Director (Gastro Surgery)

Chandan Institute of Gastro-Liver & Biliary Sciences

Dr. Alankar Kumar Gupta

MBBS
MS
DNB (GI Surgery)
Senior Registrar - PGIMER , New Delhi
Senior Registrar - RML Institute, Lucknow
Fellowship - HPB Surgery, Seoul, South Korea

Director (Gastroenterology & Hepatology)

Chandan Institute of Gastro-Liver & Biliary Sciences

Dr. Shivam Sachan

MD (Medicine)
DM (Gastroenterlogy)

Gastroenterology at Chandan Hospital is the branch of diseases of gastrointestinal tract, which include the organs from mouth into anus, along the alimentary canal, are the focus of this specialty. Gastroenterologists perform a number of diagnostic and therapeutic procedures including colonoscopy, endoscopy, endoscopic retrograde cholangiancreatography (ERCP), endoscopic ultrasound and liver biopsy.

Upper gastrointestinal surgery (upper GI surgery) refers to a practice of surgery that focuses on the upper parts of the gastrointestinal tract.

  • Pancreaticoduodenectomy
  • Esophagectomy
  • Liver resection

Lower gastrointestinal surgery includes colorectal surgery as well as surgery of the small intestine.

  • Colectomy
  • Low or ultralow resections for rectal cancer, etc.

Bariatric surgery (weight loss surgery) at Chandan Hospital includes a variety of procedures performed on people who have obesity.

  • Surgical procedures
  • Blocking procedures: Part of the stomach is resected, creating a smaller stomach (however the patient can eat a free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum.
  • Restrictive procedures: Procedures that are restrictive shrink the size of the stomach or take up space inside the stomach, making people feel more full when they eat less.
  • Mixed procedures: Mixed procedures apply block and restrict at the same time.

Minimum Invasive surgery (Laparoscopic Surgery)

Laparoscopy at Chandan Hospital is an operation performed in the abdomen or pelvis through small incisions (usually 0.5-1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen. There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time.

Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations are performed through small incisions (usually 0.5-1.5 cm) elsewhere in the body.

There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. Pain and hemorrhaging are reduced due to smaller incisions and recovery times are shorter. The key element in laparoscopic surgery is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.

Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in a laparoscopic surgery include: forceps, scissors, probes, dissectors, hooks, retractors and more. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy.

Laparoscopic cholecystectomy is the most common laparoscopic procedure performed. In this procedure, 5-10 mm diameter instruments (graspers, scissors, clip applier) can be introduced by the surgeon into the abdomen through trocars (hollow tubes with a seal to keep the CO2 from leaking).

Laparoscopic approach is intended to minimise post-operative pain and speed up recovery times, while maintaining an enhanced visual field for surgeons.

Advantages:

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include:

  • Reduced hemorrhaging, which reduces the chance of needing a blood transfusion.
  • Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scarring.
  • Less pain, leading to less pain medication needed.
  • Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.
  • Reduced exposure of internal organs to possible external contaminants thereby reduced risk ofacquiring infections.
  • There are more indications for laparoscopic surgery in gastrointestinal emergencies as the field develops.

Gynecological diagnosis:

In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries and fallopian tubes, for example in the diagnosis of female infertility. Usually, there is one incision near the navel and a second nearto the pubic hairline.

Endoscopy

An endoscope can consist of :

  • a rigid or flexible tube.
  • a light delivery system to illuminate the organ or object under inspection. The light source is normally outside the body and the light is typically directed via an optical fiber system.
  • a lens system transmitting the image from the objective lens to the viewer, typically a relay lens system in the case of rigid endoscopes or a bundle of fiberoptics in the case of a fiberscope.
  • an eyepiece. Modern instruments may be videoscopes, with no eyepiece. A camera transmits image to a screen for image capture.
  • an additional channel to allow entry of medical instruments or manipulators.

An endoscopy is used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imagingtechniques, endoscopes are inserted directly into the organ.

There are many types of endoscopes. A patient may be fully conscious or anaesthetised during the procedure. Most often the term endoscopy is used to refer to an examination of the upper part of the gastrointestinal tract, known as an esophagogastroduodenoscopy.

Medical uses:

  • investigation of symptoms, such as symptoms in the digestive system including nausea, vomiting, abdominal pain, difficulty swallowing, and gastrointestinal bleeding.
  • confirmation of a diagnosis, most commonly by performing a biopsy to check for conditions such as anemia, bleeding, inflammation, and cancers of the digestive system.
  • giving treatment, such as cauterization of a bleeding vessel, widening a narrow esophagus, clipping off a polyp or removing a foreign object.

Applications:

  • The gastrointestinal tract (GI tract):
    • oesophagus, stomach and duodenum (esophagogastroduodenoscopy)
    • small intestine (enteroscopy)
    • large intestine/colon (colonoscopy, sigmoidoscopy)
    • Magnification endoscopy
    • bile duct
      • endoscopic retrograde cholangiopancreatography (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy
  • rectum (rectoscopy) and anus (anoscopy), both also referred to as (proctoscopy)
  • The respiratory tract
    • The nose (rhinoscopy)
    • The lower respiratory tract (bronchoscopy)
  • The ear (otoscope)
  • The urinary tract (cystoscopy)
  • The female reproductive system (gynoscopy)
    • The cervix (colposcopy)
    • The uterus (hysteroscopy)
    • The fallopian tubes (falloposcopy)
  • Normally closed body cavities (through a small incision):
    • The abdominal or pelvic cavity (laparoscopy)
    • The interior of a joint (arthroscopy)
    • Organs of the chest (thoracoscopy and mediastinoscopy)

Endoscopy is used for many procedures:

  • During pregnancy
    • The amnion (amnioscopy)
    • The fetus (fetoscopy)
  • Plastic surgery
  • Panendoscopy (or triple endoscopy)
    • Combines laryngoscopy, esophagoscopy, and bronchoscopy
  • Orthopedic surgery
    • Hand surgery, such as endoscopic carpal tunnel release
    • Knee surgery, such as anterior cruciate ligament reconstruction
    • Epidural space (Epiduroscopy)
    • Bursae (Bursectomy)
  • Endodontic surgery
    • Maxillary sinus surgery
    • Apicoectomy
  • Endoscopic endonasal surgery
  • Endoscopic spinal surgery