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What is Obesity and how does BMI Calculator is one of the trusted indicators

Obesity is state when “Excessive fat gets accumulated in the body to the extent that health and well being are adversely affected and puts life at possible risks”.

  • People are considered obese when their body mass index (BMI) exceeds 27.5 kg/m2.
  • As per BMI index it is a stage prior to morbid obesity i.e.advancing towards high risk.
  • Overweight, obesity and morbid obesity are the fifth leading health risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese.
  • In addition, according to WHO, 44% of the diabetics, 23% of the ischaemic heart disease and between 7% and 41% of certain cancer are attributable to overweight and obesity.

What is Obesity/weight loss surgery?

  • Obesity can be treated both medically and surgically. Medical treatments for obesity are quite time taking and difficult as the amount of weight loss is small and patients gain back most of the weight within no time.
  • Surgeries designed to deal with weight loss in patients who are severely overweight and obese are called obesity and weight loss surgeries.
  • Post surgery it is imperative to have controlled diet regimen and healthy lifestyle should be followed for best results.

Types of Obesity Surgery

There are several types of restrictive, malabsorptive and combined procedures that can lead to sustained weight loss. Each one has its own benefits and risks. The top three procedures are:

Gastric Banding

A band is placed around the upper part of the stomach to create a small pouch to hold food. The band limits the amount of food that the person eats by giving a feeling of fullness after eating small portions of food. The surgeon uses laparoscopy (which involves small cuts in the belly) to place an adjustable silicone band around the upper part of the stomach. Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can hold only about an ounce of food.

A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter. In this way, the band can be tightened or loosened as needed to reduce side effects and improve weight loss.

Benefits of Gastric Banding

  • Simple and safe procedure
  • Recovery period is short
  • Rate of major complications that have been reported is low
  • Does not require removal of any part of the stomach or intestines
  • The natural anatomy of the abdominal region remains unchanged
  • The width of the band can be adjusted from time to time
  • The band can be removed any time if the patient desires

Risks associated with Gastric Banding

  • Minimal risks include about 5% chances of failure due to the following:
  • Band erosion/migration
  • Deep infection
  • Patient’s inability to maintain proper dietary restriction and regular follow up

Gastric Bypass

This surgery refers to a surgical procedure in which the stomach is divided into a small upper pouch and a much larger lower pouch. Then, the small intestine is rearranged to connect to both. In this procedure a small pouch is created by using specially designed staplers. There are two steps during gastric bypass surgery:

The first step makes your stomach smaller. Your surgeon will use staples to divide your stomach into a small upper section and a larger bottom section. The top section of your stomach (called the pouch) is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce of food. Because of this you will eat less and lose weight.

The second step is the bypass. Your surgeon will connect a small part of your small intestine (the jejunum) to a small hole in your pouch. The food you eat will now travel from the pouch into this new opening and into your small intestine. As a result, your body will absorb fewer calories. Gastric bypass can be done in two ways.

With open surgery, your surgeon will make a large surgical cut to open up your belly. Your surgeon will do the bypass by working on your stomach and small intestine.
Another way to do this surgery is to use a tiny camera, called a laparoscope. This camera is placed in your belly. The surgery is called laparoscopy.

Benefits of Gastric Bypass

  • Effectively controls food intake thus leads to rapid weight loss
  • Controls the urge to take sweet foods
  • It can be reversed in case of any medical emergencies but should be considered as a permanent weight loss surgery

Risks associated with Gastric Bypass

  • Leak of staple line
  • Hemorrhage
  • Ulcers
  • Blockage or undesired narrowing of the stoma
  • Vomiting in case food is not properly chewed or is eaten too quickly
  • Person can re-gain weight if dietary changes are not followed for a long time.

Sleeve Gastrectomy

This is a restrictive procedure in the stomach is stapled in such a way so as to create a long narrow sleeve. By this procedure, the stomach is reduced to about 25% of its original size. The result is a sleeve or tube like structure. The procedure permanently reduces the size of the stomach, although there could be some dilatation of the stomach, later in life. The procedure is generally performed laparoscopically and is irreversible.


Benefits of Sleeve Gastrectomy

  • Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
  • No dumping syndrome because the pylorus is preserved.
  • Minimizes the chance of an ulcer occurring.
  • Very effective as a first stage procedure for high BMI patients (BMI >55 kg/m2).
  • Ideal for people who are also suffering from Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures.

Risks associated with Sleeve Gastrectomy:

  • Patients with higher BMI may still need to have a second stage procedure at a later stage to help lose all of their excess weight. However, this is an active point of discussion for bariatric surgeons.
  • Soft calories from ice cream, milk shakes, etc., can be absorbed and may slow weight loss.
  • This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur.
  • Since the procedure involves stapling, it is an irreversible procedurek

Cost of Obesity Surgery

Obesity surgery or Bariatric (Obesity) Surgery is a highly personalized treatment procedure. The cost of surgery depends on the patient condition; type of weight loss surgery performed and post operative recovery. An estimate can be given once the patients shares the medical history and current BMI parameters

You could mail your query at info@anamedglobal.com for an estimate and evaluation by the Surgeon

Appendicitis Surgery


What is Appendicitis?

Appendix is a narrow, hollow muscular tube present near the junction of the small and large intestine. It has no significant function in human beings. Appendicitis is the inflammation of appendix (infection or swelling). The term acute Appendicitis means sudden development of the inflammatory process.

It is most commonly seen in the second decade of life (adolescence), though it can occur in any age group. In almost 80% of the cases, acute appendicitis are caused.

Laparoscopic Appendix Surgery

An abdomen ultrasound may help in reaching the diagnosis in case the clinical examination and other investigations are inconclusive.

The treatment of acute appendicitis is removal of the appendix (i.e. Appendicectomy). This can be done by an open technique or laparoscopically.

Laparoscopic appendicectomy is performed by making three tiny (3-5-10 mm) incisions through which the telescope and instruments are introduced and the appendix is removed.

The advantage of laparoscopy over open technique is less pain, early recovery and excellent cosmetic results. Also, laparoscopically the entire abdomen and pelvis can be inspected to rule out any other pathology.

Inflamed appendix can create emergency situation and needs to be tended at once. The earlier signs of the appendicitis are feeble and often ignored. Open appendicitis surgery requires making a large cut on the skin and also has other disadvantages; therefore, Laparoscopic appendix surgery is preferred.

Pre & Post Surgery Instructions

Any pre-op instructions that are to be given to you by your surgeon vary as per your specific case.

After the operation you will be kept in the recovery room.This period may vary from few minutes to few hours. The anaesthetist decides about your shifting to room. The decision depends on many technical factors.

You may feel nauseated in the immediate post-operative period, and you may even vomit which should not cause any worry. This generally gets over after few hours.

You are generally allowed to have sips of water immediately after the operation and liquids on day of operation. In case of vomiting the liquid intake may be stopped and restarted after 30 minutes. The liquids may include water / cold drinks / tea / coffee / milk / juices or some clear soups.

You are allowed to have normal home cooked meals of your choice from the next morning at breakfast. And it is important that to prevent feeling bloated you should have small frequent meals for some days.

You should try to move the limbs and can sit up immediately after operation. You should also go to the toilet on your own.

You will be discharged on the same day or next day of operation unless there is some associated medical/social problems.

You are advised to visit again for follow up after 2-5 days when the dressings are removed. You should avoid wetting the dressings unless they are waterproof. After the removal of dressing, you can have normal bath with soap and water.

In very few cases there may be some bloody/whitish discharge from the wound in the post operative period. This should not bother you because it is generally harmless. You can wipe the discharge and apply band-aid so as to avoid staining the clothes. If it is more you should report to the surgeon during the next visit.

You could mail your query at info@anamedglobal.com for an estimate and evaluation by the Surgeon

Hernia Surgery

What is Hernia?

Body cavity contains internal body contents enclosed in membranes. Hernia is caused when the body content tears through the membrane and protrudes out.

Hernias are Asymptomatic and do not produce any symptom that can help in their diagnosis. But, it can cause mild to severe pain in cases when they are under continued stress or in contact with other body parts.

What is Hernia Surgery?

Pressure over body content either for a moment or continuous, when coupled with a weak opening caused due to weakness of muscles or fascia, results in hernia.

Hernia Surgery focuses on reducing the pressure over the body content, relieve the pain and put back the protruding body content back with the membrane. It is followed by covering and strengthening the weak opening minimizing the chances of re-occurrence.

Cost of Hernia Surgery in India

Type of hernia, the location of hernia, your age, other related complications and your health conditions along with various other factors are required for proper assessment of Cost of hernia surgery.

Generally, hernias are not a matter of grave concern, but in some cases if pain caused due to hernia is left unaddressed for long and if hernia gets strangulated then hernia surgery required for treating the same is complicated and so the cost of such surgery is also high. Further, it is strongly suggested that only top hernia surgery expert should be consulted for the best results and minimizing the chances of re-occurrence.

Types of Hernia

It is very difficult to put up an exhaustive list or types of hernias since many organs or parts of organs can herniate through many orifices. The four major types of Hernia are as follows:

Inguinal Hernia

Incisional Hernia

Umbilical Hernia

Ventral Hernia

Inguinal Hernia

75% of all abdominal-wall hernias are Inguinal Hernia

Its more common in men than in women (27% lifetime risk in men and 3% in women)

Inguinal hernias are divided into two different types, direct and indirect. Both of these occur in the area where the skin of the thigh joins the torso (the inguinal crease). But, both of these have different origins and for the purpose of treatment of Inguinal Hernia, it is important to diagnosis the exact type of Inguinal Hernia.

The main symptom of an inguinal hernia is a bulge in the groin or scrotum. It often feels like a round lump. The bulge may form over a period of weeks or months. Or it may appear all of a sudden after you have been lifting heavy weights, coughing, bending, straining, or laughing. The hernia may be painful, but some hernias cause a bulge without pain. Hernia might even cause swelling and a feeling of heaviness, tugging, or burning in the area affected. These symptoms may get better when you lie down. Sudden pain, nausea, and vomiting are signs that a part of your intestine may have become trapped in the hernia.

Incisional Hernia

An incisional hernia can occur after surgery in the belly, maybe after months or even years of it. Most of the time, it occurs along a vertical (up and down) incision. This type of hernia can occur in people who:

  • Are very overweight.
  • Are older.
  • Have used steroid medicines.
  • Have had lung problems after surgery.
  • Have had a wound infection after surgery or have had more than one surgery using the same incision.

Incisional hernia develops through weak abdominal walls after abdominal surgery. Up to 10% of abdominal surgeries can develop Incisional Hernia. Also, if the process of Incisional Hernia treatment is flawed, it can come back.

Umbilical Hernia

It is a common type of Hernia and constitutes around 25% of all Hernia cases. Umbilical Hernia is often noted at birth as a protrusion at the bellybutton (the umbilicus). Umbilical Hernia is caused due to weakened opening in the abdominal wall, which should normally close before birth but fails to close completely .Umbilical hernias can usually be seen when your baby is crying, laughing, or straining to use the bathroom. Although, adults can get umbilical hernias as well. The symptoms will be the same—a swelling or bulge near the navel area. These can be very painful and treatment is usually required.

Symptoms include:

  • The baby is in obvious pain.
  • The baby is vomiting.
  • The bulge (in both children and adults) is tender, swollen, or discolored.

In adults, surgery is usually suggested to make sure that no complications develop. In children, umbilical hernias often fix themselves. Before choosing surgery, doctors will normally wait until the hernia:

  • becomes painful
  • bigger than a half inch in diameter
  • does not shrink in size after one year
  • does not go away by the time your child is three or four years old
  • becomes trapped or blocks the intestines

Ventral Hernia

Ventral Hernia is a hernia that surfaces on any part of the Ventral surface of the human body. It results is a bulge or tear in the Ventral surface that develops like a balloon-like sac. A ventral hernia is a bulging of the abdominal wall, often at the midline. However, it can occur at any location on the abdominal wall. Many are called incisional hernias because they often form at the healed site of past surgical incisions where the skin has become weak or thin.

Treatment for a hernia requires surgical removal. Untreated hernias can grow into enlarged ventral hernias that become surgically difficult to remove. Swelling can lead to entrapment of the hernia contents. If not properly addressed, this can lead to a reduced blood supply to the tissues involved, causing strangulation.

Tissue strangulation is typically accompanied by intense pain, and constitutes a medical emergency that requires immediate treatment to prevent tissue death (necrosis).The success rate for hernia surgery is very good. According to the National Institutes of Health (NIH), only about one to three percent of hernias return after surgery (NIH, 2011).

Types of Hernia Surgery

The treatment of every Hernia is individualized, and a discussion of the risks and benefits of surgical versus nonsurgical management needs to take place between the doctor and patient before they choose to move ahead with option of Hernia surgery for treatment of the condition.

However, it is advised that all Hernias should be repaired to avoid the possibility of strangulated Hernia. In conditions where preexisting medical conditions make surgery unsafe, the doctor can decide against surgical treatment of Hernia. In cases of Reducible Hernia the surgery can wait if the patient decides to wait. But all acutely irreducible Hernias need emergency treatment because of the risk of strangulation.

The two types of surgical process used to treat Hernia are as follows:

  • Traditional (open) hernia repair
  • Laparoscopic hernia repair

Traditional (open) Hernia repair

What it is?

As per need and as agreed with patient, local or general anesthesia is induced. An intravenous line is also inserted into one of your veins to deliver fluids and medications. In this process the surgeon cuts through the skin and repairs the Herniated part. The surgical process start with the surgeon making an incision several inches long near the Hernia. Then the surgeon gently pushes the protruded part back into its proper place. The weakened part of the wall is then repaired and stitched. In the final stage the outer skin is closed and stitched.

Benefits of Traditional (open) Hernia repair

  • It is considered the best possible surgical option for inguinal Hernia and for several other types of Ventral Hernia.
  • Better long term results
  • Lesser complications in comparison to other types of Hernia surgery.

Disadvantages of Traditional (open) Hernia repair

  • It takes longer time to heal.
  • Patients require to consult doctor for change of stitches
  • It takes weeks to resume normal routine.
  • The surgery invokes pain

Laparoscopic Hernia repair

What it is?
It is a minimal invasive procedure to repair Hernia. Laparoscopic Hernia repair requires general anesthesia. In this process, a harmless gas is injected into the damaged area to inflate it and to give the surgeon more room to work and a better view. Then the laparoscope and other instrument are inserted through small holes. A camera on the laparoscope transmits images from of the interior part of the body part to a viewing screen allowing surgeons a greater precision. The surgical procedure remains to be the same and then a mesh is used for better results. The openings are stitched and the area is deflated by releasing the gas which was initially used to inflate the body part.

Benefits of Laparoscopic Hernia repair

  • It gives best cosmetic results, and leaves no scars.
  • The recovery time is less.
  • Least surgical pain
  • Patient can resume daily activity after a week.

Disadvantages of Laparoscopic Hernia repair

  • Not ideally suited for complex Hernia cases.
  • Higher chances of re-occurrence, unless surgery is carried out perfectly by highly trained surgeon.

Cost of Hernia Surgery

Cost of hernia surgery is highly dependent on the type of hernia and the procedure that is to be followed to treat it. In cases, if the hernia has been long left addressed, it can get strangulated and in such a situation, the cost of hernia surgery could be considerably high. Therefore, to know the exact cost for the surgical treatment of hernia, it is best to consult our hernia surgery experts.

You could also share your medical reports for an evaluation at info@anamedglobal.com

Gallbladder Surgery

Symptoms

  • When your gallbladder is not working correctly (biliary dyskinesia) these symptoms may occur:
  • Indigestion
  • Nausea
  • Vomiting

Gallstones can be quite painful and, if left untreated, can lead to serious complications. For example, if the stones move to nearby bile ducts, they can cause blockages that lead to jaundice (the buildup of bile chemicals in the blood), or inflammation of the pancreas (pancreatitis). Once gallstones have been identified, either through an Ultrasound, CT or CAT scan, hepatobiliary (HIDA) scan, or other test, surgical removal of the gallbladder is usually the best option.

Gallbladder surgery procedure

Gallbladder surgery (cholecystectomy) can be performed as an open surgery or laparoscopic surgery (pictured above.) Laparoscopic surgery offers a less invasive approach to gallbladder removal and allows for quicker healing time. The easiest and common way to remove a gallbladder is with a laparoscope, a thin tube that is inserted into your belly through a small incision. The tube is lighted and a tiny TV camera inserted into it so the doctor can view your internal organs on a TV monitor. Through a few other small incisions in your abdomen, the surgeon inserts surgical instruments to remove the gallbladder. To make it easier to move instruments within your belly, it is inflated with gas. Gallbladder surgery involves first cutting the cystic duct and blood vessels attached to it. Then the gallbladder can be removed with the laparoscope. Sometimes dye is injected into your bile duct if gallstones are suspected to have migrated into the common bile duct. A type of x-ray (cholangiogram), can see if other gallstones are present in the common bile duct and should be removed. Gallbladder surgery is performed using general anesthesia, so you are asleep and unable to feel pain.

The risks for gallbladder surgery include:

  • Bleeding
  • Damage to the blood vessels that go to the liver
  • Infection in your belly
  • Injury to the common bile duct
  • Injury to the small intestine
  • Pancreatitis (inflammation in the pancreas)