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, including extensive experience in performing hernia repair surgery. Our expertise is in minimally invasive surgery and robotic surgery. Minimally invasive and robotic surgery often allow patients to experience easier recovery than traditional open surgery. They also allow for more precise and less traumatic surgery. When robotic and minimally invasive surgery is not an option, we are also skilled and experienced in traditional open surgical procedures.

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

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

 

General Surgery

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

Laparoscopic surgery

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

Colorectal surgery

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

Endocrine surgery

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

Surgical oncology

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

 

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

What are the Symptoms of a Hernia?

signs-of-hernia-what-look-for-02A hernia is a painful condition, so you no doubt want a quick answer to that question, “What are the Symptoms of a Hernia?” Unfortunately, this answer will greatly depend on your own assessment of yourself. In order to correctly identify a hernia, there are a few specific signs you should be looking for. If you are in intense pain and are seriously concerned, talk to your doctor. This article is solely intended to assist people dealing with minimal pain and are simply curious. It is not meant to be used in place of an accurate, medical evaluation.

What is a Hernia?

In the abdominal cavity, the internal organs and structures are held in place by the abdominal muscles. Through typical use, the abdominal muscles, or abs, have a natural tension that can hold the contents of the abdominal cavity well. However, whether due to lack of use or overexertion, the integrity of the abdominal wall gives way and a small subsection of the intestines, or some other mass of tissue, protrudes out. This protrusion can potentially cause serious problems. For example, a hernia can lead to an intestinal blockage. This blockage is a serious issue and would require emergency medical attention.

The most important factor in the safety and recovery from a hernia is early identification. If closely monitored by a qualified medical professional from early on, the risk of hernia complication is greatly reduced.

Bulging

bulging-hernia-03One of the most commonly noticed signs of a hernia is bulging. Due to the very nature of how a hernia works, the affected area will bulge, creating a lump that is the hernia itself. Identifying this lump is one of the most important diagnostic tools available. The exact location of the herniated lump will vary depending on the diagnosis. In general, the hernia will be in the region after which it is named. An umbilical hernia, for instance, is located in the umbilical region at the belly button.

A femoral hernia can be found in the inner thigh area. An inguinal hernia is a hernia in the groin. Surgical hernias can also develop at the site of a relatively recent surgical incision.

Swelling

Another diagnostic sign of a hernia is swelling. Although easily confused with the bulging mentioned above, swelling is a separate and distinct symptom altogether. Swelling involves more than just visible confirmation. Swelling of the affected area will also bring redness, warmth, and discomfort when touched.

Pain

pain-from-hernia-symptoms-04The pain associated with a hernia is different than the pain caused by other means. When dealing with a hernia, the level of pain will vary depending on position and motion. For example, most people complain of greater pain when bending, lifting, or even coughing. The pain that hernias produce can vary from person a person, but typically is a dull ache in the region affected.

The difficulty with dealing with hernia pain is it the pain is not constant. Many times, people feel the intense pain that comes from exerting pressure on a hernia and schedule an appointment with a doctor. However, by the time they go to the doctor, it has been long enough that they forget the exact nature of the pain they’re dealing with this can make it difficult to relay necessary information to your doctor.

After reading this, do you think you have a hernia? Schedule an appointment with the best surgeons in NYC to develop a custom plan for dealing with your hernia.

Call Today: 646 -846-1136

 

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References:

https://www.uofmhealth.org/health-library/aba5300

https://www.webmd.com/digestive-disorders/types-of-hernias#1

https://nyulangone.org/conditions/hernia-in-adults/types

https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/symptoms-causes/syc-20351547 

Abdominal Hernia Repair

top-nyc-general-surgeons-for-hernia-repair-01Abdominal hernias account for hundreds of thousands of surgical procedures every year. Even within the category of abdominal hernias, there are many different hernias that can occur. In addition, everyone will present a little bit differently with regard to how their hernia affects them. You may wonder, though, what exactly is a hernia? How can a hernia affect your life? What are the treatment options available to you?

What is a Hernia?

In the body, the internal structures, including organs and other tissues, are held in place by muscles that are kept tight and strong. A hernia is found when a section of soft tissue, commonly the intestines, pushes through a weakened section of the abdominal muscle wall that typically holds it in place. This can happen for a number of reasons, all of which are related to increased pressure within the abdominal cavity. For example, bending over and lifting a heavy object compresses the space in the chest and puts added pressure on the abdominal cavity. The small section of tissue that is expelled is the hernia.

How Does an Abdominal Hernia Affect you?

abdominal-hernia-info-02Even though many people may have the same type of hernia, or a hernia in the same region, they will not all have the same symptoms. For some people, they may not even know about their hernia until a doctor finds it on a routine physical exam. For others, the hernia may become painful in the moment it is formed.

Some hernias are not, on their own, harmful. Most often, though, a hernia is painful, especially during strenuous activity, such as lifting or heavy coughing. This hernia can also cause additional problems, such as intestinal blockages or infection. Usually, though, a hernia is found either on accident or during a particularly rigorous task. In fact, many people have hernias for years before even being aware of their presence.

How can you Treat an Abdominal Hernia?

hernia-repair-surgery-surgeons-03The first and most important principle in treating an abdominal hernia is not making it worse. This includes limiting bending and heavy lifting, utilizing proper body mechanics principles, and trying to limit strain on the abdominal wall. If the hernia is known to have been caused or exacerbated by a persistent cough, trying to remedy the cough will be a high priority as well.

It will also be important to monitor the hernia closely. If the hernia changes size, becomes warm, or becomes more painful, it will be important to alert your doctor. This can be a sign of infection, which can lead to many complications.

No matter what the cause of the hernia was, though, hernias cannot repair themselves. If you decide that the hernia needs to be repaired through surgery, call the best surgeons in NYC. There are a number of different procedures that can be followed to help treat a hernia. For example, hernioplasty can be performed. During a hernioplasty, the herniated protrusion is pushed back into place behind the muscle wall and a small piece of mesh is placed over the hole. This allows for greater stability and decreased risk of further herniation. In other cases, the muscular wall can simply be stitched up, with no additional hardware required.

Do you have an abdominal or other type of hernia? Not sure what to expect? Call the best general surgeons in NYC so we can figure out how we can best handle your case.

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

646-846-1136

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References

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-abdominal-hernias-do-not-go-away-on-their-own/

https://my.clevelandclinic.org/health/diseases/15757-hernia

https://www.merckmanuals.com/home/digestive-disorders/gastrointestinal-emergencies/abdominal-wall-hernias

Causes & Symptoms of Hernias

causes-symptoms-hernias-01Hernias are widely common, with almost 2% of the population suffering from hernias. This may seem like a small number, but in the United States of America alone that adds up to around 600,000 people dealing with hernias. But what exactly is a hernia? What causes so many people to have hernias? And how does having a hernia affect you?

What is a Hernia?

A hernia is a protrusion of soft tissue, usually an organ or fat tissue, through the muscular lining that typically would hold it in place. One of the most common types of hernias is an inguinal hernia. In this case, the abdominal muscles that hold the intestines in place can grow weak and develop gaps that allow a small section of the intestine to jut out. This segment of the intestine can eventually become swollen, painful, and cause discomfort during regular tasks.

Many people complain of pain associated with bending, lifting, and coughing, as all of these activities create pressure on the herniated section of the abdominal cavity. Although a hernia itself may not be hazardous initially, it can lead to many other medical complications.

What Causes Hernias?

When the muscular lining that keeps organs in place grows weak, the integrity of the muscular “wall” can fail, creating weak spots. These spots can then become susceptible to internal structures pushing out and herniating. This herniation typically happens initially during a period of intense pressure. For example, exerting oneself while lifting an object can cause pressure in the abdominal cavity and result in a hernia.

Prolonged, chronic coughing can weaken the structural muscles in place, with repeated strain reducing the integrity of the muscle. Additionally, a surgical incision, if not provided enough time to heal properly, can facilitate a weak spot in the muscular lining and allow for herniation.

Congenital problems can also result in herniation in cases where the abdominal wall does not fully develop in utero. There are a number of complications that can increase the risk of herniation. This includes pregnancy, heavy lifting, rapid weight gain, chronic coughing, constipation, and recent surgical activity in the surrounding area.

What are the Symptoms of Hernias?

The most commonly reported symptom of a hernia is pain. The exact nature of the pain experienced varies from person to person, but many people note greater pain when additional pressure is applied to the abdominal region. This includes lifting, bending, coughing, or other physical exertion with straining.

Hernias are not always found as soon as they occur. Usually, it takes repeated pressure and exertion for the hernia to be noted. After a number of years, a hernia is usually identified correctly by self-assessment. A hernia does not correct itself, but would instead require surgical treatment to repair the damage.

Complications of Hernias

hernia-repair-surgeon-nyc-02

Although a hernia on its own does not require emergency treatment, there are a number of situations in which urgent action may be required. Herniated areas may not receive the blood supply they require and are at a higher risk of infection. If a hernia has become swollen, warmer than usual, or extremely painful, this can be a sign of infection. In addition, depending on the location, a hernia can cause obstruction to the bowel and digestive tract. This can quickly become an urgent situation requiring emergency medical correction.

Do you think you might have a hernia? Call the best surgeons in NYC to discuss your case and your treatment options.

646-846-1136

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References:

https://www.webmd.com/digestive-disorders/types-of-hernias#1

https://www.webmd.com/digestive-disorders/understanding-hernia-basics

https://www.uofmhealth.org/health-library/aba5300

Small Intestine Surgery – What to Expect

small-intestine-surgery-01The small intestine is actually a very long and essential organ for daily function. Measuring around 20 ft in full-grown adults, the small intestine responsible for the majority of digestion. However, there are times that part of the small intestine must be removed. In these cases, a small intestine resection, or surgery, can be completed. But how much of a small intestine can really be removed? How essential is the small intestine? What does small intestine surgery entail? And what is recovery like for small intestine surgery?

What is the Small Intestine?

nyc-surgeons-for-intestine-surgery-specialists-02

The small intestine is an essential organ in the process of digestion. When food enters the body, the digestive process begins as you chew your food. This breaks the food down from large chunks into smaller, more manageable chunks. Saliva is also involved, chemically breaking down the different parts of the food. Next, the food travels down the throat, through the esophagus, and to the stomach.

In the stomach, more aggressive enzymes continue to break down the food. Muscular contractions are also responsible for preparing the food for further digestion. The small intestine then receives the food from the stomach. Here, even more enzymes-those created by the pancreas and the liver- break down the food even more. small intestines where the majority of nutrient absorption is completed in the digestive tract. Finally, The food travels to the large intestine, or the colon. Once in the colon, leftover waste that could not be used in the digestive process is excreted. As we can see, the small intestine is essential for the proper breakdown of food and digestion.

Why Would you Need Small Intestine Surgery?

small-intestine-surgery-recovery-info-03There are a few different reasons that small intestine surgery might be deemed necessary.one of the most common causes for small intestine surgery is a blockage within the organ. As food travels through the small intestines, it may block the passage of other foods through the intestines. This can cause major problems, including infection, disease, constipation, and even potentially death. In cases where there is a blockage within the intestines, surgery is one of the most effective techniques to remediate that.

Because the small intestine is so long, it is possible to remove only a small section of it. During the process of digestion within the small intestine, vitamins and nutrients are absorbed through the lining of the intestinal wall. Therefore, a top priority for surgeons is that of leaving as much intestinal wall intact as possible. In other cases, a section of the small intestine may become diseased or cancerous. Small intestines surgery may be completed in order to protect the rest of the small intestine. If this disease were to spread, the entire small intestine could be compromised.

What to Expect from Small Intestine Surgery Recovery

The small intestine is essential for our daily life. any changes that we make to the small intestine will have an immediate impact on our daily routine. Obviously, your diet will have to change. Just prior to and shortly after the surgery, you will not be able to eat or drink anything. A nasogastric tube movie placed to give you the nutrients you need. This is typically removed within the first week of recovery. Once you are at home, activity restrictions will help protect the incision site and small intestine. Any activity that causes stress to the abdominal region, such as heavy lifting, is to be avoided.

Do you need small intestine surgery? Contact the best surgeons in NYC and schedule an appointment today.

646-846-1136

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References:

https://medlineplus.gov/ency/article/002943.htm

https://www.ariahealth.org/programs-and-services/surgery/general-surgery/surgery-of-the-small-intestine

https://www.cancer.org/cancer/small-intestine-cancer/treating/surgery.html

https://www.oncolink.org/cancers/gastrointestinal/small-bowel-cancers/small-bowel-resection

Liver Surgery – What to Expect

nyc-surgeon-for-liver-surgery-01The little is one of the most important organs in the body, responsible for filtering blood and detoxifying. However, under certain circumstances, the liver or some suction thereof must be removed from the body. But what exactly does the liver do? Why would the liver need to be removed? And what should you expect from liver surgery and recovery?

The Role of the Liver

The liver is located on the right side of the abdomen underneath the rib cage. The primary responsibility of the liver is blood filtration and chemical detoxification or absorption. Additional proteins and enzymes are also created in the liver. Drugs, including painkillers, some supplements, and alcohol are all processed by the liver. In addition, bile that is stored in the gallbladder is created by the liver. Bile is used in digestion and breaks down fats in order to allow them to be absorbed for use by the body.

When the Liver Must be Removed

There are many conditions that can seriously affect the effectiveness of the liver. Overexposure to chemicals or drugs can, over time, slow down and weaken the liver. Viral infections, such as hepatitis, can also seriously weaken the liver. One of the most common circumstances that require liver surgery is the presence of cancer. Anytime cancer is present within one section of the body, there is a threat of metastasis, or spreading of cancer. Gallstones can also lodge within the liver and cause obstruction, requiring surgical intervention. There are a few key considerations to be taken into account before liver surgery is suggested, though. Because the liver is so essential to many necessary functions, as much of the liver should stay in the body as possible. In addition, people with weakened immune systems may have difficulty recovering from surgery as demanding as liver surgery can be.

Surgery and Recovery

liver-surgery-info-procedure-recovery-02Before deciding that liver surgery is a necessity, a doctor will most likely want to perform a thorough medical examination and discuss your needs. For example, your doctor will likely want to know about your current medications, diet, and exercise regimen. Because of the critical nature of the liver, your doctor will want to be sure that this is the best course of action. Prior to the surgery, your surgeon will most likely advise you to avoid food and drink within the few hours before the surgery. During the surgery itself, we will make a small incision in the abdomen and remove as little of the liver as possible. One of the most important things to consider when selecting a surgeon is experience. We have first-hand experience with liver surgery and know exactly what to do.

After the surgery has been completed, it is usually expected that the doctor will want to keep close supervision on your recovery. The average and expected recovery time in-house is only around a week, but it will take a few weeks until you feel the same. Some things, such as strenuous physical exercise and heavy lifting, should be avoided to limit the risk of incision site agitation. Your surgeon will likely give you specific recommendations about your diet and intake. After losing a section of the liver, your tolerance of medications, alcohol, and other drugs will change. It will be important to discuss your needs with your doctor and communicate regularly.

Does your liver need to be removed? Talk to the best surgeons in NYC for a consultation today.

646-846-1136

For more information, visit our website: LenoxHillSurgeons.com

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References:

https://www.mskcc.org/cancer-care/patient-education/about-your-liver-surgery

https://www.cancer.org/cancer/liver-cancer/treating/surgery.html

https://surgery.ucsf.edu/conditions–procedures/liver-resection.aspx 

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

Dysphagia Surgery

dysphagia-surgery-problems-swallowing-nyc-surgeon-specialists-01Some functional and anatomical abnormalities of the esophagus or the pharynx can cause dysphagia which is essentially a fancy medical term to indicate difficulty swallowing. This condition can be successfully treated by surgical procedures. Also, surgery is recommended when dysphagia is found to be associated with esophageal carcinoma, and compression of this organ due to other abnormalities or tumors in the chest. The surgical methods presently available are varied, and the choice of medical procedure is decided by the causative condition of dysphagia.

Steps

  • The LES or lower esophageal sphincter is dilated in patients with achalasia. The doctor makes the patient swallow a tube having a balloon at its end. It is placed across the LES by means of an X-ray, and then the specialist blows the balloon all on a sudden. The objective is to stretch, rather tear, the sphincter. It can also be useful in treating Schatzki rings and strictures and other anatomical problems associated with
  • In esophagomyotomy, the surgeon cuts the LES by making a large incision in the abdomen, or laparoscopically where small punctures are made in the chest or the abdomen of the patient.

Benefits

esophageal-dysphagia-general-information-top-nyc-experts-02For patients with severe dysphagia disorders, it may be necessary to bypass the pharynx entirely and the oral cavity to provide them with enteral nutrition. Surgical alternatives range from IOC or intermittent oroesophageal catheterization to PEG or percutaneous endoscopic gastronomy. Surgery for chronic cases of aspiration may include the following procedures:

  • Medialization: It restores subglottic pressure and glottis closure during the swallow.
  • Laryngeal suspension: The larynx is made to be rest in a comparatively protected place under the tongue.
  • Laryngeal closure: The medical practitioner may perform it to shut the glottis off, and thus, provide ample protection for the airway while sacrificing the quality of phonation.
  • Laryngotracheal separation-diversion: It may be opted to separate the alimentary tract from the airway.

Complications

The most commonly occurring complications are bleeding and perforation of cricopharyngeus. Dysphagia is typically reported after undergoing an ACS surgery, i.e., surgery of the anterior cervical spine. Although risk factors associated with dysphagia are published in the journals, they remain controversial to date.

Precautions 

  • The healthcare professional may prescribe making an alteration in food/liquid texture, temperature, or consistency.
  • It is vital to ingest slowly and take smaller bites.
  • The caregiver should also strictly adhere to the promoting strategies to ensure increased safety.
  • It is crucial for one to maintain an appropriate positioning at the time of eating, and the ideal manner is to consume any liquid or food while holding an upright position, and also the chink being tucked a little at a right angle.
  • An individual should continue to maintain the upright position even after finishing one’s meal, and should not make any attempt to alter the present position for a minimum of forty-five minutes post-consumption of the meals.
  • If a person is found to be diagnosed with GERD also, then the head of the patient’s bed should be inclined at an angle of forty-five degrees.
  • The care provider should always remember not to give an aspiration patient anything to consume a few hours before the bedtime.
  • One should use medications that are meant to promote stomach emptying and reduce the reflux.

Prognosis

It is rather impossible for anyone to predict the outlook or prognosis for dysphagia in general, as numerous medical conditions can be held responsible for the symptoms associated with it. The outlook is case-dependent and is decided by the underlying medical issue/s of a patient.

Conclusion

Although dysphagia can appear to be frightening, this condition is not always necessarily chronic. The family physician should be consulted as soon as one starts experiencing any swallowing difficulties or other GERD (Gastroesophageal reflux disease) symptoms. The latter can be effectively treated with prescription drugs to reduce the amount of stomach acid.

Get in touch with us at 212-988-1136 or schedule an appointment to get immediate care and treatment for the condition.

References

  1. https://www.emedicinehealth.com/dysphagia_swallowing_problems/article_em.htm#dysphagia_swallow_disorder_facts
  2. https://www.healthline.com/health/gerd/dysphagia
  3. https://emedicine.medscape.com/article/2212409-treatment#d20
  4. http://www.newhealthadvisor.com/Aspiration-Precautions.html

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