FAQ

Q1 What are piles?

 Ans : ‘Piles’ are swollen blood vessels in the back passage. They may occur inside your body. In the anal canal, or sometimes be felt outside your anus. In this case they are called prolapsed piles. As one in three of us will experience Piles at some stage in our lives.

Q2 How do I know if I’ve got Piles?

 Ans :‘Piles’ is a distressing condition which, at its least, causes itching discomfort around the back passage and at its worst, becomes severe condition involving pain and bleeding. You may feel an uncomfortable ‘weight’ around yours anus, or experience discomfort or pain when passing motion. You may find blood on your stool or on your underwear after opening your bowls, and, if Piles and prolapsed, yours will be able to feel them when washing after going to the toilet.

 Q3 How do you get them?

Ans :  The most usual cause is constipation – pushing hard to passing motions puts a staring on the veins in the anal canal and they will eventually enlarge and become piles. They are more common in women during pregnancy after child birth and there is some evidence to suggest that piles run in families.

Q4 I’ve heard that surgery for piles isn’t very pleasant?

Ans : Surgery is options that doctor have historically hesitated to recommend. It is an unfortunate fact that many patients suffered some server post – surgery discomfort pain, and had to take considerable time from work.

Q5 What is Laparoscopic inguinal hernia repair?

Ans :Laparoscopic hernia repair is similar to other laparoscopic procedures. General anaesthesia is given, and a small cut (incision) is made in or just below the navel. The abdomen is inflated with air so that the surgeon can see the abdominal organs.

A thin, lighted scope called a laparoscope is inserted through the incision. The instruments to repair the hernia are inserted through other small incisions in the lower abdomen. Mesh is then placed over the defect to reinforce the abdominal wall.

There are many things to consider when deciding if you should have inguinal hernia repair surgery, such as whether your hernia is incarcerated or strangulated and whether you have other conditions that need to be addressed before hernia repair surgery is appropriate.

Q6 What to Expect After Surgery?
Ans :Most people who have laparoscopic hernia repair surgery are able to go home the same day. Recovery time is about 1 to 2 weeks. Studies have found that people have less pain after laparoscopic hernia repair than after open hernia surgery.

Q7 Why It Is Done?
Ans : Surgical repair is recommended for inguinal hernias that are causing pain or other symptoms and for hernias that are incarcerated or strangulated. Surgery is always recommended for inguinal hernias in children.

Laparoscopic surgery repair may not be appropriate for people who: -

  • Have an incarcerated hernia.

  • Cannot tolerate general anaesthesia.

  • Have bleeding disorders such as haemophilia or idiopathic thrombocytopenic purpura (ITP).

  • Are taking medicines to prevent blood clotting (blood thinners or anticoagulants, such as warfarin).

  • Have had many abdominal surgeries. Scar tissue may make the surgery harder to do through the laparoscope.

  • Have severe lung diseases such as emphysema. The carbon dioxide used to inflate the abdomen may interfere with their breathing.

  • Are pregnant.

  • Are extremely obese.


Laparoscopic hernia repair usually is not done on children. But a laparoscope may be used during open hernia repairs in children to explore the opposite groin for a hernia. This can be done by inserting the laparoscope into the side that is being operated on and looking at the opposite side. If a hernia is present, the surgeon can repair both sides during the same operation.


Q8 How Well It Works?
Ans :The chance of a hernia coming back after laparoscopic surgery ranges from 1 to 10 out of 100 surgeries done.

Laparoscopic surgery has the following advantages over open hernia repair : -

  • Some people may prefer laparoscopic hernia repair because it causes less pain and they are able to return to work more quickly than they would after open repair surgery.

  • Repair of a recurrent hernia often is easier using laparoscopic techniques than using open surgery.

  • It is possible to check for and repair a second hernia on the opposite side at the time of the operation.

  • Because smaller incisions are used, laparoscopy may be more appealing for cosmetic reasons.

Risks

Some people may need special preparation before surgery to decrease the risk of complications.

These are people who : -

  • Have a history of blood clots in large blood vessels (deep vein thrombosis).

  • Smoke.

  • Take large doses of aspirin. Aspirin slows blood clotting and may increase the chances of bleeding after surgery.

  • Take blood thinners (such as warfarin, heparin, and enoxaparin).

  • Have severe urinary problems, such as those caused by an enlarged prostate gland.

Risks of laparoscopic hernia repair include : -

  • Pain in the cord that carries sperm from the testicle to the penis (spermatic cord), in the testicles, or in the thighs.

  • Fluid (seromas) or blood (hematomas) in the scrotum, the inguinal canal, or the abdominal muscles.

  • Inability to urinate (urinary retention) or bladder injury.

  • Infection from the mesh or stitches.

  • Scar tissue formation (adhesions).

  • Injury to abdominal organs, blood vessels, and nerves.

  • Numbness in the thigh.

  • Pain in the thigh (nerve entrapment).

  • Injury to the testicle, causing testicular atrophy (rare).

  • Recurrence of the hernia (usually related to the mesh applied during surgery being too small to cover the groin area or the mesh not being stapled well).

Q9 What is laparoscopic cholecystectomy ?

Ans :The surgery to remove the gallbladder is called a cholecystectomy (chol-e-cys-tec-to-my). The gallbladder is removed through a 5 to 8 inch long incision, or cut, in your abdomen. The cut is made just below your ribs on the right side and goes to just below your waist. This is called open cholecystectomy.

A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision.


Q10 What is a laparoscope and how is it used to remove the gallbladder ?
Ans : A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cuts made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.

Are there any benefits of laparoscopic cholecystectomy compared with open cholecystectomy? With laparoscopic cholecystectomy, you may return to work sooner, have less pain after surgery, and have a shorter hospital stay and a shorter recovery time. Surgery to remove the gallbladder with a laparoscope does not require that the muscles of your abdomen be cut, as they are in open surgery. The incision is much smaller, which makes recovery go quicker.

With laparoscopic cholecystectomy, you probably will only have to stay in the hospital overnight. With open cholecystectomy, you would have to stay in the hospital for about five days. Because the incisions are smaller with laparoscopic cholecystectomy, there isn't as much pain after this operation as after open cholecystectomy.


Q 11 What are the complications of surgery ?

  • Damage to the bile duct can lead to leakage or even obstruction of bile flow. Laparotomy to drain or repair the bile duct may be necessary if this occurs. This is a serious problem but is rare with an incidence of less than 2%.

  • Bleeding from blood vessels feeding the gall bladder or liver. This is usually controllable at the laparoscopy but may require further laparotomy to stop the bleeding. If the bleeding starts after the surgery has been completed, the patient may have to return to the operating theatre to stop the haemorrhage. Again this is a very rare complication.

  • Damage to other organs or blood vessels. This is extremely rare and the incidence is minimised by using a special blunt tipped instrument to enter the abdominal cavity through the incision beneath the umbilicus.

  • Gas embolism. This can occur when the CO2 which is being used to keep the abdomen inflated enters an open blood vessel and passes to the heart. This has never occurred in my experience.

  • Pulmonary embolism. This occurs when clots form in the deep veins of the legs and pass up the veins to the lung blocking the flow of blood to the lungs. This has never occurred in my experience and should be less likely than with open surgery, as patients are in less pain and are moving about more freely on the day of surgery. Blood thinning injections and calf compressors are used during the surgery to help prevent this complication. Other medical problems such as allergic reactions, heart attacks, pneumonia and strokes can occur but are exceedingly rare.

  • Wound infections are not uncommon especially in the umbilical wound, which can be contaminated by the bacteria in the gall bladder as it is removed. These are usually minor and respond to antibiotics but can be painful and a nuisance in the short term.

  • Keloid scars. These are thickened scars to which some patients are prone. With the small incisions, scarring is minimal in most cases. 

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