Patient Resources

How Gallstones Form

• Your gallbladder stores and releases bile, a digestive fluid made up of water, bile salts, cholesterol, and waste products like bilirubin.

• If the balance of these substances is disrupted — for example, too much cholesterol or too much bilirubin — the bile can crystallize and harden into stones.

• These stones can vary in size (as tiny as a grain of sand or as large as a golf ball) and number (one or many).

Types of Gallstones

1. Cholesterol Stones – The most common type, formed mainly from hardened cholesterol.

2. Pigment Stones – Made from bilirubin (often linked to liver disease or certain blood disorders).

3. Mixed Stones – A combination of cholesterol and pigment.

Symptoms

Some people have silent gallstones with no symptoms.
When symptoms occur, it’s called gallstone disease or cholelithiasis.
Common signs include:

• Sudden, intense pain in the upper right abdomen (biliary colic)

• Pain that may spread to the back or right shoulder

• Nausea or vomiting

• Indigestion, bloating, or discomfort after fatty meals

Complications

If gallstones block the bile duct, they can cause:

• Cholecystitis – Inflammation of the gallbladder

• Jaundice – Yellowing of skin and eyes

• Pancreatitis – Inflammation of the pancreas

• Cholangitis – Infection of the bile ducts

Treatment Options

• No treatment if stones are silent and not causing problems.

• Medications to dissolve stones (rarely used and less effective).

• Surgery (most common) – Removal of the gallbladder (cholecystectomy) to prevent recurrence.

• Endoscopic procedures to remove stones blocking ducts.

A Laparoscopic Hernia refers to a hernia repair performed using laparoscopic (keyhole) surgery rather than the traditional open surgery method.
It’s a minimally invasive procedure where small incisions and a camera are used to repair the weakened or torn muscle wall through which tissue or organs have protruded.

What is a Hernia?

A hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue.
Common types include:

• Inguinal hernia – groin area (most common)

• Umbilical hernia – near the belly button

• Incisional hernia – through a previous surgical scar

• Hiatal hernia – part of the stomach pushes into the chest cavity

Laparoscopic Hernia Repair – How it Works

1. Small Incisions – Usually 3–4 small cuts in the abdomen.

2. Laparoscope Insertion – A thin tube with a camera is inserted, projecting an enlarged view of the hernia onto a monitor.

3. Repair – Surgical instruments are inserted through other small incisions to push the protruding tissue back in place.

4. Mesh Placement – A synthetic mesh is placed over the weak area to reinforce it and prevent recurrence.

5. Closure – Small incisions are closed with stitches or surgical glue.

Advantages of Laparoscopic Repair

• Smaller incisions → less pain after surgery

• Faster recovery and return to normal activities

• Minimal scarring

• Ability to check and repair both sides in groin hernias

• Lower risk of wound infection

Possible Risks

• Bleeding or infection

• Recurrence of the hernia

• Injury to surrounding structures (rare)

• Reaction to anesthesia

Recovery

• Most patients can go home the same day or next day.

• Light activities can be resumed in a few days; full recovery often takes 1–2 weeks for desk jobs and 4–6 weeks for heavy labor.

• Avoid lifting heavy objects during the healing period.

A Laparoscopic Appendectomy is a minimally invasive surgical procedure to remove the appendix using small incisions, a camera, and special instruments, rather than a large open cut.

What is the Appendix?

The appendix is a small, tube-shaped pouch attached to the large intestine, located in the lower right side of the abdomen.
When it becomes inflamed — a condition called appendicitis — it can cause severe abdominal pain and requires urgent removal to prevent rupture and infection.

When is a Laparoscopic Appendectomy Needed?

• Acute appendicitis (most common reason)

• Appendix abscess or localized infection

• Appendiceal tumors (rare)

• When diagnosis is uncertain, laparoscopy can also help look inside the abdomen and confirm the cause of pain.

How the Procedure Works

1. Anesthesia – The patient is under general anesthesia (fully asleep).

2. Small Incisions – Usually 3 small cuts in the abdomen.

3. Laparoscope Insertion – A thin tube with a camera is inserted to project an internal view on a monitor.

4. Surgical Repair – Special instruments are used to detach and remove the appendix.

5. Closure – Incisions are closed with sutures or surgical glue.

Advantages Over Open Surgery

• Smaller incisions → less postoperative pain

• Faster recovery → return to normal activities sooner

• Minimal scarring

• Lower risk of wound infection

• Better view of the abdominal cavity (helpful if the diagnosis is uncertain)

Possible Risks

• Bleeding

• Infection

• Damage to surrounding organs (rare)

• Complications from anesthesia

• In rare cases, the surgeon may switch to an open appendectomy if the appendix is very inflamed or ruptured

Recovery

• Many patients go home the same day or within 24 hours.

• Most can resume light activities within a few days, and full recovery happens in about 1–3 weeks.

• Avoid heavy lifting for at least 2–4 weeks.

Hemorrhoids — also known as Piles — are swollen and inflamed veins in the lower rectum or anus, similar to varicose veins that occur in the legs.

They are very common and can cause discomfort, itching, bleeding, or pain, especially during bowel movements.

Types of Hemorrhoids

1. Internal Hemorrhoids

   • Located inside the rectum

   • Usually painless but may cause bleeding

   • Sometimes prolapse (bulge) outside the anus

2. External Hemorrhoids

   • Found under the skin around the anus

   • Can cause pain, swelling, and itching

   • May form a thrombosed hemorrhoid (a painful blood clot inside the vein)

Causes

Hemorrhoids develop when increased pressure causes veins in the rectal area to swell. Common causes include:

• Straining during bowel movements

• Chronic constipation or diarrhea

• Sitting for long periods on the toilet

• Pregnancy (due to pressure from the uterus)

• Obesity

• Low-fiber diet

• Aging (weakened supporting tissues)

Symptoms

• Bright red bleeding during or after passing stool

• Itching or irritation in the anal region

• Pain or discomfort

• Swelling around the anus

• Lump near the anus (may be sensitive or painful)

Treatment Options

Lifestyle and Home Remedies

• High-fiber diet (fruits, vegetables, whole grains)

• Drink plenty of fluids

• Avoid prolonged sitting

• Warm sitz baths

• Over-the-counter creams or suppositories

Medical Procedures (for persistent or severe cases)

• Rubber band ligation – a band is placed to cut off blood supply to the hemorrhoid

• Sclerotherapy – injection to shrink the hemorrhoid

• Infrared coagulation – heat treatment to shrink tissue

• Hemorrhoidectomy – surgical removal (for large or recurring hemorrhoids)

• Stapled hemorrhoidopexy – staples reposition the hemorrhoids and cut blood flow

Prevention

• Eat a fiber-rich diet

• Stay hydrated

• Exercise regularly

• Don’t delay bowel movements

• Avoid straining during stool passage

An Anal Fistula is an abnormal tunnel that forms between the inside of the anal canal (or rectum) and the skin around the anus.
It is usually the result of an infection in the anal glands that didn’t heal completely and left a tract under the skin.

How It Develops

• Tiny glands inside the anus help lubricate stool passage.

• When one of these glands becomes blocked, it can get infected, forming an abscess (a collection of pus).

• If the abscess drains but does not heal properly, it can leave a tract (fistula) connecting the anal canal to the skin.

Common Causes

• Anal abscess (most common cause)

• Crohn’s disease (chronic bowel inflammation)

• Tuberculosis (rare)

• Trauma or injury to the anal region

• Complications after anal surgery

• Radiation therapy (rare cases)

Symptoms

• Pain and swelling near the anus

• Redness and tenderness

• Persistent pus or bloody discharge from an opening near the anus

• Irritation of the surrounding skin

• Fever or chills (if infection is active)

• In some cases, symptoms may flare up repeatedly

Complications if Untreated

• Recurrent abscesses

• Chronic infection

• Spreading infection to deeper tissues

• In rare cases, incontinence (if surrounding muscles are damaged)

Treatment

Anal fistulas do not heal on their own — they usually require surgery.
Treatment options include:

1. Fistulotomy – Opening and cleaning the tract so it heals from the inside out.

2. Seton placement – A surgical thread is placed through the tract to keep it open and drain infection.

3. Advancement flap procedure – Moving healthy tissue to cover the internal opening.

4. Fibrin glue or plug – Special sealing agents or plugs to close the fistula (less common).

Recovery

• Most patients recover within 2–6 weeks depending on the procedure.

• Good hygiene and sitz baths help healing.

• Follow-up is important to check for recurrence.