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New Delhi -110062

GI and cancer surgeries

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Pancreatic Pseudocyst

It is a condition which occurs after an attack of acute pancreatitis in which a fluid collection becomes walled off from the rest of the abdominal cavity giving rise to a cyst like condition. This cyst may press on the stomach or intestines giving rise to pain, vomiting and early satiety of food. This condition is diagnosed by ultrasound or CT scan of the abdomen and can be treated by surgical drainage. Most cases can be performed by laparoscopy in which the cyst is drained internally into the stomach by creating a common channel between the back wall of the stomach and front wall of the cyst.

Liver cysts

Liver cysts are fluid filled cavities within the liver. They can be single or multiple, small or large in size. In most cases, they do not produce any symptoms and are diagnosed incidentally on ultrasound scan of the abdomen. Simple cysts do not require treatment and can be left alone. Larger cysts and those which are related to parasitic infections and which are causing symptoms may require treatment in the form of laparoscopic drainage

Gallbladder cancer

Cancer of the gallbladder mostly occurs in the setting of long standing gallbladder stones. Patients present with pain in the abdomen, weight loss and weakness. In advanced cases, they may develop a mass in the abdomen and jaundice. Diagnosis is by ultrasound and CT scan of the abdomen. Curative treatment is possible only in early cases and is by radical surgery. Advanced cases can only be treated symptomatically by medication, stenting or chemotherapy.

Stomach cancer

Stomach cancer affects older adults who have a history of tobacco and alcohol abuse. It may also be genetic in which case it presents at a younger age. It presents with pain in abdomen, loss of appetite and blackish stools. The diagnosis may be suspected in ultrasound scan but it requires an upper GI endoscopy to visualise a lesion and take a biopsy. Once biopsy proves the presence of cancer, a CT scan is done for staging the lesion and for treatment planning.

Treatment of stomach cancer involves combination of surgery and chemotherapy. Surgery involves radical resection of the stomach along with the draining lymph nodes and can be done by open approach or laparoscopy. Chemotherapy helps in killing the microscopic cancer cells in distant parts of the body and improves the long term survival and prevents recurrence of cancer.

Pancreatic cancer

Pancreatic cancer is one of the deadliest types abdominal cancers since it has a poor survival rate.  It presents vaguely with abdominal pain, weight loss and oily stools. It can be diagnosed early with a CT scan of the abdomen and the only curative treatment is by radical surgery. The surgery can be done by open approach or by laparoscopy. Nowadays, the surgery can be done by the robotic approach which helps in better visualisation and ease of manipulation of instruments which translates into a better surgical outcome.

Colorectal cancer

Colorectal cancer is one of the most common intra abdominal malignancies which have a good outcome especially in the early stages. The patient presents with change in bowel habits, weight loss and may have blood in stools. The diagnosis may be suspected on ultrasound scan of the abdomen but is confirmed with the help of a colonoscopy which reveals the site and extent of the lesion and can help to take a biopsy. The treatment is by a combination of radical surgery, chemotherapy and in some cases radiotherapy may also be required. Laparoscopic surgery is the gold standard since it allows excellent visualisation with precise dissection and helps in faster recovery and better long term outcomes.

Rectal prolapse

Rectal prolapse is condition in which part or whole of the rectum descends downwards to protrude outside the anal opening. It can happen at any age but usually affects women more than men. The symptoms are those of a mass protruding from the anus which increases on straining and usually reduces spontaneously otherwise. There may be pain, mucoid discharge or bleeding associated with prolapsed and in late cases, it may get obstructed which requires manual reposition.

The treatment of rectal prolapse is with surgery which is best done by laparoscopic approach. The operation may require placement of a mesh to anchor the rectum to the pelvis wall which prevents recurrence in the future.