Laparoscopic Surgery – What is it?

Laparoscopic surgery is a form of minimally invasive surgery in which small incisions are used instead of the big incisions as in an open surgery. This surgical procedure uses a long thin camera known as a laparoscope to diagnose and treat a variety of illnesses and disorders of the chest, abdomen, and pelvis. A laparoscope sends images from inside of your body to a monitor where the surgeon can see them.

Laparoscopic surgery is generally used when non-invasive techniques and imaging tests such as ultrasound, CT scan, MRI scan fail to aid in the diagnosis.

This procedure is recommended to treat conditions such as abdominal pain, endocrine conditions, female reproductive system disorders, intestinal conditions, hernia, urinary tract conditions, lung conditions, liver and gallbladder ailments, stomach and oesophagus conditions and vascular conditions.

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Laparoscopic surgery is considered to be the gold standard for many treatments due to the following benefits:

  • It creates smaller scars
  • The hospital stay is shorter
  • It aids in quicker recovery
  • It causes lesser pain

While laparoscopic surgery has various benefits, it also has certain risks like any other surgery which are as follows:

  • Bleeding
  • Infection
  • Damage to the abdomen organs
  • Redness, swelling, bleeding or drainage at the sites of incision
  • Continuous nausea or vomiting
  • Continuous cough
  • Shortness of breath
  • Inability to urinate
  • Light-headedness
  • Fever and chills
  • Intense abdominal pain
Laparoscopic surgery

What happens in Laparoscopic Surgery?

Before you go for laparoscopic surgery, it is recommended that you clear any queries that you have about your laparoscopic surgery’s recovery, level of pain, etc. with your laparoscopic surgeon.

Laparoscopic surgery

As far as the recovery after laparoscopic surgery is concerned, you will be kept in the recovery room until your vital signs are stable. The duration varies, but it usually lasts an hour or two. In most cases, you will be sent home on the same day. A hospital stay may be necessary for more complex operations.

The full recovery, however, takes time. The length of your recovery depends on the surgery, the type of anaesthetic used, your overall health, your age, and other factors. You can return to your routine work within a day or two after simple operations. You should nevertheless try to avoid activities such as heavy lifting, intense exercise, and contact sports for some time or as prescribed by your doctor.

Talking about pain control is also critical here for healing and a speedy recovery. You will experience some pain after your surgery but if your discomfort changes or becomes too intense, you should contact your surgeon right away since it might be a sign of some complication.

Also if you’re using narcotic pain relievers, you may feel sleepy. If you feel nauseous, inform about it to your doctor so that it can be addressed.

Lastly, it is very important to know when to call your surgeon. Although you will have routine check-ups after your laparoscopic surgery, you should call your doctor right away if you experience bleeding, shortness of breath, chest discomfort, severe sore throat, inability to urinate/have bowel movement, unexpected drainage from incision or experience other such signs that you feel are unusual. 

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Importance of door to needle time

In the treatment of Acute Ischemic Stroke (AIS), Intravenous thrombolysis (IVT) is a common form of treatment. The sooner IVT is started, the better are the chances of a successful outcome. As a result, recording the in-hospital time to IVT treatment, also known as the door-to-needle time (DNT), is an effective approach to track quality improvement. 

In other words, Door to Needle (DTN) time is the period between when a stroke patient arrives in the emergency room to when recombinant tissue plasminogen activator (rt-PA) pharmacological treatment is started.

1. Importance of Door to Needle Time
2. Reasons for delay in Door to Needle Time
3. Practices that can reduce Door to Needle Time
4. Conclusion

Importance of Door to Needle Time

Stroke is the world’s fourth greatest cause of death and the top cause of disability and suffering in the world. The majority of ischemic strokes are caused by thromboembolic or atheromatous processes occluding blood vessels. For individuals with AIS, IVT using recombinant tissue plasminogen activator (rtPA) is a well-established treatment option.

IVT improves the chances of self-sufficiency. As already mentioned, the earlier the therapy begins, the better are the chances of a successful outcome. The DTN time has become even more critical since the advent of the “Time is Brain” idea, which says that each minute a stroke goes untreated, 1.9 million neurons and 14 billion synapses die.

In AIS, DTN time to therapy has been shown to be a significant predictor of 90-day and 1-year functional results. The door to needle time (DNT) to when IVT is initiated can be used to assess the quality of acute stroke care given by each institution.

According to a research study, there was a 5% reduction in risk-adjusted in-hospital mortality for every 15-minute reduction in door-to-needle times. If the IVT is administered within 90 min after the onset of symptoms, the number needed to treat (NNT) is 4.5 which is increased to an NNT of 9 between 91 and 180 min. It has been demonstrated in various studies that DTN times of 60 minutes or less than 60 minutes can be consistently achieved which can be worked upon.

Reasons for delay in Door to Needle Time

The DTN time is delayed for a variety of reasons, including patient-related factors like uncertainty about symptom onset, unknown medical history, uncontrolled blood pressure or sugars, uncertainty about anticoagulation status, fluctuating neuro deficit, and in-hospital factors like incorrect triage, insufficient emergency room staff or untrained staff in stroke recognition, and difficulty with in-hospital transfers, which is why it is important to approach a trusted hospital.

Practices that can reduce Door to Needle Time

There are a few practices that can reduce DTN time which are given below:

  • Advance notification to a stroke-equipped hospital’s emergency room
  • Rapid triage protocol and notification of the stroke team
  • Single call activation system for the entire stroke team
  • Stroke toolkit
  • Rapid brain imaging
  • Rapid laboratory testing
  • Rapid access to rt-PA drug
  • Mixing rt-PA medication ahead of time for likely cases
  • Well-prepared team-based approach
  • Prompt data feedback

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A basic level of awareness about stroke symptoms should be established in the community, such as using the simple “FAST” (Face, Arm, Speech, Time) method to detect the warning signs of stroke and immediately transferring the patient to a nearby stroke-ready hospital, establishing well-organized and tested acute stroke protocols in hospital emergency rooms, and training medical and paramedical staff to reduce Door to Needle Time.

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Is it safe to go to hospital during covid time for general checkup in Chandigarh

Should you go to the hospital if you have a medical problem that isn’t caused by the coronavirus? Given that the pandemic is still ongoing, with cases reported from all around the country, this is a genuine concern. However, in the present scenario, a growing number of hospitals have begun to welcome non-covid patients with all safety measures and covid protocols. 

While these activities are gradually returning to normalcy, it is natural to be concerned about whether it is safe to go to the hospital during the covid time for a general check-up. 

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To answer the question, it is safe to visit hospitals for a general check-up that observe the following safety and security measures:

  1. Separate area for treating Covid-19 patients: Hospitals are increasingly making provisions for separate waiting areas for Covid-19 patients.

Along with this, measures are taken to call the patients just moments before their appointment for the least risk of exposure. Healthy patients are mostly asked to wait outside or in their cars until their exact time of appointment.

  1. Added attention to hygiene and disinfection: Along with all the regular cleaning and disinfection methods, hospitals now use cleaning procedures that are proven to destroy the COVID-19 virus. 

Sanitisers are also kept at every corner so that they are in everyone’s reach to ensure proper hygiene and safety.

  1. Measures for easing social distancing: Many hospitals have changed the layout of their waiting rooms and lobbies to facilitate social distancing.  Using new layouts and helpful signs make it easier to know where and when to go. 
  1. No entry without masks: All patients, family members, and visitors are asked to wear a mask or face covering while in the hospital to prevent the spread of COVID-19. At the entrance, the screening personnel hands masks to anyone without a mask or wearing an ineffective one.
  1. Temperature check at the entrance: Although there are a variety of symptoms of COVID-19, the majority of positive cases possess a fever

Associates, vendors, doctors, staff and all visitors entering the hospital premises are checked for temperature every time they want to get in the building. This exercise helps in keeping the premises of the hospital safe and infection-free. 

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What can you do to stay safe?

  1. Consider video consultation: In this age of technology, patients can now visit their doctors without stepping a foot into the hospital. Nowadays, many doctors are increasing the availability of online appointments.  So, if you have a scheduled health appointment that you don’t want to miss, see if you can do it online. 
  1. Take safety measures when in hospital: Even though most hospitals are following all covid protocols, there is no harm in taking precautions from your side. So in cases when you cannot avoid going to the hospital, make sure to follow the following safety measures:
  • Try to get vaccinated against Covid-19 before your appointment.
  • Keep a safe space (at least 6 feet) between yourself and others.
  • Put on a mask.
  • Wash your hands with soap for at least 20 seconds, if possible.
  • When you can’t wash your hands, use a hand sanitiser.
  • Keep your hands off your face.
  • Try not to touch surfaces.
  • To clean areas that you do need to touch, use disinfectant wipes.

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Your well-being is crucial. It’s crucial to receive the proper diagnosis or treatment if anything is troubling you. Putting off medical treatment might lead to difficulties later on or make recovery more difficult. So you can either book an online consultation or walk in a covid-19 safe hospital in Chandigarh

Take care, stay safe!