Category Archives: Surgery

Vitamin D supplements may promote weight reduction in obese children

1Vitamin D supplements may promote weight loss and reduce risk factors for future heart and metabolic disease in obese and overweight children. The findings indicate that vitamin D is the simple supplementation may be part of an effective strategy to tackle childhood obesity and reduce the risk of serious health problems, such as heart disease, in adulthood.

Obesity in childhood and adolescence represents a major health problem worldwide, which leads to the development of expensive, debilitating and serious complications, including diabetes and heart disease, in later life. Vitamin D deficiency is stereotypically associated with impaired bone health, in recent years it has been increasingly linked with increased body fat accumulation and obesity, with the precise nature of this relationship currently under intense investigation by scientists. However, the effect of vitamin D supplementation on the health and weight of obese children and adolescents had not yet been investigated.

In this study, researchers assessed 232 obese children and adolescents over 1 year, with 117 randomly assigned to receive vitamin D supplementation, in accordance with the guidelines on treatment and prevention of deficiency. Levels of vitamin D, body fat, and blood markers of liver function and heart health were assessed at the start of the study and 12 months later. The study reported that children given vitamin D supplements had significantly lower BMI, body fat and improved cholesterol levels after a year of supplementation.

These findings suggest that simple vitamin D supplementation may reduce the risk of obese and overweight children developing serious heart and metabolic complications in later life.

The team now plan to investigate the effects of vitamin D supplementation on the health of obese children and adolescents that already have unhealthy conditions, such as high blood pressure, high cholesterol and high blood glucose all of which increase the risk of heart disease, stroke and diabetes.

Although these initial findings indicate that vitamin D could be used in the treatment of obesity, there remains a lack of evidence on the safety and long-term effects of supplementation, particularly if there is no vitamin D deficiency. However, if your child is obese or overweight I recommend that you consult your primary care physician for advice, and consider having their vitamin D levels tested.

Surgical Techniques

10 Most complicated surgical techniques:

Due to the rapid improvement in the field of surgery and surgical instrumentation number of minimally invasive surgical procedures has also been developed to save the life of the victims. Below list shows some of the challenging and the complicated surgeries.

1.Septal Myectomy-Unclog the congealed muscles of the heart.

2.Bariatric Surgeries/Gastric Bypass-Weight loss surgery by reducing the size of the stomach.

3.Thoracic Aortic Dissection Repair-Fixes the tear in the deepest layer of the heart.

4.Bladder Cystectomy -surgically removes the part or entire urinary bladder.

5.Spinal Osteomyelitis Surgery-Infections in the spine that requires the surgery to remove them.

6.Craniectomy -removes the skull portion to inspect the brain.

7.Conjoined twins separation-separation of twins who shares their body parts and others.

8.Coronary revascularization-The surgical procedure to restore the flow of blood to heart.

9.Surgical Ventricular Restoration-restores the heart to its original size and shape after the attack.

10.Esophagectomy -Aids in esophageal removal and reconstruction.

All the above-mentioned surgeries mostly come under the minimally invasive surgery techniques and are found to increase the quality of life of the patients with shorter hospital stays and very less blood loss. Cardiac surgery and the bariatric or gastric bypass surgery has become two most common surgery due to the changes in the life style of the human beings and the food habits. All these complicated surgical techniques are performed by the experienced surgeons of the respective institution very carefully to increase the standard of living and the life span of patients. Anesthesiologists and the surgeons work together to bring up the success of these surgeries.

The use of robotics in the field of surgery has also been successfully developed and created the greater influence in the field of surgery.

Recent advancement in the field of surgery


As we know medical advancement in the field of robotics and noninvasive surgery have changed the procedures in the operating room. But the fact is that these technologies have not yet reached the success to the full extreme due to their novelty and cost.


Minimally invasive surgery can be considered as the one of the boons to the medical field because the surgery would not be possible without the doctor in the past decades but now the surgical procedures has been modernized the best example is the natural orifice transluminal endoscopic surgery where the instruments enters through the openings in the body instead of cutting the skin.


The next level improvement in the medical field after the minimally invasive surgery is the robotic surgery. Robots have been introduced into the field of surgery only in the recent years. In these kinds of robotic surgery, the doctors usually control the robots through the computer. This fact proves that the surgery nowadays has been modernized and gained greater development when compared to the past decades.


More interesting development than the robotic surgery is the telesurgery in which the doctors may not be physically present they may present in the different countries and may assist the surgery through telecommunication. The challenging fact is the time delay in the transmission of data between two locations.

It is obvious that the growth in the field of surgery has improved the standard of living of the patients and made the surgery painless and took the medical field to the next generation.

Pediatric and fetal surgery- Let’s get to know more!!!

1.Pediatric surgery is one of the most important branches of surgery and require intense monitoring due to the complexity and the small size of the babies and the difficulties in explaining situations.

Facts about Babies and Surgery!!!

  • Most babies or infants needs surgery for the specific purposes.
  • Some problems must be surgically corrected such as gastroschisis which requires surgery in the first hour following birth and omphalocele which can be corrected in the next few days.
  • Premature babies are at the higher risk for needing surgery.
  • A pediatric trained surgeon has special expertise in the anatomy and physiology of babies.
  • Some conditions which requires surgery may be trained during prenatal testing itself.
  • Babies or infants need special needs special needs when it comes to the field of surgery because of their small size and uniqueness.2.

Some of the important fetal surgeries.

  • Fetal Surgery for Congenital Diaphragmatic Hernia
  • Fetal Surgery for Congenital Heart Disease
  • Fetal Surgery for Congenital High Airway Obstruction
  • Fetal Surgery for Congenital Pulmonary Airway Malformation
  • Fetal Surgery for Neck Masses
  • Fetal Surgery for Sacrococcygeal Teratoma
  • Fetal Surgery for Urinary Tract Obstruction
  • Prenatal Diagnosis and Fetal Therapy

Advances and limitations of minimally invasive techniques in pediatric surgery

  • Application of minimally invasive surgery in adult is slowly developing rather than compared to adults in surgery.
  • The application of endoscopic pediatric surgery in the Head and Neck is still untouched possibly due to the unavailability of exact size of scopes and surgical equipment’s.
  • Laparoscopy and Thoracoscopy are the usual MIS procedures performed in various surgical disciplines

Types of Head and Neck Surgery

HeadTransoral Laser Microsurgery (TLM)

TLM is used for tumors in throat and larynx and was first proposed in 1972. General anesthesia is given for patients who are undergoing TLM for throat of larynx. No visible scars are seen as the surgery is performed through the mouth. A thin endoscope is inserted though the mouth which has a specially designed microscope which allows the surgeon to see the tumor and the surrounding tissues during the surgery.

In TLM instead of scalpel to cut through the tissue a highly specialized carbon dioxide laser beam is used, and it produces less heat energy which limits the damage to the tissues around the tumor.

There are different laser systems available for use with TLM, if the cancer if larynx is diagnosed in earlier stages then digital AcuBlade laser surgery is used. In this method the specialized robotic adapter creates precise incisions.

System designed by Lumenis uses computer to operate, the surgeon program the computer by entering the information about the procedure, laser beam pattern, incision length and depth the laser light penetrate. The surgery is done by manipulating the joystick on an operating microscope. The carbon dioxide laser moves in straight, curved and circular patterns while minimizing the effect on the surrounding tissues.

Flexible fiber-optic carbon dioxide laser id another type for throat cancer with high risk of bleeding.

Endoscopic Thyroid and Neck Surgery

Patients with thyroid cancer or benign thyroid tumors for surgery is needed, traditional thyroid surgery with an open incision in the neck or robotic thyroidectomy or minimally invasive thyroid surgery is done.


In Robotic thyroidectomies the view of the operative field is magnified, increasing the surgical precision and reducing the risk of complications.

Robotic Thyroidectomy

Robotic surgery uses advanced technology that allows surgeons to safely remove certain thyroid tumors through discrete incisions several inches away from the neck. In order to avoid scar on the neck.

The surgeon cuts a 1-inch to 2-inch incision in the folds of skin under the patient’s arm and inserts the systemic robotic arms, which have been customized to resemble standard surgical instruments. The surgeon guides the robotic arms beneath the skin.

The surgeon views the surgical field on a 3-D screen, which magnifies up to 10 times. The skilled surgeons the systemic robotic arms as one might control conventional surgery. The instruments present on the robotic arm can move with 7 degrees and rotates 540 degrees for movement and providing the easy operating with delicate tissues with precision

Robotic thyroidectomy is not suitable for all thyroid tumors. If the thyroid tumor is less than 3 cm in size and is likely to be benign, then robotic surgery may be an option.

Let’s get to know about some of the interesting facts of bariatric surgery

Myths and reality!!!

Due to the changing lifestyle and tremendous increase in the obesity related problem bariatric surgery has become one of the emerging fields.

Myth 1: Bariatric surgery is only for the morbidly obese

Reality: Obesity is only the primary category that makes the situations for the victims to undergo surgery but, the overweight patients are also subjected to bariatric surgery when they are supposed to have the problems like diabetes, hypertension, sleep apnea, arthritis and others.6

Myth 2: Liposuction and Bariatric surgery are same

Reality: Liposuction is cosmetic surgical procedure that is involved in shaping the body whereas the bariatric surgery is the metabolic surgery that works on the general mechanism of the body to gain control over the weight.

Myth 3: Vitamin & Mineral deficiencies are caused by the bariatric surgery.

Reality: Bariatric nutritionists generally gives the diet chart through which the vitamin and mineral deficiencies supposed to occur can be balanced.

Myth 4: After Bariatric surgery you cannot eat any foods that tastes to be good.

Reality: Patients who underwent gastric bypass should avoid very sweet foods because it can cause some side effects but most of the victims eat their favorite foods and enjoy after they recover from the surgery.7

Myth 5: Post-surgery diet before you have the operation

Reality: Post surgery diet before the operation is essential since we can have some natural weight reduction and reduces the risk of complication at the later stages of operation.

Conjoined twins: Separation: Merits and Demerits

1What are conjoined twins?

Conjoined twins are usually found to be the identical twins joined in the utero and this rare case of occurrence occurs in one in 50,000 births to 1 in 189,000 births approximately. Two reasons exist for the formation of conjoined twins one is that the fertilized egg splits partially or the other theory is that the fertilized egg separates completely but the stem cells on one finds the similar type of cells in the other and fuses together. Conjoined twins have the common chorion, placenta, and amniotic sac.

How are they separated?

Generally, surgeries are employed as the solution for the separation of the conjoined twins and this surgical procedure may vary from easy to difficult based on the point of attachment and the organs shared.

Types of conjoined twins?

Thoraco-omphalopagus: Two bodies fused from the upper chest to the lower chest.

Thoracopagus: Fusion occurs from the upper thorax to the lower belly.

Omphalopagus: Fusion found to be occurred in lower abdominal region.

Craniopagus: The twins are found to have fused heads but two separate bodies.

Ethical Issues on the separation of conjoined twins by surgery:

Taking the decision of separation of conjoined twins by surgery remains risky because the probability of survival and better standard of living after the surgery may be same as the probability of the death rates due to the complex nature of surgeries. In most of the cases one or the both the twins die, and, in some cases, they are becoming the victims for the severe damages.

However, the researchers are still going on for the separation of conjoined twins in the beneficial way. This is one of the most important pediatric surgical research should be carried out in accompany with the all the other branches of surgery.