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

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. 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.

General Surgery

Here are some brief descriptions about some general types of surgeries:

Trauma surgery/ Surgical Critical Care

In the United States and Canada, the overall responsibility for trauma care falls under the auspices of general surgery. Some general surgeons obtain advanced training in this field (most commonly surgical critical care) and specialty certification surgical critical care. General surgeons must be able to deal initially with almost any surgical emergency. Often, they are the first port of call to critically ill or gravely injured patients, and must perform a variety of procedures to stabilize such patients, such as thoracostomy, cricothyroidotomy, compartment fasciotomies and emergency laparotomy or thoracotomy to stanch bleeding. They are also called upon to staff surgical intensive care units or trauma intensive care units.

All general surgeons are trained in emergency surgery. Bleeding, infections, bowel obstructions and organ perforations are the main problems they deal with. Cholecystectomy, the surgical removal of the gallbladder, is one of the most common surgical procedures done worldwide. This is most often done electively, but the gallbladder can become acutely inflamed and require an emergency operation. Ruptures of the appendix and small bowel obstructions are other common emergencies.

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.

Breast surgery

General surgeons perform a majority of all non-cosmetic breast surgery from lumpectomy to mastectomy, especially pertaining to the evaluation and diagnosis, of breast cancer.

Vascular surgery

General surgeons can perform vascular surgery if they receive special training and certification in vascular surgery. Otherwise, these procedures are performed by vascular surgery specialists. However, general surgeons are capable of treating minor vascular disorders.

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.

Transplant surgery

Responsible for all aspects of pre-operative, operative, and post-operative care of abdominal organ transplant patients. Transplanted organs include liver, kidney, pancreas, and more rarely small bowel.

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).

Cardiothoracic surgery

Most cardiothoracic surgeons in the U.S. (D.O. or M.D.) first complete a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years).

Pediatric Surgery

Pediatric surgery is a subspecialty of general surgery. Pediatric surgeons do surgery on patients age lower than 18. pediatric surgery is 5–7 years of residency and a 2-3 year fellowship.

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

Gallbladder and Gallstone Surgery – NYC General Surgeon

Gallstone and Gallbladder Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

gallbladder-medical-information-surgery-nyc-03Gallstone and gallbladder surgery referred to as cholecystectomy in medical parlance, is an operative procedure where your gallbladder is removed. Gallbladder surgery is chiefly performed to get rid of gallstones or cholesterol stones which if not removed could lead to severe complications like cholangitis, pancreatitis, and cholecystitis. Gallbladder deletion or excision is the best solution if this biliary-tract organ becomes swollen (cholecystitis) or infected or if you’re diagnosed with biliary dyskinesia (compromised outflow of bile), choledocholithiasis or pancreatitis.

Cholecystectomy is the most popular and preferred treatment mode of doing away with gallstones as these do not resolve or dissolve as a matter of course. You know that you’re due for surgery when you suffer from acute abdominal pain, nausea, vomiting, flatulence, fever or jaundice.

Surgery Types & Methods

In very rare circumstances, gallstones can be melted away or resolved by making dietary changes like reducing consumption of fatty foods or taking certain medications. However, these strategies are, for the most part, ineffective if the stones are sizable. For nearly 80% of individuals with gallstones, surgery is the best and the only alternative.

gallstone-removal-expert-surgeon-nyc-02

There are primarily three surgical procedures that surgeons carry out for gallstone elimination: cholecystectomy (gallbladder resection), ERCP (endoscopic retrograde cholangiopancreatography), and cholecystostomy (drainage of the bladder).

  1. Cholecystectomy is the most widely used technique for clearing away cholesterol stones. Two types of gallbladder surgery are in vogue-laparoscopy (keyhole surgery) and open surgery. The laparoscopic operation is more popular in comparison to the open surgery mode because of the former’s inherent benefits.
  2. The open surgical method is resorted to especially when anatomical issues are resulting from previous gastrointestinal surgeries, like the presence of scar tissues. Though it takes roughly 1-2 hours for performing both the types of operation, open surgery entails a longer stay in the hospital and an extended recovery period, largely because of the wider opening.
  3. In ERCP, an endoscope is inserted into the small intestine via the esophagus for dealing with an obstructed common bile duct. Surgical tools are slotted in together with the endoscope for correcting the constricted or blocked sections of CBD once the gallbladder is excised. Often, it may not be possible to conduct surgery on some patients.

In these circumstances, the excess bile is drained away from the bladder with the help of a catheter. Nevertheless, these patients will have to consider surgery in the long run.

Benefits

Opting for a laparoscopic or open gallbladder surgery has its benefits. Removing a diseased or contaminated bladder ensures that you’ll be able to get back to leading a normal life quickly. Choosing laparoscopic intervention ascertains that your hospital stay will be shorter-you may be discharged on the very day the operation is performed. Also, the recuperation will be faster compared to open surgery.

The chances of the complications returning or recurring are also very slim once the surgery is done.

Side Effects

  • Bleeding
  • A hernia
  • Blood clots
  • Heart attack or stroke
  • Wound infection
  • Abdominal swelling
  • Allergic reactions from general anesthesia
  • Bile leakage
  • Pneumonia
  • The possibility of damage to organs surrounding the gallbladder

Precautions

  • Cleanse and dress the incision area periodically
  • Walk as much as you can to prevent thrombosis
  • Wear loose fitting clothes so that the incision is not abraded against
  • Follow the dietary chart prescribed by the surgeon
  • Take all medications on time and complete the course

Prognosis

gallstone-gallbladder-surgeon-specialists-experts-new-york-01As far as the short-term prognosis is concerned, the success rate of bladder operations is excellent. The kind of surgery you go for determines the recuperation period. You’ll experience mild postoperative pain if laparoscopy is involved. Talking about the long-term scenario, you’re less likely to suffer from the complications you had before the surgery.

Concluding Remarks

Laparoscopic or open surgery is the feasible option for getting relief from complications or issues related to the gallbladder. For more details about this treatment option and to evaluate if this is the right stage to get this treatment, we advise you to fix an appointment with one of our specialists for consultation.

References

 

Spleen Surgery – NYC General Surgeon

Spleen Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

spleen-surgery-medical-information-02Surgical excision of the spleen or splenectomy becomes imperative when this vital immunologic organ becomes diseased or cancerous or is damaged due to an injury or wound. You could also be a potential candidate of splenectomy if you suffer from an acute blood disorder (polycythemia vera, idiopathic thrombocytopenic purpura, hemolytic anemia or sickle cell anemia) or have a ruptured or enlarged spleen resulting from trauma. Since the spleen is a vital cog in the immunity system, helping to combat diseases and removing worn-out and damaged cells from the bloodstream, its absence could leave you vulnerable to infections.

As removal of the spleen compromises the healthy functioning of your immunological system, you’ll need to take prophylactic antibiotics and vaccines on a regular basis.

Steps

open-splenectomy-laprascopic-splenectomy-spleen-surgery-expert-surgeons-nyc-01A spleen operation is either performed as an open surgery mode or laparoscopically. In open surgery, the surgeon makes a long and broad cut across the left side of the abdomen, and after that excises the spleen. The opening is then ligatured using sterilized catgut. Open splenectomy is suitable for patients with a swollen or ruptured spleen; those with disfigured splenic tissues from past surgeries, and those who are overweight.

The procedure for laparoscopic splenectomy is nearly the same as the traditional technique only that the former is more advanced. This surgical technique entails the insertion of a laparoscope via a few tiny cuts or keyhole incisions made in the abdomen. A high-resolution video camera attached at the laparoscope’s head transmits images of the spleen and the surrounding area to a large VDU.

The surgeon based on the transmitted images channels small surgical tools inside the highlighted area for cutting off the spleen. The incisions are then sewn up.

Benefits

Splenectomy is usually the last resort to get rid of an infected or dysfunctional spleen. As the surgery can considerably weaken the immune system, the operation should be carried out only on an emergency basis. Nevertheless, a spleen surgery can help mitigate a range of health problems including but not limited to benign or malignant cysts, infection, and blood disorders that may not be treatable through other techniques.

Side effects

The risks or complications about a splenectomy usually involve:

  • Bleeding from the operated area
  • Infection
  • Heart attack or stroke
  • Thrombosis or blood clots
  • Allergic reactions resulting from general anesthesia
  • Breathing problems
  • Pus formation beneath the diaphragm
  • Pneumothorax or lung collapse
  • Herniation in the incision area
  • Venous blood clot shifting to the liver causing portal vein thrombosis
  • Organs in the vicinity of the spleen like stomach, pancreas, and gallbladder becoming dysfunctional

 Precautions

 spleen-surgery-information-prognosis-causes-procedure-best-surgeons-nyc-03Before the surgery, you’ll be recommended to stop taking specific medicinal supplements and medicines. At the same time, you may have to refrain from consuming foods and water. You also may have to go for blood transfusion, (depending on the state of your health) to make sure that you do not become deficient in blood after the operation. You’ll be inoculated with a pneumococcal vaccine to minimize risks of infection once your spleen is expunged.

Prognosis

You’ll stay in the hospital for about a week following the surgery and depend upon the severity of the complication; complete convalescence might take 5-7 weeks. In the long term, you’ll tend to stay healthy but will remain vulnerable to particular infections and to alleviate the chances of outbreak you’ll have to take prophylactic antibiotics and inoculations lifelong. For more details on how Spleen surgery can be beneficial for you, you can consult our specialists by making an appointment.

References

  1. https://www.jstor.org/stable/3406279?seq=1#page_scan_tab_contents
  2. https://www.healthline.com/health/spleen-removal#outlook
  3. https://www.webmd.com/digestive-disorders/splenectomy#1
  4. https://www.mayoclinic.org/tests-procedures/splenectomy/about/pac-20395066
  5. https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-spleen-removal-splenectomy-from-sages/
  6. https://my.clevelandclinic.org/health/treatments/14614-splenectomy
  7. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc2195

 

Pancreas Surgery – NYC General Surgeon

Pancreas Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

pancreatic-surgery-expert-surgeon-medical-information-01The pancreas being a key organ of the endocrine and digestive systems of the body is indispensable for the smooth functioning of the human body. Hence, a diseased condition of the pancreas, like a tumor, abscess or malignancy that causes pancreatitis and makes the dysfunctional organ calls for pancreatic surgery. There are different methods, or kinds of pancreas surgery and the type that a patient will have to opt for will depend upon whether his or her pancreatitis is chronic or acute.

More often than not, the condition or syndrome can be treated and managed without going for invasive intervention or surgery. Nevertheless, if an infection or degeneration of the pancreatic tissues becomes longstanding and acute, surgery is the only treatment option.

Steps

healthy-vs-inflamed-pancreas-top-nyc-surgeons-cancer-02The most common pancreatic surgery procedures include minimally invasive pancreatic resection, spleen-preserving pancreatectomy, ‘The Whipple’, and Enucleation of pancreatic tumor.’ Minimally invasive pancreatic resection surgery is conducted laparoscopically giving the interventional radiologist or gastroenterologist good access to the abdomen via tiny keyhole notches. This surgical method is appropriate for patients having pancreatic cysts.

Spleen-preserving pancreatectomy is conducted laparoscopically where the pancreas is excised, but the spleen is kept intact for preserving its immunological functionality as well as minimize the risks of complications and infections in the future. The traditional pancreatectomy method entails the removal of the spleen along with the metastatic pancreas for reversing the spread of cancer. Nevertheless, if the surgery is carried out for a benign condition like pancreatic tumor or cyst, then spleen resection is not necessary.

Enucleation process is appropriate for dealing with benign or non-cancerous tumors where these are scraped out carefully instead of expurgating a large pancreatic section.

‘The Whipple’ surgery or ‘pancreaticoduodenectomy’ is the go-to procedure for treating pancreatic cancer and also for dealing with complications or abscesses related to the bile duct, intestine, and pancreas. The surgery where the top of the pancreas, bile duct, gallbladder, and duodenum are removed can be extremely complex and demanding, fraught with risks.

Benefits

If the surgery is for treating pancreatitis or tumors, then opting for laparoscopic surgery is the best option. In such a case, recuperation is faster necessitating a shorter hospital stay. However, if the surgery is for pancreatic cancer, then the operation lasts for several hours and the patient may have to be in the hospice for at least a week.

Complete recovery might take many weeks and even months. Benefits of going for a major pancreatic surgery are:-

  • Best treatment technique for remedying cancer and reversing chronic pancreatitis
  • Increased lifespan
  • Digestive issues and complications associated with pancreas might be resolved post surgery
  • Chemotherapy and radiotherapy for continued treatment in case cancer recurs

Side Effects

pancreatic-cancer-surgeons-specialists-experts-nyc-03Pancreatic surgeries for dealing with cancer tend to be extremely complicated, and it is no wonder that such operations have a very high mortality rate. Nearly 50% of the patients report grave complications and about 2%-4% expire. The most common risks include:-

  • Wound infection or cardiac infection
  • Hemorrhage (bleeding)
  • Leakage from pancreas from the point where it is linked with the intestine
  • Allergic reaction to general anesthesia (very rare)

Precautions

Fully recuperating from a complex pancreas surgery takes time and the convalescing process could be exhausting, especially for older patients. You’ll be required to report to your surgeon 1-2 times in a month following your recovery. The doctor will evaluate your progress and may recommend CT or MRI scans, and blood tests to ensure that there is no recurrence of cancerous tumors or lesions.

Dietary and lifestyle changes to have to be made to maintain overall health and also to reduce the risks of relapse.

Prognosis

Pancreatic cancer and all other serious complications of the pancreas are, by and large, regarded as untreatable and hence incurable. Nevertheless, the mortality rates related to pancreatic cancer (post surgery) have steadily declined over the decades.

Concluding Remarks

Living without a pancreas can be a challenge for any individual. If you’re diagnosed with a tumor or inflammation of your pancreas, you can continue to live an almost normal life, provided you opt for an appropriate treatment plan and abide by our physician’s guidelines. If you’ve cancer, then surgical removal of the pancreas is the only option. However, you’ll have to keep your fingers crossed on whether cancer will recur or not.

References

  1. https://www.mayoclinic.org/tests-procedures/whipple-procedure/about/pac-20385054
  2. https://stanfordhealthcare.org/medical-treatments/c/cancer-surgery/types/complex-pancreatic-surgery.html
  3. https://www.mskcc.org/blog/drug-reduces-risk-serious-pancreatic-surgery-complication
  4. https://stanfordhealthcare.org/medical-treatments/p/pancreatic-surgery/types/spleen-preserving-pancreatectomy.html
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2023932/
  6. https://www.ariahealth.org/programs-and-services/surgery/general-surgery/pancreatic-surgery
  7. http://columbiasurgery.org/pancreas/what-expect-after-operation
  8. https://www.cancer.org/cancer/pancreatic-cancer/treating/surgery.html
  9. http://pancreatic.org/pancreatic-cancer/about-the-pancreas/prognosis/

 

 

     

 

What to do after Stomach Surgery

What You Need to Do After Stomach Surgery

top-nyc-surgeons-for-stomach-surgery-01 There are various different types of stomach surgery that can be performed for a range of different reasons. By and large, this type of surgery will be a major one, which means that you will need to be prepared for a lengthy recovery period and you need to know the ins and outs of what you should be doing once you have had the surgery.

Important factors to bear in mind

stomach-surgery-medical-information-best-surgeons-nyc-02

When you have stomach surgery, there are a number of important factors that you need to bear in mind. First off, make sure you plan ahead and arrange for someone to come and collect you from the hospital on the day of discharge. You won’t be able to drive home on your own or walk/use public transport after a major surgery, so ensure you have someone on hand to help.

Once home following the surgery, it is a good idea to have someone come and stay for a while – perhaps a few days or a week just in case there are any issues. If you live alone, arrange this in advance so that you have minimal stress to deal with once the surgery is over. In addition, you will need to get plenty of rest so you need to have someone around to do day to day tasks for you while you take it easy.

Before you leave the hospital, you will most likely receive details about what you should and shouldn’t eat after your stomach surgery. Make sure you familiarize yourself with this and check with a professional if there is something you are not sure on. The food in these plans is designed to ensure you get the vitamins and minerals you need without causing any issues, so you need to follow it.

gastrointestinal-surgery-info-expert-stomach-surgeons-03One more thing that may be beneficial depending on the type of stomach surgery you have had is an abdominal binder. This provides valuable support while you are going through the recovery period, so it may be worth speaking to your doctor to see whether it is something that could help you and boost your recovery.

Do bear in mind that there are generally a variety of side effects that come with stomach surgery, so you need to prepare yourself for this. Your doctor will be able to provide further information based on the surgery and your general health.

Seek advice from an expert

 To learn more about recovering after major stomach surgery, you can get in touch with one of the best general surgeons in NYC for advice and information.

 

 

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

fresh-food-post-hernia-surgery-during-recovery-03You 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.

Eat fresh, organic foods, and include more vegetables and fruits in your diets to keep constipation at bay. 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

 

Laparoscopic appendectomy – NYC General Surgeon

Laparoscopic appendectomy: Steps, Benefits, Side-Effects, Precautions & Prognosis

top-nyc-surgeon-for-laparoscopic-appendectomy-appendicitis-01The procedure of surgically removing the narrow, elongated tube attached to the colon-known as an appendix when it becomes diseased, inflamed or infected (appendicitis) is called appendectomy. It is normally carried out on an emergency basis as swollen appendicitis could burst if not excised, causing the clogged stool and bacteria to spread. It would eventually infect other gastrointestinal organs and lead to peritonitis-a life-threatening condition. A ruptured appendix could also create an abdominal abscess which is also a grave condition that could endanger your life.

Steps

Generally, two kinds of appendectomy are carried out to do away with appendicitis:

  1. The traditional ‘open appendectomy’
  2. Laparoscopic appendectomy (a more advanced form of surgery)

laparoscopic-appendectomy-info-procedure-surgical-experts-02Open appendectomy is more suitable for patients whose appendices have split open and also for those who have undergone abdominal surgery before.

A laparoscopic appendectomy, on the other hand, involves accessing the appendix via three tiny incisions or openings made in the lower abdomen. A cannula filled with carbon dioxide (a slender and small tube) is inserted through the openings for inflating the abdomen following which a laparoscope is slotted in.

A high-resolution camera fixed at the head of the laparoscope transmits the image to a display screen. The displayed images will clearly show the precise location of the appendix which in turn will help the surgeon to channelize the surgical instruments for ligation (of the appendix) and excising it. Keyhole surgery usually resorts if the patient happens to be overweight and aged.

Benefits

The specific benefits of laparoscopic appendectomy vary from one patient to another, depending upon his or her condition. Nevertheless, the common benefits entail:

  • Short stay in the hospital
  • Reduced postoperative pain
  • Faster restoration of normal bowel function
  • Speedier return to a normal lifestyle

Side Effects

The associated risk factors or complications are more or less the same for both laparoscopic appendectomy and open appendectomy. Following are some common side effects:

  • Bleeding from the operated site
  • Seepage from the colonic edge, especially at the juncture from where it was ligatured and removed
  • Clotting of the blood vessels in the deeper venous layer and the clots getting transported to the lungs causing pulmonary embolism which could turn fatal
  • Increased likelihood of the urinary bladder, ureter, large and small intestines suffering injury
  • Heightened risk of infection

Precautions

nyc-appendix-removal-surgeons-specialists-03Once you’re through with the surgery, you’ll need to abide by the surgeon’s instructions to stay safe and secure. Your surgeon will generally list the following instructions and precautions:

  • Walking from the day following the surgery to minimize chances of muscle soreness and blood clots
  • Taking the prescribed medications on time and completing the medicine course
  • Cleaning the incisions regularly to prevent infection risks
  • Watching out for symptoms of infection diarrhea, abdominal cramps, and inflammation in the incisions and reporting the same to your physician immediately

Prognosis

Most patients convalesce from appendicitis within 4-5 weeks of the conduction of laparoscopic appendectomy. Nevertheless, a very slim chance of getting infected is always present.   

Concluding Remarks

Laparoscopic appendectomy is generally resorted to when there is imminent risk of the inflamed appendix bursting open. The risks related to leaving appendicitis untreated are remarkably grave and could endanger the affected individual’s life. For complete information on laparoscopic appendix surgery of the appendix, you can contact our general surgeon and make an appointment with him for possible surgery.

References

  1. https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-appendectomy-from-sages/
  2. https://www.healthline.com/health/appendectomy#recovery
  3. https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/appendectomy_92,P07686
  4. https://www.everydayhealth.com/appendicitis/guide/appendectomy/
  5. https://www.findatopdoc.com/Healthy-Living/Everything-You-Need-to-Know-About-an-Appendectomy
  6. https://www.cochrane.org/CD006437/COLOCA_determining-optimal-method-securely-closing-base-appendix-during-keyhole-surgery-after-removal
  7. https://www.healthpages.org/surgical-care/what-kind-surgeon/
  8. https://www.cochrane.org/CD006437/COLOCA_determining-optimal-method-securely-closing-base-appendix-during-keyhole-surgery-after-removal

 

 

Surgery for Esophageal Cancer – General Surgeon NYC

Esophagus Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

expert-top-esophagectomy-cancer-surgeon-nyc-01

Esophagogastrectomy or esophagus surgery entails doing away with the entire esophagus (and often a stomach part) for treating esophageal cancer, Barrett’s esophagus, achalasia, esophageal stenosis, and GERD. The thoracic surgeon transforms the remaining section of the stomach into a tubular form serving as the replacement for the excised esophagus. The reconstructed esophagus enables the patient to swallow as he or she was doing before the surgery.

Steps

A surgical team comprising of medical specialists and headed by a thoracic or general surgeon performs esophagogastrectomy. The surgical procedure is usually open-type and is carried out in three separate ways.

  1. Transthoracic esophagectomy (TTE) is conducted via the chest cavity
  2. Transmittal esophagectomy (THE) is performed by making incisions in the breastbone and the neck’s left side
  3. En bloc esophagectomy is performed by perforating the abdomen, chest, and neck

Nowadays, the majority of the esophageal surgeries are done using the minimally-invasive laparoscopic procedure where 5-6 fine incisions are made in the abdomen, chest, and neck. The total number of slits (along with their locations) to be made are decided based on the purpose of carrying out the operation and whether the patient has undergone abdominal or thoracic surgeries on previous occasions.

Regardless of the type or method used, the operation is complex thereby necessitating an extended stay in the hospital. If the metastasis is limited to the esophagus and not spread further, excising the gullet and adjacent lymph nodes might help reverse cancer. Alas, most of the cases are detected at an advanced stage compelling the surgeon to go for a compound surgery.

 Benefits

esophageal-cancer-surgeons-minimally-invasive-esophagectomy-nyc-02

Minimally invasive esophagectomy has proven to be more effective compared to open esophagectomy as the postoperative mortality and morbidity rates related to the former are much lower. There are numerous studies to corroborate the outcomes associated with MIE are better than PE. Some of the likely benefits associated with MIE vis-à-vis PE comprise:

  • Ashorter period of hospitalization
  • Less painful procedure
  • Reduced risk of complications or infections
  • Less bleeding (and hence fewer transfusions)
  • Speedier return to leading a normal life

Side Effects

Some complications related to esophageal surgery are common to other forms of surgery including but not limited to:

  • Stroke and heart attack (while the operation is in progress)
  • Shortness of breath
  • Anastomotic leaking (low blood pressure, vomiting, surgical wound drainage, increased heart rate, and so on)
  • Bleeding
  • Pulmonary embolism

Complications or risks particularly associated with esophagogastrectomy (which are somewhat rare) include:

  • Acute chest infection
  • Pulmonary complications, particularly pneumonia
  • An injury or wound to the adjacent organs during the operation
  • Leakage at the junction of the conjoined stomach and esophagus

Precautions

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The surgeon who will operate will spell out the risks about the surgery as well as the preparations and precautions you to need to take before, after and during the procedure. You’ll have to quit smoking altogether at least before the surgery and possibly afterward as well. You’ll have to abide by the instructions specified by your surgeon once you’re discharged from the hospital.

The precautions that you’ll need to take will revolve around your diets, medications, clothing, personal accessories, and lifestyle.

Prognosis

The quality of life of most patients improves post-surgery, but some complications linger on. Follow-up care in the form of pain management, lung therapy, psychosocial care, and nutritional evaluations are highly recommended by the medic to keep the complications or risks at bay.

Concluding Remarks

Minimally invasive esophagectomy or esophagogastrectomy is evidentially the best form of surgical treatment for patients with esophageal cancer. If you or somebody close to you has been diagnosed with neoplasm of the esophagus, you can contact us to make an appointment with our general surgeon for a consultation.

References

  1. https://www.uwhealth.org/healthfacts/surgery/4281.pdf
  2. https://www.cancer.org/cancer/esophagus-cancer/treating/surgery.html
  3. https://www.ariahealth.org/programs-and-services/surgery/general-surgery/surgery-for-esophagus
  4. https://www.cancercenter.com/esophageal-cancer/surgery/
  5. https://www.healthline.com/health/esophagectomy-open#postsurgery
  6. https://www.cancercenter.com/esophageal-cancer/da-vinci-surgical-system/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283863/
  8. https://www.mayoclinic.org/tests-procedures/esophagectomy/about/pac-20385084
  9. https://www.uwhealth.org/healthfacts/surgery/4281.pdf
  10. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contentid=154

 

Stomach Surgery: Gastric Bypass by NYC Top Surgeon

Stomach Surgery (Gastric Bypass): Steps, Benefits, Side-Effects, Precautions & Prognosis

top-gastric-bypass-surgeons-surgeon-ny-nyc-01Gastric bypass is a type of surgical process chiefly carried out for treating a series of lifestyle conditions like type 2 diabetes, hypertension, obesity, and sleep apnea. These conditions more often than not occur concomitantly. The surgery is performed using a laparoscope (an elongated & slim tube featuring a high-resolution camera with intense light at the top) that is popped inside a slit made in the belly.

The laparoscope allows the surgeon to view the entire abdomen to restructure the small intestine to enable food to bypass the duodenum. This rearrangement leads to the body absorbing and assimilating fewer nutrients and calories, thereby enabling you to shed excess flab as well as stay fit and trim in the long run.

Steps

Stomach surgery is conducted in two distinct manners namely, open surgery and laparoscopy or laparoscopic surgery. In open surgery, the surgeon uses a scalpel for cutting open the stomach while in laparoscopy numerous small cuts are made in the abdomen. The end objective of both the types of surgery is to clearly view the digestive organs and the gastrointestinal tract and carry out the operation effectively.

The bypass surgery involves two necessary steps:
gastric-bypass-surgery-stomach-stapling-experts-info-031. The surgeon makes use of staples for sectioning the stomach into two halves: a larger bottom-half and a smaller upper half. The goal is to decrease the stomach’s size-the eventually reduced the volume of the upper section (known as pouch where the swallowed food will settle) will make you consume less, thereby letting you slim down.
2. The bypass surgery is performed in the 2nd step. The surgeon creates a notch in the pouch and links the jejunum (the initial part of the small intestine) with the opening. So, whatever you take will pass directly from the stomach’s upper pocket to the small intestine via this aperture, ultimately making you take in lesser calories.

On the whole, laparoscopy is preferred over general surgery as the former is less painful, involves shorter hospitalization and faster recuperation, and risks of infections are also lower.

Benefits

  • The Roux-en-Y gastric bypass (the medical term for gastric surgery) results in considerable weight loss provided you fully abide by the instructions
  • A good proportion of patients can maintain the postoperative bodyweight even 15-16 years after the surgery
  • Optimal use of stored or available energy
  • Feeling of fullness after taking a small meal and diminished appetite

Side effects

Like any other surgical procedure, gastric bypass is not without its complications and side effects. The following complications have been observed:

  • Gastrointestinal/intra-abdominal hemorrhage
  • Venous thromboembolism
  •  Increased risk of intra-abdominal infections like blisters and peritonitis
  • Bowel obstruction
  • A hernia
  • Dumping of contents into the jejunum more frequently, especially when excessive foods or sugary foods are eaten
  • Nutritional deficiencies (deficiency of calcium, iron, zinc, and folate as well as vitamins A, B1, and B12)

Precautions

There are certain precautions you’ll need to take once you’re released from the hospital following your surgery:

  • Taking the prescribed medications on a regular basis
  • Taking multivitamins, vitamin D, calcium, and vitamin B12 every day
  • Taking balanced diets with limited consumption of calories
  • Exercising daily for at least half an hour
  • Remaining socially active
  • Regular follow-up with the surgeon

Prognosis

nyc-dr-surgeon-specialist-gastric-bypass-surgery-for-weight-loss-02Majority of individuals who opt for gastric surgery can lose 65% of their excess bodyweight. About 85% of those who undergo gastric bypass are successful in maintaining 50% of the excess weight they lost initially.

Concluding Remarks

Though gastric surgery is a practical solution for getting rid of inordinate bodyweight, the procedure can never be a panacea for obesity. If you wish to keep your weight under check post surgery and lead a fulfilling, healthy life, you’ll need to make lifestyle changes as well as heed dietary and exercise guidelines. To know more about stomach surgery as well as to fix an appointment with our bariatric surgeon, you can send us an email or contact us via phone.

References

  1. https://bariatric.surgery.ucsf.edu/conditions–procedures/laparoscopic-gastric-bypass.aspx
  2. https://medlineplus.gov/ency/article/007199.htm
  3. https://asmbs.org/patients/bariatric-surgery-procedures
  4. https://www.healthline.com/health/laparoscopy
  5. https://obesitynewstoday.com/gastric-bypass-success-rate/
  6. https://www.ucsfhealth.org/education/life_after_bariatric_surgery/
  7. https://www.acefitness.org/education-and-resources/lifestyle/blog/896/after-gastric-bypass-surgery-are-there-specific-exercise-precautions-i-should-take

 

Esophagus Surgery

What Happens After Esophagus Surgery?

top-esophagus-surgery-specialist-surgeon-nyc-ny-01 The esophagus plays a vital part in our functioning, as it is the tube that enabled food to be moved from your throat when you swallow through to your stomach. This tube, which is around eight inches in length, is made up of muscles, which then contract to move food and drink along to your stomach.

 Anyone that suffers from cancer of the esophagus or from severe damage of the stomach may find that they are in need of surgery. Either a section or the entire esophagus may need to be removed depending on the condition and the extent of the damage.  In the event that the entire esophagus has to be removed, it is then rebuilt using sections of either the stomach or the large intestine.

What to expect

 As you can imagine, this is a major surgery and the recovery period can be lengthy depending on the surgery carried out and any complications that may have arisen. You may need to spend a day or two in a high dependency ward immediately after the surgery, as this is a big operation. Being in this type of unit means that medics can keep a closer eye on you.

There will be a number of tubes in you when you come round for the surgery. These serve functions such as administering fluids, draining blood and fluid, draining the chest, and even checking on your blood pressure. In addition, once you start to come round properly and the anesthetic wears off, you will experience some pain and discomfort but will receive painkillers to help deal with this.

After a couple of days, you may be moved to a standard ward but you should expect to be in hospital for around ten days or so. After the surgery, you will have dressings applied to the wounds, and these will be changed after a couple of days and the wounds cleaned by medical staff. In addition, the clips or stitches that you have will stay in for around ten days and are generally removed prior to you leaving the hospital to go home. In the event you cannot have them taken out before being discharged, a nurse may come out to do this or you may have to return to hospital to have them removed.

Prior to your discharge, it is important that you pay careful attention to the information provided to you in relation to caring for your wounds while you heal.

 Find out more from our expert

 If you would like further information about esophagus surgery and would like to speak to an expert, get in touch with the best general surgeon in NYC today.

NYC General Surgeons Discuss Rheumatoid Arthritis

What is Rheumatoid Arthritis?

rheumatoid-arthritis-info-02

According to the Arthritis Foundation, there are approximately 1.5 million Americans who are living with rheumatoid arthritis right now. Both men and women can develop it, but statistics show that women are almost three times more likely to suffer from the condition. If you have recently been diagnosed with rheumatoid arthritis, or suspect you may have it, it’s imperative to learn all you can so you can find the best treatment plan for your specific needs.

Understanding Rheumatoid Arthritis

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Classed as a chronic inflammatory autoimmune disorder, rheumatoid arthritis can severely affect a number of areas on a person’s body. While many people assume it just affects the joints, it doesn’t stop there. Rheumatoid arthritis can also affect a person’s heart, lungs, blood vessels, eyes, and even their skin. When a person has rheumatoid arthritis, their own body turns against itself and starts attacking the tissue.

Over time, it can cause swelling which is exceptionally painful, joint deformity, and even bone erosion.

What Are the Signs and Symptoms?

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In the beginning stages of rheumatoid arthritis, typically the person may notice stiffness of the joints after activity or, in the morning, swollen joints, tender joints – joints that feel warm to the touch. Weight loss, fatigue, and even a fever are other common symptoms.
While each case is different, it tends to start in the fingers and toes; in other words, the smaller joints.

What Are the Causes?

While doctors understand how rheumatoid arthritis develops, what they are unclear about is what actually sets off that motion or process. When a body’s immune system starts to attack the synovium, then the process begins.
Some doctors believe that genes play a big factor in determining whether or not you will develop it, while others point towards environmental factors and even certain bacterial viruses.

What Are the Treatment Options?

rheumatoid-arthritis-treatment-04Because rheumatoid arthritis gets worse over time, leaving it is not an option. You want to get a proper diagnosis as early as possible, and then start up with an appropriate course of action. Treatment can include a medication such as NSAIDs and/or steroids, as well as physical therapy.
In severe or advanced cases, it may be necessary to have a surgeon repair or even rebuild the tissue that has been damaged. This will help to prevent more problems down the road.

Contact us today to schedule an appointment with the best surgeons in Manhattan.