Right-hemicolectomy
Surgical Gastroenterology

Surgical Gastroenterology

Gastrointestinal tract refers to the digestive system consisting of the stomach and the intestines. It can be divided into two branches – the upper gastrointestinal tract consisting of the stomach, mouth, oesophagus and duodenum, and the lower gastrointestinal tract consisting the small intestine, large intestine and anus.

Gastroenterological surgery refers to the surgery performed on the above mentioned organs as a treatment of ulcers, cancer or tumours, or obesity surgeries.

Dr.Kiran KJ is one of the leading gastrointestinal surgeon in Bangalore offering surgical solutions.

Dr.Kiran KJ can be approached for the following Surgeries :

Radical Gastrectomy

Radical Gastrectomy refers to the partial or complete removal of the gastric tissue along with the surrounding lymph nodes. This is often the only available curative treatment option in cases of stomach (gastric) cancers. In this, either partial or the complete stomach is surgically removed, generally due to stomach cancer, life threatening obesity or ulcers. In this, the esophagus (food pipe) is directly connected to the small intestine or the remaining part of the stomach. You will still be above to digest liquids and foods but you may need to make several lifestyle changes after the procedure.

Gastrectomy being a major surgery, is conducted on general anesthesia and one will have to be in hospital for up to 2 weeks after the procedure.

Radical Gastrectomy

Right hemicolectomy

Right-hemicolectomy

Open right hemicolectomy is a procedure where the cecum (a pouch connected to the junction of the small and large intestines, the ascending colon, the hepatic flexure (where the ascending colon joins the transverse colon), the first one-third of the transverse colon, and part of the terminal ileum (the distal end of the small intestine that intersects with the large intestine), along with fat and lymph nodes are surgically removed. It is the standard surgical treatment for malignant or cancerous right colon. Often a stoma (bag) is not required, but in case of complications wherein the bowel cannot be attached back to the intestine, the bowel is brought outside the body from the abdomen and a stoma (bag) is attached to collect the waste.

The surgery is performed on general anaesthesia and can be discharged 24 – 48 hours after the surgery. The average recovery time is around 7 days.

Left Hemicolectomy

Open left hemicolectomy is a procedure done for the surgical removal of the left side of the large bowel – splenic flexure (located at the right upper quadrant of the human abdomen), sigmoid colon and the descending colon. This procedure is generally undertaken for the treatment of the cancer of left colon. Post removal of the malignant part, the two ends of bowel are then brought together and stapled.

left hemicolectomy

Anterior Resection

Anterior Resection

This is an operation to remove part or complete rectum, which is the final part of the large intestine, before the anus as a treatment for rectal cancer. It is also sometimes performed for patients with diverticular disease, where small bulges or pockets (diverticula) develop in the lining of the intestine. The blood vessels and lymph nodes on this part of the bowel are removed in this procedure. The remaining part of the colon is then joined with the remaining part of the rectum either through sutures or special staples.

The surgery usually lasts 3-4 hours, and the average recovery time is 6 – 8 weeks.

Abdominoperineal Resection

This is a surgery where the anus, rectum, and sigmoid colon are removed. This procedure is most often used to treat cancers located very low in the rectum or in the anus. Once the anus and rectum are removed, a stoma (bag) is attached to the intestine. This is a major operation and usually takes 3-4 hours to complete. The average hospital stay is for about 2-5 days and average recovery time is about 2 – 4 weeks.

Abdominoperineal-Resection

Open Splenectomy

Splenectomy

Open splenectomy is a conventional surgical procedure where the damaged spleen is surgically removed through an open surgery. Since spleen is an important organ that helps fight infection and filters out unwanted things from the system, and also one of the most frequently injured intraperitoneal organs, splenectomy is a major surgery and leaves you with a compromised immune system. That is the reason it is performed only when necessary.

It is performed on general anesthesia and takes about 4-6 weeks to return to routine.

Hepatectomy

A hepatectomy is the surgical removal of the liver to surgically remove tumors from the liver. The extent of the surgery will depend on the size, number, and location of the tumor as well as the functional ability of the liver. Hepatectomy can either be partial or full removal of the liver. This operation is considered as a major surgery and can take up to 10 hours to perform. The liver can regenerate some of its lost function over time if part of it is removed but in cases of total hepatectomy, liver transplant is advised, the patient might need to be in hospital for around 7 – 10 days and sometimes longer. It normally takes up to 3 months to get back to normalcy.

Hepatectomy-surgery

Retro Peritoneal Tumour Surgery

Retroperitoneal tumour surgery or the Retroperitoneal sarcoma surgery is conducted to treat a rare form of cancer called sarcoma that develops in the connective tissues: muscle, bone, nerves, cartilage, tendons, blood vessels and the fatty and fibrous tissues. Retroperitoneum is the area behind the peritoneum, the lining of the abdominal space that covers the abdominal organs.

Surgery is the main treatment for sarcoma, especially for the tumour in the retroperitoneal region. The tumour will be removed along with a part of the normal tissue to ensure the cancer cells are completely removed. This is done since muscles, bones, cartilages, tissues etc sometimes touch or press on surrounding organs. By removing the adjacent part of tumour the spread of cancer to healthier areas is stunted.

This is an extremely rare, tricky and risky surgery. There is also a risk of recurrence of the cancer in the same spot after 2-3 years.

Gut Malrotation Surgery

Gut or Intestinal malrotation is a rare congenital condition caused by incomplete rotation or even the absence of small bowel during the embryonary period. Gut malrotation in adults is very rare and those that are affected are asymptomatic.

The treatment involves a surgical procedure called Ladd’s procedure where the Ladd’s bands (fibrous stalks of peritoneal tissue that attach the cecum) are surgically divided, small intestine’s mesentery is widened, appendix is removed and the colon and cecum are then correctly placed.

Gut Malrotation

Rectopexy

Laparoscopic Rectopexy

Laparoscopic rectopexy is used to repair a rectal prolapse (where the rectal walls have fallen out of its place (prolapsed) and they protrude out the anus and are visible outside the body). In this surgery, the rectum is restored to its normal position in the pelvis, so that it no longer prolapses (protrudes) through the anus. Usually, stitches are used to secure the rectum, often along with mesh. Average recovery time is usually about 4-6 weeks after surgery

GIST Tumour Removal Surgeries

Gastrointestinal stromal tumours (GISTs) start in special cells in the wall of the gastrointestinal (GI) tract or the digestive tract. These tumours are very rare form of cancer of the digestive track. Most GISTs start in the stomach and Some start in the small intestine. However, GISTs can form anywhere along the GI tract. They are also known to form outside the GI track like the peritoneum and omentum.

GIST-tumor

Stomach / intestinal perforation

intestinal-perforation

Perforation in the stomach or intestine called as Gastrointestinal Perforation (GP) occurs when a hole forms through the stomach, large bowel, or small intestine. This can occur due diseases like appendicitis and diverticulitis. It can also be the result of trauma, such as a knife wound or gunshot wound. GP is considered as an emergency and if immediate medical attention is not given can prove fatal. Surgery is used as the most common option to seal the hole/perforation. Sometimes, a piece of the intestine will also need to be removed. The average operation duration and recovery time depends on the severity of the wound and the disease.

Intestinal Obstruction

Bowel obstruction, also known as intestinal obstruction, is an obstruction in the intestines which prevents the normal movement of digested food. Either the small bowel or large bowel may be affected. This can be caused by Tumours, scar tissue, twisting or narrowing of the intestines, inflamed bowel, damaged blood vessels and paralyzed muscle walls. As a treatment, either a stent can be placed to force the bowel open, or have the diseased part of the intestine removed as appropriate to the patient.

intestinal-obstruction

Obstructed / Strangulated Hernia

Strangulated Hernia

Strangulation of Hernia occurs when blood flow to the hernia in abdominal region. Initially, lymph and veins are obstructed, leading to oedema and venous congestion but with continued arterial inflow. When the tissue pressure equals arterial pressure, arterial flow ceases and tissue necrosis ensues. Strangulation is extremely serious and if not treated on time can prove fatal since dead tissues when gets into blood stream can turn toxic. Surgery is performed with a priority to reduce the hernia, i.e., to release the strangulated hernia and return it to its original position.

WHIPPLE’S Surgery

Whipple surgery, also known as a pancreaticoduodenectomy, is a procedure to surgical remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. It is a complex, difficult and demanding operation to treat tumours in the above organs and can have serious risks. However, this surgery is often lifesaving therefore a very important procedure.

WHIPPLE

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