A coronary angioplasty is a therapeutic procedure to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. These stenotic segments are due to the buildup of cholesterol-laden plaques that form due to atherosclerosis. A percutaneous coronary intervention is first performed. A PCI used with stable coronary artery disease reduces chest pain but does not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.[1]
Access to the vascular system is typically gained percutaneously (through the skin, without a large surgical incision). An introducer sheath is inserted into the blood vessel via the Seldinger technique. Fluoroscopic guidance and radiopaque contrast dye are used to guide angled wires and catheters to the region of the body to be treated. To treat a narrowing in a blood vessel, a wire is passed through the stenosisin the vessel and a balloon on a catheter is passed over the wire and into the desired position. The positioning is verified by fluoroscopy and the balloon is inflated using water mixed with contrast dye to 75 to 500 times normal blood pressure (6 to 20 atmospheres). A stent may or may not also be placed. At the conclusion of the procedure, the balloons, wires and catheters are removed and the vessel puncture site is treated either with direct pressure or a vascular closure device. Access to the vascular system is typically gained percutaneously (through the skin, without a large surgical incision). An introducer sheath is inserted into the blood vessel via the Seldinger technique. Fluoroscopic guidance and radiopaque contrast dye are used to guide angled wires and catheters to the region of the body to be treated. To treat a narrowing in a blood vessel, a wire is passed through the stenosisin the vessel and a balloon on a catheter is passed over the wire and into the desired position. The positioning is verified by fluoroscopy and the balloon is inflated using water mixed with contrast dye to 75 to 500 times normal blood pressure (6 to 20 atmospheres). A stent may or may not also be placed. At the conclusion of the procedure, the balloons, wires and catheters are removed and the vessel puncture site is treated either with direct pressure or a vascular closure device. Recovery After angioplasty, most patients are monitored overnight in the hospital, but if there are no complications, patients are sent home the following day. The catheter site is checked for bleeding and swelling and the heart rate and blood pressure is monitored. Usually, patients receive medication that will relax them to protect the arteries against spasms. Patients are typically able to walk within two to six hours following the procedure and return to their normal routine by the following week.[4] Angioplasty recovery consists of avoiding physical activity for several days after the procedure. Patients are advised to avoid any type of lifting, or other strenuous physical activity for a week.[5] Patients will need to avoid physical stress or prolonged sport activities for a maximum of two weeks after a delicate balloon angioplasty.[6] After the initial two week recovery phase, most angioplasty patients can begin to safely return to low-level exercise. A graduated exercise program is recommended whereby patients initially perform several short bouts of exercise each day, progressively increasing to one or two longer bouts of exercise.[7] As a precaution, all structured exercise should be cleared by a cardiologist before commencing. Patients with stents are usually prescribed an antiplatelet, clopidogrel, which is taken at the same time as acetylsalicylic acid(aspirin). These medicines are intended to prevent blood clots and they are usually taken for at least the first months after the procedure is performed. In most cases, patients are given these medicines for one year. Patients who experience swelling, bleeding or pain at the insertion site, develop fever, feel faint or weak, notice a change in temperature or color in the arm or leg that was used or have shortness of breath or chest pain should immediately seek medical advice. These procedures need 1 day hospitalization ,
Why brain surgery is done Brain surgery is done to correct physical abnormalities in the brain. These can be due to birth defect, disease, injury, or other problems. You may need brain surgery if you have any of the following conditions in or around the brain: • abnormal blood vessels • an aneurysm • bleeding • blood clots • damage to the protective tissue called the “dura” • epilepsy • abscesses • nerve damage or nerve irritation • Parkinson’s disease • pressure after head injury • skull fracture • a stroke • brain tumors • fluid building up in the brain Not all of these conditions require brain surgery, but many may be helped by it, especially if they pose a risk for more serious health problems. For example, a brain aneurysm doesn’t require open brain surgery, but you may need open surgery if the vessel ruptures. Types of brain surgery There are several different types of brain surgery. The type used depends on the problem being treated. Craniotomy A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated. During open brain surgery, your surgeon may opt to: • remove tumors • clip off an aneurysm • drain blood or fluid from an infection • remove abnormal brain tissue When the procedure is complete, the bone flap is usually secured in place with plates, sutures, or wires. The hole may be left open in the case of tumors, infection, or brain swelling. When left open, the procedure is known as a craniectomy. Biopsy This procedure is used to remove a small amount of brain tissue or a tumor so it can be examined under a microscope. This involves a small incision and hole in the skull. Minimally invasive endonasal endoscopic surgery This type of surgery allows your surgeon to remove tumors or lesions through your nose and sinuses. It allows them to access parts of your brain without making an incision. The procedure involves the use of an endoscope, which is a telescopic device equipped with lights and a camera so the surgeon can see where they’re working. Your doctor can use this for tumors on the pituitary gland, tumors on the base of the skull, and tumors growing at the bottom part of the brain. Minimally invasive neuroendoscopy Similar to minimally invasive endonasal endoscopic surgery, neuroendoscopy uses endoscopes to remove brain tumors. Your surgeon may make small, dime-sized holes in the skull to access parts of your brain during this surgery. Deep brain stimulation As with a biopsy, this procedure involves making a small hole in the skull, but instead of removing a piece of tissue, your surgeon will insert a small electrode into a deep portion of the brain. The electrode will be connected to a battery at the chest, like a pacemaker, and electrical signals will be transmitted to help symptoms of different disorders, such as Parkinson’s disease. How to prepare for brain surgery Your doctor will give you complete instructions on how to prepare for the procedure. Tell your doctor about any medications you’re taking, including over-the-counter medicine and nutritional supplements. You most likely will have to stop taking these medications in the days before the procedure. Tell your doctor about any prior surgeries or allergies, or if you’ve been drinking a lot of alcohol. You may be given a special soap to wash your hair with before surgery. Be sure to pack whatever belongings you may need while you stay at the hospital. Finding a doctor for brain surgery Looking for doctors with the most experience performing brain surgery? Use the doctor search tool below, powered by our partner Amino. You can find the most experienced doctors, filtered by your insurance, location, and other preferences. Amino can also help book your appointment for free. Following up after brain surgery Immediately after the surgery, you’ll be closely monitored to ensure everything is working properly. You’ll be seated in a raised position to prevent swelling in your face and brain. Recovery from brain surgery depends on the type of procedure done. A typical hospital stay for brain surgery can last up to a week or more. The length of your hospital stay will depend on how well your body responds to the surgery. You’ll be on pain medications during this time. Before you leave the hospital, your doctor will explain the next steps of the process. This will include how to care for the surgical wound, if you have one. In this surgery , the patient usually stay in hospital for about 3 days .
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease. CHD is a condition in which a substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle. If the blockage is severe, angina (an-JI-nuh or AN-juh-nuh), shortness of breath, and, in some cases, heart attack can occur. (Angina is chest pain or discomfort.) UCSF Medical Center earned a “high performance” rating – the highest rating possible – for heart bypass surgery in the U.S. News & World Report 2017-2018 Best Hospitals survey. The survey evaluated data from more than 4,500 hospitals. CABG is one treatment for CHD. During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This creates a new passage, and oxygen-rich blood is routed around the blockage to the heart muscle. Coronary Artery Bypass Grafting As many as four major blocked coronary arteries can be bypassed during one surgery. CHD isn't always treated with CABG. Many people who have CHD can be treated other ways, such as with lifestyle changes, medicines, and a procedure calledangioplasty (AN-jee-oh-plas-tee). During angioplasty, a small mesh tube called astent may be placed in an artery to help keep it open. CABG or angioplasty with stent placement may be options if you have severe blockages in your large coronary arteries, especially if your heart's pumping action has already been weakened. CABG also may be an option if you have blockages in the heart that can't be treated with angioplasty. In this situation, CABG is considered more effective than other types of treatment. If you're a candidate for CABG, the goals of having the surgery include: • Improving your quality of life and decreasing angina and other CHD symptoms • Allowing you to resume a more active lifestyle • Improving the pumping action of your heart if it has been damaged by a heart attack • Lowering the risk of a heart attack (in some patients, such as those who have diabetes) • Improving your chance of survival You may need repeat surgery if the grafted arteries or veins become blocked, or if new blockages develop in arteries that weren't blocked before. Taking medicines as prescribed and making lifestyle changes as your doctor recommends can lower the chance of a graft becoming blocked. In people who are candidates for the surgery, the results usually are excellent. Following CABG, 85 percent of people have significantly reduced symptoms, less risk of future heart attacks, and a decreased chance of dying within 10 years.
Before surgery When considering surgery, make sure you see a qualified spine (orthopedic or neurosurgical) surgeon, and get a second opinion. Before recommending one surgical procedure over another, your surgeon will likely order imaging tests, which may include: • X-ray: An X-ray produces clear pictures of your vertebrae and joints. • Computed tomography (CT/CAT scan): These scans provide more detailed images of the spinal canal and surrounding structures. • Magnetic resonance imaging (MRI): An MRI produces 3-D images of the spinal cord and nerve roots, as well as the disks themselves. • Electromyography or nerve conduction studies (EMG/NCS): These measure electrical impulses along nerves and muscles. These tests will help your surgeon determine the best type of surgery for you. Other important factors in the decision include the location of your herniated disk, your age, and your overall health. Types of surgery for herniated disk After gathering all the information they can, your surgeon may recommend one of these surgeries. In some cases, a person may require a combination of surgeries. Artificial disk surgery For artificial disk surgery, you’ll be under a general anesthesia. This surgery is usually used for a single disk when the problem is in the lower back. It’s not a good option if you have arthritis or osteoporosis or when more than one disk shows degeneration. For this procedure, the surgeon enters through an incision in your abdomen. The damaged disk is replaced with an artificial disk made from plastic and metal. You may need to stay in the hospital for a few days. Spinal fusion General anesthesia is required for spinal fusion. In this procedure, two or more vertebrae are permanently fused together. This may be accomplished with bone grafts from another part of your body or from a donor. It may also involve metal or plastic screws and rods designed to provide additional support. This will permanently immobilize that portion of your spine. Spinal fusion usually requires a hospital stay of several days. Preventing problems To help prevent future problems with your back, try to maintain a healthy weight. Always use proper lifting techniques. Strong abdominal and back muscles help support your spine, so be sure to exercise them regularly. Your doctor or physical therapist can recommend exercises designed for that purpose.
Endoscopy These tests allow the doctor to look inside the upper and lower parts of your digestive system. Gastroscopy: a test where a long flexible telescope (gastroscope) about the thickness of your index finger, with a bright light at its tip is carefully passed through your mouth allowing the doctor to look directly at the lining of your food pipe (oesophagus), stomach and small bowel (duodenum) - see diagram. How long does it take for an endoscopy and colonoscopy?
An upper endoscopy takes approximately 10 to 15 minutes. A colonoscopy takes approximately 15 to 30 minutes. How long will I be there after the procedure? Patients remain in the recovery area 30 to 40 minutes after their procedure.
What can be diagnosed with an endoscopy?
Endoscopy can also help identify inflammation, ulcers, and tumors. Upper endoscopy is more accurate than X-rays for detecting abnormal growths such as cancer and for examining the inside of the upper digestive system. In addition, abnormalities can be treated through the endoscope
Colonoscopy
The doctor will carefully pass the colonoscope through your bottom (anus) into your rectum and on into your colon. You may experience some abdominal cramping and pressure from the air which is introduced into your colon to help the doctor get a clearer view of your bowel. This is normal and will pass quickly. You may get the sensation of wanting to go to the toilet, but as the bowel is empty, there is no danger of this happening. This may also make you need to pass wind and, although this may be embarrassing, remember the staff do understand what is causing it. The air is sucked out at the end of the test. We will try to keep you as comfortable as possible. You may also be asked to change position during the procedure, and will be helped by a nurse. The nurse may need to press on your abdomen for a few moments during the procedure to help the colonoscope around awkward bends in your bowel. You will be warned before any pressure is applied. When the examination is finished, the colonoscope is removed quickly and easily Follow-up Appointments? You will have a follow-up appointment with the GP or specialist (who referred you for the procedure). At this appointment, please ask for the details of any biopsy results or further investigations.
What Is a Hysterectomy? A hysterectomy is a surgical procedure to remove a woman’s uterus. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. The uterine lining is the source of menstrual blood. You may need a hysterectomy for many reasons. The surgery can be used to treat a number of chronic pain conditions as well as certain types of cancer and infections. The extent of a hysterectomy varies depending on the reason for the surgery. In most cases, the entire uterus is removed. The doctor may also remove the ovaries and the fallopian tubes during the procedure. The ovaries are the organs that produce estrogen and other hormones. The fallopian tubes are the structures that transport the egg from the ovary to the uterus. Once you’ve had a hysterectomy, you’ll stop having menstrual periods. You’ll also be unable to get pregnant.
Why Is a Hysterectomy Performed? Your doctor may suggest a hysterectomy if you have any of the following: • chronic pelvic pain • uncontrollable vaginal bleeding • cancer of the uterus, cervix, or ovaries • fibroids, which are benign tumors that grow in the uterus • pelvic inflammatory disease, which is a serious infection of the reproductive organs • uterine prolapse, which occurs when the uterus drops through the cervix and protrudes from the vagina • endometriosis, which is a disorder in which the inner lining of the uterus grows outside of the uterine cavity, causing pain and bleeding • adenomyosis, which is a condition in which the inner lining of the uterus grows into the muscles of the uterus Alternatives to a Hysterectomy According to the National Women’s Health Network, a hysterectomy is the second most common surgical procedure performed on women in the United States. It’s considered to be a safe, low-risk surgery. However, a hysterectomy may not be the best option for all women. It shouldn’t be performed on women who still want to have children unless no other alternatives are possible. Luckily, many conditions that can be treated with a hysterectomy may also be treated in other ways. For instance, hormone therapy can be used to treat endometriosis. Fibroids can be treated with other types of surgery that spare the uterus. In some circumstances, however, a hysterectomy is clearly the best choice. It’s usually the only option for treating uterine or cervical cancer. You and your doctor can discuss your options and determine the best choice for your specific condition.
What Are the Types of Hysterectomy? There are several different types of hysterectomy. Partial Hysterectomy During a partial hysterectomy, your doctor removes only a portion of your uterus. They may leave your cervix intact. Total Hysterectomy During a total hysterectomy, your doctor removes the entire uterus, including the cervix. You’ll no longer need to get an annual Pap test if your cervix is removed. However, you should continue to have regular pelvic examinations. Hysterectomy and Salpingo-Oophorectomy During a hysterectomy and salpingo-oophorectomy, your doctor removes the uterus along with one or both of your ovaries and fallopian tubes. You may need hormone replacement therapy if both of your ovaries are removed. How Is a Hysterectomy Performed? A hysterectomy can be performed in several ways. All methods require a general or local anesthetic. A general anesthetic will put you to sleep throughout the procedure so that you don’t feel any pain. A local anesthetic will numb your body below the waistline, but you’ll remain awake during the surgery. This type of anesthetic will sometimes be combined with a sedative, which will help you feel sleepy and relaxed during the procedure.
Abdominal Hysterectomy During an abdominal hysterectomy, your doctor removes your uterus through a large cut in your abdomen. The incision may be vertical or horizontal. Both types of incisions tend to heal well and leave little scaring. Recovering from a Hysterectomy After your hysterectomy, you’ll need to spend two to five days in the hospital. Your doctor will give you medication for the pain and monitor your vital signs, such as your breathing and heart rate. You’ll also be encouraged to walk around the hospital as soon as possible. Walking helps prevent blood clots from forming in the legs. If you’ve had a vaginal hysterectomy, your vagina will be packed with gauze to control the bleeding. The doctors will remove the gauze within a few days after the surgery. However, you may experience bloody or brownish drainage from your vagina for about 10 days. Wearing a menstrual pad can help protect your clothing from getting stained. When you return home from the hospital, it’s important to continue walking. You can walk around inside your house or around your neighborhood. However, you should avoid performing certain activities during recovery. These include: • pushing and pulling objects, such as a vacuum cleaner • lifting heavy items • bending • sexual intercourse If you’ve had a vaginal or laparoscopic hysterectomy, you’ll probably be able to return to most of your regular activities within three to four weeks. Recovery time will be a little longer if you’ve had an abdominal hysterectomy. You should be completely healed in about four to six weeks.
Liver cysts are thin-walled sacs filled with air, fluids, or semi-solid material. Liver cysts occur in approximately 5% of people. The majority of cysts are benign, but all cancers are able to produce malignant cysts. Patients typically present with a single liver cyst, although multiple cysts sometimes develop. Liver cysts rarely impair the liver's ability to function. Most liver cysts do not cause symptoms. If they do occur, symptoms include: • Upper abdominal fullness, discomfort, or pain. • Sudden and severe right upper quadrant and shoulder pain caused by bleeding into the cyst, but this occurs In only in a small group of patients,
Diagnosis & Treatment Cysts are diagnosed using ultrasound or with a CT scan. Only patients with symptoms require treatment, which consists of surgically removing a large portion of the cyst wall. Only removing the fluid from the cyst is ineffective because it will fill up again within days.
Reduction is a surgical procedure to restore a fracture or dislocation to the correct alignment. This sense of the term "reduction" does not imply any sort of removal or quantitative decrease but rather implies a restoration: re ("back [to initial position]") + ducere ("lead"/"bring"), i.e., "bringing back to normal." When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re- aligned to their normal anatomicalposition. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement. Reduction could be by "closed" or "open" methods. • Open reduction is where the fracture fragments are exposed surgically by dissecting the tissues. • • Closed reduction is the manipulation of the bone fragments without surgical exposure of the fragments. Because the process of reduction can briefly be intensely painful, it is commonly done under a short- acting anaesthetic, sedative, or nerve block. Once the fragments are reduced, the reduction is maintained by application of casts, traction or held by plates, screws, or other implants which may in turn be external or internal. It is very important to verify the accuracy of reduction by clinical tests
and X-ray, especially in the case with joint dislocations.
Partial knee replacement: The surgeon replaces the damaged portions of the knee with plastic and metal parts. Total knee replacement: In this procedure, the knee is replaced with an artificial joint. It requires a major surgery and hospitalization.
What is a total knee replacement? A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thighbone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic "button" may also be added under the kneecap surface. The artificial components of a total knee replacement are referred to as the prosthesis. The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thighbone. In total knee replacement surgery, this ligament is either retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its own particular benefits and risks. undergoing a total knee replacement? Risks of total knee replacement include blood clots in the legs that can travel to the lungs (pulmonary embolism). Pulmonary embolism can cause shortness of breath, chest pain, and even shock. Other risks include urinary tract infection, nausea and vomiting (usually related to pain medication), chronic knee pain and stiffness, bleeding into the knee joint, nerve damage, blood vessel injury, and infection of the knee which can require reoperation.
Thyroidectomy is the removal of all or part of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck. It produces hormones that regulate every aspect of your metabolism, from your heart rate to how quickly you burn calories. Removal of part of the thyroid can be classified as: 1. An open thyroid biopsy – a rarely used operation where a nodule is excised directly; 2. A hemi-thyroidectomy or thyroid lobectomy – where one lobe (one half) of the thyroid is removed; 3. An isthmusectomy – removal of just the bridge of thyroid tissue between the two lobes; used specifically for small tumors that are located in the isthmus. 4. Finally, a total or near-total thyroidectomy is removal of all or most of the thyroid tissue. The recommendation as to the extent of thyroid surgery will be determined by the reason for the surgery. For instance, a nodule confined to one side of the thyroid may be treated with a hemithyroidectomy. If you are being evaluated for a large bilateral goiter or a large thyroid cancer, then you will probably have a recommendation for a total thyroidectomy. However, the extent of surgery is both a complex medical decision as well as a complex personal decision and should be made in conjunction with your endocrinologist and surgeon.