Month: March 2017

Your Gallbladder

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Hanging out just below the liver’s right lobe is your hollow, pear-shaped gallbladder. When it’s full of bile that’s waiting to help digest some food, the organ can grow as long as 8 to 10 centimeters (cm), and as wide as 4 cm.

Unless you’ve had a gallstone or your gallbladder has been surgically removed, you probably think little of it. And that’s fine. But if it’s causing you serious pain or other problems, you may need to ditch this little organ.

Your gallbladder serves as a storage pouch.

While the liver is hard at work making the dark green bile that helps with digestion, the gallbladder holds the bile until you actually need it.

Gallstones are formed mostly from hardened cholesterol.

Gallstones form when one of two substances — cholesterol or bilirubin — become supersaturated in the bile and crystallize, much the way sugar crystallizes when someone makes rock candy. Bilirubin is a brownish-yellow substance found in bile that results when old red blood cells in the liver break down. Your body normally eliminates bilirubin through your bowels (it’s the reason for the color of feces). Bilirubin-caused gallstones are rarer than those formed from hardened cholesterol, and are more common in those with blood disorders, such as sickle cell anemia.

A low-cholesterol and low-fat diet is best for a healthy gallbladder.

A diet good for your heart is good for your gallbladder, too.

Any diet that would qualify as “heart-healthy” is “gallbladder-healthy,” too. That means a diet with some healthy monounsaturated fats, such as those in nuts, avocados, seeds, olives, peanut butter, and the oils from these products. Polyunsaturated fats should be part of that balanced diet, too, and are found in fatty fish, walnuts, flaxseeds, and vegetable oils. Avoiding foods that increase your cholesterol levels also reduces the risk of gallstones.

Almost as important as what you eat, however, is how frequently you eat. If you eat one large meal a day, it increases the likelihood of stones, because the bile sits in the gallbladder for a long period of time before it’s excreted.

The most common sign of gallstones is intense pain.

Up to 80 percent of people will never have symptoms for their gallstones, and nothing needs to be done about that. But if there is a problem, you’ll usually know it: the pain can be intense. The pain is generally described as sharp, stabbing, and very excruciating — a 10 on a scale of 1 to 10. The pain most commonly comes after eating a fatty meal because fat is the strongest trigger for the gallbladder to empty.

The pain typically occurs on the right side where your gallbladder is, below your breastbone, and can radiate to your back, Dr. Khandelwal says. It can last several hours and may be accompanied by nausea, she adds.

But the pain can also be a dull ache on the right side, like an upset stomach or heartburn with bloating.

The best test for gallstone is an ultrasound.

The best test for gallstones is an ultrasound. It’s quick and safe and gives us a lot of information about how the gallbladder looks, and it has pretty high accuracy. The ultrasound tech will be able to see gallstones or gallbladder irritation, such as a thickened wall or fluid around the gallbladder.

Some patients may be referred for a second kind of test called an HIDA (hepatobiliary) scan, in which a radioactive chemical is injected into your arm and the tech watches what happens when it reaches your gallbladder. Generally, HIDA scans are only performed on patients who have other underlying conditions or who have gallbladder pain symptoms, but no stones on an ultrasound.

Escaped stones could lead to jaundice or pancreatitis and require surgery.

If it’s not causing symptoms, or if you pass it as a few lucky people do, nothing. But if they are causing trouble,the gallbladder may need to be removed. If the person is experiencing pain, called biliary colic, or develops a gallbladder infection, called cholecystitis, gallbladder surgery is probably needed.

If the stones get outside your gallbladder and travel down the duct, they can cause some pretty serious complications, so it’s important to have them taken care of if you’re having a problem.

Escaped stones can cause obstructions in the ducts that lead to jaundice or pancreatitis, Any of these symptoms would require gallbladder surgery, called cholecystectomy.

Gallbladder removal surgery is usually an outpatient procedure, with a short recovery time and for most people,no long-lasting effects.

 

From Everyday Health

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da Vinci Hernia Surgery

da Vinci® Hernia Surgery

Cross Section Ventral Hernia-and-Repaired HerniaIf you have a hernia it can be done using open surgery or minimally invasive surgery. During hernia surgery, the weak tissue in the wall of the stomach or groin is secured and any holes are closed.

If minimally invasive surgery is an option for you, ask your doctor about da Vinci Surgery.

Why da Vinci Surgery?

Early clinical data suggests that as a result of this technology, da Vinci Ventral Hernia Surgery offers the following potential benefits:

  • Low rate of the hernia returning
  • Low rate of pain
  • Low rate of surgeon switching to open surgery
  • Short hospital stay

da Vinci technology enables your surgeon to operate through a few small incisions (cuts), like traditional laparoscopy, instead of a large open incision. The da Vinci System is a robotic-assisted surgical device that your surgeon is 100% in control of at all times. The da Vinci System gives surgeons:

  • A 3D HD view inside your body
  • Wristed instruments that bend and rotate far greater than the human hand
  • Enhanced vision, precision and control

The da Vinci System has brought minimally invasive surgery to more than 3 million patients worldwide. da Vinci technology – changing the experience of surgery for people around the world.

Ventral Hernia

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Ventral Hernia
A ventral hernia is a bulge (of tissues) through an opening, or defect, within the abdominal wall muscles. 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.

An increasing number of patients have large or complex abdominal wall defects. Such defects may result from incisional hernia related to multiple abdominal operations, surgical resection of the abdominal wall, necrotizing abdominal wall infections, or therapeutic open abdomen.

Hernias generally grow larger due to pressure on them, such as a loop of intestine or fatty tissue pushing into the weak abdominal tissue or tear.

The result is a sac that forms in the abdominal wall. A bulge may appear.

If left untreated, a hernia as it grows, may become more painful. A portion of the intestine could become trapped in the abdominal wall. This can obstruct the bowel, causing severe pain, nausea, and constipation

What Causes a Hernia?
Hernias happen in all ages and in both men and women. Adult hernias usually are the result of strain on the abdominal wall.

Factors that contribute to this include aging, genetic predisposition, heavy lifting, pregnancy, athletic activities, obesity, previous surgery, constipation, and chronic coughing.

Surgical Hernia Repair
Laparoscopic ventral hernia repair is a technique to fix tears or openings in the abdominal wall using small incisions, laparoscopes (small telescopes inserted into the abdomen) and a patch (screen or mesh) to reinforce the abdominal wall.

Robotic Surgery – Robotic assisted surgery for hernia repair can increase precision, shorten both time under anesthesia and recovery duration.

Healing GERD

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Once you swallow a bite, food travels through the esophagus to the stomach. A valve-like ring of muscle called the lower esophageal sphincter opens to let the food in. Then it’s supposed to close again to prevent stomach acids from sliding up into the esophagus.

In some people, the sphincter between the stomach and esophagus doesn’t work as well as it should. This allows acid to seep into the esophagus (called acid reflux), where it can cause pain and irritation. Not everyone with acid reflux suffers from heartburn, and some people with “heartburn” symptoms don’t actually have acid reflux but may have some other condition causing this pain.

The hallmark of acid reflux is heartburn — a painful burning sensation in the middle of the chest. Heartburn typically strikes after meals and can last several hours. The discomfort may be worse after bending over or lying down. Other symptoms of severe acid reflux include a sour-tasting fluid in the back of the throat, difficulty swallowing, or feeling that food is stuck in the chest or throat. A chronic cough or asthma attacks can also be caused by acid reflux. A description of heartburn symptoms is usually all that’s needed to diagnose acid reflux.

Heartburn usually doesn’t pose a serious threat to your health. However, complications can occur with severe, frequent, and persistent acid reflux. If you have severe heartburn or heartburn two or more times a week, you may have a condition called GERD (gastroesophageal reflux disease) and you should see your doctor. Without treatment, chronic GERD can cause inflammation, ulcers, and scarring. GERD can also lead to changes in the cells lining the esophagus. Known as Barrett’s esophagus (shown here), these changes raise the risk of esophageal cancer.

Adopting lifestyle changes usually allows the body to heal itself in the majority of cases, and it means there won’t be long-term damage to the esophagus, throat, or teeth. However, sometimes lifestyle changes are not enough. More serious cases of GERD can often be treated with medications such as: antacids or surgery may be needed.

From Web MD