Women have tendency to accumulate fat in the lower abdomen that gives a bad look. This loose abdominal skin and fat that is concentrated, in the lower abdomen, can not be reduced by exercises or dieting. Multiple pregnancies cause drooping of abdomen due to muscle weakening. Sometimes these female have dragging pain in long standing. Our specialists provide cosmetic solution for these problems.

Liposuction

Liposuction (lipoplasty) is well-suited for women who are of relatively normal weight but have isolated pockets of fat in the abdomen that cause their body to appear disproportionate. Liposuction is often the only way to eliminate them.

Liposuction can be done at almost any age, but the best results are obtain when skin still has enough elasticity to achieve a smooth contour following fat removal. When skin is loose or inelastic, it may require skin tightening procedure.

Abdominoplasty

Women who have loose abdominal skin and fat that is concentrated in the lower abdomen can benefit from abdominoplasty. Sometimes these conditions are inherited. In other instances, substantial weight loss may cause abdominal skin to become flaccid. Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. The procedure may somewhat improve the appearance of stretch marks, especially those located below the navel.

Hernias are common surgical problems faced by females. It is more common in umbilical and femoral region contrary to males where inguinal hernias are more common. Due to multiple pregnancies abdominal muscles get stretched and become prone for ventral hernias. Incisional hernia is another common type hernia in females due to scar on abdomen produced by surgeries like caesarian section, uterus removal, tubectomy etc. Normally patient carries these muscle defects for long duration as they do not cause worrying symptoms. When the hernia gets obstructed it become a serious problem. Patient feel excruciating pain in the abdomen with vomiting and constipation .Hernia projection does not go inside even in lying down position . At this time surgery is an emergency.

Femoral Hernia

Femoral hernias occur just below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal. They can be hard to distinguish from the inguinal type, they generally appear more rounded. The incidence of strangulation in femoral hernias is high. Where the hernia contents push through a weak spot in the back wall of the inguinal canal are called Inguinal hernias more common in men than women while femoral hernias are more common in women.

Repair techniques are similar for femoral and inguinal hernia.

Umbilical Hernia/Paraumbilical Hernia

Umbilical hernias are especially common in infants. Umbilical hernias in adults are largely acquired, and are more frequent in obese or pregnant women. Abnormal stretching of muscle fibers at the midline may contribute for it. Hernia around umbilicus is commonly called Para umbilical hernia. All these hernias are treated Laparoscopically.

                 
  Pre operative ventral hernia                      Post operative treated laproscopically

Incisional Hernia

An Incisional hernia occurs when the defect is the result of an incompletely healed surgical wound or excessive weight gain after surgery. When these occur in median laparotomy incisions in the linea alba, they are termed ventral hernias. When patient stands up large part of abdominal scar will protrude out which can be reduced on lying down.

Hiatus Hernia

Higher in the abdomen, an (internal) "diaphragmatic hernia" results when part of the stomach or intestine protrudes into the chest cavity through a defect in the diaphragm. Patient feels discomfort after meals, burning sensation in the chest, inability to lie down immediately after meals. They are best diagnosed by endoscopy or Barium meal.

Treatment of Hernias

Hernia is a weakness of abdominal wall so the wall is strengthened by a specialized net (mesh) which provides extra strength to the muscle. In all the hernia repair mesh is used now to provide extra strength to the muscles. Hernia repair can be done by open surgery or Laparoscopic surgery, in both the cases mesh is applied over the defect. For all hernias we offer Laparoscopic surgery to our patient unless there is any contra-indication to it

Appendicitis

Appendicitis is inflammation of appendix. Appendics is apart of intestine where large and small intestine meet it is a tubular blind end structure. This gets infected by food or other reasons. This infection spread through the wall of the appendix may lead to pain abdomen, fever, vomiting with or without altered bowel habits. Sometimes appendicitis healed with antibiotics without surgical treatment and the infection and accompanying inflammation do not spread throughout the abdomen

Many times infection can spread out in the abdomen leading to peri-appendicular abscess or rupture of the appendix or many more complications. Patients may come to the doctor long after the episode of appendicitis with a lump or a mass in the abdomen.

Appendicitis is diagnosed by the classic symptoms. Clinical examination with blood test can confirm appendicitis Urine test may be performed to exclude urinary tract infection or ectopic pregnancy in females as they also cause similar symptoms. Ultrasound imaging test also help in diagnosis and differentiation of other pelvic conditions in female. When the diagnosis is not clear CT scan of the abdomen is done.

Treatment of appendicitis is Laparoscopic surgery. It is a gold slandered now especially in female patients it helps in examination of whole abdomen including evaluation of uterus and ovary. Any other pelvic problem can be dealt with removal of appendics.

Gallbladder disease is a common condition that affects women more than men. The most common reason for gallbladder disease is gallstones.

The symptoms vary widely from mild discomfort to severe pain which mainly begins after food. These symptoms are more after fatty meals these patients avoid fried food. Gallstones are seen in all age groups but they are common in Fat, Fertile and Forty years Female. The possibility of developing gallstones increases with- age, high blood cholesterol levels, use of drugs containing estrogen, (contraceptive pills), and chronic intestinal inflammation diseases (Crohn's disease and ulcerative colitis). The following groups are considered to be at increased risk:

Chronic Cholecystitis
This is a long-term inflammation of the gall bladder and causes: sporadic pains in the middle of the upper abdomen or just below the ribs on the right side some times pain at the right shoulder or between the shoulder blades. This pain can be accompanied by nausea and vomiting and sometimes excessive wind passage. The frequency and severity of such attacks is variable. In severe cases the patient can suffer from jaundice , nausea and fever.

Diagnosis of gall stones is easily done by abdominal ultrasound, which is a very simple test. Normally there are multiple stones filled in gall bladder.

Treatment of gallstones is surgical remove the gall bladder called cholecystectomy

Gall bladder is removed by Laparoscopic surgery.

Laproscopic Surgery

Laparoscopic surgery also referred as minimal access surgery .In this; surgical procedures are performed with the assistance of a laparoscope that is basically a video camera with long cylindrical instrument. When this instrument introduced in the abdomen by a small hole, images of the abdominal organs can be viewed on a (monitor) TV screen. It gives better visualization and clarity of the internal organs than that of conventional surgery since the image is magnified. During the surgical procedure, CO2 gas is introduced inside the abdominal cavity so the scope can move freely in the abdomen. Now 2or 3 small incisions of up to 5 to 10 mm are made, through these small incisions operative Laparoscopic instruments (long pen like instruments with handle)are placed .The surgical procedure inside the body remains the same as in open surgery for example gall bladder is removed completely along with stones or whole appendix is removed .

This Laparoscopic surgery is now preferred over conventional surgeries as it gives small scar, short hospital stay less post operative rest and early return to activities.

.In our center we are routinely doing Laparoscopic surgeries

Gallbladder removal is very common surgery at our hospital as north India has more incidence of stone disease. In this procedure 2holes of 10 mm&2holes of 5mm are made. Gallbladder removed from upper abdomen incision. Patient is relieved from hospital same day or next day.

Appendix removal is done only when diagnosis is very clear because many other diseases like ovarian cyst, ectopic pregnancy also mimic like appendicitis. In these cases laparoscopy has advantage as it helps in examination (Diagnostic Laparoscopy) of abdomen and treatment of disease. Appendics is normally operated by 3 small holes and patient is relieved on next day.

Hernia repair is done Laparoscopically in our center. In female umbilical, paraumbilical and Incisional hernias are very common, they arise due to muscle weakness In conventional and Laparoscopic surgery both mesh(a type of net) is applied within the abdominal wall to give it more strength. Laparoscopic surgery provides more advantage as it can be done with 3 holes and does not cut muscles as they are already weak.

Hospital stay varies from 1 to 4 days depending on type of hernia.

Hiatus hernia if done conventionally requires a very long abdominal incision which gives too much pain and requires long stay in hospital with ugly scar. While Laparoscopic surgery can be done with 4 or 5 holes but it requires surgical skills. We are doing such surgeries at our hospitals in association with Advanced Laparoscopic Surgeon.

Many advanced specialized Laparoscopic surgeries been done here for example gut surgeries- resection anastomosis, pancreatic surgery-pseudo pancreatic cyst, pancreo necrosectomy etc.

Ulcerative colitis is common disease in women .It is an inflammation of the lining of the large bowel (colon and rectum). Symptoms include rectal bleeding, diarrhea, abdominal cramps, weight loss, and fevers. In addition, patients who have had extensive ulcerative colitis for many years are at an increased risk to develop large bowel cancer.

Initial treatment of ulcerative colitis is medical, using antibiotics and anti-inflammatory medications.  If these fail, steroids can be used for a short period of time but long-term use can be associated with significant side effects. Immunomodulators can be used to control active disease. "Flare-ups" of the disease can often be treated by increasing the dosage of medications or adding new medications.  Hospitalization may be necessary to put the bowel to rest and deliver steroids directly into the blood stream. These patients are followed carefully with repeated colonoscopy and biopsy, and surgery is recommended only if precancerous signs are identified.

Surgery is indicated for patients who have life-threatening complications of inflammatory bowel diseases, such as massive bleeding, perforation, or infection .There are many surgical options our specialist council these patients individually give the detailed pros and cons of surgery.

Miscellaneous

There are many other problems on the abdomen like

•  Kidney and urinary bladder stones
•  Morbid obesity
•  Intestinal tuberculosis
•  Acute intestinal obstruction
•  Abdominal injuries
•  Intestinal Cancer

For all these problems our surgeon provides detailed examination and treatment. We do involve other specialists whenever required.