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Laparoscopic, G.I. & colorectal surgery, Navi Mumbai, India


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Incontinence treatment and symptoms

Incontinence treatment and symptoms

What is incontinence?

Do you have a frequent or sudden need to urinate or you can’t control your bladder? You may have this common condition known as urinary incontinence which is more commoner among the female gender.

Types of urinary incontinence:

Stress incontinence is when urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.

Urge incontinence is if you have a sudden, intense urge to urinate followed by an involuntary loss of urine, you may need to urinate often. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as neurologic disorder or diabetes. Urge incontinence is also called overactive bladder, spastic bladder or reflex incontinence.

Overflow incontinence is when you experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.

Functional incontinence is where a physical or mental impairment keeps you from making it to the toilet in time.

Symptoms of incontinence are — feeling a sudden need to urinate or feeling a frequent need to urinate (more than 7 times a day or 2 times a night), weak bladder control and leaking. Some people experience occasional, minor leaks of urine. Others wet their clothes frequently.

What are the main causes for incontinence?

Diseases like diabetes, Parkinson’s and multiple sclerosis (MS) can damage the nerves that control your bladder.

Vaginal childbirth, recurrent urinary tract diseases, strokes, surgeries and treatments for pelvic cancers can also cause urinary incontinence.

What are the treatment options available for this condition?

Treatment depends on what kind of incontinence you have and how bad your symptoms are. There are four main treatment approaches for incontinence which include bladder and pelvic floor muscle training, lifestyle changes, medications, surgery and bladder retraining.

For Urge incontinence– Practices like double voiding (urinating and wait for another few minutes and doing again), toilet trips which involves 2-3 hourly scheduled toileting rather than waiting

until an urge arises and proper fluid and dietary management play a major role in reaching a symptomatic improvement.

Behavioral modification therapy is the therapy where an urologist might suggest techniques like limiting the amount of fluid you drink, eliminating caffeine because it irritates your bladder or bladder training, which will teach you to hold your urine longer and doing exercises to strengthen your pelvic floor.

Both Stress incontinence and Urge incontinence can be treated effectively with Electrical stimulation which enhances the tone and strength of pelvic floor muscles.

Furthermore, medications like Anticholinergics, Mirabegron (Myrbetriq), Alpha blockers and topical estrogens can also be used to address symptoms in all the three types.

Is there any place for surgical treatments?

In patients who do not respond to any of the conservative or pharmacological management, can be treated with surgical interventions like Sling procedures, bladder neck suspension, prolapse surgery and artificial urinary sphincter fixation, depending on the etiology

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Life style modifications for GERD

Life style modifications for GERD

Do you also get a burning chest pain following meals which hugely interrupts your day today life? The presence of an incompetent valve between esophagus and stomach can cause a leakage of food and acid from the stomach back into the oral cavity by a reflux mechanism causing heart burn.

Gastroenterologists in Mumbai encourage GERD Patients to practice life style modifications to prevent from mild GERD episodes.

Diet modification for GERD

Be extra cautious on what you are eating
Always try to find the ingredients, containing in a meal before you consume them, to make sure that they don’t have too much spices like chilies, pepper, oils, fats, tomatoes, garlic, peppermint, onions, citrus, chocolate etc. which possibly have an exacerbating impact on the acid reflux.
Some beverages can also agitate your symptoms, so it is good to keep an eye on what you are consuming. Few of the commonest acid-reflux triggers include coffee, tea and carbonated soft drinks.
It is recommended to cut down sugars, fatty food and oils and consume a balanced diet rich in vitamins and proteins.
Have small meals in a frequent basis
According to latest research studies, it has been found out that the best method of staying healthy in every aspect is to consume tiny quantities of main meals as well as snacks in a frequent manner.
Large meals take a long time to get emptied from our stomach and therefore apply an extra pressure on the valve between the stomach and esophagus. Persistent pressure on this valve, can later become weakened and incompetent, resulting in GERD.

Lifestyle modification for GERD

Stop smoking and alcohol which are major risk factors for GERD.
Do not wear excessively tight clothes since they could squeeze the stomach contents, favoring the back flow of acids through the incompetent valve.
Do not stay reclined at least for 3 Hours after Eating
Lying flat on a bed results in an elimination of the gravity. This will place the stomach contents here and there, making it quite easier for the incompetent valve to act ineffectively, with a subsequent back flow of acids into the esophagus and throat- Heart burn
When sleeping- Make sure to use pillows and raise the head end of your bed around six to eight Inches. Because when there is a slight inclination, gravity can act on the down-ward food flowing pathway, helping the stomach to reduce nighttime reflux attacks.
Monitor weight- Over weight and obesity are two major risk factors for GERD due to their potential impact on the distortion of esophageal valve anatomy thus resulting in an acid-reflux.
Since GERD is a chronic condition, these simple life style alterations can ease the symptoms effectively but it is important to practice these with proper medical advice, based on the severity of the condition.

Gastroenterologists in Navi Mumbai are experts in healing GERD patients, thanks to their years of experience in the field.

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Dietary Precautions-Anal Fistula

Dietary Precautions For Anal Fistula

What you eat is what you are, especially when it comes to taking care of your internal organs like, stomach, liver, intestines, rectum, etc. your diet reflects their health. Conditions like anal fistula can be prevented with a healthy diet and lifestyle.

What is an Anal fistula?

Anal fistula is defined as an abnormal communication between the epithelial surface of the anal canal and the perianal skin. Anal fistula usually initiates with a tissue damage.

Patients with this condition usually are present with,

  • A constant pain in the area, throbbing in nature which gets worsen on sitting down.
  • A chronic irritation of the skin associated with swelling, redness and tenderness around the anus.
  • A smelly discharge of pus with or without blood
  • Constipation
  • Pain on bowel movement
  • Mild to moderate fever

In acute stage, a fistula can be extremely painful and may bleed frequently but if ignored for a long time for more than 7-8 months, it gets partially healed up and a skin growth known as sentinel tag or sentinel pile surrounds it.

What are the causative factors for Fistula?

In most of the individuals, anal fistulae usually develop following an anal abscess. Untreated abscesses in the anal area or ones which have not healed completely can give rise to fistula.

In fact, research studies have put forward a fact that one in every two-four people with an anal abscess have the chance of developing an anal fistula, later in life.

There is also a significant male predominance between the ages 20-40 years.

Other less common causes for anal fistula include,

  • Crohn’s disease
  • Diverticulitis
  • Hidradenitis Suppurativa
  • Tuberculosis

How anal fistula can be prevented through diet?

Diet plays a major role in improving this condition. Furthermore, since constipation is one of the major reasons for the exacerbation of anal fistula, it is highly important to control it as much as possible using dietary remedies.

  1. Take adequate dietary fibers such as bran, beans, passion fruit, berries, green leaves, mushrooms, banana, cabbage etc.
  2. Eat more vegetables, fruits and salad.
  3. Avoid gluten-free junk food, French fries, potato chips, processed meat and refined grains.
  4. Drink plenty of water and fluids but avoid much coffee and tea.
  5. Avoid straining during defecation (especially while constipation)
  6. Avoid excessive oils, chilies and spices in food items.
  7. Avoid much of non-veg. food. Try to be vegetarian.
  8. Use of buttermilk (Lassie without butter) with a pinch of cumin powder and black salt keeps the digestion correct

How do you manage anal fistula?

Prevention is the best treatment. Maintaining a good nutritional habit is a great way to maintain health issues and ward off fistulas. In addition, abstaining from smoking is important to promote fistula healing.

Are there any specific dietary measures to be taken?

Apart from the general precautions mentioned above, it is recommended to refrain from alcohol and smoking since they are known to play a major role in exacerbating the signs and symptoms of anal fistulae

In addition, you can take dietary advice from a dietician or the specialist to choose the best schedule of meals, depending on the individual requirements and severity of the condition.

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Precautions after a laparoscopic gallbladder surgery

Precautions After a Laparoscopic Gallbladder Surgery

Laparoscopic gallbladder surgery (cholecystectomy) removes the gallbladder and gallstones through several small cuts (incisions) in the abdomen. The surgeon inflates patient’s abdomen with air or carbon dioxide in order to see clearly.

Sometimes patients are nauseated after waking from the anesthesia. This sensation usually passes. If it does not, medication can be given to relieve it.
Postoperative pain can usually be controlled with over-the-counter pain relievers. Some patients may need a stronger, prescription analgesic.

The incisions are covered by small adhesive bandages that can be removed in about 5 days and the stitches dissolve over time. The area must be kept dry until the wound begins to heal and sponge baths are recommended for the first day or two.

Recovery from the laparoscopic procedure is quicker than from the open procedure. As the anesthesia wears off, and once vital signs stabilize, the nurse offers the patient ice chips. If ice is tolerated, water and other clear liquids are offered. Once liquids are tolerated, patients can eat a light meal and the IV is removed.

How is it different from an open surgery?

Recovery from open surgery is not as rapid. Patients experience pain at the incision site and a narcotic pain reliever is usually required for the first day or two. The patient may not be able to eat until the morning after surgery. The intravenous is left in until food and fluids are taken and tolerated.
Patients are usually able to get out of bed by the next morning. It is important to get up and walk as soon as possible to help blood circulation return to normal and to avoid complications such as blood clots. The hospital stay generally lasts 3 to 7 days and it usually takes about 3 weeks to fully recover. This procedure leaves a large abdominal scar, which may fade over time…

Diet instructions you need to know after the surgery

When you consider about your diet after the gallbladder surgery. No need to follow a special diet after having the surgery, as the gallbladder isn’t essential for digestion. You can usually start eating normally a few hours after your operation, although you’ll probably prefer to eat small meals to start with.

You may have been advised to follow a low-fat diet for several weeks before surgery, but this doesn’t need to be continued afterward. Instead, you should aim to have a generally healthy, balanced diet (including some fats).

Conclusion

Even Though cholecystectomies are safe, but complications can develop. The main disadvantage of laparoscopic surgery has increased the risk of injury to the bile duct, which connects the gallbladder and the liver. This rarest complication can cause serious liver damage.
If you experience side effects from the surgery – including indigestion, bloating, flatulence or diarrhea – it may help to make some small adjustments to your diet such as

  • Avoid drinks containing caffeine – such as coffee and tea,
  • Avoid foods that make the problems worse – such as spicy or fatty foods,
  • Gradually increase your intake of fibre – good sources of fibre include fresh fruits and vegetables, wholegrain rice, whole-wheat pasta and bread, seeds, nuts, and oats.
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how are gallstones treated

How are gallstones treated?

Laparoscopic gallbladder surgery is the best choice of treatment for gallstones with severe signs and symptoms, disrupting one’s life style. It is time-saving and minimally invasive.

What are gall stones?

Gallstones are some stone like hard depositions in the gallbladder made out of Cholesterol, salt and Bilirubin (made out of destructed blood cells). Being a very common condition, gallstones vary a lot in size whereas some can be as small as a particle of sand where others can be as large as apples.

Obesity, high consumption of cholesterol rich food, a rapid weight loss within a short period of time, Diabetes mellitus and long term intake of a high-fiber diet are the major risk factors for this condition to occur. Moreover, owing to a significant female predominance, Gallstones are most likely to affect people over 65 years of age, pregnant mothers and individuals with a positive family history.

Treatment options

Gallstones are usually treated depending on the severity and how they could disrupt the quality of life.

Patients without symptoms yet diagnosed with gallstones, coincidentally in ultra-sound scans, the concept of ‘active monitoring’ is recommended. This method doesn’t involve any immediate treatment, but prompt medical advice should be sought as soon as you notice unusual presentations like yellowish discoloration of the skin or mucosal membranes (obstruction by gallstones)

As a rule of thumb, the more you go without getting any sign or symptom, related to gallstones, the less likely it is to get the condition worsened. But there are occasions where you may need to get medical treatment even if you don’t get any presentation mentioned above, which include underlying Diabetes, portal hypertension or scarring of the liver-Cirrhosis

Treatment is also indicated if a scan reveals a high level of calcium inside the gallbladder which can lead to gallbladder cancer in future or if there are frequent episodes of abdominal pain. If they are mild and infrequent, conservative management is alright with painkillers to relieve discomfort and healthy diet which might help in reducing further episodes.

Some doctors prescribe medications to dissolve gallstones which are small in size and do not contain cholesterol e.g. Ursodeoxycholic acid

Surgical interventions are considered if the signs and symptoms of the gallstones become severe such and disrupt a person’s quality of life to avoid complications due to stones.

The main surgical treatments available for Gallbladder removal

  • Gall bladder laparoscopic surgery – A keyhole surgery performed under general anesthesia, which will only take 60-90 minutes.
  • Patients will be fully recovered after about 10 days.
  • Single-incision keyhole surgery – Latest type of keyhole surgery where the gallbladder will be removed by making only one hole on the abdomen.
  • Open surgery – A cut-open type surgery indicated in pregnant mothers in their third trimester, extremely overweight and unusual anatomical structure of gallbladder or surrounding structures which might make the surgery difficult.
  • Endoscopic retrograde cholangio-pancreatography (ERCP) – Removes only the stones from the gallbladder without removing the entire organ.

Because of all these latest and advanced laparoscopic surgical options available nowadays, you won’t have to suffer from gallstones anymore.

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Nissen Fundoplication Surgery

Precautions after a Nissen (laparoscopic) Fundoplication Surgery for GERD

Laparoscopic Nissen fundoplication is a surgical approach to treating gastroesophageal reflux disease (GERD). This surgery aims to strengthen the weakened area of the esophagus that causes stomach acid to flow up instead of down. Nissen fundoplication surgery is designed to fix the weak area of the esophagus. The surgery is performed laparoscopically.

Few complications after a fundoplication surgery are difficulty in swallowing, esophagus sliding out of the wrapped portion of the stomach, Bloating and discomfort from gas buildup, excess gas, risks of anesthesia, risks of major surgery (infection or bleeding).

If an open surgery is done, you have to spend several days in the hospital and you may need 4 to 6 weeks to get back to your normal routine. If the laparoscopic surgery method is used, you have to stay in the hospital for only 2 to 3 days and most people can go back to their normal routine in about 2 to 3 weeks.

After your surgery, you have to follow a special diet to help prevent diarrhea, gas, and problems swallowing. You can drink clear liquids for your first few meals. Then follow a full liquid diet and then a Nissen soft diet. Eat small, frequent meals (six to eight per day). This will help you consume the majority of the nutrients you need without causing your stomach to feel full or distended. Drinking large amounts of fluids with meals can stretch your stomach.

Eat very slowly. Take small bites and chew your food well which will help in swallowing and digestion. Avoid crusty breads and sticky, gummy foods, such as bananas, fresh doughy breads, rolls and doughnuts. Sit upright while eating and stay upright for 30 minutes after each meal. Do not lie down after eating. Sit upright for 2 hours after your last meal or snack of the day.

The first bowel movement may occur anywhere from one to five days after surgery. As long as you are not nauseated or having abdominal pain, this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum; this is because you will not be able to really belch.

There are no significant restrictions on activity after surgery. You can walk, climb stairs, mow the lawn or exercise, as long as it does not put a strain on you. Returning to normal activity as soon as possible will most likely enhance your recovery. Try to avoid heavy lifting for several weeks.

Important

Contact your surgeon immediately, if a fever arises up to 100.4 or greater, shaking chills, pain that increases over time, redness, warmth, or pus draining from incision sites, persistent nausea or inability to take in liquids.

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Risk-Factors-involved-in-Hernia

Causes and Risk Factors involved in Hernia

Hernia is a protrusion of an internal structure of the body through a weak boundary in the surrounding muscle or tissue wall, usually occurring between chest and hips, giving rise to a small, often painless swelling or lump in the tummy or groin area.

Through this blog post you will find general information about causes of hernia and risk factors for development of hernia, for any doubt please visit General and laparoscopic surgeons who are hernia treatment specialist also.

Causes of Hernia:

A failed embryonic closure in male fetuses can result in the formation of an indirect inguinal hernia later in life. Prematurity is another identified cause for hernia formation due to the developmental issues of muscles and tissues of infants.

The commonest cause for hernia has identified to be a raised pressure inside the body together with a pre-existing weak area in the tissue or muscle wall, creating a potential site for a bulging out to take place.

Increased abdominal pressure can be a result of various external factors. Long-term activities like frequent heavy weight lifting associated with certain jobs, strenuous exercises and long hours of standing are among the commonest.

Weakened abdominal walls or tissues as a result of injuries to abdominal wall, sports, sudden movements and dislocations of discs can also give rise to hernia formation in certain individuals.

Other commonest risk factors associated with the development of hernias are as follows.

  • Age – Commoner in adults, since advanced age can weaken connective tissues.
  • Gender – Inguinal hernias are commoner in men, femoral hernias are commoner in women whereas umbilical hernias are commoner in women.
  • Genetics – Individuals with a positive family history are more susceptible.
  • Obesity – Over weight individuals, naturally present with an increased intra-abdominal pressure which will eventually push out the increased amount of fatty tissue content and organs through a weakened spot
  • Ascites – Excessive formation of fluid inside the peritoneal cavity, occurring due to various medical conditions like chronic liver failure and tend to increase the intra-abdominal pressure, thus resulting in protrusion
  • Cystic Fibrosis – Being a genetic condition associated with abnormalities in tissue formation and chronic cough can result in a combination of both fundamental factors, required for a bulging out to take place
  • Chronic constipation – Long-term straining due to the difficulty in passing out dry faeces, can obviously cause a raised intra-abdominal pressure, where most of the affected individuals tend to develop hernias later in life
  • Pregnancy – Increased pressure inside the abdomen due to a developing fetus, can also act as a cause for Hernia formation, in certain individuals.
  • Surgery – Those who have undergone a previous abdominal surgery, have an increased potential to develop hernias due to a weakened abdominal wall

The most important point to keep in mind is that, those who are known to have a single or multiple risk factors, should seek medical advice from a hernia specialist to prevent from possible hernia development or other complications associated.

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Anal-Fistula-treatment-Tools

VAAFT: Best Anal Fistula Treatment

Video Assisted Anal Fistula Treatment, also known as VAAFT is so far the newest and most advanced surgical intervention introduced for Fistula-in-ano. This procedure is usually done under general anesthesia, where a tiny telescope is entered through the external opening of the site of the skin where the fistula-in-ano is located. The HD-camera of latest technology attached to the other end, thereby visualizes the inner aspect of the fistula pathway on a HD- monitor and the surgeon will remove the complete length of the fistula with the help of precise visualization up to its inner opening, located on the wall of the anal canal.

More importantly, this method can also detect abnormal branching patterns of the fistula tracts and carry on the necessary therapeutic techniques at the same time. After the complete removal of the fistula, the internal opening is closed with the help of either sutures or staplers, preventing the leakage of stools back in to the fistula tract and the entire canal is sealed off using a mild electric cautery. Some surgeons may also use fibrin or cynao-acrylate glue in order to obliterate the fistula pathway.

At the end gentle flushing of the wound with normal saline is done followed by a routine dressing at the site of fistula removal.

This method is highly encouraged, in order to clean dead tissue left inside the fistula tunnel so that it will result in a proper and quick healing.

What are the advantages of VAAFT:

  • In this procedure, an incision is not made on the skin around the anus and therefore there is no visible scars unlike in other major surgeries.
  • Being a camera guided and very precise procedure, no damage is caused to the muscles around the anus which are responsible in controlling bowel movements. As a result, possible adverse effects like bowel incontinence and leakage are highly unlikely when compared to other open surgeries done.
  • Due to the minimal invasive nature of VAAFT and the lack of excisions, wounds or scar formation, the pain caused after the wearing off of anesthesia is very mild or negligible.
  • Complete removal of the fistula is guaranteed since the whole procedure is being done under direct visualization of the canal. As a result of that, the incidence of recurrence is very rare.
  • Since VAAFT is known to be a day surgery, patient will be discharged on the same day of the surgery after wearing off of anesthesia.
  • Complete and quick healing of the wound will take place within a few days compared to that of a normal open surgery so patient can get back to his day to day life relatively in a short period of time.
  • According to several research studies carried out, the technique of VAAFT has been accepted world-wide as a very efficient intervention made on fistula-in-ano, with a 100% success rate.
  • More importantly, the cost of VAAFT is comparatively lower than what is expected for normal open surgery, so in patient’s point of view it is a huge benefit.

Dr Nitish Jhawar, head of colorectal department at Fortis Hiranandani Hospital Vashi , Navi Mumbai has been trained for VAAFT procedure at Germany by the inventor Dr P.Meinero and he offers this procedure along with other latest treatments for Fistula in Ano.

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Esophageal manometry

Esophageal Manometry : Diagnosing Disorders Affecting your Esophagus (Food pipe)

Esophageal Manometry is a procedure which is used to identify various pathological conditions associated with the esophagus (food pipe) and lower esophageal sphincter (LES), the valve like ring of muscle, located between the esophagus and stomach. This valve is responsible in controlling the movements taking place when food bolus is passed through the esophagus to the stomach and improper functioning of it can result in condition like acid reflux or gastro esophageal reflux disease (GERD).

Patients who present with symptoms such as acid regurgitation, heart burn, chest pain (which mimic heart attack), difficulty or pain in swallowing, nausea and vomiting can be advised to go for esophageal manometry. It is also done Prior to anti reflux surgery.

Before esophageal manometry eight hour or over-night fasting is advised by the Gastroenterologist. In addition to that, a complete history including current medications and past surgical history will be taken from the patient where certain drugs like calcium channel blockers, nitrates, nitroglycerin and sedatives might have to be withdrawn for a certain duration.

Patient will be lied down on bed, and an application to numb the nasal canal (anesthetized) is applied which will help in reducing the discomfort throughout the procedure.

Thereafter, a very thin and flexible tube is inserted into the nose which will pass down the esophagus until it reaches the stomach and when it is pulled back gradually, the patient is asked to swallow at different points so that the individual pressures and tone of the esophageal muscles and lower esophageal sphincter is measured by sensors attached to the tube. This test is also used to measure the pH value of the esophageal contents with the help of the pH probe attached to the same tube.

This whole procedure takes approx 30 to 45 minutes.

It is normal that some patients may gag or feel uncomfortable when the tube is inserted initially and get a stuffy nose during the procedure. However, breathing is not interfered by the procedure.

Major complications of esophageal manometry include perforation, where a trauma to the esophagus might have caused a hole on it resulting in leakage and aspiration where an inhalation of saliva or some other contents in the stomach takes place which can give rise to pneumonia and lung injuries.

The results obtained by esophageal manometry will help to diagnose problems such as abnormal contractions of esophageal muscles, Achalasia cardia (improper opening of LES), Hiatus Hernia and GERD (weak LES), spasmodic movements of the esophagus and Scleroderma (an autoimmune condition which will paralyze muscles of esophagus).

Methods of treatment will be planned based on the type and severity of the conditions diagnosed by esophageal manometry.

Esophageal Manometry is useful test to diagnose food pipe movement and pressure disorders and is available at colorectal department of Fortis Hiranandani hospital Vashi , Navi Mumbai, headed by Dr Nitish Jhawar.

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Most Common Laparoscopic Procedures

Most common Laparoscopy Procedures

What is meant by a laparoscopy?

Also known as Key-hole surgery, laparoscopy is a mode of surgical intervention on patients who have been diagnosed with different conditions in the abdomen or pelvis. This procedure allows the surgeon to visualize the inner aspect of the abdomen and pelvis using laparoscope without creating a large incision on the skin for its diagnostic access.

More importantly, laparoscopy is used to carry out various additional surgeries and procedures other than simple visualization, where the surgeon could connect numerous instruments to the laparoscope and excise or trim tissues, take out tissue samples known as biopsies, grasp organs whenever necessary. Being a minimally invasive surgery, laparoscopy has been accepted world-wide as a very effective surgical intervention preferred by health professionals as well as patients over extensive open surgeries.

Laparoscopy is vastly used in the aspects of gynecology and obstetrics, gastroenterology and urology which mainly deals with pathological conditions related to organs lying inside the body.

Most common surgeries carried out using this latest technology include, gall bladder removal (laparoscopic cholecystectomy), Removal of the appendix (appendicectomy), Hernia Repair, Fundoplication, removal of the ectopic endometrial tissues (in Endometriosis), removal of various part of the bowel, female sterilization, surgical intervention for ectopic pregnancy, biopsy samples in suspected cases of malignancy etc.

Most of the Laparoscopic surgeries are carried out under general anesthesia so that the patient will be unconsciousness and pain free throughout the surgery. The surgeon will then make one (single-incision or single port laparoscopy) or few tiny incisions on the abdomen using a special needle.

Through a small flexible tube Co2 gas is pumped inside. This gas is very much useful to push bowel away from the operative site, in order to make a clear visualization. Laparoscope is inserted inside abdomen through tiny hole.

Once the procedure is over, the gas is pumped out, the incision is sutured and a dressing is put on.Some patients will be discharged on the same day after wearing off of anesthesia while others will be kept for monitoring for 24 hours depending on the post-operative condition of the patient and type of surgery.

Complications of laparoscopic surgeries are quite rare but there can be mild bleeding or bruising at the site of excision, accidental trauma to the organs inside the abdomen resulting in perforation (generalized sepsis) which might need emergency laparotomy or open abdomen surgery, general complications of anesthesia and wound infections which might need antibiotics. The incidence of these complications will vary according to the type of surgery carried out and comorbidities of the patient.

However, despite of all the complications reported, Laparoscopy is still preferred over open surgeries due to its minimal invasive nature, negligible pain post operatively, shorter duration of hospital stay, quick recovery and comparatively small scar.

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Testimonial

What patient says about Dr. Nitish Jhawar

  • Person Image

    I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at M.... hospital, he .... asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Fortis staff was also very caring and good. I would mention fortis Vashi in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

  • I had surgery of my left hydrocele on 27th May 2017 by Dr Nitish Jhawar. An excellent experience of service I got particularly from Dr Jhawar. He is not only a qualified experienced doctor but also a splendid human being. Thanks a lot.

  • It was a Laparoscopic operation for the removal of Gall Bladder (stones). I had developed on and off pain in abdomen before the operation, after the operation feeling good, totally pain free. Thanks and respect for handling my case very well.

  • Person Image

    I met doctor Nitish for piles problem and wanted to undergo LASER procedure only, my operation is successful and I thank doctor for being a good human being and great surgeon.

  • Person Image

    I was suffering from piles since long time. For bleeding heavily I met Dr Nitish Jhawar and after meeting him decided to go for Stapler surgery for piles. I found him a doctor who listens to our problem and explains properly.

  • Person Image

    I got diagnosed about a year back but was avoiding operation for Hernia repair, Dr Nitish Jhawar explained me why surgery should be done and I chose surgery by laparoscopy method. I am happy with the doctor and the hospital.

  • Person Image

    I visited for Gall Bladder removal by Laparoscopy after searching for best laparoscopic surgeon. After meeting dr my fear for surgery was vanished and my surgery went well and recovery was smooth.

  • Person Image

    Honest doctor, expert in his field....can trust his words

  • Person Image

    Very good he describe everything in very pleasant manner about the problem which was very helpful to me to understand my disease.

  • Person Image

    Very nice. Doctor is very patient and gives you correct advice.

  • Person Image

    He is very erudite and smart at getting to the bottleneck of the problem. And before realized he had pinched away d growth bothering me near my anal area.

  • Person Image

    Dr. Jhawar is few of the best doctors in town. Extremely pleasant and comfortable experience