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March 20, 2017

hiatal hernia 2

(Treated by radiofrequency ablation and antireflux surgery)

The esophagus passes via an opening in the diaphragm as it paths throughout the chest to the stomach eventually ending in the stomach. This opening is generally sufficient for passing of the esophagus and nothing else. Patients which have a hiatal hernia have an increased opening. The sliding hernia is the most typical of the four representing over eighty percent of all hiatal hernias. The low esophageal sphincter- the high pressure area near the junction of the gut and esophagus- fails and allows gut contents to reflux into the esophagus. The symptoms related with hiatal hernia are variable, but typically include: Heartburn – 30 – sixty minutes after eating.

Upper endoscopy: Identify injury due to reflux Biopsy esophagus for assessment of malignancy. The patient due to repeated attacks of acid forms a different kind of mucosa in the lower esophagus which can be pre-malignant known as Barrett”s esophagus.

Esophageal manometry: Evaluate the function of the lower esophagus and rule out any motility disorders.

Patient who are symptomatic with constant heart burn, difficulty in sleeping and chronic cough need an evaluation.

The presence of Barrett’s is seen on endoscopy and if the biopsy shows high grade dysplasia, patient may need an Radiofrequency ablation of the barretts followed by antireflux surgery.

hiatal hernia hiatal hernia 2

Laparoscopic Cruroplasty and Nissen fundoplication is the process of selection for repair of the hiatal hernia.

repair of the hiatal hernia

After sufficient repair of the hiatus, a brand new lower esophageal valve is built by covering a two centimeter part of the gut around the lower most part of the esophagus. The procedure usually lasts for 1to 2hours depending upon the size and contents of the hernia. Patients are started on clear fluids the next morning and are released in the afternoon.

Ventral Hernia

(Open Surgery To Laparoscopic Surgery)

For a lot of people, the 1st time they look down at their midsection and see certainly a hernia bulging through, it might be an odd vision – and more than simply somewhat unsettling. It may likewise be confounding for all those people for whom the hernia occasionally carries on to pop in and pop from vision, making the individual second guess be it even actually there at all. The first stage in the process of healing is diagnosis by a physician and after that, for most, surgery. Hernia operation became a pretty routine procedure, and thousands of them are done by surgeons around the world every year.

A hernia is actually comprised of a rip in the muscle which makes up the wall of the abdomen or crotch Ventral Herniaregion. This tear enables part of the intestines beneath to poke through this rip in the muscle, appearing on the exterior of the body as certainly a bulge in the skin. A hernia may be painful, but just as often it’s not painful at all. This leads some people to put off diagnosis and or surgery.

The changes in surgical concept of hernia repair have undergone immense changes and revolution over a period of time. Initially they were done by open surgery over the defect or the scar of previous surgery; later they have been performed laparoscopically with the us
e of a mesh.

The surgeon places the mesh on the affected region, which functions to reinforce the weakened muscle Hernia Surgeryregion. The most important target the surgeon wants to achieve is that there should not be a recurrence of the hernia.

Sometimes the intestines may get stuck in the hernia leading to major life threatening issues; so a hernia without symptoms should not be ignored.

Large hernia’s which may come as a result of previous surgeries resulting in weakening of the abdominal wall or multiple pregnancies require a customized approach to each patient.

(Dr. Ritu Khare has been performing the laparoscopic hernia surgery for all kinds of simple and complicated cases since last many years. The results are very encouraging and patients have been on 10 years follow up)

IMG 2793 e1486473456424 1043x800 - Diverticulitis of the COLON

IMG 2793 e1486473456424 1024x873 - Diverticulitis of the COLON


That day I woke up at 2.00 am in the night with a constant sweating and severe pain on the left side of the abdomen. I had some bowel issues for the last few weeks and although I was chronically constipated, but this time the session in the washroom lasted a lot longer. I had tried a lot of medicines and even changed the position on the toilet seat but nothing helped. Having known all this, I was totally unprepared for the excruciating pain I experienced. My husband rushed me to the emergency of Lapsurgery (the best hospital of colonoscopy Dubai), The ER doctor examined me and reconfirmed my age; 56 years that’s it. His hand on the left side sent a sharp painful sensation and I winced, even more, when he suddenly withdrew his hand. He looked quite sure and told the nurse, “She has diverticulitis”!!

Continue reading Diverticulitis of the COLON

Cancer Treatment - Cancer: the fear and the shock

Cancer: the fear and the shock

The first diagnosis of any cancer in a patient puts him a phase of denial. The news is always taken as a shock laced with fear and then comes the acceptance.

If you are the cancer doctor of the patient who is referred to you, it is usually not possible to give all the information, options and prognosis to the patient and his relatives in a single go. Firstly, it is not feasible because of the dependency on the staging, surgery, tissue biology and response to medicines. It is a gradual course and a decently lengthy procedure, the patient has to realize he has to take a long journey to get results. Secondly, it is extremely difficult to precisely predict where that journey will take them to.

Continue reading Cancer: the fear and the shock

surgery - When I continued to have burning in chest after sleeve gastrectomy

surgery - When I continued to have burning in chest after sleeve gastrectomy

Back in the year 2011, I weighed a good 99kg, I had read enough about bariatric surgery and weight loss procedures. I went to my surgeon in Lebanon and discussed the option of surgery. I did not have diabetes or any other metabolic syndromes. He convinced me that sleeve gastrectomy would be the best weight loss procedure for me, as it is a much simple procedure from the traditional gastric bypass. He enumerated various advantages like the simplicity of the procedure, fewer complications, fewer vitamins and sustained weight loss. It appeared like a “holy grail”.

Continue reading When I continued to have burning in chest after sleeve gastrectomy

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