Who Should Undergo The Surgery? 

In order to identify degrees of obesity and evaluate whether bariatric intervention is necessary, the body mass index (BMI), a measurement of height in proportion to weight, is utilized.

You would need to undergo bariatric surgery if,

1. You have a BMI of 40 or above (extreme obesity).
2. You have a major body fat related health issue, such as type 2 diabetes, high blood pressure, or chronic sleep apnea, and your BMI anywhere between 35 and 39.9 (obesity). If your BMI is between 30 and 34 and you have major weight-related health issues, you could be eligible for some forms of weight-loss surgery.

Types Of Bariatric Surgery  

There are basically 4 forms of bariatric surgeries which are as follows…

1.Roux-En-Y Gastric Bypass (roo-en-wy).RYGB

The most popular technique for gastric bypass is this process. Usually, this operation cannot be reversed. It functions by limiting the quantity of food you can eat at one time and lowering nutritional absorption.

Your stomach’s top is separated from the rest of it by an incision made by the surgeon. Only approximately an ounce of food may fit in the resultant pouch, which is roughly the size of a walnut. Your stomach can typically store three quarts of food. The small intestine is then partially sliced and sewn onto the pouch by the surgeon. Food reaches the middle portion of the small intestine without passing through much of your stomach or the initial part of your small intestine.

2.Vertical Gastric Sleeve Surgery (VSG)

With a sleeve gastrectomy, approximately 80% of the stomach is removed, leaving a protracted pouch that resembles a tube. There is less room for food in this smaller stomach. Additionally, it generates less ghrelin, a hormone that controls appetite, which may reduce your urge to eat. This treatment has benefits including considerable weight reduction and no gut rerouting. Additionally, compared to most other surgeries, a sleeve gastrectomy needs a shorter hospital stay.

3.Biliopancreatic Diversion with a Duodenal Switch (BPD-DS) –

In Duodenal switch with biliopancreatic diversion. the first stage of this two-part treatment, a sleeve gastrectomy-like technique is carried out. Bypassing the bulk of the intestine, the second procedure (duodenal switch and biliopancreatic diversion) connects the terminal section of the intestine to the duodenum close to the stomach.

This procedure both restricts how much you may consume and decreases nutritional absorption. Although it is quite successful, there are more risks associated with it, such as starvation and vitamin deficiencies.

4.Adjustable Gastric Banding (AGB)

This is done through a process called Laparoscopy. A flexible band is wrapped around the top of the stomach by the surgeon. This results in a tiny stomach pouch. This implies that you’ll feel satisfied after consuming less food, aiding in weight loss.

Adjusting the band is possible. This is accomplished by changing the amount of fluid in a balloon around the band. This is accomplished through  a port inserted beneath the skin of your belly. Once the surgery is completed, a needle will be inserted into the port by the physician through the patient’s skin. The port is injected with fluid. The liquid enters the balloon through the tube, wraps around the band, and compresses the top of the stomach. At each clinic visit, a little quantity of fluid is often added while your weight reduction will be monitored.

Post Surgery 

After the completion of bariatric surgery, the patient will be kept only on a liquid diet for a few days until the digestive system, stomach and the small intestines can heal. Then moves on to extremely soft, pureed meals, and finally, ordinary foods. How much and what you can eat and drink may be subject to a variety of limitations or restrictions.

In the initial months following weight-loss surgery, patients will have to undergo routine medical examinations to track their health. The patient has to make sure to maintain a healthy lifestyle post surgery for consistency in good health.

Result 

Excessive weight/fat leads to many ailments which are inter related hence post surgery multiple results can be seen as the outcome of weight reduction. The patient is seen to recover from many underlying issues by time. The most common one’s are as follows

• Heart problems
• Abnormal / Elevated blood pressure
• Diabetes type 2
• Obstructive Sleep Apnea (OSA)
• Nonalcoholic steatohepatitis, often known as nonalcoholic fatty liver disease                                         (NAFLD) (NASH)
• Disease of the gastroesophageal reflux (GERD)

Why is Esophagectomy surgery done?

The primary surgical remedy for esophageal cancer is esophagectomy. Either the malignancy is eradicated or the symptoms are alleviated. If aggressive precancerous cells are present, esophagectomy is occasionally used to treat Barrett’s esophagus in addition to being a common therapy for advanced esophageal cancer. When other attempts to salvage the esophagus have failed, such as with end-stage achalasia or strictures, or after ingesting anything that harms the esophageal lining, an esophagectomy could be advised for noncancerous diseases.

How is the surgery Performed?

An incision is made in the neck, chest, or belly during an open esophagectomy, during which the surgeon removes all or part of the esophagus. In most cases. the esophagus is replaced with another organ, usually the stomach although on occasion the small or large intestine may also used to replace the esophagus.

Esophagectomy may often be performed minimally invasively using laparoscopy, robot assistance, or a combination of these techniques. These operations, which are carried out through a series of tiny incisions when necessary, can be less painful and have a quicker recovery time than traditional surgery.

Types Of Esophagectomy 

• McKeown Esophagectomy or Open Esophagectomy – During an open esophagectomy, one or more significant incisions are made in the neck, chest, or belly and rebuild the gastrointestinal tract. A transthoracic esophagectomy, which involves making incisions in the chest and belly to remove the esophagus, is an option for the surgeon. Alternately, the doctor might conduct a transhiatal esophagectomy, which involves making incisions in the neck and belly. Occasionally, a three-field esophagectomy is required, which involves making incisions in the neck, chest, and abdomen.
• Thoracoabdominal Esophagectomy – In this process, on the left side, a single incision is created that extends from the chest to the belly, as well as a neck incision.
• Transhiatal Esophagectomy – Cuts are made in the neck and belly, and the esophagus in between is severely dissected out (with the fingers).
• Ivor Lewis Esophagectomy – The right side of the chest has one incision, and the abdomen has another.
• Minimally Invasive Esophagectomy – This method entails removing the esophagus by several tiny incisions in the chest or the belly (laparoscopically) (thoracoscopically). The thoracoscope and laparoscope are two long, slender, flexible tools used for chest and abdominal examination. In laparoscopic surgery, the surgeon makes small incisions and inserts tools and a camera-tipped device to examine and carry out the procedure without severing any muscles or breaking any ribs. This technique could be aided by a robot in some hospitals.

Post Surgery 

No matter what kind of esophagectomy is performed, the patient is transported to the intensive care unit (ICU) for 24-48 hours following surgical esophagectomy. The epidural will be modified to provide the best possible pain relief when the patient is weaned off the ventilator and transitioned to tube feedings with the help of a jejunostomy tube (feeding tube) which is inserted as part of the procedure. As the patient regains the ability to swallow, this is utilized to deliver nutrients for up to 30 days following surgery.

A nasogastric tube, a drain that enters via the nose, will also be present in the patient. This tube is necessary to maintain the stomach’s decompression so that the newly formed link between the esophagus and the stomach has a greater chance of healing.

What is open surgery for hernia repair?

In an open hernia repair, a cut or incision is made in the groyne. The bulging intestine is located within the hernia “sac.” In order to strengthen the abdominal wall, the surgeon next pulls the hernia back into the abdomen and inserts stitches or synthetic mesh. After surgery, most patients can return home within a few hours and are usually in good health within a few days. Exercise and strenuous activities are prohibited for four to six weeks following surgery.

Laparoscopic Hernia Surgery

• A laparoscope, a narrow, telescope-like equipment, is used in laparoscopic (minimally invasive) hernia repair. It is inserted through a tiny incision at the umbilicus (belly button). Before the surgery, you will undergo a general health assessment that includes a history, physical exam (and potentially lab testing), and an electrocardiogram because this treatment is typically done under general anaesthesia (EKG).
• During this procedure, you won’t experience any pain. An “inside view” of your body is shown on television screens in the operating room through a laparoscope that is attached to a tiny video camera.
• A non-harmful gas (carbon dioxide) is used to expand the abdomen, which makes room for your doctor to see your inside organs. To reveal the abdominal wall’s frailty, the peritoneum, which lines the inside of the abdomen, is sliced. To cover the holes in the abdominal wall and fortify the tissue, mesh is inserted from the inside.
• The small abdominal wounds are stitched or covered with surgical tape after the surgery is finished. The incisions become hardly invisible after a few months.
• Laparoscopic hernia surgery has advantages such as minimal scars, reduced pain following surgery, a quicker return to work, and a quicker recovery (days instead of weeks).

Robotic Hernia repair surgery

• Similar to laparoscopic surgery, robotic hernia repair utilises a laparoscope and is carried out in the same way (small incisions, a tiny camera, inflation of the abdomen, projecting the inside of the abdomen onto television screens).
• Robotic surgery varies from laparoscopic surgery as the surgeon controls the surgical instruments from a console while seated in the operating room. Robotic surgery is currently also utilised to repair the abdominal wall, in addition to treating some smaller hernias or weak spots.
• One of the most significant distinctions between robotic surgery and laparoscopic surgery is that the latter uses a robot to produce superior three-dimensional images of the abdomen (vs. the two-dimensional images of laparoscopic surgery). Additionally, with the use of robotic surgery, the surgeon may quickly sew tissue and meshes inside the abdomen.
• Other advantages of robotic hernia surgery include the absence of a single, major incision scar and potential for reduced postoperative pain when compared to open surgery.

Why is Polypectomy surgery Performed?

Polyps have to be removed as some might be cancerous or precancerous and in some instances non cancerous. The first step in finding any polyps is by undergoing a colonoscopy. If any are found, the tissue is removed during a polypectomy. Colon cancer can be avoided in this way.

Where Do Polyps Occur?

Additional reasonably frequent locations for polypectomy

include:

1. Nose
2. Cervix
3. Voice box
4. Abdomen
5. Uterus
6. Rectum /Colon

What Happens If The Polyps Are Not Removed?

Some polyps may be cancerous and precancerous which make them necessary to be removed.

Few polyps are non cancerous yet these need to be removed because these polyps can expand to enormous sizes even when they are not malignant. If they occur, they might change blood flow, put pressure on organs, and bring on a variety of other symptoms.

Surgery

• The surgical procedure and the location of the polyps will determine how to prepare for a polypectomy. For the procedure, many patients prefer to be awake. Some people might favor general  anesthesia. In this situation, the medical professional will provide an IV needle-based sedative to the patient. They get tranquilized and sleepy as a result.
• With an endoscope, doctors can remove the majority of polyps. This is a tube that the doctor into the body rather than making a significant incision. But before a colon polypectomy may be performed, the colon must be empty . Laxatives, enemas, or both may be required 12 to 24 hours prior to surgery. Different surgical methods are used to remove polyps depending upon the condition of the patient. The most common ways are as follows
• Hot Snare Polypectomy (HSP) – Polypectomy with a heated snare is known as a hot snare polypectomy (HSP) and is the treatment of choice for the majority of polyps. A loop called a snare can seize and remove the polyp. To burn away any residual polyp tissue, the surgeon may also employ electrocautery.
•  Cold Snare Polypectomy (CSP) – Cold snare polypectomy is the method of choice whereA cold snare is used, exclusively for small (1–5 mm) polyps.
•  Cold or Hot Forceps Polypectomy – This is a more antiquated method of removing tinypolyps involves forceps to pull the polyp out. This is known as a cold or hot forceps polypectomy. Additionally, the surgeon will use a wire to cut away the polyp & tissue invading section. If the polyp is particularly heated, the surgeon may additionally employ electrocautery to burn off (cauterization) any residual polyp tissue and stop any bleeding.
• During the process, the patient may feel pressure or tugging, but they shouldn't experience any discomfort. A doctor may administer painkillers prior to, during, or after the treatment, depending on the location of the polyp and other elements. Once the polyp is removed the tissue sample is sent to the laboratory to find if it’s cancerous or not.

What is the Surgery procedure in case of Large Polyps?

Large polyps are thought to be more technically difficult to treat or to have a higher risk of problems because of their size, location, or structure. Either endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) procedure can be applied in these circumstances. Prior to excision in EMR, the polyp is removed from the underlying tissue via a fluid injection.

Saline is frequently used to make this fluid injection. Piecemeal resection refers to the removal of the polyp one piece at a time. ESD involves injecting fluid deep inside the lesion, which allows the polyp to be completely removed. Bowel surgery could be required for some bigger polyps that cannot be eliminated endoscopically.

Post Surgery Recovery 

• Driving shouldn’t be done for 24 hours after a polypectomy.
• Recovery usually happens quickly. Minor side effects including bloating, cramps, and gas normally go away in a day or two.
•  It may take up to two weeks to fully recuperate from a more complex surgery.
• The doctor might even suggest some dietary restrictions for a few weeks especially caffeine intake, tea, sodas / aerated beverages, alcohol and spicy peppery food.

A cancerous tumor is surgically removed from the head (right side) of your pancreas using the Whipple procedure, also known as a pancreaticoduodenectomy, to prevent it from spreading to other organs (metastasizing). 15% to 20% of those who have pancreatic cancer are candidates for this procedure.

What does the pancreas do and where is it located?

An essential organ present in your abdomen, Pancreas is a fish-like form where the head is the widest area on the right and the thick end is referred to as the tail, while the central portion is known as the neck or body. Your pancreas produces hormones, aids in food digestion, and regulates your blood sugar levels.

Pancreatic cancer: What is it?

A growth (tumor) in your pancreas is what causes this particular sort of cancer. The head, neck, or body of your pancreas are where the tumor typically develops. In the tail, few sprout. Most people who are diagnosed with pancreatic cancer are between the ages of 60 and 80, and smoking is the main risk factor.

When is a Whipple operation performed?

The most frequent cause for a Whipple procedure performed by your surgeon is pancreatic cancer. However, this procedure can also be required for:

• Cysts in the pancreas.
• Pancreatitis.
• Duodenal small bowel cancer.
• A small intestine or pancreas injury.
• Ovarian cancer.
• Liver cancer.
• Neuropathic tumors

Mode of Surgery

Major inpatient surgery is required for the Whipple procedure. For around a week, you’ll need to recover in the hospital.

How to Prepare for Surgery? 

Before having surgery if you have cancer, you could have radiation or chemotherapy.

You will be told by your surgeon to cease taking specific drugs in the days before your operation. You ought to:

• Unless otherwise instructed, wait eight hours before visiting the hospital for your Whipple procedure before eating or drinking.
• To improve heart and lung health, stop smoking, even for just two weeks before the Whipple procedure.
• As instructed by your doctor, stop using herbal supplements one to two weeks before surgery.
• As directed by your doctor, you should occasionally (but not always) take blood pressure drugs
• When you arrive at the hospital, a nurse will place an intravenous (IV) line into your arm so that you can receive the fluids and medications you’ll need for the procedure. A spinal injection or epidural catheter may also be required. They obstruct your nerves, which helps to lessen post-operative discomfort.

What type of surgery is Whipple Procedure? (Open or Minimally Invasive)

An open operation is one in which the surgeon creates a single, sizable incision. Laparoscopic (minimally invasive) surgery involves numerous tiny incisions (incisions). There is typically less blood loss, fewer problems, and a quicker recovery period with minimally invasive surgery. The Whipple technique is often an open surgery, even though a laparoscopic procedure is excellent for many purposes.

Which steps make up the Whipple procedure?

The Whipple process can be distilled into the following steps:

• A large incision will be made to cut open your abdomen (or, if laparoscopic surgery is performed, only a few minor ones).
• The area of your pancreas where the tumor is located, the duodenum that surrounds it in the small intestine, the lower piece of the bile duct, the gallbladder, and occasionally a portion of your stomach, will all be removed by your surgeon.
• Your small intestine connects to the pancreas and bile duct that are still present.
• The small intestine is then joined back to the stomach, allowing food to move freely throughout the entire digestive system.

What is the duration of the Whipple procedure?

The Whipple technique is a challenging operation that takes 4–12 hours to complete.

What to expect?

After your Whipple procedure, you’ll have pain for some time. Your care team will control your pain while keeping an eye out for any infections or other issues during your hospital stay. Prior to your healthcare professionals determining that you are ready to consume solid foods, you will be on a clear, liquid diet for a few days. When you’re ready, you should begin doing lung exercises (incentive spirometry).

 How is it Performed

The doctor performs cholecystectomy with the help of a laparoscope. The most typical way to execute a cholecystectomy is by creating four tiny incisions, implanting a tiny video camera, and using specialized surgical equipment to view into the belly to eventually remove the gallbladder. Hence the name Laparoscopic Cholecystectomy.

In some instances, based upon the severity of the case, the doctor might follow a slightly different procedure, where the gallbladder may be removed with a single, substantial incision. This procedure is known as an open cholecystectomy.

Why is it Performed

The most frequent reason for a cholecystectomy is to treat gallstones and the difficulties they bring on. A cholecystectomy may be advised by the doctor if one has:

1. Gallbladder gallstones (cholelithiasis)
2. Liver duct gallstones (choledocholithiasis)
3. Inflammation of the gallbladder (cholecystitis)
4. Large polyps in the gallbladder
5. Gallstones cause pancreatitis, an inflammation of the pancreas.

Preparation For Surgery

Generally the patient is advised not to consume any food or beverages for at least 4 hours prior to the surgery.

Inform the assigned doctor about any current medications and pre existing medical conditions, if any. Depending upon the condition the doctor might alter or may suggest to stop some medicines as it may trigger heavy bleeding post surgery.

 During The Surgical Procedure

Initially the patient won’t be conscious throughout a cholecystectomy since general anesthetic is used to conduct the surgery. The patient receives anesthesia through a vein in the arm. The medical team will put a tube through the patient’s neck to assist him/her breathe once the medications start working. The cholecystectomy is subsequently carried out by the doctor, either by a laparoscopic or open operation depending upon the severity of the case.

Later, either of the two surgical procedures are performed. Laparoscopic cholecystectomy or Open cholecystectomy.

Laparoscopic Cholecystectomy – This is the method which is minimally invasive where a tiny camera is inserted through four micro incisions in the abdomen. While viewing the scenario of the abdomen the doctor then inserts the surgical tools through other incisions to remove the gallbladder.

If your surgeon suspects gallstones or other issues with the bile duct, patient may then next go through an imaging test like an X-ray or ultrasound.  The patient is then brought to a recovery area once the incisions have been sutured. In one to two hours, a laparoscopic cholecystectomy is performed.

For certain individuals, a laparoscopic cholecystectomy is not recommended. In rare circumstances, the surgeon may start with a laparoscopic technique and end up needing to create a bigger incision due to problems or scar tissue from prior surgeries.

Open Cholecystectomy – This is also known as the old traditional way of performing the surgery by large open incision for removal of the gallbladder. A 6-inch (15-centimeter) incision is made behind the right ribcage in the abdomen during an open cholecystectomy. The liver and gallbladder are made visible by pulling aside the muscle and tissue. The gallbladder is subsequently removed by the designated surgeon. The patient is transferred to a recovery area once the incision is stitched up.

It takes one to two hours to do an open cholecystectomy.

Post Surgery

Gallstones can cause pain and suffering, and may frequently reoccur despite conservative therapies including dietary changes which is now eased after undergoing a cholecystectomy. A cholecystectomy will typically stop gallstones from recurring.

Depending on the technique the surgeon chooses and the general health of the patient, the length of time it takes to resume all regular activities following a cholecystectomy will vary.

For instance, after a laparoscopic cholecystectomy, most patients may be able to resume their jobs within a few days. Meanwhile, one week or more may pass before an open cholecystectomy patient is well enough to go back to work.

We are one of the best Surgical Gastroenterology hospitals in Hyderabad, Telangana backed by a team of excellent gastrologists. We offer expert care in both medicine and surgical gastroenterology. We have advanced intensive care units backed by state-of-the-art equipment. We treat diseases such as gastrointestinal cancer, colon polyps, cirrhosis of the liver, jaundice, peptic ulcer disease, gallbladder, Irritable Bowel Syndrome, gastroesophageal reflux, Constipation, Colitis, Diarrhea, Gas and indigestion, Gallstones, Gastrointestinal bleeding, Loss of appetite, Stomach ulcers, Metabolic liver disease, Vomiting, Hepatitis, Gastric, and duodenal ulcer, etc. 

Treatment:

 We offer treatments such as surgeries, Hepatology, liver transplants, pancreatic transplantation, and endoscopy. We offer surgeries such as Gastroesophageal Reflux Disease (GERD), Anal (Faecal) Incontinence, Stretta Therapy, and Endoscopic Non-Ablative Radiofrequency (NARF) Treatment. We aim to take the best care of our patients. We understand dealing with diseases can be exhaustive and strenuous, hence we connect with our patients and understand their needs. We have successfully conducted liver and pancreatic transplantations too. We offer Hepatobiliary procedures such as Gastroenterology Services & Adult Hepatology, Hepatology, Fatty Liver Disease, Non-Alcoholic Fatty Liver Disease, Hepatobiliary surgery, and Biliary Disorders. Liver Disorders, Pancreatic Disorders, endoscopy, etc.

Diagnostic Services

• Fistula open.
• Fistula laser.
• Inguinal Hernia open.
• Inguinal Hernia Lap.
• Hernia incisional /umbilical open.
• Esophagectomy.
• Colectomy.
• Hernia incisional /umbilical lap.
• Bariatric Surgery.
• Colonoscopy.
• Polypectomy.

Gastroenterologists in Hyderabad

• Dr. Raja Prasad
• Dr. Ravinder Reddy
• Dr. V. Gopala Krishna

Testimonials

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Omni Hospitals was recommended to me by a family friend who has to know my trouble with irritable bowel syndrome. I have previously consulted many doctors but my condition was not improving. When I started my treatment at Omni, I was desperate for results. Thanks to the supportive doctors, nurses, and management I have been showing a lot of improvement of late. Thanks to Omni hospitals for taking the best care of me. 

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I was suffering from Jaundice and to make matters worse this was my second fight with Jaundice. My second fight against Jaundice has proved to be more dangerous as my liver has developed complications. Thanks to the constant guidance and care from my assigned doctor and his team at Omni hospitals I have recovered completely without any complications. 

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