Friday 13 October 2017

Laparoscopic Surgery: Why it is a boon?


                        
                            Laparoscopic surgery is not a new word for most of us. People in general are quite aware of this mode of surgical treatment, that it is better than formal open surgery in terms of recovery. And it is not uncommon for patients to demand laparoscopic surgery for various surgical treatment they need. It is really good that people are aware of their options and are asking for it. 

                             Today  I feel like talking  about aspects of this modality of surgical treatment that people are not much aware about. Laparoscopy means Lapro that is your tummy and scopy means a telescopic camera, thus any surgery of abdomen that is done by a minimal invasive method using a telescope is called Laparoscopic surgery. Similar modality used for any surgery of your chest is called Thoracoscopic surgery. Thus a surgery is performed by making very small incision (cuts) in your tummy and inserting instruments and a telescopic camera through it and performing surgery. Whatever is done in your tummy  is seen on the monitor in the operation theater and thus a big cut in your tummy is avoided.   
                     
                           The general perception is that the faster recovery is due to the small cut on the skin. My patients commonly ask me " Sir how many stitches I will get?" , and I always say it does not matter. What people don't know is that, the wall of your tummy is itself an organ. Just like your leg and hands, and it is not just skin but multiple layer of muscles, fat and skin. It has many important function also, like they are the key muscles in your basic body function like breathing, coughing, passing stool and urine. They are also very important for different body movements like bending, lying and getting up. Any decrease is the health of the wall of your tummy affects you in multiple ways. And laparoscopic surgery does not just reduce the length of scar on the skin but also on the whole wall of your tummy. Hence it helps to maintain the natural strength of your tummy, causes faster recovery, less breathing problems after surgery and decreases the chances of hernia through the operation site.     

                            It is a technically demanding skill, and also needs very specialized equipment. Fortunately with time there has been significant advances in the instruments and skills of surgeons. So the technique which was previously used for some basic surgeries like gallbladder and appendicectomy is now widely used for even very complex surgeries like cancer, weight loss and other major surgeries of your tummy and chest. For a lot of medical conditions, surgery was previously avoided due to the complications and poor recovery with open surgery and patents used to suffer, with no option of an effective treatment with low complication rate. But with laparoscopy, the recovery being faster and complications less, many of these diseases are very effectively treated with laparoscopic surgery with acceptable rate of complications. The patients are being able to walk within hours of surgery, can take liquids and diet very early depending on the type of surgery and are being discharged very early due to laparoscopy.         

                           Thus I would like to again reaffirm that " There is much more to Laparoscopic surgery than mere small scar and your tummy wall is not just skin but an active organ of your body".

Disclaimer: The same article has been published by me on practo.com


Sunday 1 October 2017

Making genuine information available to the patients: Need of today's time

                      A lot of doctors get irked by the patients who come to their clinic with a self made diagnosis by reading a lot of things on Google. Sounds fair to some extent, because they come with the wrong facts firmly embedded in their head. This makes it difficult to treat them, as they are not convinced easily by the genuine advice that is given by doctors. The doctors have to spend more time to convince them and prevent them from making wrong decisions, which may harm them rather than being of any help.

                  What we doctors fail to understand is, the problem is not Google or the patients who search Google for their problems, and even if it is the fact is this is going persist. The problem is the false and confusing or wrong information that is there and the way to counter it is to provide the people in general with more and more genuine and authentic information. So that it helps them in making proper choices for their problems, especially when they are being advised different treatment options by different set of doctors. If we see from their perspective, they feel totally confused and clueless what to do when different qualified and expert doctors give a different opinion about their treatment.

                   To believe that someone is not capable of understanding the problems they are facing, and not capable of taking an informed decision is big mistake. So we as doctors should strive to get as much information about different problems as possible, in a language that is easily understood by a non medical person. This will not only help them take better decision, this will improve the compliance of patient to the advice of doctor as they will understand the reason behind the advice.
But with this the responsibility of the patient also increases, as they are now the active partner in their own treatment. They need to learn the art of understanding what is genuine and what is fake.

                       A lot of patient’s complaint that some doctors misguided them to a wrong treatment. From my experience I can say, all such patients had opinion of multiple doctors and among these doctors were also those gave them proper guidance. But they chose to follow the one who gave the wrong advice, either deliberately or out of their poor knowledge. Not going into the discussion who is to blame, it is very clear that only the patients are at an immediate loss. But it the responsibility of both the public and the doctors both to make sure that people in need of guidance should get a correct one. We are in a new age and literacy is no more just the ability to read and write. Literacy in today’s time is ability to read between the lines, and the ability to send a true message in a stronger way such that it is louder the wrong ones. The onus is on all of us, and surely we will achieve that mark.

Disclaimer; The same article had been published by me on practo health feed with the below link
https://fit.practo.com/#!/content/29965