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Minimal Access GI And Bariatric Surgery Services

Our range of products include Minimal Access And GI Surgery Services, GI And Bariatric Surgery Services, General Surgery Services, Bariatric Surgery Services, Fistula Treatment Surgery Services and Gall Bladder Surgery Services.

Minimal Access And GI Surgery Services
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General Information

The department of Minimal Access & GI Surgery consists of an extremely qualified team of doctors. With an unparalleled domain knowledge and availability of the most advanced technology along with a caring and compassionate approach towards patient care, we provide each patient with a comprehensive evaluation and customized treatment in the best possible manner available.

Some of our commonly performed procedures include:

  • Single Incision Laparoscopic Cholecystectomy
  • SILS Appendectomy (Single Incision Surgery)
  • Lap Hernia Repairs (Almost zero recurrence for all inguinal/ventral/incisional /multi-recurrent hernias)
  • Lap Colo-rectal Surgeries (For the benign (Prolapse/Diverticula) & malignant conditions)
  • Lap Surgery for GERD/ Hiatus Hernia
  • MIPH (Stapled Haemorrhoidectomy)
  • STARR Stapled Trans Rejection of Rectum
  • Advanced Bariatric Surgeries
  • Laparoscopic Sleeve Gastrectomy
  • Laparoscopic RNY Gastric Bypass
  • Laparoscopic Adrenalectomy/Splenectomy
  • Lap & other bilio pancreatic surgery
  • (VATS) Video Assisted Thoracoscopic Surgeries: e.g. Thymectomy/ lung /esophageal surgery

FAQ’s for Minimal Access & GI Surgery

What does Minimal Access Surgery Mean?
It is a highly developed technique for doing all types of surgical procedures. It is also known as Laparoscopic Surgery, Keyhole Surgery or Band-Aid surgery. A thin telescope known as laparoscope and working instruments are inserted through small incisions (3-12mm) in the abdominal wall and the laparoscope is attached to a tiny video camera which shows the inside view of patient’s body to a high resolution in the monitors. These incisions are usually covered with surgical glue/ closed with absorbable sutures and after a few weeks are barely visible thus avoiding any follow-up visit for suture removal.

What are the benefits of Minimal Access Surgery?

There are several advantages like:

  • Rapid recovery,
  • Hospital stay are shorter
  • Negligible pain
  • Minimal scarring,
  • Back to daily routine within few days

How long will be my hospital stay?

Minimal Access surgery or the laparoscopic surgery reduces the hospital stay by half. In some MAS the patient can be discharged on the same day.

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GI And Bariatric Surgery Services
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General, Minimal Access, GI & Bariatric Surgery

General Information


The Department of General Surgery, Minimal Access, GI & Bariatric Surgery at Primus continues to lead the way in improving patient outcomes with cutting-edge surgical care. The department specialises in performing all major surgeries related to abdomen, skin, breast, soft tissues, and hernia.
The Division of General Surgery at Primus provides comprehensive surgical consultation and care in many subspecialties including colon and rectal surgery and trauma. The Department’s primary aim is to help patients improve their overall health and lead a good quality of life.

General, Minimal Access and GI Surgery:

The Division of General Surgery at Primus provides comprehensive surgical consultation and care in many subspecialties including colon and rectal surgery, trauma and burn, pediatric surgery, endocrine surgery, bariatric surgery etc. Our skilled surgeons are trained in various specialties and are leaders in their respective disciplines.

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General Surgery Services
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General Surgery Services

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General Information

The General Surgery department aims towards providing the highest standard of quality patient care, encompass across a broad spectrum of complex surgical interventions. We are highly committed to providing the safest, compassionate and most result-oriented clinical care to enhance patient outcomes.

Some of our commonly performed procedures include:

  • Appendectomy
  • Biopsy
  • Breast
  • Breast Augmentation
  • Breast Biopsy
  • Breast Cancer: Lumpectomy and Partial Mastectomy
  • Minimally Invasive Breast Biopsy
  • CAPP Catheter Placement
  • Cholecystectomy
  • Esophagogastric Fundoplasty
  • Laparoscopic Surgery
  • Gastrointestinal malignancies
  • Peritoneal carcinomatosis
  • Melanomas
  • Splenectomy
  • Cholecystectomy
  • Gastric Bypass
  • Exploratory Surgery
  • Liver resection
  • Whipple
  • Nissen
  • Retroperitoneal lymph node excision
  • Laparoscopic and Open Hernia Repair
  • Inguinal
  • Umbilical
  • Incisional
  • Hiatal
  • Lipoma Excision



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Bariatric Surgery Services
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General Information

Obesity cannot be brushed aside as a cosmetic predicament. In fact, it is a medical condition with serious health consequences. It is actually a chronic disease involving accumulation of excess body fat, which increases the risk of medical conditions such as diabetes mellitus, high blood pressure (Hypertension), Obstructive Sleep Apnea and others, and shortens your life span.

Luckily, obesity can be treated by a multidisciplinary approach involving a team of dedicated weight management experts. By concentrating on key areas and causes, the team can make sure successful and sustainable weight loss.

We at Primus offers bariatric procedures to obese patients. We offer comprehensive evaluations before surgery and follow-up care after surgery including support groups, dietitian services and continuing education. We consider bariatric surgery a tool to help you live a healthier, longer life.

Weight loss surgery is a life-altering process and procedure that requires careful thought, considerable awareness and adjustment and it gives you a second chance to healthy life. Changes occur both emotionally and physically. Weight loss surgery is not a cure-all. Instead, it is a tool to help you achieve a healthier weight. We want you to be as successful as you can with weight loss surgery!

Our Approach:
There are many causes that may contribute to weight gain and lead to obesity. Hence, only a multidisciplinary approach can identify the different factors and engage a program that leads to necessary reduction in weight.

Dietary Management:

You can lose weight as long as you eat healthy and maintain it. Our dietitians will assess your diet patterns and suggest alteration to keep the weight under control.

Medical analysis:

Our physicians will conduct a thorough health assessment to check for possible underlying causes of obesity and prescribe suitable medical treatment.

Surgery:

Individuals with BMI greater than 32.5 are advised to consider surgery for obesity (also referred to as Bariatric Surgery when all other treatment options have been unsuccessful. Surgery enables you to successfully lose weight and treat obesity- related diseases. It also helps to sustain your weight loss for years, thus improving overall quality of life.
Post Surgery Care

We will be having regular support meetings where operated patients will meet the preoperative patients and will help each other towards common goal- Healthy Life Style

SURGERIES PERFORMED AT PRIMUS:

  • Laparoscopic Gastric Banding
  • Laparoscopic Sleeve Gastrectomy
  • Laparoscopic Gastric Bypass
  • Laparoscopic Mini Gastric Bypass

Laparoscopic Adjustable Gastric Banding:
Most common gastric bypass surgery
On an average, 60- 70% of excess weight is reduced after the surgery
Procedure:

Laparoscopic Sleeve Gastrectomy:
It is a surgical weight-loss restrictive and irreversible procedure
By removal of large portion of the stomach, the stomach size is reduced by 15% of its original size.
The open edges are joined to give the remaining stomach a shape of tube or sleeve. This can be used as a first stage operation prior to a gastric bypass or as a definite procedure.
On an average, 60- 70% of excess weight is reduced after the surgery

Laparoscopic Roux-en-Y Gastric Bypass:
Most common gastric bypass surgery
On an average, 60- 70% of excess weight is reduced after the surgery

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  • Fistula Treatment Surgery Services
  • Fistula Treatment Surgery Services
Fistula Treatment Surgery Services
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General Information

What is Fistula in Ano?
A fistula-in-ano is an abnormal tract or cavity with an external opening in the  area that is communicating with the rectum or  by an identifiable internal opening. Most fistulas are thought to arise as a result of cryptoglandular infection with resultant perirectal abscess.

What are the types of Fistulae?

 

LIFT Procedure for Fistula Repair

LIFT procedure or ”Ligation of Intersphincteric Fistula Tract” is an operation used to treat fistulae that are not amenable to laying open. Usually these fistulas involve more muscle, and hence the fistula cannot be layed open or cut safely.

The procedure aims to tie off and close the fistula tract or “tunnel” as it travels between the internal and external sphincter muscle.

The operation is done once the fistula tract is well delineated and there is no other infection. Usually there will be at least one previous operation performed to control the infection or abscess, and inserted a seton to drain it well.

The operation is usually carried out as day surgery. You may be prescribed antibiotics for a week, and simple analgesia.

Sometimes the operation deals with half of the fistula, and the remaining tract can be safely layed open only cutting a small amount of internal sphincter muscle, rather than both the internal and external muscle. There is less chance of faecal incontinence in these cases.


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  • Gall Bladder Surgery Services
  • Gall Bladder Surgery Services
Gall Bladder Surgery Services
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GallBladder Surgery ( Laparoscopic Cholecystectomy)

General Information

What is the function of gall bladder in the body?
Gallbladder is a pear shaped pouch like structure situated below the liver and stores bile which is secreted by the liver and pumps bile into the intestine for the digestion of food.

What are Gallstones?

Gallstones are pieces of solid material that form in the gallbladder. These stones develop because cholesterol and pigments in bile sometimes form hard particles.

The two main types of gallstones are:

Cholesterol Stones: Usually yellow-green in color, approximately 80% of gallstones are cholesterol stones.

Pigment Stones: These stones are smaller and darker and are made up of bilirubin.

What are the causes of gall stones?

Several factors may come together to create gallstones, including:

  • Genetics
  • Body weight
  • Decreased motility (movement) of the gallbladder
  • Diet

What are the symptoms of Gallbladder Stones/ Gallstones disease?

Gallstones often don’t cause symptoms. Those that don’t are called “silent stones.” A person usually learns he or she has gallstones while being examined for another illness. When symptoms do appear, they may include:

  • Pain in the upper abdomen and upper back; the pain may last for several hours.
  • Nausea,Vomiting.
  • Other gastrointestinal problems, including bloating, indigestionand heartburn.

What are the complications of Gallbladder (GB) stones?

Infection / Inflammation of GB (Cholecystitis), perforation of GB , pus in GB (Empyema) & jaundice (due to slippage of stone into the common bile duct), Acute pancreatitis (severe pain in abdomen) and rarely carcinoma gall bladder.

Procedure for laparoscopic cholecystectomy

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

After a cholecystectomy

In general, you can expect to go home in day once you’re able to eat and drink without pain and are able to walk unaided. It takes about a week to fully recover in a day.

A laparoscopic cholecystectomy isn’t appropriate for everyone. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or complications of Gall stomach

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  • Inguinal Hernia Repair Services
  • Inguinal Hernia Repair Services
  • Inguinal Hernia Repair Services
Inguinal Hernia Repair Services
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General Information
What is Inguinal Hernia?
An inguinal hernia occurs when soft tissue inside the abdominal cavity (omentum) or part of the intestine — protrudes through a weak point in the groin. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object and may disappear spontaneously on lying down. An inguinal hernia once formed, doesn’t get better or go away on its own and can lead to life-threatening complications.

What are the symptoms of inguinal hernia?

Inguinal hernia signs and symptoms include:

  • A bulge in the area on either side of your pubic bone
  • A burning, gurgling or aching sensation at the bulge
  • Pain or discomfort in your groin, especially when bending over, coughing or lifting
  • A heavy or dragging sensation in your groin
  • Weakness or pressure in your groin
  • Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum

What are the causes of Inguinal Hernia?

  • Congenital (Since birth)
  • Increased pressure within the abdomen
  • A pre-existing weak spot in the abdominal wall
  • Straining during bowel movements or urination
  • Heavy weight lifting
  • Fluid in the abdomen (ascites)
  • Pregnancy
  • Excess weight
  • Chronic coughing or sneezing

What are the Inguinal Hernia Complications?

  • Pressure on surrounding tissues causing pain and swelling. Most inguinal hernias enlarge over time if they’re not repaired surgically. Large hernias can put pressure on surrounding tissues. In men, large hernias may extend into the scrotum, causing pain and swelling.
  • Incarcerated hernia. If the omentum or a loop of intestine becomes trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas.
  • Strangulation. An incarcerated hernia may cut off blood flow to part of your intestine. This condition is called strangulation, and it can lead to the death of the affected bowel tissue. A strangulated hernia is life-threatening and requires immediate surgery.

What is the treatment of Inguinal Hernia & period of recovery?

Inguinal Hernia Surgery is the only treatment available & there are two types of Inguinal Hernia surgical procedures

  • Open Meshplasty (Lichtenstein repair).
  • Laparoscopic Meshplasty (TAPP or TEP).

Recovery time is 5-7 days after laparoscopic surgery and about 2 weeks after open surgery

How to prevent inguinal hernia?

You can’t prevent the congenital defect that makes you susceptible to an inguinal hernia. You can do things to reduce strain on your abdominal muscles and tissues, however.

  • Maintain a healthy weight. Talk to your doctor about the best exercise and diet plan for you.
  • Emphasize high-fiber foods. Fruits, vegetables and whole grains contain fiber that can help prevent constipation and straining.
  • Lift heavy objects carefully or avoid heavy lifting altogether. If you must lift something heavy, always bend from your knees — not your waist.
  • Stop smoking. Besides its role in many serious diseases, smoking often causes a chronic cough that can lead to or aggravate an inguinal hernia.
  • Avoid relying on a truss. Wearing a supportive garment designed to keep hernias in place (hernia truss) doesn’t correct the underlying problem or help prevent complications. Your doctor might recommend a hernia truss for a short time before surgery to help you feel more comfortable, but the truss isn’t a replacement for surgery.

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  • Diabetes Obesity Surgery Service
  • Diabetes Obesity Surgery Service
Diabetes Obesity Surgery Service
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General Information

Diabetes Surgery (Metabolic surgery)
Diabetes Surgery (metabolic surgery) is the Obesity surgery or weight loss surgery that is performed in obese patients who have type II diabetes.

Diabetes Surgery can be considered in:

  • Patients with Type 2 diabetes who have consistently failed to lose weight beyond a point using conventional weight loss methods (dietary restriction, increased exercise and physical activity, and medication)
  • Patients with BMI (body mass index = Weight/ height2) over 32.5kg/m2 with Type 2 diabetes

In the recent years, studies have shown that obesity surgery can improve or even cure diabetes. It was seen that obese patients with type 2 diabetes who underwent surgery for weight loss had a marked improvement in diabetes after surgery. Studies have now shown that substantial and long-term weight loss after Diabetes surgery causes resolution of diabetes and increases the lifespan. Diabetes can be resolved completely or can become less dramatic. Around one-third of the patients who undergo surgery have resolution of Diabetes Mellitus immediately after the surgery. They may not for diabetes. In another one-third of the patients the diabetes usually resolves within three months. They may not require anti diabetic medicines after a few months. Last one-third of diabetics after surgery may continue to be diabetic but their blood sugar levels and dosage of anti diabetic medicines falls drastically. The lifespan of these patients is also increased. The chances of resolution of diabetes are high in patients who have had diabetes for less than 10 years.

Diabetes surgery (metabolic surgery) is being performed in India for nearly a decade. The surgery involves re-alignment of the stomach and intestines in such a manner that the size of the stomach reduces, thereby causing less hunger and earlier satiety. The Roux-en-Y Gastric bypass/ Mini Gastric bypass and Sleeve gastrectomy are two popular bariatric procedure categories. These procedures are being performed laparoscopically (key-hole surgery) and the patients can have the benefits of faster recovery, small scar, less pain and early return to routine activities.

Laparoscopic Sleeve Gastrectomy (LSG)

How is sleeve Gastrectomy procedure carried out?

Most sleeve gastrectomies performed today are done through Laparoscope. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera (laparoscope) and long instruments that are placed through these small incisions.

Sleeve gastrectomy is a restrictive form of operation in which approximately 2/3rd of the left side of the stomach is removed laparoscopically using endoscopic staplers. The stomach thus takes the shape of a hockey stick or sleeve. No intestines are removed or bypassed during the sleeve gastrectomy

How do Sleeve gastrectomy causes weight loss?

It greatly reduces the size of the stomach and limits the amount of food that can be eaten at one time. After this surgery, patients feel full after eating very small amounts of food. Sleeve gastrectomy may also cause a decrease in appetite. In addition to reducing the size of the stomach, the procedure reduces the amount of the “hunger hormone,” ghrelin, produced by the stomach.

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Laparoscopic Mini Gastric Bypass Treatment Service
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General Information
LMGB is minimally invasive weight loss surgical procedure Mini gastric bypass surgery (MGB) is a laparoscopic weight loss surgery similar to the traditional RNY bypass but only has one connection (single anastomosis) to the small intestine and pouch is larger. Laparoscopic Mini Gastric Bypass (LMGB) is considered to be equally effective procedure of choice compared to Laparoscopic Rouxen- Y Gastric Bypass (LRYGB)

Three Important Ways the Mini Gastric Bypass Surgery Helps Your Body Shed Pounds

Restrictive:

A small stomach pouch is created restricting the amount of food you can eat.

Malabsorptive:

A portion of the small intestine is bypassed. Since the small intestine is responsible for absorbing the calories from the food you eat, bypassing a portion of the small intestine results in fewer calories being absorbed, thus creating additional weight loss.

Hormonal:

The hormone ghrelin has been nicknamed the “Hunger Hormone” by researchers because of its significant effect on appetite. Gastric Bypass results in a fall in ghrelin levels resulting in a reduced appetite.

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Laparoscopic Roux-En-Y Gastric Bypass Treatment Service
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General Information

RYGB works by restricting food intake and by decreasing the absorption of food. Food intake is limited by a small pouch that is similar in size to the adjustable gastric band.

How is Roux-en-Y gastric bypass carried out?
The operation, usually performed laparoscopically, involves making five to six small incisions in the abdomen through which a small scope connected to a video camera and surgical tools are inserted. The surgeon staples the top portion of the stomach so it is separated from the bottom to create a small stomach pouch. This small pouch restricts food intake. A section of the small intestine called the jejunum is then attached to the small stomach pouch permitting food to bypass the lower stomach, the duodenum. This bypass reduces the amount of calories and nutrients the body absorbs, called malabsorption

 


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