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Laparoscopic, Robotic and LASER Surgery - GI & Colorectal, Navi Mumbai


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    All Posts Tagged: Key-hole surgery

    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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    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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    Open and Laparoscopic Surgery

    Comparison between Open and Laparoscopic Surgery, what’s the best?

    You may be wondering why your surgeon suggested two options to choose from, in order to perform the surgery which is due on next month. Open or laparoscopic? It is not a hard question at all, if there are no other special indications to go for an open surgery.

    But, we shall let you decide by your own by providing a complete comparison between these two methods available, with all the pros and cons associated with.

    What is an open-surgery?

    This is a surgical procedure, performed by making a large (8cm-10cm) incision into the abdomen in order to expose the area inside, on which the intervention is to be done. Resulting in a comparatively more post-operative pain due to the large incision and this kind of surgeries often need a longer hospital stay (5-7 days) until a satisfactory wound healing and recovery takes place. In some cases, you will have to rest for up to six weeks before returning to routine activities and occupation due to several possible negative outcomes like infections and breaking of sutures.

    Open surgery also has a higher risk of adhesion formation, wound infections and incisional hernias due to its wide exposure of tissues to external environment. However, this types of surgeries are still carried out in some cancer operations and huge pelvic masses.

    What is a Laparoscopic surgery?

    Also known as ‘keyhole surgery’, Laparoscopic surgery is usually performed by making a ½-1 cm incision where a flexible tube attached to a camera and light source is inserted into the abdomen. The surgeon will see the whole inside-scenario on a monitor, where handling of instruments inside will be done by a visual guided procedure which requires a highly specialized training.

    These type of surgeries do not require large incisions which is safe and effective compared to that of open surgery.

    What is the need of having two options as open approach and laparoscopic approach?

    The laparoscopic technique, introduced in early 1990s based on the successful outcomes of a laparoscopic gallbladder removal, many research studies were carried out to find out, further benefits of this un-opened approach.

    As a result of that, beneficial factors like-

    • Minimal pain
    • Early return to normal day today activities and work
    • Minimally visible scarring
    • Lesser risk of wound infections, adhesion formation and incisional hernias

    over open-approach were identified, which eventually made laparoscopic surgeries to become highly popular among health care professionals as well as the general population all over the world.

    However, it is important to know that, there can be instances where planned Laparoscopic surgeries will have to be performed as open ones, being quickly decided on the operating table due to various unexpected findings, complications and difficulties.

    Also, some surgeons prefer to perform open surgeries over laparoscopic interventions due to various reasons including inexperience, assessing the risk of possible bowel obstruction and traditional like preference for proper visibility and handling rather than doing procedures over a monitor.

    Considering all these factors, it is highly convincing that laparoscopic surgeries have several beneficiaries over the open-surgery which is why it is widely used.

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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 Max hospital, he just 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. Apollo staff was also very caring and good. I would mention Apollo Hospital, Navi Mumbai 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.

    • 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.

    • Kishore-Kumar-Das

      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.

    • Siddappa-Hasbi

      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