Monthly Archives - July 2022

Horror accident leaves man with 4feet steel rod impaled from groin to neck, saved by JJ docs inspite of vital organ injury.

On Friday the 9^th March 2018, a team of surgeons at the  Sir J J Group of hospitals, Mumbai undertook a daunting challenge, where they operated and surgically removed a 130cm steel rod which had accidentally impaled 33 year Salim Sheikh.

What seemed like just another day at work for 33 year old Mr Sheikh turned out to be the nightmare of his life when around 5pm on Thursday  while working on the first floor at a construction site, near Lasalgaon, he slipped and fell 9 feet below. Sheikh fell onto a pile of steel rods, one of which impaled him, entering his scrotum, traversing the entire length of his abdomen and chest to emerge above his right collar bone.

His shocked colleagues did not lose their cool. They wisely cut the rod at its base and with the rod still inside Sheikh, they shifted him to Niphad PHC. Niphad PHC promptly administered prelimnary treatment, and Sheikh was immediately referred to Nashik civil hospital. Sheikh was resuscitated and stabilized at Nashik civil hospital. Overwhelmed by the task at hand, the hospital referred him to JJ hospital for further management.

Sheikh reached JJ Hospital at 2am on Friday morning. Even the most experienced members of the emergency team were taken aback by the nature of his injury. Then began the process of evaluating his injuries & deciding a surgical plan. Sheikh was immediately shifted for a CT scan to assess the trajectory of the rod inside his body. However, Sheikh’s vitals started dropping probably due to ongoing internal bleeding secondary to internal organ damage. The emergency team was very prompt to spring into action and start resuscitation. After stabilizing his vital parameters the group of surgeons took Sheikh up for an emergency surgery, where they laparoscopically and thoracoscopically assessed the degree of damage the impaled rod had done to the internal organs. In the abdomen, the rod had pierced through not only the small intestine, but also its mesentry, attachment containing the blood vessels supplying it. Damage was also found at the right side of the colon, finally passing through the liver.

After injuring the liver, the rod penetrated the diaphragm, finally entering the chest. It had passed through the lung to finally emerge from the zone 1 of the neck. After the degree of damage was determined, the rod was dislodged under direct vision. Damage to the organs affected was repaired in the same sitting. The surgery lasted for 5 hours, after which the patient spent two days in the ICU.

Management of such cases provides a challenge to anesthetists and surgeons as the extent of injury is unknown and there is inadequate time for evaluation and resuscitation of the patient.

The anaesthesia team, headed by Dr. Usha Badole skilfully tackled the situation inspite of restricted mobility due to the rod emerging from the neck, performing a single lung ventilation. The team managed the intra-operative course very efficiently.

Two teams of surgeons started the procedure simultaneously.

Thoracoscopic team comprising of Dr. A.H. Bhandarwar, Dr. Shekhar Jadhav, and Dr. Noaman Shaikh gained access to the chest and very cautiously managed the safe retrieval of the rod from the neck under direct vision. They also repaired the damage to the lung.

Laparoscopy team comprising of Dr. S.R. Bhagwat, Dr. Amol N. Wagh, and Dr. Jalbaji  more gained access to the abdomen. But in order to ensure safe retrieval of the rod and to avoid concomitant injuries to the surrounding vital organs during retrieval, the procedure was converted to an open laparotomy.They managed to control bleeding from the liver and the mesentery afterwhich, they repaired the damage to abdominal vital organs.

Urology team headed by Dr. Venkat Gite and cardiovascular team headed by Dr. K. N. Bhosle were also kept standby for the surgery.

The patient was fortunate enough to have avoided injury to important structures in abdomen like urinary bladder, kidney and inferior vena cava, and the superior vena cava in the chest. The patient was able to survive the accident as it narrowly missed the major vessels.

Though an exploration of both chest and abdominal cavities is mandated in such situations, the use of thoracoscopic and laparoscopic procedures for the initial assessment of the trajectory of the rod prevented the patient from undergoing a painful thoracotomy.

Currently, the patient has been shifted to general ward. His clinical progress has been satisfactory.

The challenges posed by massive impalement could be successfully managed due to rapid pre-hospital transfer and co-ordinated team effort.

Entry Wound

Exit  Wound

CT guided 3d reconstruction.

Hernias can be painless or painful while, sometimes, dangerous too. For these reasons, it is essential to know about different types of hernias and reasons to go for hernia surgery. Hernia is a condition in which a specific part of a body bulges out from provided area that it occupies normally. It usually affects the abdominal fatty tissues and intestines. Some hernia does not produce any signs, but they all have some risks. In the herniated area, blood supply gets blocked and if this occurs in the abdominal cavity, an immediate hernia surgery is needed. The tissues should be cut off for constant supply of blood and oxygen.

There is a huge range of hernias known by now. Some of them are more prevalent in women while other often attacks males.

Below are different types of hernias, read on to know about them:

1.    Inguinal Hernia

The Inguinal hernia affects abdominal walls and it is of two types: direct and indirect. Both, direct and indirect hernia impacts the groin portion where the skin of torso joins thighs. Indirect hernia can occur at any age while, direct hernia is more common in elderly and middle-aged people. Hernia surgery pushes back the bulge into place.

2.    Femoral Hernia

Femoral canal is the portion through which femoral nerve, veins and arteries leave the abdominal cavity and reach the thighs. This can become extensive and wide when abdominal contents overhang into the femoral canal. This usually affects female and untreatable in most cases.

3.    Umbilical hernia

This category holds about 10-30% of all hernias. In this type, an umbilical hernia can be observed at birth protrusion of the belly button. The reason behind this can be any opening in the abdominal wall. If the opening is small, say for, less than half an inch, it can be closed before 2 years of age. In case of large openings, hernia surgery is required to close it.

4.    Incisional Hernia

Abdominal surgery leads to weakness in body, especially in the treated area. Sometimes, hernia develops again even after the surgery, in such situations, one has to go for an incisional hernia that involves a complex and long procedure of treatment.

5.    Spigelian Hernia

It affects the rectus abdominal muscles and lies several inches in the side and middle portion of the abdomen. A spigelian hernia is rarely observed in patients.

6.    Obturator Hernia

It is another rare type of hernia that is usually observed in women. The hernia bulges from the pelvic cavity through a pore in the pelvic bone. An obturator hernia rarely shows any bulge but instead; act as a bowel that leads to symptoms like nausea and vomiting. Since there are no bulges, hence, they are difficult to diagnose.

If you feel that you are suffering from hernia, visit a hernia specialist doctor or surgeon immediately. Not only, they will help you to clear your doubts about it, but also try their best to fix the problem before it becomes dangerous. You can also seek help from Dr. Shirish Bhagvat, he is a renowned laparoscopic surgeon in Mumbai who has been practicing since 25 years. Visit them for best results!

Appendix inflammation is one of the symptoms of complicated health situation that may lead to appendix surgery. It is also known as laparoscopic appendectomy. If you are confused about recovery after appendix surgery, you have to prepare for it before time. As long as your case is not complicated, the procedure is not so bad; hence, there is no need to afraid. However, one has to keep certain things in mind to come up with surgery pain.

Appendectomy is a biological term that is taken into use for surgical approach to remove the appendix from body. People know it with different names like appendicitis surgery or appendix surgery or appendectomy.

Appendix is a vestigial organ that is located at the lower right portion of abdomen and is does not perform any practical function in the body. When the appendix gets inflamed and causes pain, the ignorance may result in bruising inside the walls that may lead to serious infection and illness, sometimes, it is lethal too. Rarely, the vestigial organ scars up from infections and results in recurring pain. If you suffer from any symptoms, consult with a reputed surgeon and go for appendix surgery India to make your body disease-free. However, in some cases, appendix is found normal after removal.

Appendicitis is termed when the surgery is carried out in emergency condition to treat the swollen appendix. The reasons behind appendicitis can be many like hard mass of faeces resulting in swelling, insertion of foreign particle or bowel adhesion, infection, inflammation of lymphatic muscles due to viral infection. The common symptoms for appendix are pain, vomiting, nausea and constipation. The pain begins in the central abdomen and reached to right abdomen. Sometimes, these symptoms are not observable and need intensive investigation of the abdomen area.

Appendix surgery in India is either open appendectomy or laparoscopy. In the open procedure, the surgeon incises skin and abdominal layers to access the appendix. Laparoscopy appendectomy is done by making 3 incisions in the abdominal cavity; surgical instruments are inserted into them to fill the cavity with carbon-dioxide and separate visceral organs from the abdominal layer. If you have an infected appendix then it might be possible that laparoscopic surgery can turn into open surgery.

Appendix infection is the most prevalent complication that can happen in the appendix surgery. Reputed appendix may lead to abscess in intestinal cavity that can be drained out after the appendicitis surgery. Other important steps are-disinfection of gut cavity and administration of intravenous fluids. Wounds may also lead to common type of infections.

Make sure you have a health insurance before undergoing appendix surgery otherwise medicals bills may crush you. You can also visit The Surgery by Dr. Shirish Bhagvat. He is a well-known laparoscopic surgeon who is working in this field for 25 years. He is currently Professor of Surgery & Head of Surgical Unit at Grant Medical College, J.J. Group of Hospitals (since August 2002) which is the first and the oldest medical institution in Mumbai. You can visit there for best treatment.

Laparoscopic surgery utilizes extraction to expel endometrial inserts is seen by numerous master endometriosis specialists as the most ideal approach to treat endometriosis. Despite the fact that laparoscopic surgery is one of the slightest intrusive sorts of surgeries, it is still not a simple methodology to persevere. Recuperating from the surgery requires significant investment and requires a ton of determination with respect to the patient. You will find the best surgeons to perform laparoscopic surgery in Mumbai.

Here are top ten tips which you can follow to have a successful laparoscopy recovery

1. Utilize the over counter cure

Amid laparoscopic surgery, your specialist will fill your stomach pit with gas keeping in mind the end goal to lift the stomach dividers far from the pit to show signs of improvement perspective. After the surgery the gas remains, and this can bring about exceptional shoulder or back torments. The medicine will help you a lot.

2. Utilize a mild stool softener:

Drinking no less than 64 ounces of water a day will help with this issue. Albeit more grounded suppositories, diuretics and bowel purges may not be prompted post-surgery, inquire as to whether a mellow stool conditioner such a Colace can be taken post-operatively.

3. Keep your eating routine light for the initial few days:

4. Keep your heating pad close:

A heating pad is each endometriosis patients’ closest companion, including after surgery. The physical anxiety of the operation consolidated with the weight on my different muscles attempting to adjust for my hurt mid-region, would bring about my back to hurt. The heating pad can assist hugely with these a throbbing painfulness furthermore can diminish your swollen mid-region.

5. Advantages of moving around:

It is essential to begin moving around 24-hours post-surgery. Little strolls to the restroom or around your bed can really help you mend speedier. Remember, at the outset, accomplishing something minimal like getting up to go to the restroom can deplete, yet it will get simpler.

6. Don’t overdo it

Whether it is working out, vacuuming, or lifting, make a point not to try too hard and get your specialist’s endorsement first. Your body is utilizing the vast majority of its assets to mend, so doing anything excessively exhausting on top of that can set your recuperation back, or far more terrible, cause interior sutures to blast. Resting for so long can debilitate. Try not to be discouraged, you will have returned to your ordinary life in the blink of an eye.

7. Watch out for your entry points:

If shut legitimately cuts ought to seem recuperated inside a week and after that it takes around 6 weeks for them to mend totally.

8. First period post-surgery is constantly terrible:

Normally there is a considerable measure of recuperating that needs to happen to feel totally better. That recuperating does not completely happen inside the season of your next cycle. So as your conceptive parts begin once more, remember they are still delicate.

9. Try not to Be Afraid to Call Your Doctor:

On the off chance that you feel in your gut that something isn’t right with you, call the specialist, regardless of the fact that it is midnight. Positively if you encounter fever, queasiness, heaving, chills, trouble urinating, compelling agony in your legs or stomach area or trouble breathing, call instantly.

     10. Keep the Faith:

This surgery is physically depleting. The uplifting news is that extraction surgery helps such a large number of ladies feel so much better. They feel as if they recover their lives.

Appendicitis is aggravation of the appendix. It can either be acute or chronic. It is the most widely recognized reason for stomach torment bringing about appendix surgery in India.

It can happen at any time; however it happens frequently between the ages of 10 and 30. It’s more regular in men than in ladies.

Causes of Appendicitis

In most of the cases, the cause for appendicitis is obscure. There can likewise be various causes for any one instance of appendicitis. Specialists trust that one reason for this condition an obstruction in the appendix.

Obstruction is frequently because of a collection of fecal matter. It can likewise be the consequence of:

• developed lymphoid follicles
• worms
• injury
• tumors

At the point when there’s an impediment in your appendix, bacteria can increase inside the organ. This prompts the development of pus. The expanded weight can be agonizing. It can likewise pack neighborhood veins. An absence of blood stream to the addendum may bring about gangrene.

Symptoms of Appendicitis

Some of the symptoms are listed below:

• torment around the bellybutton
• bring down right side stomach torment
• loss of craving
• sickness
• regurgitating
• looseness of the bowels
• clogging
• failure to pass gas
• stomach swelling
• second rate fever
• a sense you may feel better in the wake of passing stool

You may encounter one or more of these symptoms.

An infected appendix torment may begin off as gentle cramping. It regularly turns out to be all the more unfaltering and serious with time. You won’t as a matter of course notice changes in your gut propensities. In any case, once in a while an infected appendix can influence pee.

How appendicitis is being diagnoses?

Your doctor will start by performing a physical test. A physical test for appendicitis looks for delicacy in the lower right quadrant of your abdomen. In case you’re pregnant, the agony might be higher. On the off chance that perforation happens, your stomach may turn out to be hard and swollen.

A swollen, rigid belly is a symptom that you need to discuss with your doctor immediately.

Along with this test, your doctor will also perform other tests, such as Urinalysis, Pelvic exams, pregnancy tests, abdominal imaging, chest x-rays.

Treatments for Appendicitis

Treatment for appendicitis varies.

In rare cases, an infected appendix may show signs of improvement without surgery. Treatment may include just anti-microbial and a fluid eating routine.

In most of the cases, surgery is required. The sort of surgery will rely upon the subtle elements of your case.

In the event that you have a sore that hasn’t burst, you may get anti-toxins first. Your specialist will then deplete your sore utilizing a tube put through your skin. Surgery will expel your supplement after you’ve gotten treatment for the disease.

On the off chance that you have a cracked boil or informative supplement, surgery might be vital immediately. Surgery to expel the supplement is known as an appendectomy.

A specialist can play out this methodology as open surgery or through a laparoscopy. Laparoscopy is less intrusive, making the recuperation time shorter. Be that as it may, open surgery might be important on the off chance that you have an ulcer or peritonitis. You can easily undergo appendix surgery in India.

Hernia is one of the most common medical conditions experienced by both men and women. Though some hernia may require surgical treatment for cure, hiatal hernia may not always require a surgery or medicinal treatment. In most of the cases, patients suffering from hiatal hernia get mild symptoms for this condition and may require medicines for managing them. However, in some cases, the complications can be quite serious and the doctors may even conduct surgery for coping up with the problems.

Many of you may associate hernia as a problem of elderly people. It is not the actual truth. Hernia surgery is not just required in elderly people, depending on the complications young patients may also need hernia operation. Irrespective of the age or the sex of the patient, recovering from hiatal hernia operation needs proper rest and care. It is also recommended to follow a few things mentioned below for a speedy recovery.

Read the discharge order carefully – This is one of the most important factors to be taken into account when you want to get faster recovery after your surgery. You as well as your near ones should read the discharge order or the hospital release order carefully and follow everything that the hernia surgeon has mentioned in it. The recommendations may vary from one patient to other. Therefore, it is always better to follow the discharge order carefully and act accordingly.

Bed rest varies depending on the type of surgery – Hiatal hernia can be operated with laparoscopic surgery or with open surgery. In some cases, it depends on the choices of patient while at other cases, the doctors decide the type of surgery depending on the condition of the patient. A patient, who has undergone a laparoscopic surgery generally, needs to spend one night in the hospital and get back to his regular activities within a couple of days. However, someone recovering from the wounds of open surgery will have to spend multiple nights in the hospital and may need more than a week to resume his normal life.

Recommended Restrictions – In most of the cases, hernia surgeon does not impose much restriction on the patient and they can perform almost every activity that they used to do earlier. The only exception is lifting heavy weight. Neither the patients suffering from hiatal hernia nor the ones, who have undergone a surgery can lift heavy weight even after months or weeks. Lifting heavy weights or practicing any rigorous activity might strain the area once again, which in turn may lead to severe complications.

Hernia surgery has become much simplified in the recent days and you can find several doctors to perform these types of surgeries. However, just taking the help of any of them may not offer you the desired results. If you want to get complete cure from the condition, you should check the reputation of the doctors before taking their assistance. It is also recommended to check for the reviews of the hospital, where you want to be operated. Though the fees of the doctor as well as the hospital charges are important concerns before selection, you should never make any kind of compromise with the service, just for saving a few dollars.

Hernia is noted as one of the most common health issues experienced by people in different parts of the world. Though it does not causes severe complications to the patients, the constant or chronic pain related to the condition often make people to visit a specialist doctor for treatment. Whether you are a man or a woman, young or an elderly person, you can be at risk of getting a hernia. Yet, the condition can be avoided if you are aware of the major causes of the condition and avoid it in an intelligent manner.

Hernia is a medical condition in which an organ pressurizes through any tissue or muscle opening and covers up the space. In some cases, it is the intestines that tries to push out of the walls of the abdomen while in some other cases, hernia may occur in the groin area, belly button or in the upper thigh. Though hernia in most of the cases cause severe pain to the patients and symptoms at times may become unbearable, it does not generally have any threat to the life of the patient. Hernia treatment in India as well as in abroad is also quite simple and can be obtained under the guidance of an expert medical practitioner or doctor. Depending on the place of occurrence, hernia mostly needs surgery or operation. Yet, a single surgery does not reduce the risk of hernia recurrence. Therefore, it is always recommended to act carefully for reducing the risks of hernia surgery.

Obesity – Almost everybody is aware of the fact that obesity or excess weight gain has become one of the major health problems of the present days. Yet, you may not know that obesity paves the way for several other health problems. Hernia is one of the major health problems experienced by obese people and you may also like to know that people who are obese have higher risks during the hernia surgery. In most of the cases, doctors need the patient to slim down before operating them. Also in some cases, obese patient complain of tearing their hernia all over again after treatment.

Diabetes – Diabetic patients are also at a higher risk of getting hernia treatment in India. Doctors recommend them proper diet chart and medicines for controlling their blood sugar level before operation.

Lifestyle – You may not know that your lifestyle problems may also increase the risks of hernia. People who lead an extremely stressful life or have to lift heavy weights may get hernia all over again after surgery. Some people may also complain of post-surgery complications after lifting heavy weights.

Hernia surgery or hernia treatment has become quite simple these days. Yet, you need to get the assistance of a reputed doctor in this field. If you or any of your near ones is dealing with the problem of hernia, it is important for you to opt for immediate treatment and check severe complications. When selecting a doctor for your treatment, it is always advised to check their reviews at first and do not make the decision based on their fees.