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.

Colorectal Cancer Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

Colorectal Cancer Surgery

colorectal-cancer-surgeons-nyc-01When cells and tissue of your rectum and colon undergo neoplasm and start metastasizing, you could be diagnosed with colorectal cancer. Approximately 140,000 men and women are diagnosed with colorectal cancer annually which makes the malignancy one of the most prevalent forms of cancer. Surgical intervention is the best and most widely used treatment technique for dealing with colorectal cancer, usually preceded or succeeded by radiation and chemotherapy.

Though the colon or rectum could metastasize separately, both cancers are referred collectively owing to their exhibiting common traits. Cancer of the colon is more prevalent than rectal cancer.

Surgical options and methods

colorectal-cancer-medical-information-nyc-surgeons-02There are numerous types of colorectal cancer surgery based on the specific area of the large intestine that becomes cancerous. Some of the most common forms are:

  • Ileocolectomy/right colectomy – In lleocolectomy, the ileum, lying on the colon’s right end is removed together with the colon’s right section. During a right colectomy procedure, only the colon’s right part is eliminated.
  • Partial colectomy – In partial colectomy, only a specific section of the colon is expunged, as the expression indicates. After the malignant part is removed, the residual components are reconnected using a procedure known as anastomosis in medical parlance. Your bowel movement is usually not affected when you undergo partial colectomy.
  • Total abdominal colectomy – Excision of the large intestine in entirety is referred to as total abdominal colectomy.
  • The proctosigmoidectomy – proctosigmoidectomy procedure entails excising the infected part of the sigmoid colon and the rectum.
  • Total proctocolectomy – The colon and the rectum is completely removed in a total proctocolectomy operation. In case, the anus is left intact, and its functioning is smooth, then the surgeon devises an ileal pouch shaped like the letter ‘J’ that stores feces temporarily until you defecate it.
  • Abdominoperineal resection – Abdominoperineal resection involves the removal of the sigmoid colon, rectum, and anus followed by colostomy procedure for facilitating stool discharge.

Benefits

Surgeries are carried out either through the open mode or the minimally invasive, ‘keyhole’ technique where a laparoscope is used. Laparoscopic surgery is the choice option for the majority of patients as the process is less painful compared to open surgery, requires a shorter hospitalization, and a quicker recovery.

Side-effects

Like any other type of surgery, colorectal cancer surgery has the following common complications:

  • Fatigue
  • Pain
  • Appetite loss
  • Inflammation around the incision or incisions
  • Leakage of pus and fluids
  • Bleeding and laceration at the surgery site
  • Numbness
  • Organ dysfunction
  • Infection

Precautions

polyp-stages-colorectal-cancer-03After the operation, the patient experiences extreme weakness and is not able to move about without assistance. Pain medication is administered intravenously or through injections. Antibiotics are also given to combat the risks of infections. Smooth stool passage indicates that the colon is recovering. Patients should start ambulating as early as possible post-surgery to trigger bowel movement and at the same avoid strenuous activities for about a month or two to expedite healing.

Prognosis

Survival rate five years after the surgery is less than 65% in Europe and North America. Chances or rate of survival is determined by the stage of cancer. Patients have a better chance of surviving longer if the malignancy is detected early at least five times more compared to delayed diagnosis.

Concluding Remarks

Colorectal cancer is more prevalent in developed countries in comparison to developing or underdeveloped nations. Surgery is the best option for treating and reversing the adverse effects of colon and rectal cancers.

Make an appointment with one of the experts to understand if this treatment can be the best as per your case.

References

  1. http://www.healthcommunities.com/gastrointestinal-surgery/postoperative-care-colon-colon-resection.shtml
  2. https://www.cancercenter.com/colorectal-cancer/questions/
  3. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/side-effects-surgery
  4. https://www.webmd.com/colorectal-cancer/surgery-treat-colorectal-cancer#1
  5. https://www.hopkinsmedicine.org/health/articles-and-answers/ask-the-expert/colon-cancer-treatment-what-to-know-about-surgery
  6. https://www.webmd.com/colorectal-cancer/colorectal-cancer-treatment-options#1
  7. https://en.wikipedia.org/wiki/Colorectal_cancer

 

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

Adrenal Surgery

adrenal-gland-problems-surgery-medical-information-02A pair of small glands, each weighing about four to six grams, located just above the kidneys in the rear of the abdomen is known as the adrenal glands. They secrete a number of hormones which are indispensable to sustaining the regular functions of the human body. Adrenal diseases typically manifest when a local tumor is formed, either benign or malignant, and/or an overactive adrenal gland making increased amounts of any of the adrenalin hormones.

The major adrenal disorders are (too much adrenalin) pheochromocytoma/paraganglioma, (too much cortisol) Cushing’s syndrome, and (too much aldosterone) primary hyperaldosteronism.

The two most followed methods for performing adrenalectomy or surgical removal of the adrenal gland/s are minimally invasive and open operation.

Steps

top-nyc-doctors-adrenal-surgery-info-01Doctors used to make a large half to one-foot-long incision in the back, flank, or abdomen to remove any tumor in the adrenal gland in the past. Presently, with the help of minimally invasive surgery, medically known as laparoscopic adrenalectomy or laparoscopically removing the adrenal gland, can be done by making three or four incisions that are as small as a quarter to half an inch.

  • The surgery is done under general anesthesia to make the patient unconscious during the entire procedure.
  • A narrow tube-shaped instrument called a cannula is put into the upper abdomen or flank right under the ribs of the patient.
  • A tiny telescopic device known as a laparoscope connected to a highly sophisticated camera is passed through the cannula. It provides an enlarged view of the internal organs of the patient on a computer monitor.
  • Other cannulas are also inserted to allow the doctor to carefully separate the affected adrenal gland/s from the tissues. The operated adrenal gland is placed in a tiny bag after being dissected free and then extracted through any of the incisions made. Removing the entire adrenal gland for safe removal of the tumor is almost always a dire necessity.
  • The opened incisions are closed after the removal of the adrenal gland/s.

Note: The laparoscopic procedure cannot be done in a few patients, and open surgery is performed in such exceptional cases.

Benefits

Patients may be discharged one to two days after the surgery and could resume work faster than those recovering from open surgery. Outcomes of operation may vary and depends on the opted procedure and the overall condition of a patient. The most common benefits are as follows:

  • Shorter hospital stay
  • Less postoperative pain
  • Improved cosmetic result
  • Faster return to routine activity
  • Reduced risk of wound separation or herniation

Complications

Research has observed that a surgeon’s experience is directly associated with the risk potential of any complications that could be caused by surgery of the human adrenal gland/s. As such surgeries are reasonably uncommon, it is crucial to find a doctor who specializes in operative procedures of this vital gland.

Precautions

Patients should not engage in vigorous activities and avoid heavy lifting (anything that weighs more than ten pounds) for a month typically to minimize the odds of developing a hernia at the incision site. They may take a shower two days after the operation, but should not bathe and swim for a week to avoid submerging the incision area in the water.

Prognosis

laproscopic-adrenal-surgery-nyc-03The overall time for recovery is variable and differs from case to case. After laparoscopic adrenalectomy is performed, a vast majority of the treated patients usually resume their routine activities after a fortnight or a month. The overall recovery holiday after open adrenalectomy is substantially slower and one to one-and-a-half month’s time is generally required for recuperation.

Conclusion

In order to do an adrenal surgery successfully, apart from the procedural skills, one also needs careful judgment as well as a sound understanding of anatomy, relevant hormone physiology, and radiology. There are many technical approaches for such operations and choosing the appropriate one needs proper knowledge of the past medical history of the patient, the anatomy of that particular patient and the lesion, and the surgeon’s skill set as well.

Contact us today to schedule an appointment or undergo a consultation from our experts.

References

  1. https://www.sciencedirect.com/topics/medicine-and-dentistry/adrenal-surgery
  2. http://columbiasurgery.org/adrenal/adrenal-glands-and-adrenal-diseases

Liver Cancer Surgery: Steps, Benefits, Side-Effects, Precautions & Prognosis

nyc-top-surgeon-for-liver-cancer-01When an area of the human liver is surgically removed, it is known as the liver resection. The most typical reason for such operative procedures is to eliminate metastases of the liver, i.e., liver cancer. Metastases are essentially cancer-causing cells that have propagated from the liver to another area inside the body. Liver resection surgery is also recommended for benign liver problems.

Steps

A liver surgery could either be laparoscopic, also known as minimally invasive, or traditional/open. The two major types of surgery for treating early liver cancer are as follows.

  • Liver resection/lobectomy
    Removing the cancerous and also the surrounding tissues in one’s liver is called a resection. When a lobe of the patient’s liver is removed, it is known as lobectomy/hemi-hepatectomy.
  • Liver transplant
    It is performed in patients with HCC or hepatocellular liver cancer.

Benefits

resection-surgeon-for-liver-cancer-02Resection means the partial or total removal of a body organ. The human liver’s phenomenal regenerative ability permits it to continue working, even when some parts of this vital organ are removed. Liver resection provides the best opportunity for long-term survival or even cure for patients with liver cancer. Removing a malignant tumor from one’s liver is the surest way of:

  • Eradicating the cancer
  • Preventing its growth to other regions of the body
  • Curing cancer or extending one’s life expectancy

Side-Effects

  • Excessive bleeding is pretty much standard for up to forty-eight hours post-surgery
  • Acute (generally occurring in the first one to two weeks post-operation) or chronic (very rarely happening after a year post-surgery) rejection of the transplanted liver by the patient’s immune system
  • Infection
  • Sleep disturbances
  • Depression and anxiety

Precautions

Wound care:

  • The patient should religiously follow the instructions provided by the caregiver.

medical-info-liver-cancer-diagnosis-surgery-03Care provider should be contacted if the:

  • Patient has a fever
  • Wound is swollen, warm, and red
  • Region surrounding the wound is painful and does not subside with medication or rest
  • Stitches are found to be becoming loose
  • Patient is experiencing trouble breathing or chest pain and which is becoming worse over time
  • Patient is not able to ingest and is losing weight
  • Foul smelling leakage is oozing from the wound
  • Experiencing severe pain in the upper abdomen
  • Skin of the patient is turning yellow, or the eyes are becoming white
  • Wound is bleeding continuously and without any cessation
  • Patient is experiencing new and sudden pain in one’s chest, which intensifies at the time of coughing or taking deep breaths, and may also cough up blood
  • One has difficult breathing and suddenly feels lightheaded
  • One’s leg or arm feels painful, tender, and warm; and may even appear red and swollen

Prognosis

The (National Cancer Institute’s Surveillance, Epidemiology, and End Results) SEER database classifies cancer cases into the following summary stages:

  • Thirty-one in every hundred patients with localized liver cancer
  • Eleven in every hundred patients with regional liver cancer
  • Three in every hundred patients with distant liver cancer

Note: The figures mentioned above indicate to the five-year survival rate in all the three stages.

Conclusion

Surgical resection is usually recommended for patients diagnosed with major and minor liver tumors. Mortality and morbidity rates have increased for sure, after the recently growing trend of applying newer surgical procedures like laparoscopic liver resection using radio-frequency ablation to transect liver parenchyma.

Contact us today to schedule an appointment and get the required care as soon as possible.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828596/
  2. https://www.cancerresearchuk.org/about-cancer/liver-cancer/treatment/surgery/liver-transplant/problems-after-surgery
  3. https://www.drugs.com/cg/liver-resection-aftercare-instructions.html
  4. http://www.upmc.com/SERVICES/LIVER-CANCER/TREATMENTS/SURGICAL-RESECTION/Pages/default.aspx
  5. https://www.cancerresearchuk.org/about-cancer/liver-cancer/treatment/surgery/types-surgery

Hernia Repair Surgery: Overview, Types, Precautions & More

Hernia Repair Overview

abdominal-pain-do-i-need-hernia-surgery-medical-nyc-specialists-03

You’ll be considered for a hernia repair surgery if visceral tissues constituting internal organs like the brain, groin or abdomen become herniated. Herniation of the viscera including the abdomen, intestines, heart, and lungs cause these organs to become bulged or swollen, forcing them to protuberate through the walls sheathing them. Two of the most predominating kinds of a hernia is an inguinal hernia (involves the groin) and umbilical hernia (entails the umbilical cord).

Surgical intervention becomes indispensable to prevent or allay unwarranted complications shortly as a hernia usually tends to grow bigger with the passage of time. Hernia surgery is a simple procedure is conducted as an outpatient mode, doing away with the need to stay in the hospital.

Types

top-nyc-hernia-repair-surgeons-info-01

Regardless of whether your hernia is diagnosed as reducible, irreducible or strangulated, you could opt for either of the two broad types of hernia repair surgery: “genioplasty’ and :”herniorrhaphy”. Herniorrhaphy is the conventional mode of correcting or repairing a hernia.

The surgeon creates a large incision over the area surrounding the bulging tissues or organ. Then, he does away with the protuberance so that he can put the displaced organ back to its original position. At last, the opening is sutured and disinfected to keep infection at bay.

The surgical procedure of hernioplasty is nearly identical to herniorrhaphy with the exception that the surgeon instead of ligaturing the notch, places a sterilized mesh. Hernioplasty or herniorrhaphy can be done as open surgery or laparoscopically.

What Should You Keep in Mind?

You’ll be eager to go back to leading a normal life once the surgery has been carried out effectively. Do not be alarmed on seeing the IV tube and the bandages or dressings encasing the incisions after you starting gaining consciousness following the surgery. Nursing assistants and hospital staff will be there by your bedside to offer you any help you need.

The faster you’re able to eat, drink, and walk around on your own, the sooner will you be discharged. Additionally, you’ll need to urinate to be considered for an early discharge. Finally, the doctor will let you go home, if and only if there is someone to take you home.

hernia-repair-surgery-methods-faq-info-02

Since you’ll not be in a position to return to a normal lifestyle at least for the first two weeks, it’ll be better if you’ve someone who can take good care of you. Your surgeon will specify the instructions you’ll have to abide by in the days to come, in your discharge note. The doctor will also make you aware of the guidelines verbally which will usually pertain to cleaning and dressing the incisions, the medications you will have to take, the symptoms to look out for, and so on.

You’ll be given a contact number or helpline number in case you need to report a symptom or clarify an issue. You’ll become tired quickly in the first couple of weeks after the surgery but may recuperate completely within 3-6 weeks. You’ll have to amble around frequent to boost circulation which in turn will expedite healing.

You’ll have to keep the openings thoroughly dry so you may have to wait for 3-4 days before you can start showering. Since you’ll be physically weak, you’ll have to stick to a diet rich in fibers as well as take fresh fruits, vegetables and fluids to stay energetic. Pain medications and stress resulting from remaining idle could cause constipation. You can take a laxative to deal with it but only if the doctor allows it.

Concluding Remarks

If your hernia is mild, you may or may not have symptoms. You may be able to live with a herniated organ for a long period, but you never know when the herniation might aggravate leading to grave complications. Hence, it is better to go for repair surgery to stay on the safe side and for complete peace of mind.

Schedule an appointment with us to know more about the advanced forms of treatments that can aid in treating such cases.

References

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