeve gastrectomy (LSG) precedes laparoscopic roux-en-y gastric bypass (LRYGB) was first tabled by Regan et al. in 2003 to solve the complications faced by the super-morbid patients. Over time more investigations were made to modify the surgical method to improve the postoperative quality of life of heavily morbid patients. Sleeve gastrectomy is often now practiced in isolation because it describes effectiveness as regards to excess weight loss (EWL) and determination co-morbid obesity condition.

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