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Other Laparoscopic Procedures


1. What is gall bladder?

Gall bladder is a small hollow pear shaped organ located inside the abdomen under the liver which is responsible for storage of bile.


2. Why do stones form inside the gall bladder?

Bile has high concentration of cholesterol and bile pigments. Most stones form inside gall bladder when the concentration of cholesterol increases. This usually occurs in females, during pregnancy, prolonged fasting, high fat diet and taking birth control pills. They can also form when infections affect the gallbladder like typhoid fever. Sometimes stones can form idiopathically (i.e without any known causes)


3. What are the symptoms of gall bladder stones?

Patients can be asymptomatic or have severe symptoms. Usually, they have complaints of heaviness after meals, nausea, gas bloat and pain in the upper abdomen. Sometimes, the pain can be very severe and is located in right upper abdomen and goes to the back or shoulder. There can associated vomiting and fever. In complicated cases, the stone can slip and block the common bile duct which will result in jaundice.


4. What is the treatment for gall stones?

The internationally accepted treatment for gall bladder stones is by surgical removal of the gallbladder together with the stones. The current recommendation is to do this operation laparoscopically.


5. Is it not possible to remove the stones through medicines?

Till date, there is no drug which is effective in dissolving or removing the stones. Moreover, if a drug does result in expulsion of the stone, there is a risk of causing blockage of the CBD resulting in jaundice.


6. Is it not possible to remove only the stones leaving the gall bladder behind?

Since the stones form in a gallbladder which is diseased, it is necessary to remove the entire gallbladder; otherwise stones would definitely form inside again.


7. Is there any problem of digestion of food if the gallbladder is removed?

Since the gallbladder is only responsible for storage of bile, the production of bile from the liver is unaffected by this operation. Hence, the digestion of food remains normal even after surgery.


8. How long does the surgery take and what is duration of hospital stay?

The surgery taken around 30 -45 minutes to perform and the duration of hospital stay is normally two days.


9. What kind of diet is advised after surgery?

The patient is started on liquids 4-6 hours after the operation. They can take soft diet the next day and can have their full diet 2-3 days after the surgery. They are told to avoid fatty/fried food for at least 2 weeks after the operation.

1. What is appendix?

Appendix is a long, narrow, tubular organ located in the lower abdomen on the right side just near the junction of small and large intestines.


2. What is appendicitis?

Appendicitis is inflammation of the appendix which is usually caused when its opening in the intestine is blocked by fecal matter or parasites.


3. What are the symptoms of appendicitis?

Initially, there is pain the central abdomen associated with nausea, vomiting and loss of appetite. Later on, the pain migrates to the right lower abdomen. There may be fever, diarrhea, urinary complaints, etc. in some cases.


4. How is it diagnosed?

The diagnosis of a case of acute appendicitis is essentially made by a doctor based on his/her clinical experience. The tests which help to support the diagnosis are blood counts and USG abdomen. In some cases, a CT scan may be required but none of the investigations are 100% sensitive/specific.


5. What is the treatment of appendicitis?

The treatment of a suspected case of acute appendicitis is emergency appendectomy i.e. surgical removal of the appendix. It may be done by open or laparoscopic surgery.


6. What are the advantages of laparoscopic appendectomy?

The advantages of laparoscopic appendectomy are smaller incision, less pain, lesser blood loss and shorter hospital stay. The other benefit is that the entire abdominal cavity can be visualized and any other co-existing disease can also be treated at the same time.


7. How much time does operation take and what is the length of stay?

The operation takes around 30-45 minutes to perform and the length of stay for an uncomplicated case is around 2 days.


8. What kind of diet is advised after surgery?

The patient is usually kept nil per oral for 12-24 hours after the surgery. They can take liquid diet the next day and can have soft diet subsequently.

1. What is hernia

Hernia is basically protrusion of fat or intra-abdominal organs through a weakness or defect in the layers of the abdominal wall.


2. What are the different types of hernia?

In males, it is commonly found in the groin region and known as inguinal hernia while in females, it is seen in the abdominal area known as ventral hernia. Sometimes, hernia occurs after prior surgery which is called as incisional hernia.


3. What are the symptoms of hernia?

Hernia is usually associated with swelling in the region of the weakness which increases during exertion and often disappears on lying down. There can be mild dragging pain related to the swelling. Sometimes, there is severe pain and the swelling becomes tense and tender. This is an emergency known as obstruction/strangulation of the hernia and requires immediate operation.


4. What is the treatment of hernia?

The treatment of all hernias is surgical repair which can be open or laparoscopic. Nowadays, laparoscopic repair is preferred in which a large mesh is placed within the abdomen which seals the defect and prevents the hernia from forming again.


5. When should the patient get operated if hernia develops?

The current recommendation is to get operated as soon as possible to avoid the chances of complications.


6. How much time does operation take and what is the length of stay?

The duration of operation depends upon the type of hernia. Usually takes around 60 -90 minutes to perform and the length of stay for an uncomplicated case is around 2 days.


7. What kind of diet is advised after surgery?

The patient is started on liquids 4-6 hours after the operation. They can take soft diet the next day and can have their full diet 2-3 days after the surgery.

1. What is GERD?

GERD stands for gastro esophageal reflux disease. It is caused as result of reflux of acid produced in the stomach into the food pipe through a defective valve.


2. What are the symptoms?

The patient complaints of bloating, heartburn, sour taste in mouth, nausea and cough. Sometimes, liquid or even solid food can come to the mouth because of reflux. The symptoms occur after heavy meals or spicy/oily food. They can occur at night when patient is sleeping.


3. How is it diagnosed?

The diagnosis is suspected by the clinical history and confirmed by doing an upper GI endoscopy. This would show the presence of a lax sphincter at the GE junction with or without hiatal hernia.


4. What is the treatment of GERD?

Initially, patients are started on medical treatment with drugs which lower acid production and decrease reflux. They are also advised to modify their lifestyle and eating behavior to minimize symptoms.


5. Who are the patients who require surgery?

Patients who have severe, chronic reflux symptoms, lifestyle impairment, not responding to medical treatment or complications like ulcers or difficulty in swallowing food may require surgery.


6. What is the surgery for GERD and how is it performed?

The operation for GERD is fundoplication. It is almost always performed laparoscopically. It consists of wrapping the upper portion of stomach around the lower esophagus to create a new valve which prevents reflux.


7. How long does the surgery take and what is the length of stay?

The operation takes around 90-120 minutes to perform and the length of stay is around 3-4 days.


8. What kind of diet is advised after surgery?

The patient is kept nil per oral for 24 hours after the operation. Initially, clear liquids are started and they can take soft diet subsequently which is continued for 2 weeks following the surger

1. What is diagnostic laparoscopy?

Diagnostic laparoscopy is basically a test to find out the cause for complaints related to the abdomen for which other tests have failed to conclude anything.


2. What are the indications for this test?

It is indicated in patients with suspected appendicitis, chronic lower abdominal pain, adhesive colic, peritonitis, blunt/penetrating abdominal trauma with suspected injury and as staging for abdominal cancers.


3. How is this test performed?

It is performed as any other laparoscopic surgery with the patient in OT under general anesthesia.


4. How long does it take and what is the hospital stay?

It usually takes less than 30 minutes to perform and the patient may be discharged the same day.

1. What are the gynecological surgeries performed using laparoscopy?

Diagnostic laparoscopy is basically a test to find out the cause for complaints related to the abdomen for which other tests have failed to conclude anything.

2. What is the advantage of laparoscopy over open surgery?

The laparoscopic surgery is performed by small incisions. As a result, there is less pain, lesser blood loss and faster recovery which leads to a shorter hospital stay. Also, modern technology for imaging makes visualization better which improves dissection and the energy sources make the surgery bloodless.

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