Specialties

Gastroenterology Treatments

Who should consider Gastroenterology Surgery ?

Weight loss and change in bowel habit are the alarming symptoms for gastroenterology. Apart from these, there are some conditions where the patient is required to consult a specialist –

  • Constipation
  • Abdominal Pain
  • Diarrhea
  • Blood in the stool
  • Gastroesophageal Reflux Disease or Acid Reflux
Gastroenterology Disorders

The organs affected by gastrointestinal system

  • Bowel and colon cancers
  • Biliary tract disease
  • Peptic ulcer disease
  • Irritable bowel syndrome
  • Cholecystitis
  • Gastric cancers
  • Hepatitis
  • Pancreatitis
  • Colon polyps
  • Esophageal cancers
  • Cancer and gall bladder stones
  • Achalasia
  • Pancreatic Cancer
  • Malabsorption and nutritional problems
  • Gastroesophageal Reflux
Types of Gastrointestinal Surgery

Different types of gastrointestinal surgery can treat the following conditions that can improve quality of life of for many patients. Some of these conditions include –

  • Mediastinal masses
  • Achalasia
  • Laryngopharyngeal reflux disease (LPR)
  • Paraesophageal hernias, hiatal hernias and ventral hernias
  • Gastrointestinal reflux disease (GERD) or severe heartburn
  • GIST and other stomach tumors
  • Esophageal disease
  • Anorectal disease including rectal prolapse, incontinence
  • Gallbladder disease
  • Ulcerative colitis and Crohn’s disease
  • Enterocutaneous fistula and short bowel syndrome

The extent and type of GI (Gastrointestinal Surgery) largely depend upon the location and the size of the cancer. Gastrointestinal surgery could be the only treatment and can also be performed along with radiation therapy and chemotherapy.

Gallbladder Cancer : Surgery is used for treating the early stages of gallbladder cancers
Stomach Cancer : Gastrectomy is the procedure by which the stomach cancer is treated. Partial gastrectomy is used for removing a part of the stomach. The remaining part of the stomach is connected with esophagus to the small intestine.
Liver Cancer : Hepatectomy is the surgical procedure for removing the parts of liver. 80% of the liver can be removed if the rest liver tissue is healthy. The left part of the liver helps in proper functioning of the liver.
Pancreatic Cancer : Whipple procedure is used for treating pancreatic cancer in order to remove the first part of the small intestine, head of the pancreas, part of the stomach and the bile duct. The tail and body of the spleen and the pancreas can be removed with the help of a distal pancreatectomy procedure.
Esophageal Cancer : A part or the entire esophagus can be removed with the help of esophagectomy procedure. This is done for treating the esophageal cancer.
Colorectal Cancer : The removal of the rectum or a segment of the colon and the 2 remaining ends are reconnected for the purpose of treating the colorectal cancer. The colostomy is the rare procedure by which a new path is created for taking out the waste products. An opening is made in the abdomen for connecting the opening with the intestine. A bag is then fitted in the opening in order to collect the waste.
Gastroenterology Diseases and Treatments
  • Obscure bleeding and Diverticulosis
  • Mal Absorption Syndrome
  • Tuberculosis
Diseases of the Duodenum and Stomach
  • Fungal Infections
  • Ulcers
  • Cancer
Diseases of the Gall Bladder
  • Cancer of the Bladder
  • Cholecystitis
  • Stone diseases
Diseases of the Colon
  • Tuberculosis
  • Inflammatory Bowel Disease
  • Cancer and Diverticulosis
Diseases of the Pancreas
  • Pseudo Pancreatic Cyst
  • Pancreas Cancer
  • Chronic Pancreatitis
  • Acute Pancreatitis
Diseases of the Esophagus
  • Achalasia Cardia
  • Variceal Bleeding
  • Foreign body removal
  • Malignant and benign strictures
Diseases of the Liver
  • Cirrhosis
  • Acute Hepatitis
  • Amoebic Abscess
  • Chronic Hepatitis
  • Liver Cancer
Capsule Endoscopy (Inpatients)

It is a procedure where the patient has to swallow a vitamin-sized capsule which contains a tiny wireless camera. This helps in getting pictures of your digestive tract for medical diagnosis.

Colonoscopy (Full Length)

Colonoscopy is a medical test to examine the abnormalities and changes in the large intestine and rectum. The doctor will do so by inserting a long, flexible tube into the rectum with an attached tiny video camera to it. This help in viewing the inside of the entire colon for better diagnosis.

Endoscopy (UGI Endoscopy)

It is a test done to examine any part of the upper digestive system or UGI (upper gastrointestinal tract including the small intestine, stomach, esophagus, and mouth). The same is done by inserting a long, flexible pipe through the mouth for diagnosis and treatment.

Endoscopy Pseudocyst Drainage

Pancreatic pseudocysts are cysts on the pancreas which appear as fluid-filled sacs that cause trauma or pancreatitis. The procedure followed is where an endoscopic ultrasound is inserted in the GI tract, just a little close to the pancreas in order to drain the cysts.

ERCP (Diagnostic)

Endoscopic retrograde cholangiopancreatography is a technique to examine the problems in the gall bladder, pancreatic ducts, and the bile. It uses both endoscopy and fluoroscopy.

Esophageal stenting

It is a procedure in which a pipe is inserted in the esophagus (throat) to open the blocked area. Basically, it is done to help swallow fluids and solids and is a part of the treatment for peptic esophageal strictures, esophageal perforation, tracheoesophageal fistula, etc.

Sigmoidoscopy

It is a procedure to view the inside of the rectum and lower colon also known as sigmoid colon and descending colon for any cancers, polyps or ulcers. The same is done with the help of a small tube with a camera and light also called sigmoidoscope.

Whipple Procedure

It is a surgical operation for the removal of tumors from the pancreas. The procedure involves the removal of the head of the pancreas, gall bladder and the first part of the small intestine and part of the bile duct. After the surgery, the organs are reconnected for the patient to digest food normally.

What is Laparoscopy ?

The procedure of Laparoscopy makes use of a laparoscope for looking into the patient’s abdomen. The purpose of using a laparoscope is to magnify and light up the structures within the abdomen.

A laparoscope has a light source that can be passed inside the abdomen by making a tiny incision into the skin. The symptoms of pelvic pain, pelvic region, abdominal pain and swelling of the abdomen can be found out by using a laparoscopy procedure. The Doctor can clearly see inside the patient’s abdomen by using laparoscopy. The few common conditions that can be perceived by laparoscopy –

  • Appendicitis
  • Ectopic pregnancy
  • Endometriosis
  • Pelvic inflammatory disease
  • Ovarian cyst
What is Laparoscopic Surgery ?

Laparoscopic surgery, also referred to as minimally invasive surgery or keyhole surgery, makes use of several thin instruments and a video camera. About a half an inch tiny incisions are made and then the placement of the ports (plastic tubes) is done from these incisions. Then the instruments and the camera are introduced from the ports. This enables in accessing the inside of the patient. The most commonly performed procedures are –

  • Female sterilization
  • The removal of parts of the intestines
  • Treating ectopic pregnancy
  • Removal of the gall bladder
  • The removal of patches of endometriosis
  • The biopsy of different structures within the abdomen
  • The removal of the appendix
Why Laparoscopic surgery is done ?

Laparoscopies technique is performed for many intestinal surgeries. For some colorectal cancers, the laparoscopic surgery is very successful and safe. Some of the conditions treated by laparoscopy surgery include –

  • Diverticulitis
  • Ulcerative colitis
  • Crohn’s disease
  • Rectal prolapse
  • Severe chronic constipation that was not successfully treated with the help of medication.
  • Colon polyps which are very large to remove by using colonoscopy
  • Colorectal cancer
  • Bowel incontinence
  • Familial polyposis (a condition that causes multiple colon polyps)
Who should consider Laparoscopic Gallbladder Surgery ?

The procedure of laparoscopic gallbladder removal is not appropriate for the patients having pre-existing medical conditions or had earlier upper abdominal surgery. A physician properly evaluates the medical conditions of the patients. The laparoscopy trained surgeon determines an appropriate procedure for removing the gallbladder.

Benefits of Laparoscopic Procedures
  • A shorter stay in the hospital
  • Involves small scars
  • Less post-operative discomfort
  • Less internal scarring
  • Quick recovery
Benefits of Laparoscopic gallbladder Surgery
  • The recovery is faster if the removal of gall bladder is done laparoscopically.
  • Instead of 5-7 inch incision, 4 small openings is required in the abdomen.
  • The patients can return to their home after a day.
  • Minimal post-operative pain is involved.
Laparoscopic Abdominal Surgery

The abdominal cavity organs are thoroughly examined with the help of laparoscopic surgery procedure. The procedure is performed under general anesthesia. The procedure makes use of a thin flexible tube having a video camera and a laparoscope. By making tiny incisions, the placement of a laparoscope is done inside the abdomen. It then generates the images of the abdomen on the screen. The major benefit of laparoscopy is that it provides a clear view of the abdominal structures and organs eliminating the need for surgery. After the completion of the surgery, the other instruments and the laparoscope are removed. All the incisions are then stitched back.

Laparoscopic Hysterectomy

The minimally invasive procedure of laparoscopic hysterectomy is performed for removing the uterus. In this procedure a small camera is inserted by making a tiny incision in the belly button. The procedure is done by seeing the images on the screen by the means of a small camera. Then in the lower abdomen, 2 or 3 incisions are made. The insertion of the specialized instruments is done in the process of removal.

In some cases, the ovaries of the women are not removed while going through hysterectomy. If a woman chooses her ovaries to stay inside then there is no need of taking out the hormones after the completion of the surgery. Also she does not feel any hot flashes. The cause for the removal of ovaries could be abnormal growth of the ovaries or due to family history of ovarian cancer. Women can either choose a laparoscopic supra-cervical hysterectomy that keeps the cervix in place or total laparoscopic hysterectomy that entirely removes the uterus. The procedure of laparoscopic hysterectomy only requires several tiny incisions instead of 3-6 inch incision in the case of traditional abdominal hysterectomy. As a result of which there is less blood loss, less scarring and less post-operative pain.

Robotic Laparoscopic Surgery

Robot-assisted surgery is regarded as the best minimally invasive alternative to both laparoscopy and open surgery. The surgeon performs the operation with the DA Vinci’s robotic system that has no direct mechanical association with either the patient or the surgeon. The surgeon is seated at a computer console and is a few feet away from the patient. The operating field can be viewed by the surgeon from a three-dimensional view. The surgeon uses the console having hand control and directs the micro instruments, wrists and robotic arms of the machine. The benefits of robot-assisted technique includes –

  • A shorter hospital stay
  • Better clinical outcomes
  • Significantly less pain
  • Less scarring
  • Reduced blood loss
  • Fewer complications
  • A faster return to routine daily activities
Laparoscopy Surgery for Endometriosis

Mild to moderate conditions of endometriosis is removed by the means of laparoscopy. A lighter weight laparoscope is used and is inserted by making a tiny incision. The procedure is performed for treating conditions such as severe endometriosis pain, endometriosis cyst on an ovary, endometriosis as the possible cause of infertility and severe scar tissue and endometriosis which is interfering with the internal organs namely bladder or bowel.

What is a Gall Bladder Surgery ?

Gallbladder surgery, also referred to as Cholecystectomy, is the procedure that involves the removal of the gallbladder (a pear-shaped organ below the liver on the upper side of the abdomen)

The surgery is necessary if a person experiences pain from gallstones that obstructs the flow of the bile. The procedure is minimally invasive and uses small incisions in the abdomen that allows a surgeon to gain access of the gallbladder with the help of surgical tools such as a laparoscope (a high definition camera). Sometimes a big incision is also made for removing the gallbladder and the procedure is known as open Cholecystectomy.

Symptoms of Gallstones
  • Infection of the gallbladder
  • Significant abdominal pain
  • Significant recurrence of indigestion
  • Serious vomiting or nausea attributed to gallbladder stones
Who should consider Gallbladder Surgery

The laparoscopy has many benefits but the procedure may not be suitable for those patients who earlier had upper abdominal surgery. The patients who had some pre-existing medical condition is also not appropriate for gallbladder surgery. A thorough examination of the patient is done in order to determine whether or not the procedure is right for you.

The Conditions that Causes Gallbladder Problems
  • If a gallstone blocks the common bile duct then the condition of Jaundice may develop.
  • It is not clear as to why some people form gallstones.
  • The gallstones are responsible for causing gallbladder problems.
  • The gallstones can obstruct the flow of bile out of the gallbladder. This causes swelling of the gallbladder that results in severe abdominal pain, indigestion and vomiting.
Gallbladder Removal Surgery

Cholecystectomy is the surgical procedure for removing the gallbladder. While performing traditional surgery, a long incision of about 5-8 inches is made in the abdomen for removing the gallbladder. The incision is made beneath the ribs on the right side and reaches below the waist. This procedure is termed as open Cholecystectomy.

Laparoscopic Cholecystectomy is the newer procedure for removing the gallbladder. A high definition camera is used for viewing inside the body and the doctor views the patient’s gallbladder on a TV screen. The surgeon then does the surgery with surgical tools that are inserted in three tiny cuts in the right upper part of the abdomen. The surgeon then takes out the gallbladder by the means of one of the incisions.

Benefits of Laparoscopic Gallbladder Removal Surgery
  • The patients can go home within a day.
  • A faster recovery period where the patients can get back to their normal activities.
  • Patients have minimal post-operative pain.
  • Instead of 5-7 inch large incision, the procedure requires 4 small openings in the abdomen.
  • Patients also experience a quicker recovery than open gallbladder surgery patients.
Living Without a Gallbladder

The person can live a normal life without a gallbladder. Though the organ can be useful but it is not necessary. The liver of a person will still produce bile for digesting the food. By adopting simple lifestyle changes, a person can live a normal life. Some of the lifestyle changes include –

  • Avoid eating a large quantity of food after fasting all day.
  • Eat small and frequent meals.
  • Adopt a low-fat diet regime.
  • Avoid eating fried and high calorie food.

Hernia Treatment

What is Hernia Surgery ?

The condition of hernia arises when the contents (abdominal fatty tissue or portions of the intestine) of a body cavity bulge out of the area where they are generally contained.

The thin membrane encloses all the contents that outline the inside of the cavity. The condition of hernia may not produce any symptoms but may result in severe pain. The blood supply is cut off when the contents bulge out through the opening that creates severe pressure on the blood vessels. This calls for surgical or medical emergency as blood supplies the oxygen to the tissues.

Types of Hernia
Femoral Hernia
The femoral nerve, vein and artery pass through the path of femoral canal and leaves the abdominal cavity to come into the thigh. A bulge is caused by a femoral hernia beneath the inguinal crease around the mid-thigh area. This condition is usually seen in women where the femoral hernias are not able to be strangulated (have their blood supply cut off) or pushed back into place (irreducible). It is not that all the hernias are strangulated or irreducible. All irreducible hernias need to be thoroughly examined by the doctor.
Incisional Hernia
In the case of abdominal surgery, a flaw is caused in the abdominal wall. This procedure may lead to the development of hernia. This happens after 2-10% of every abdominal surgical procedure. Incisional hernia may come back again even after going through surgical repair.
Epigastric Hernia
The epigastric hernia hardly ever contains intestine and are made up of fatty tissue. Epigastric hernia occurs in between the lower part of the rib cage in the mid line of the abdomen and the navel. This type of hernia is usually painless and they cannot be pushed back into the abdomen.
Inguinal (groin) Hernia
This type of hernia is mostly seen in men (25 times more often) as compared to women. Inguinal hernia makes up around 75 percent of all the abdominal-wall hernias. Direct and indirect are the two kinds of inguinal hernia. Both indirect and direct takes place in the groin area where the skin of the thigh joins the inguinal crease (the torso). Both of them emerge as a bulge in the groin area.
Direct Inguinal Hernia
This hernia develops within the location of the indirect hernia, in the abdominal wall area which is naturally thinner. This type of hernia usually develops in the elderly and middle aged people when the abdominal wall weakens.
Indirect Inguinal Hernia
The pathway is followed by an indirect hernia that is created by the testicles at the time of fetal development, sliding from the abdomen into the scrotum. Generally this pathway gets closed before birth and can happen in later stages of life.
Obturator Hernia
This is a rare type of hernia is frequently seen in women. Obturator hernia stands out from the pelvic cavity through an opening in the obturator foramen (pelvic bone). This type of hernia may not show any bowel obstruction but can result into vomiting and nausea. This is hard to diagnose as there is no bulging.
Spigelian Hernia
Spigelian hernia develops at the border line of the rectus abdominus muscle throughout the spigelian fascia. This is also a rare type of hernia.
Umbilical Hernia
Umbilical hernia is one of the common hernias that can be noticed at the time of birth due to protrusion at the umbilicus (belly button). This happens when the opening of the abdominal wall does not close properly. Umbilical small hernia generally closes by the age of two. On the other hand, umbilical large hernias need surgery at the age of 2-4 years. This kind of hernia may also develop in later stages of life as the spot can stay at a weaker place in the abdominal wall. This hernia may also happen in those women who have given birth or are pregnant.
Who Should consider Hernia Surgery ?

The surgery is meant for those who have the following conditions –

  • If the hernia is growing larger.
  • If the hernia is restricting your daily activities or causing any discomfort.
  • If you are worried about the bowel getting trapped.
Symptoms of Hernia
Symptoms of Strangulated hernia include –
  • This hernia is a surgical or medical emergency.
  • Strangulated hernia is an irreducible hernia where entrapped intestine has its blood supply cut off.
  • A person may feel ill or may have fever.
  • Sometimes there are symptoms of vomiting and nausea (bowel obstruction).
  • Pain is always there in this type of hernia that is followed rapidly by tenderness.
Symptoms of Reducible hernia include –
  • Reducible hernia may be pushed back into the abdomen unless very large.
  • It could appear as a new lump in the other abdominal area or groin area.
  • Pain can be noticed first before discovering of the lump.
  • This hernia may ache but is not tender when touched.
Symptoms of Irreducible hernia include –
  • This type of hernia is also known as incarcerated hernia.
  • It may show signs of bowel obstruction like vomiting and nausea.
  • It could also be a painful enlargement of earlier reducible hernia which cannot return to the abdominal cavity when pushed or on its own.
  • This may also result in strangulation.
  • It could also be chronic without a feeling of pain.
Causes of Hernia

Hernias can be present at the time of birth and can also develop in the later stages of life. When the abdominal cavity’s pressure increases, it may result in the formation of hernia. It include –

  • Coughing
  • Chronic lung disease
  • Obesity
  • Fluid in the abdominal cavity
  • Heavy lifting
  • A family history of hernias that increase the chances of developing a hernia Straining during urination or a bowel movement
Hernia Repair

The surgical procedure for fixing a hernia is termed as hernia repair. Herniorrhaphy is the other name for this procedure. There are 2 kinds of hernia repair –

  • Laparoscopic Hernia Repair This minimally invasive procedure involves some holes in the skin. Through these holes, long-handled surgical instruments and a laparoscope are inserted. The entire procedure is performed under general anesthesia and also involves a proper evaluation of the patient’s health that include physical exam and history, EKG and lab work. There is no feeling of pain during the surgery. With the help of carbon dioxide gas, the abdomen is inflated that enables the doctor to view internal structures. In order to expose the weakness in the abdominal wall, the inner lining of the abdomen (peritoneum) is cut. Also to secure the weak area, a patch is attached below the peritoneum. The inner lining of the abdomen is then sutured.
  • Traditional (open) Hernia Repair During open hernia surgery, an opening in the skin is created by making a cut. Then hernia is fixed through this opening which is many inches long.
Benefits of Laparoscopic Hernia Repair Surgery
  • Quick recovery time and the patient can return to its daily activities earlier.
  • 3 small incisions are made instead of 1 large incision.
  • Less postoperative pain.
  • A quick return to work.

Inflammatory Bowel (Crohn’s )Disease Treatment

What is Inflammatory Bowel (Crohn’s) Disease?

Inflammatory Bowel Disease (IBD) is the term used for a collection of disorders where the intestines become red and swollen (inflamed). This happens when an immune reaction of the body is against its own intestinal tissue.

Crohn’s disease (CD) and ulcerative colitis (UC) are the two kinds of inflammatory bowel disease. Crohn’s disease can affect the colon or the small intestine and it also involves any part of the gastrointestinal tract and results in malnutrition, abdominal pain and severe diarrhea. Ulcerative colitis affects the large intestine (colon). This disease results in continuing inflammation in part of the digestive tract.

Symptoms of Inflammatory Bowel Disease (IBD)

When IBD flares up in the case of chronic diseases, it can lead to different symptoms that can sometimes disappear or decrease and a person can return to their normal health. The symptoms of IBD vary from mild to severe depending upon which part of the intestinal tract is concerned. Some of the symptoms are –

  • Loss of appetite
  • Diarrhea that could be bloody
  • Weight loss
  • Abdominal pain and cramps
  • Iron deficiency anemia due to blood loss
  • Fever
  • Severe urgency to have a bowel movement
Causes of Inflammatory Bowel Disease

There is no exact cause of IBD. However, the disease could be due to malfunctioning of the body’s immune system. Ulcerative Colitis and Corhn’s disease both can be seen in the family history of patients. Few environmental factors can also be responsible for causing ulcerative colitis and Crohn’s disease. IBD can also be influenced by psychological, infectious, immunologic and genetic factors.

Diagnosis for Inflammatory Bowel Disease

The tests depend on the symptoms of IBD that include –

Complete Blood Count
  • If a patient has severe bleeding then hemoglobin level may drop and the count of the red blood cells decrease.
  • An inflammation in the body occurs when there is an increase in the count of white blood cells.
Stool Examination
  • The presence of blood traces in the stool can only be examined through a fecal occult blood test.
  • A stool is properly examined for eliminating the possibilities of parasitic, viral or bacterial causes of diarrhea.
Colonoscopy : This helps in examining the entire colon.
Barium X-ray
  • Lower Gastrointestinal Tract : In this test, a barium is given in the form of an enema which retains in the colon and the x-rays can be taken. Through this, colon in patients having ulcerative colitis and Crohn’s disease and also abnormalities in the rectum can also be noticed.
  • Upper Gastrointestinal Tract : The test is used for finding abnormalities in the upper gastrointestinal tract. A patient is required to swallow a chalky white substance known as barium. This barium helps in coating the inside of the intestinal tract which can further documented on x-rays.
Sigmoidoscopy

The last one-third part of the large intestine can be visualized by using a sigmoidoscope. This one-third part includes the sigmoid colon and the rectum. The test helps in examining bleeding, ulcers and inflammation.

Upper Endoscopy

An endoscope is used if a patient has gastrointestinal symptoms such as vomiting and nausea. The duodenum, esophagus and stomach are examined using an endoscope.

Treatments for Inflammatory Bowel Disease

Surgical or medical treatments are available for inflammatory bowel disease (IBD). Both the types of IBD- ulcerative colitis and Crohn’s disease can be treated with the help of several drugs. Surgery is the last option available and it depends upon the type of inflammatory bowel disease. It is possible to ulcerative colitis through surgery. Certain drugs can also be used for treating IBD.

Robot Surgery for Inflammatory Bowel Disease

DA Vinci robotic surgery is a minimally invasive procedure that involves less scarring, small incisions and also results in quick recovery. The robotic surgery provides the best results in the treatment of ulcerative colitis and Crohn’s disease. This procedure involves patented surgical instruments, state of the art surgical platform and high definition vision. The procedure reduces the side effects of inflammatory bowel disease.

Benefits of Inflammatory Bowel Disease Treatment

After the treatment of IBD, there is a drastic improvement in the health related quality of life of a patient. The health related quality of life is seen in both the cases of ulcerative colitis and Crohn’s disease.

Intestinal Fistulas

Tubular connections between the skin, the bowel or other organs are termed as intestinal fistulas. The formation of the fistulas happens when there is extended inflammation through every layer of the bowel. Then fistulas proceed to tunnel through other tissue layers. Fistulas are numerous and is more commonly seen in Crohn’s disease. Fistulas can link the bowel to the skin around the anus, to the abdominal wall, to other loops of the bowel and also with internal locations like scrotum, vagina, urinary bladder and muscles.

Whipple Procedure

What Is a Whipple Procedure?

The Whipple procedure is a common surgery for removing tumors in the pancreas. The surgery is seen as a cure to extend life for pancreatic patients.

Whipple procedure gets its name from Allen Whipple, MD, a Columbia University surgeon who first operated in 1935. Besides, in a classic Whipple procedure, the doctor will remove the head of the pancreas, gallbladder, duodenum, a portion of the common bile duct and part of the stomach. Thereupon, the surgeon reconnects the remaining pancreas and digestive organs.

Whipple procedure is a complex surgery and can have serious risks. However, a successful Whipple procedure turns out to be lifesaving for pancreatic patients.

Who Is a Candidate for the Whipple Procedure?

Whipple procedure is a treatment option for the patients whose pancreas, bile duct or duodenum is affected by cancer. A surgeon will do tests on your body to understand the complexity of your case and then you will be suggested with the right treatment. If a tumor is in the head of the pancreas and has not spread to other parts of the body, the Whipple procedure might be the right treatment. In case the tumor has grown in the body and tail of the pancreas, distal pancreatectomy is performed.

Furthermore, the Whipple procedure is one of the best ways to provide long-time cure to pancreatic patients. What shocking to know is that about 30-50% of people who are eligible for the surgery are told otherwise. Which is why it is strongly recommended to go for institutions and doctors with a high volume of pancreatic surgery and a success rate. Your doctor will propose surgery to treat:

  • Pancreatic tumors
  • Pancreatic cysts
  • Pancreatic cancer
  • Bile duct cancer
  • Small bowel cancer
  • Ampullary cancer
  • Trauma to the pancreas or small intestine
  • Pancreatitis
  • Neuroendocrine tumors
  • Tumors or disorder apart from the ones mentioned above
Risks

Whipple procedure is also known as Pancreatoduodenectomy. It is a complex surgery and it has risks and complications linked to it. Some of them are mentioned below:

  • Leaking of pancreatic juices
  • Bleeding from surgical areas
  • Infection inside the abdomen or the incision area
  • Delay in the emptying of the stomach
  • Diabetes
  • Weight loss
Who is the best surgeon for the Whipple procedure?

If you go by popular recommendation, then it is best to consult a surgeon and hospital with a high volume of pancreatic surgery. The higher the volume of pancreatic surgeons with a high success rate, the more is a chance that you will get the best treatment, proper pre, and post-surgery care. The patient should do enough research regarding this and he should be mentally prepared before making a firm decision for the surgery. Below mentioned are the few ways in which Whipple procedure may be undertaken:

  • Open surgery It is the traditional type of surgery in which the doctor makes an incision in your abdomen to access your pancreas and then perform the surgery.
  • Laparoscopic surgery In this type of surgery, your surgeon will make several smaller incisions in the abdominal wall and insert a long thin tube with an attached camera through one of them. The rest of the surgery is performed through the other incisions guided by the laparoscopic images. This kind of surgery is preferred because the doctor can reduce blood loss and chances of infection for the patient.
  • Robotic surgery Robotic surgery uses the minimally invasive technique for carrying forward the procedure. The doctor sits at a console and directs the robot with the help of hand controls. It is an efficient procedure because the robot can work in tight spaces and around corners inaccessible by human hands.

Even when minimally invasive surgery has a lot of plus points like lower blood loss and chances of infection for the patient, it is a time-consuming procedure. Besides, there can be cases in which the procedure begins with minimally invasive surgery however due to technical difficulty the doctor may be conditioned to make an open incision to finish the operation.

Other treatments recommended/given with the Whipple procedure

The patient has to be calm and composed throughout the whole process. If you are feeling any sort of discomfort or stress, you should always discuss it with your loved ones. Sometimes the patient is given treatment before or after surgery such as neoadjuvant therapy and adjuvant therapy. The therapy aims to kill the remaining cancer cells that may still be present to prevent the tumor to circle back again. Know that clinical trials are available for pancreatic patients seeking neoadjuvant or adjuvant therapy.