Sergei Dolgopolov MD General Surgeon NYC
Valery Dronsky MD General Surgeon NYC
Roman Grinberg MD General Surgeon NYC
  • best-general-surgeons-ues-nyc

Surgical Experts Dedicated to Improving Lives

2019-best-gastrointestinal-surgeons-award-new-york-NY-awards
We recently received an award for Best Gastrointestinal Surgeons in NY for 2019. Click for the Press Release.

At Lenox Hill Surgeons, our dedicated team of nyc surgeons and medical professionals provide compassionate care with the highest ethical & professional standards. In our state of the art facility, we offer surgical services using only the most cutting edge and current procedures and treatments.We specialize in general surgery, including extensive experience in performing hernia repair surgery. Our expertise is in minimally invasive surgery and robotic surgery. Minimally invasive and robotic surgery often allow patients to experience easier recovery than traditional open surgery. They also allow for more precise and less traumatic surgery. When robotic and minimally invasive surgery is not an option, we are also skilled and experienced in traditional open surgical procedures.

All of our doctors are experienced and skilled surgeons having undergone extensive training in school, residency and fellowships. They all practice medicine with ethical behavior, compassion and superb bedside manner. In the operating room they all exhibit precise mechanical abilities, analytical thinking and the ability to visualize tissue in three dimensions. These innate and learned skills allow our surgeons to be some of the most dexterous and skilled professionals in all of New York City and the Country.

Lenox Hill Surgeons

Hernia Repair Surgery – NYC Surgeon

Hernia Repair Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

best-hernia-repair-surgeon-experts-nyc-info-process-prognosis-01Hernia repair surgery entails the application of instrumental and manual procedures for correcting herniation of tissues or viscera including groin, abdomen, brain, and diaphragm. Internal organs, composed of tissues, could get herniated or bulged, forcing them to protrude via the wall encasing them. Hernias involving the groin (an inguinal hernia) and the umbilical cord (an umbilical hernia) are two of the most prevalent forms of a hernia.

Since a hernia does not heal on its own but rather expands over time, it is crucial that you opt for surgical treatment to avoid unnecessary/preventable complications in the long run. Hernia surgery, usually performed on an outpatient basis, is a moderately simple operation that can help remedy the organ’s bulging and restore it to its original position.

Steps

umbilical-hernia-surgeons-nyc-info-02Two of the most popular types of hernia repair surgery is ‘herniorrhaphy’ and ‘hernioplasty’. Herniorrhaphy-the traditional hernia repair technique-is still conducted extensively where the surgeon makes a wide and long notch over the herniated organ.  Thereafter, the physician removes the protrusion and reinstates the dislodged organ or tissues to its actual site.

Finally, the doctor sutures the hole in the muscle via which the protuberance developed, sterilizes the incision, and sews it up. Hernioplasty is very much similar to herniorrhaphy procedurally excepting that in the final step, the surgeon overlays a sterile mesh (produced from animal tissues or polypropylene) on the muscular notch rather than suturing it. The nature or type of your herniation will determine the mode of repair surgery you’ll need to opt for.

Strangulated, reducible, and irreducible hernias are the three most widespread kinds of hernias. Both of the aforementioned surgical operation procedures can be carried out using a laparoscope or via open surgery.

Benefits

Both hernioplasty and herniorrhaphy are straightforward and uncomplicated surgical repair processes that take about 30-40 minutes to complete. You won’t feel any pain as the surgery will be done using either local or general anesthesia. Majority of patients are discharged from the hospital or medical center on the very day the laparoscopic surgery is performed. The usual benefits of the laparoscopic repair operation include:-

  • Very short duration of stay
  • Faster healing
  • Reduced pain post surgery
  • Quicker return to normal life
  • Minimal costs (including all the expense heads)
  • Lower risks of infection

Side Effects

The side effects of this type of surgery, most of which are rare, involve:-

  • Swelling and redness around the incision or opening
  • Blood clot
  • Mesh pain
  • Urinary tract infection
  • Urinary incontinence
  • Infection
  • Difficulty urinating
  • Hernia recurrence
  • Neuralgia or nerve damage
  • Constipation
  • Kidney failure or complications
  • Breathing problems or pneumonia

Precautions

You must abide by the surgeon’s instructions once you return home (which are usually on the same day the surgery is carried out) for a speedy recovery. Take all the prescribed medications on time, including the anti-inflammatory drugs for minimizing the possibilities of incision swelling. Contact your surgeon instantly if you’ve recurrent spells of fever, coughs, chills, nausea, abdominal swelling, bleeding as well as experience difficulty in urinating. Make sure you get sufficient rest for at least two weeks following the operation so that you can get back to work at the earliest.

Prognosis

Most hernia surgeries are effective, enabling patients to recover fully within 4-6 weeks. A typical person who has undergone hernia repair surgery can resume normal activities 2 weeks after the procedure.

Concluding Remarks

Opting for a surgical procedure for remedying a hernia is highly recommended not only for avoiding complications which could take a fatal turn (though very rare) but also for going back to leading a normal life. You can make an appointment with our general surgeon for a detailed, one-to-one consultation.

References

 

General Surgery

Here are some brief descriptions about the different types of general surgery we perform:

Laparoscopic surgery

This is a relatively new specialty dealing with minimal access techniques using cameras and small instruments inserted through 0.3 to 1 cm incisions. Robotic surgery is now evolving from this concept (see below). Gallbladders, appendices, and colons can all be removed with this technique. Hernias are now repaired mostly laparoscopically. Most bariatric surgery is performed laparoscopically.[citation needed] General surgeons that are trained today are expected to be proficient in laparoscopic procedures.

Colorectal surgery

General surgeons treat a wide variety of major and minor colon and rectal diseases including inflammatory bowel diseases (such as ulcerative colitis or Crohn’s disease), diverticulitis, colon and rectal cancer, gastrointestinal bleeding and hemorrhoids.

Endocrine surgery

General surgeons are trained to remove all or part of the thyroid and parathyroid glands in the neck and the adrenal glands just above each kidney in the abdomen. In many communities, they are the only surgeon trained to do this. In communities that have a number of subspecialists, other subspecialty surgeons may assume responsibility for these procedures.

Surgical oncology

Surgical oncologist refers to a general surgical oncologist (a specialty of a general surgeon), but thoracic surgical oncologists, gynecologist and so forth can all be considered surgeons who specialize in treating cancer patients. The importance of training surgeons who sub-specialize in cancer surgery lies in evidence, supported by a number of clinical trials, that outcomes in surgical cancer care are positively associated to surgeon volume—i.e., the more cancer cases a surgeon treats, the more proficient he or she becomes, and his or her patients experience improved survival rates as a result. This is another controversial point, but it is generally accepted—even as common sense—that a surgeon who performs a given operation more often, will achieve superior results when compared with a surgeon who rarely performs the same procedure. This is particularly true of complex cancer resections such as pancreaticoduodenectomy for pancreatic cancer, and gastrectomy with extended (D2) lymphadenectomy for gastric cancer. Surgical oncology is generally a 2 year fellowship following completion of a general surgery residency (5-7 years).

 

Contact us at 646-846-1136 to schedule an appointment.

Liver Surgery

They say the liver is the mother of all organs. It is the body’s detoxifying machine that breaks down metabolic products and toxic substances. It produces vital enzymes and proteins for our body and also plays role in fat metabolism. Liver diseases, disorders, and tumors can cause liver failure and abnormalities in the body’s regular functions. There are various surgical treatment options for treating liver diseases and abnormalities

Types of Liver Surgery

Following are the common four types of procedures for liver surgery.

  1. Liver Biopsy

Some people regard liver biopsy as a surgical procedure, but it is basically the collection of liver tissues to diagnose any disease or problems in the liver. The procedure involves the insertion of a needle to collect the liver tissue samples. A laboratory technician will analyze the sample of tissue that will help the doctor to diagnose the liver disease or disorder. Your doctor will ask you for a liver biopsy if you have the following conditions:

  • Abnormal blood enzyme levels persistently
  • Yellowing of the skin (an indication of jaundice)
  • Liver enlargement
  • Liver abnormality found in ultrasound or scan.
  1. Liver Resection

Liver resection or partial hepatectomy is the surgical removal of a certain part of the liver. The open liver surgery is the treatment for removing tumors and the neighboring cells around the tumor from the liver.  Sometimes, the doctor would need to remove the entire lobe of the liver, called lobectomy or hemi hepatectomy.

  1. Laparoscopic Liver Surgery

Minimally invasive laparoscopic liver surgery involves removing a tumor with a few incisions without removing a whole part of the liver. Your surgeon can remove a benign or malignant tumor with only three to four key-hole incisions.

  1. Liver Transplant

Liver transplant or full hepatectomy is the removal of the diseased liver and transplanting a healthy one in its place. It is the treatment option for end-stage liver disease or total failure of the organ. This surgery option is the least common, and finding a liver donor with a good match is not easy.

Advantages of Laparoscopic Liver Surgery

Laparoscopic Liver surgery is the easier and less painful surgical treatment to remove a benign or malignant tumor from the liver. The incisions are smaller and not more than three or four. Such small incisions heal fast and the patient is back to normal in a very little time. In the case of liver resection, the incisions and stitches take a long time to recover and can cause severe pain.

Who Cannot Undergo Liver Surgery?

If the tumor has covered more than half of the liver, then liver resection and laparoscopy cannot treat the liver. A liver transplant is the only option in that case. Patients with severe liver complications are not fit for liver surgeries. Those who previously had upper abdominal surgery cannot undergo liver resection and laparoscopic surgery.

If you experience problems within your liver, contact us and get a consultation to know if  you need a biopsy or not. If you are already diagnosed with tumor or some other disorder within your liver then get in touch with Lenox Hill Surgeons. Our highly qualified surgeons have expertise in Liver Resection and Minimally Invasive Liver Laparoscopy. They will help you know which treatment options are suitable for you.

Call us at 212-988-1136 or visit lenoxhillsurgeons.com to learn more about us.

Laparoscopic Colon Resection

What Is Laparoscopic Colon Resection? The human digestive system comprises organs that help break down the food, absorb nutrients, and excrete waste material from the body. When you eat something, the food travels from the mouth to the stomach through the esophagus.

The food then enters the small intestine where it is absorbed, and the un-dissolved nutrients move into the large intestine (colon). The colon stores the waste until it is removed through rectum or anus.  The large intestine is vital to the digestive system, and adverse effects of a medical condition may require you to go through surgical intervention.

What Is Laparoscopic Colon Resection?

Essentially, Colectomy or colon resection is a surgical technique to treat the diseases affecting your colon, such as colon cancer. During the surgery, the doctor removes the cancerous part of the colon. Depending upon the severity, the surgeon may perform

  • Total colectomy – removing the colon completely
  • Partial Colectomy – removing a part of the colon affected by cancer
  • Hemi-colectomy – removing the left or right half of the colon.
  • Proctocolectomy – removing both the colon and rectum

After the removal of the cancerous portion, the surgeon sews the healthy ends of the colon to leave enough space for the waste to leave the body. However, if the surgeon has cut the colon completely, then he/she may perform a colostomy.

Conditions That Colectomy Treats

A patient may undergo a colon resection for various medical conditions associated with the large intestine.  For instance, you may need surgery for colon cancer, polyps, inflammatory bowel diseases, obstruction in the intestine, bleeding, and other problems.

  • Intestinal Blockage: Obstruction in the colon calls for urgent medical help. The surgeon may perform a total or partial colectomy to clear the colon.
  • Colon Cancer: Colon cancer affects more than 100,000 US citizens each year. However, proper screening may help prevent cancer. For the newly developed cancer, the surgeon may remove a part of the colon. On the other hand, for advanced-stage cancer, the doctor is likely to remove a bigger portion of the intestine.
  • Excessive Bleeding: To treat uncontrolled bleeding, the surgeon may perform partial colectomy.
  • Diverticulitis: In the case of complex diverticulitis, the surgeon may remove the affected area of the colon.

Preparation for the Surgery

Colon resection is a major surgical procedure, and it is better to take some preventive measure before the surgery day.

  • Talk to your doctor and avoid the medicines that may complicate the surgical procedure.
  • For certain colon resections, your doctor may ask you to keep fast hours before the surgery.
  • In some situations, the surgeon may prescribe antibiotics to evade a possible infection.
  • Your colon has to be empty before the surgery. And for this purpose, the surgeon may give you an oral solution to drink hours before the surgery.

The Surgical Procedures

Your surgeon may perform the surgery in either of the following ways:

Open Colectomy

During the traditional open surgery, the surgeon makes a large cut in the abdomen to access the colon. With the help of the surgical tools, the doctor then removes the affected tissues surrounding the colon. He/she may go for total or partial colectomy.

Laparoscopic colectomy

The minimally invasive technique, also called laparoscopic colectomy, involves several tiny incisions in the abdomen. The surgeon may mark as many as 4 to 5 cuts and insert a laparoscope through one of them.

The real-time video helps the surgeon monitor the patient’s internal organs. With a surgical tool, the doctor takes out the colon from the body and removes the affected part. After the removal, the surgeon places the colon back in the abdomen through an incision.

Final Thoughts

Laparoscopic colon resection does not cause pain or discomfort, and the patient recovers faster as compared to open colectomy. If your colon is affected and requires a colon resection, Lenox Hill Surgeons is the right place in NYC. Our dedicated and skilled surgeons have expertise in minimally invasive surgeries, and we provide quality healthcare. Contact us today and book an appointment with the best surgeons in town.

LENOX HILL SURGEONS
155 East 76th Street
Suite 1C
New York, NY 10021

646-846-1136

Surgery For The Appendix

Appendix Surgery or Appendectomy involves the removal of appendix after the occurrence of appendicitis. Let’s find out about when you need an appendix surgery, what the procedure involves, and where to get best surgeons for appendectomy.

Why do People Get an Appendix Surgery?

Appendicitis is a serious medical condition that requires an appendix surgery. It occurs due to the infection in the appendix because of growing bacteria or clogging of the stool in the appendix. The infection causes inflammation and severe pain that is only treatable with the removal of the appendix. In the case of an accident or serious injury that causes the trauma and appendicitis, appendectomy is the only surgical option available. Peritonitis is a serious condition resulting from the inflammation of the appendix and can cause the appendix to rupture.

Procedure for Appendix Surgery

First, the surgeon will administer the patient with certain antibiotics to prevent the overgrowth of bacteria. The dose of antibiotics will depend upon the degree of the damage. In the case of sepsis, the patient would have a single dose of injectable antibiotic. If the appendix has ruptured already, the surgery will start without administering the antibiotics.

The patient will undergo general anesthesia before the surgery. For the surgery, there are two common methods; open surgery and laparoscopic surgery.

Open Surgery for the Appendix Removal

The surgeon will sterilize the skin with a germ-killing solution first. In rare cases, the surgeons do need to shave the skin in the appendix area. The surgeon will then cut the skin deeply (2-3 inches) to open the portion of lower abdomen to expose the appendix.  If there is some mass growing on the appendix, the surgeon will make incisions on the mass as well.

Beneath the skin, the surgeon will make incision through the layer of protective tissues and abdominal walls to reach the appendix. Once the surgeon identifies the location of the appendix, he/she will carefully cut the appendix and remove it out of the patient’s body. After that, the surgeon will stitch the peritoneum layer, which he/she had previously ruptured for the removal of the appendix. The surgeon will stitch the skin of the lower abdomen.

Minimal Invasive Laparoscopy

Laparoscopy is the recent trend in surgical procedures, which involves cutting certain a part of an organ or removing if entirely. This process involves making three small incisions (of ¼ or ½ inches) to expose and remove the appendix instead of opening a larger portion of the stomach or lower abdomen. This surgery also uses a small camera or laparoscope, which is a mini tv-like monitor to show the appendix and the surgery procedure in an enlarged view. To remove the appendix laparoscopically, our surgeons have special instruments that can easily perform the surgery without any deep incisions.

Advantages of Laparoscopic Appendectomy

Laparoscopic appendectomy has several benefits over the open surgery appendectomy.

  • The surgeon will make only a few stitches on the patient’s body. This means the post-operative pain significantly reduces in this procedure as compared to an open surgery.
  • The recovery is also quicker.
  • The patient achieves the normal functioning of the bowel quickly.
  • The hospital stay is lesser for laparoscopic surgery.
  • Laparoscopic surgery gives better cosmetic results. The stitch marks do not look horrible.

Are you having problems with your appendix? Call us at 212-988-1136 to book an appointment. We have NYC’s best surgeons for laparoscopic appendix surgery. For more information visit our main website.

Gastroesophageal Reflux Disease (GERD)

What is gastroesophageal reflux disease (GERD)? If you have experienced acidity or heartburn many times, you are not alone. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that 20 percent of American population gets affected by Gasteresphageal reflux diseases (GERD).

More than 15 million adults in the US, especially pregnant women, suffer from heartburn daily. GERD is essentially mild acid reflux that may occur twice a week. However, some people may also experience severe acid reflux, at least once a week.

What Causes GERD to Occur?

Your digestive system is home to several digestive enzymes and acid. Normally, when you eat something, the lower esophageal sphincter (LES), i.e., the lining of the stomach, opens. It allows the food to enter the stomach and then closes. This helps to obstruct the food or any acidic enzymes from flowing back to the esophagus. However, sometimes the LES does not close properly.

As a result, the acid and digestive stomach enzymes flow back into the esophagus. The frequent backward flow of stomach acid, i.e., the acid reflux, may irritate LES, thereby weakening the lining. Hence, if your acid reflux returns multiple times every week, you probably have GERD (Gastroesophageal Reflux Disease).

Symptoms of GERD

The occurrence of the following signs or symptoms may indicate that you are likely to have GERD.

  • A sharp or burning sensation in your chest behind the breast bone
  • The sensation, also called heartburn, may get worse when you eat, lie down or bend.
  • Tightness in the upper abdomen or chest
  • Difficulty in swallowing
  • Food or sour liquid regurgitation, i.e., the backflow of stomach juices in your oral cavity
  • Sore throat
  • Developing a sour taste at the back of the mouth

Some people may have nighttime acids reflux and are likely to experience sleep disruption, chronic cough, laryngitis, and worsening asthma. Also, the chest pain may radiate toward the neck at night.

Diagnosis

People, who are obese, have connective tissue disorders, Hiatal hernia, gallbladder diseases, are prone to having GERD. Similarly, pregnant women are prone to the condition.

For the diagnosis of GERD, your doctor may conduct the following tests (as per requirement):

  • X-Ray of the Upper Digestive system: the patient gets a barium solution to drink and the doctor conducts an X-ray test to examine the esophagus.
  • Esophageal manometry: the doctor inserts a flexible tube into your esophagus to measure the rhythmic contraction of your esophageal muscles when you swallow
  • Esophageal pH monitoring: the surgeon inserts a monitor into your esophagus to measure the pH level. Usually, the doctor keeps the patient under observation for one day to see when the acid stomach enters the monitor.
  • Upper Endoscopy: the surgeon threads a flexible tube with a tiny camera down your throat to examine your esophagus and stomach. He/she may also collect a sample of the tissue (biopsy).

Treatments

Changing your lifestyle may help relieve the symptoms of GERD. For instance, reducing or abandoning smoking may help. Also, including a balanced diet and avoiding fatty food and certain beverages may work. In mild acid reflux cases, over-the-counter medications can be a good option. Also, your doctor may recommend prescription medications. However, if medicines prove to be of little help, your doctor may suggest a surgical procedure.

Nissen Fundoplication

It is a surgical procedure that exerts pressure in your lower esophagus. The surgeon folds the top of your stomach (partially or completely) around the esophagus. Thus, the stomach is tightened to prevent acid reflux. The surgeon may perform the procedure through conventional open surgery or a laparoscope. However, most surgeons prefer minimally invasive surgery.

Stretta Procedure

It is yet another minimally invasive surgical procedure. The surgeon threads into the esophagus with a small tube and uses radiation to tight the barrier between the esophagus and stomach.

LINX surgery

The surgeon folds a ring of tiny titanium beads around the junction of the esophagus and the stomach. The magnetic force between the beads helps keep the junction closed, thereby preventing the acid reflux. However, the band allows the food to pass through. The surgeons use minimally invasive surgery to implant the Linx device.

So, if you’re facing heartburn or acid reflux frequently and the symptoms are severe, you should seek medical help immediately. Our highly professional team of surgeons at Lenox Hill Surgeons has expertise in minimally invasive surgery. For consultation, appointment or surgery, contact us today.

LENOX HILL SURGEONS
646-846-1136

Dysphagia

Doo you have Dysphagia? Do you often choke or cough while swallowing food? Do you take more time than others to chew or swallow your food? Is the swallowing process painful for you? If yes, then you possibly have Dysphagia, or swallowing difficulties.

You may not have faced such problems before as swallowing problems are common in older people. However, dysphagia may occur at any point in life. Eating too fast or not properly chewing the food may cause swallowing difficulties occasionally. In case of persistent dysphagia, it is better to seek medical help.

Types of Dysphagia

People who have this condition may face problems swallowing certain foods or liquids. In extreme cases, people may not be able to swallow food at all or have to cut it into smaller pieces to avoid swallowing difficulty.

Esophageal dysphagia: After you start swallowing the food, you may feel that the food is not passing down the throat. Instead, it seems as though it has stopped in your chest.

Oropharyngeal dysphagia: Your throat muscles may become weak due to a certain condition, thereby causing swallowing difficulties. You may frequently choke or gag while swallowing, or sense that the food is going up to your nose or down the windpipe. Oropharyngeal dysphagia may lead to pneumonia.

Symptoms

The signs that suggest you are likely to have dysphagia include:

  • Coughing or choking while eating or drinking
  • Pain while swallowing (odynophagia)
  • Sensation that the food has stopped in your throat or chest
  • Persistent saliva drooling
  • Food regurgitation (sometimes through the nose)
  • Being hoarse when eating or drinking
  • Frequent heartburn
  • a sudden weight loss
  • Frequent chest infections, such as pneumonia

Causes

Swallowing difficulties may be a result of several medical conditions interfering in the swallowing process. Some of the problems that may cause dysphagia are:

  • Neurological Damage: Your oral muscles may become dysfunctional due to stroke or injury, thereby making it difficult to swallow food.
  • Achalasia: When the sphincter muscle does not relax properly, it may cause food regurgitation
  • Esophagus Stricture: Esophagus narrows down due to acid reflux or presence of tumor in the esophagus. The large food pieces get trapped in the narrowed esophagus, causing dysphagia.
  • Neurological Disorders: Certain neurological problems may also slow down your swallowing ability. These include Parkinson’s disease, multiple sclerosis, and muscular dystrophy.
  • Cancer Treatment: Chemotherapy may inflame or scar your esophagus.

Diagnosis

To devise the best treatment plan for your swallowing difficulties, your doctor may perform certain physical exams and tests to find the root cause. Besides CT scan and MRI, you may undergo:

Cineradiography/ Barium X-ray: The X-ray requires the patient to drink a barium solution. After that, the surgeon threads an X-ray machine with a camera in the patient’s esophagus.

Manometry: The purpose of this test is to evaluate the esophageal muscle contractions while swallowing.

Upper Endoscopy: The surgeon inserts an endoscope into the esophagus that captures the images of the internal structure. The doctor may collect tissue samples (biopsies) of the esophagus to check for a possible esophageal stricture, inflammation, or tumor.

Treatment

If you are facing dysphagia due to neurological disorders, the doctor will recommend some swallowing therapies and modification in the diet. Sometimes, in extreme dysphagia, the doctor may suggest feeding tubes for the patient.

For the swallowing difficulties because of the esophagus, the doctor may prescribe medicines or go for a surgical procedure.

  • Esophageal dilation: The surgeon may carry out a laparoscopic procedure for narrowed or scarred esophagus. With the help of an endoscope, the doctor will examine your esophagus. Using the images as a reference, the surgeon will then insert a balloon in the narrowed esophagus to expand its width (dilation).
  • Laparoscopic Heller Myotomy: This procedure helps cut the sphincter if it does not work (open and release food) properly.
  • Esophageal Cancer: Tumor in the esophagus requires the partial or complete resection of the esophagus through a surgery. The surgeon may either go with the traditional surgical procedure or perform a laparoscopy. If you have esophageal cancer, the surgeon may pass flexible tubes or stents in your esophagus as an alternative to balloons.

Whether you have minor swallowing difficulties or severe dysphagia that requires surgery, make sure to seek the help of the best surgeons. We, at Lenox Hill Surgeons, use the cutting edge treatments and have expertise in minimally invasive surgery.

Contact us today to book an appointment.

LENOX HILL SURGEONS
646-846-1136

Gallstones

Gallstones are not stones. Instead, they are pebble-like solid pieces of digestive fluid that form in the gallbladder. The gallbladder is a small, pear-shaped pouch, found just beneath the liver, on the right side of the abdomen. The small organ stores digestive fluid called bile that flows from the liver to your small intestine.

The salt in the bile helps digest fat easily. It also contains waste products, such as cholesterol and bilirubin. When either of the waste products begins to cluster together as a solid lump, the result is the formation of gallstones. The size of the gallstones may be as large as a golf ball, or as small as a pearl.

Types of Gallstones

Two main types of gallstones that can form in the gallbladder include:

Cholesterol Gallstones

These are the most common types accounting for 80% of gallstones in the US citizens. The cholesterol gallstones are yellowish-green in color. They mainly comprise un-dissolved cholesterol, but may also contain other components.

Pigment Gallstones

Pigment gallstones are smaller and dark brown or black. When there is excessive amount of bilirubin in the bile, it forms pigment gallstones.

Symptoms

Gallstones often cause no signs or symptoms. The patient might not be aware of a gallstone’s existence unless a doctor diagnoses it. Nearly 20% of American adults may have gallstones, yet only around three percent of them develop any symptoms.

The symptoms start to appear when a gallstone lodges into a duct, causing a blockage. Hence, you feel excruciating pain in the upper right part of the abdomen. The pain may last from a few minutes to a few hours, or may come back in episodes, referred to as an “attack.”

You might experience pain in:

  • Your right shoulder
  • The center of your abdomen, just below the breastbone
  • Back pain radiating between your shoulder blades

Or other signs like:

  • Nausea or vomiting
  • Digestive problems like bloating, heartburn, belching
  • Intolerance for greasy food
  • Jaundice and weight loss

Causes

Many reasons may cause you to have gallstones, including your weight, genes, diet, and gallbladder issues.

  • The human body needs bile, but sometimes the liver excretes more cholesterol than the bile can dissolve. Thus, it may lead to crystal or gallstone formation.
  • Bilirubin is another chemical produced during the breakdown of red blood cells. When the liver makes excessive bilirubin, it causes gallstones.
  • When your gallbladder does not empty properly, the bile becomes concentrated, thereby forming gallstones.

Risks

Certain factors make people susceptible to gallbladder issues, especially gallstones. The people who are at risk include:

  • Women, especially those who are pregnant, using birth control pills, or undergoing hormone replacement therapy
  • Obese or overweight people
  • People on a crash diet
  • Diabetic patients
  • Those using cholesterol-lowering drugs

Treatments

Silent gallstones usually don’t require any treatment. For the diagnosis, the doctor may draw a blood sample, recommend an ultrasound, endoscopy, or CT scan. However, if the symptoms appear, the patient may have to get the gallbladder removed through surgery.

Cholecystectomy

Cholecystectomy is a common procedure for gallbladder removal. The surgeon makes incisions in the abdomen and passes the surgical instruments, a light, and a camera for images, through the cuts. The doctor monitors the video and removes the gallbladder safely. After the surgery, the bile flows from your liver to the intestine directly. The patient may go home the same day following the surgery.

In open cholecystectomy, the doctor has to make bigger cuts to remove the gallbladder. Hence, the patient may have to stay in the hospital for a few days.

Medication

If surgery is not the best option for you because of your medical condition, then oral medications may help dissolve the gallstones. The doctor may prescribe Ursodiol (Actigall, Urso 250, Urso Forte), Chenodiol (Chenodol), or both. However, the process may take months or years. Thus, the gallstones may form again if the patient does not take the medication regularly.

Final Thoughts

Removing a gallbladder has no harmful effects on your digestion ability, and you can survive without a gallbladder. Our dedicated team of surgeons at Lenox Hill Surgeons uses the cutting edge technology and current procedures for a safe removal of the gallbladder. Contact us today if you have any of the symptoms stated above.

LENOX HILL SURGEONS
646-846-1136
lenoxhillsurgeons@gmail.com

Appendicitis

Appendicitis is one of the most common factors responsible for abdominal pain, which can lead to surgery. More than 5 percent of people in the US experience appendicitis at some point. However, the pain most often occurs in people aged between 10 and 30.

Appendicitis is the inflammation of a 3.5-inch long appendix tube that protrudes from the large intestine. The condition calls for an immediate treatment, most probably surgery to remove the appendix.

Leaving an inflamed appendix untreated will cause the tube to burst. Thus, the inflamed appendix may start spilling infectious bacteria into the abdominal cavity. And, it may prove fatal sometimes.

Symptoms of Appendicitis

Usually, the first sign of appendicitis is a sudden pain that begins in the upper abdomen and radiates to the lower right portion of the abdomen. The pain may become excruciating when you cough or walk.

The inflamed appendix may cause you to lose appetite, or you may feel nausea or vomiting as soon as the pain begins. Abdominal bloating and low-grade fever, usually 99 – 102 Fahrenheit, may also serve as signs of the inflammation of appendix.

The other symptoms of appendicitis include severe cramps, dull or sharp pain in the back, rectum, or the lower or upper abdomen.

What Causes Appendicitis?

While the root cause of appendicitis remains unknown in most of the cases, doctors believe that inflammation occurs when the appendix is blocked. The obstruction in the lining may occur due to hardened stool, intestinal worms, enlarged lymphoid follicles or cancer.

The blockage in the appendix results in an infection, which may multiply the bacteria. Thus, it leads to the swelling and formation of pus in the appendix, thereby causing inflammation. You may also feel severe pain in the abdominal region, and if not treated timely, the appendix may rupture.

Appendicitis’ Diagnosis

The symptoms of appendicitis are often confused with that of the gallbladder diseases, bladder or urine infection, intestinal infection, gastritis, and ovary problems. This makes the diagnosis of appendicitis tricky. Your doctor may conduct these tests for diagnosing the inflammation in the appendix.

  • Examination of the abdominal region: This helps identify the stiffening of the abdominal muscles when the doctor applies pressure on the appendix.
  • Rectal Exam: The doctor examines the lower rectum with a lubricated gloved finger.
  • Blood Test: The blood tests show a high white blood cell count in the body, thereby indicating an infection.
  • Urinalysis: The urine test helps rule out a urinary tract infection or a kidney stone as a possible cause of the pain.
  • Imaging Tests: The doctor may require an abdominal X-ray, ultrasound, a CT scan, or an MRI of the patient for the diagnosis of appendicitis.

Treatment: Appendectomy

The standard treatment for all appendicitis is appendectomy, i.e., the removal of appendicitis. The doctor may either perform open surgery or a laparoscopic surgery depending on the severity of the problem.

During the open surgery, the doctor makes an incision, which is usually 2 to 4 inches long. Doctors perform this type of surgery when the appendix has ruptured, and an excess abscess or puss has formed around it. Thus, the doctor drains the fluid and cleans the abdominal cavity.

Once the infection is under control, the doctor may perform minimally invasive or laparoscopic surgery. The surgeon will use some incisions to insert surgical instruments and a video camera into the abdominal region to remove the appendix.

Final Word

Do not neglect the pain that you experience in your abdomen. It may be a sign of an inflamed appendix. If you do not go for a treatment promptly, it may cause your appendix to rupture. Contact Lenox Hill Surgeons in NYC today and book an appointment with the experts of minimally invasive surgery.

Pancreas Surgery – What to Expect

Pancreaticoduodenectomy – what a mouthful! This long word is the technical name for one of the most common pancreas surgery procedures. Also known as the Whipple procedure, this surgery involves removing a diseased section of the pancreas. But what even is the pancreas? Why do we need it? And what should you expect if you need this surgery?

What is the Pancreas?

Many people would likely have difficulty pointing up the location of the pancreas, let alone naming what it does. The pancreas can be found in the abdomen, just behind the stomach. It is a small organ, not more than a few inches long, but one of the most essential organs for daily life. The pancreas is responsible for the creation of specific chemicals that the body uses for digestion. These chemicals, also known as enzymes, are used to break down the food that we eat. without these enzymes, we would be unable to process the fat, proteins, and carbs within our food into energy.

At the same time, the pancreas also responsible for creating the two hormones that monitor and regulate blood sugar- insulin and glucagon. In cases where the pancreas is unable to produce the hormones and enzymes it should, serious and life-threatening side effects can develop.

Why Would you Need Pancreas Surgery?

When functioning properly, the pancreas is an essential organ for regulating energy levels and providing the body with the nutrients it requires. However, in some cases, the pancreas can pose a potential threat to the rest of the body. For example, in the case of pancreatitis, those enzymes used to digest food begin the process of digestion on the pancreas itself.

Other times, the pancreas can develop cancer. This can be a serious risk, as cancer can spread to other parts of the body. This makes the pancreas a risk to the other organs within the body.

What to Expect from Pancreas Surgery

During the procedure for pancreas surgery, you will be anaesthetized and the surgeons will do what they do best. Depending on your specific needs, they may remove certain sections of the pancreas and even surrounding tissue. Usually, the general needs can be identified long before the surgery starts. Some decisions need to be made while the surgery is happening. That is why you want to have the best surgeons you can find working with you!

Once the surgery has been completed, a short stay is to be expected. This gives us an excellent opportunity to closely monitor your recovery, vital signs, and medication use to ensure you are healing properly. Your stay will likely not be more than a few days, but full recovery from pancreas surgery can take up to a few months. While you recover, there are a few side effects and changes you can expect. The first and most common is operation site pain or discomfort. Digestive problems have also been noted. As the pancreas plays such a large part in digestion, it is only to be expected that the body will have to adjust to a new way of doing things. The most noteworthy aspect of this is the fact that you will not be able to eat for a few days after the surgery.

Any time there is a procedure near the abdomen, there is a potential for essential skills such as walking and sitting up to be impaired. It will be important to, in accordance with your specific instructions from your surgeon, stay active to the extent possible.

Are you in need of pancreas surgery? Call the best surgeons in NYC for a consultation today.

LENOX HILL SURGEONS

646-846-1136

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References

https://www.pancreaticcancer.org.uk/information-and-support/treatments-for-pancreatic-cancer/surgery-for-operable-pancreatic-cancer/types-of-surgery/
https://www.cancer.org/cancer/pancreatic-cancer/treating/surgery.html
http://columbiasurgery.org/pancreas/what-expect-after-operation

History of Hernia Repair

You may think that hernia repair surgery is a relatively recent concept. And why not? Many people may view hernias as minor, insignificant problems. However, hernias can develop into serious, potentially life-threatening issues if left on checked. For centuries, people have been aware of just how dangerous a hernia can really be. Since ancient times, surgeons have been doing the best they can to correct this comment issue. Today, we have advanced techniques that allow safe and effective treatment with minimal recovery time. That has not always been the case, as we will consider.

The First Hernia Surgery

Ancient records of hernia surgery can date all the way back to ancient Egypt. Of course, there was minimal understanding of many of the concepts required to effectively perform any kind of surgery. Don’t even still, ancient Egyptians were able to understand the very basic information about hernias. For example, Even back then they understood that hernias could present a significant risk. They also understood many of the symptoms and potential causes for them. Just think! Long before computers, x-rays, and precision tools designed with the specific intent of performing surgery people wear attempting to correct such a serious issue. How effective were they? As you might expect, they were nowhere near as effective then as we are today. Due to the lack of evaluative and diagnostic understanding, many surgeries were performed in a sort of “trial and error” method. This included removing large sections of intestinal tissue, massive bloodletting to reduce the size of the hernia, and removing surrounding tissues. Some of these showed minimal results at best, leading many to dismiss the thought of treating hernias.

Technological and Medical Advancements

As time went on, more and more discoveries about anatomy and microbiology were developed that benefited the progress of hernia treatment. For example, the development of anesthetics allowed for a significant reduction in pain and therefore a more tolerable surgical experience. A growing understanding of antiseptic and hygiene techniques allowed for a much higher rate of recovery and greatly lower the risk of infection after surgery. In addition, further anatomical discoveries were constantly being made. This led to a better understanding of what exactly makes up a hernia, allowing for more effective and focused treatments. By the early 19th century, hernia surgeries were still being attempted with little to no success. This was all soon to change.

Landmark Developments

Has further medical understanding was refined, more effective treatment for a number of conditions with found. One primary development was with the implementation of prosthetic instruments. Originally, metal mesh sheets were implanted into the herniated region in order to prevent further herniation or relapse. This technique continues to be used today. Regular improvement on the materials, design, and placement of these mesh sheets continues to be made to this day. Also essential to hernia repair has been the greater use of the appropriate surgical procedures. For example, better laparoscopic techniques for entering the affected region and more effective sutures have made for better recovery times and less risk of complication. It is to be expected that constant improvement and development will be made to the surgical procedures. Advanced techniques, such as using robotic arms or lasers for increased precession, are just around the corner. We can be sure, regardless of what comes next, that the already effective and safe surgery involved in hernia repair will only get better!

Are you in need of the most up-to-date an advanced hernia surgery available today? Talk to the best surgeons in NYC to get your surgery scheduled.

Lenox Hill Surgeons, LLP
155 East 76th Street
Suite 1C
New York, NY 10021

646-846-1136

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References

https://www.ncbi.nlm.nih.gov/pubmed/19140492
https://www.ncbi.nlm.nih.gov/pubmed/14586774
https://jamanetwork.com/journals/jamasurgery/article-abstract/212807

Hernia Repair Surgery – What to Expect

There are many different types of hernias; inguinal, femoral, umbilical, incisional, and more. Regardless of the exact diagnosis, every hernia has a few things in common. First and foremost, every hernia causes pain and discomfort. Whatever the location of the hernia, every hernia repair surgery has many similarities. If you are planning a hernia repair surgery, you likely have a few questions. What exactly is involved in hernia repair surgery? What will the recovery be like? How long until I can get back to doing the things I want to do without pain or discomfort?

Surgical Prep

The first step in hernia repair surgery is discussing your exact problems with your surgeon. Although many hernias are very similar, no two people are exactly alike. Instead, talk with your surgeon about the exact location of pain, what you have found that relieve pain, how long you have been dealing with your hernia, and other information about your specific case. Your doctor will likely have questions about your personal medical history, what medications you are currently taking, if you have a family history of hernias or other similar conditions, and more.

Surgical Procedure

There are two distinct surgical procedures used for hernia repair surgery. One technique is known as herniorrhaphy. In herniorrhaphy, the abdominal cavity is opened up and the lump of tissue, called the hernia sac, is removed or placed into the correct position. Any adjustments to internal organs that are needed are then made, including blocking any further protrusions. The muscular wall that is meant to hold the soft tissue in place is then repaired. In other cases, additional support to the muscular wall is required. In these situations, a layer of mesh is placed over the weak point in the muscular wall. This procedure is known as a hernioplasty.

In some rare cases, there are hernias on both sides of the body. This will call for a longer, more intensive surgery with a potentially longer stay. The two hernias may also require different procedures in order to deal with them in a minimally invasive but effective way. Once all internal adjustments have been made, the incision site is then stitched shut.

Recovery

Hernia surgery is typically an outpatient procedure, meaning that an overnight stay is not expected. However, extenuating circumstance may arise that require an extended stay. Instead, you may only need to spend a few hours in the recovery room. Here, the staff will monitor your vital signs and ensure that no obvious complications have arisen. A standard recovery from a hernia surgery for healthy patients is usually around three weeks. Within those three weeks or so, strenuous movements must be limited. This includes bending, lifting, and rigorous activity. Even once these basic restrictions have been lifted, avoid movements that cause pain to the incision site or the former location of the hernia. It will be important to discuss recovery time with your surgeon. Even though hernia repair surgery is a common procedure, every surgery and patient is different.

Your surgeon may have share different expectations for your recovery. Keep a close eye on the incision site and the former location of the hernia. Monitor for signs of swelling, infection, or reoccurrence. These are rare, but potentially serious outcomes. Talk with your doctor if any of these occur.

Are you preparing for hernia repair surgery? Schedule a consultation with the best surgeons in NYC to and plan for your surgery.

LENOX HILL SURGEONS
155 East 76th Street
Suite 1C
New York, NY 10021
646-846-1136
lenoxhillsurgeons@gmail.com

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References

https://nyulangone.org/conditions/hernia-in-adults/types
https://www.uofmhealth.org/health-library/aba5300
https://www.webmd.com/digestive-disorders/need-surgery-hernia