GENERAL SURGERY

general surgery orsolini merate



Inguinal hernia

DEFINITION: For inguinal hernia is defined as a swelling inguinal expandable to coughing , caused by the leakage of a viscus , or a part of it , from the abdominal cavity.

The intervention

It is performed under local anesthesia and can last depending on the indication by 30 a 60 minutes. Will be administered a single incision at the groin that will be synthesized with intradermal suture. The technique we used , tension free , contemplates the application of a prosthetic mesh preformed. At the end of the intervention will be applied a dressing and a splint to wear while in restraining day for some time.

Conclusions relating to the intervention

Duration intervention: 30-60 my

Type of anesthesia: Local

Dressings: 2

Length of stay: 5 hours

Resumption of normal activities: 8 gg. ( heavy activity / sport 15-30 gg)

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RAGADE ANALE

DEFINITION: Ulceration in the form of slit dermoepidermal , located at the bottom of a fold radiata anus.

The intervention

It is performed under local anesthesia and can last from 15 a 30 minutes. A very small incision will be practiced at the level anal and isolated internal sphincter muscle that will be partially dissected. At the end of the intervention will be applied a dressing. For those who request it is possible to infiltrate the fissure with growth factors PRP. for a more rapid re-epithelialization and.

Conclusions relating to the intervention

Duration intervention: 15-30 my

Type of anesthesia: Local

Dressings: 1

Length of stay: 2 hours

Resumption of normal activities: 1/2 gg.

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HEMORRHOIDS

DEFINITION: For hemorrhoids indicates un'ectasia of the veins of the anal canal that can cause bleeding.

The intervention

It is performed under local anesthesia and can last depending on the indication by 30 a 60 minutes. Normally we deal in a single sitting one or when its size permits 2 packages hemorrhoidal. This allows you to minimize post-operative discomfort. The single package hemorrhoidal will be isolated and removed.

Conclusions relating to the intervention

Duration intervention: 30-60 my

Type of anesthesia: Local

Dressings: 1

Length of stay: 5 hours

Resumption of normal activities: 2 gg. ( emorroidectomia Monofocal)

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Sacrococcygeal pilonidal cyst

DEFINITION: For pilonidal cyst ( which contains in most cases hairs) is defined as a cystic mass located in the subcutaneous region sacrum coccyx.

The intervention

Is usually done under local anesthesia and can take depending on the size of 20 a 40 minutes. After highlighting the fistula by injection of liquid dye will proceed to the complete removal of the cyst to the fascia pre sacral. A dressing will be maintained for a few days.

It is possible to integrate the intervention with the PRP treatment in order to improve the healing of the wound.

Conclusions relating to the intervention

Duration intervention: 20-40 my

Type of anesthesia: Local / spinal

Dressings: 3

Length of stay: 4 hours

Resumption of normal activities: 10 gg.

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CANCER OF THE LARGE INTESTINE

DEFINITION: For cancer refers to an uncontrolled proliferation of cells , this may be benign if it remains confined to the site of development , malignant if it invades surrounding tissues or spread through remote metastases. Tumors of the large intestine can be benign or malignant. In the first category we find all polyps ( sessile or pedunculated neoplasm that juts out into the intestinal lumen) benign; amartomatosi, inflammatory and hyperplastic. In the second category are neoplastic polyps ; tubular adenomas and hairy that may evolve into carcinomas, that constitute the group of highest importance of malignant intestinal. In the following descriptions we will consider mainly the colon cancer.
The intervention
The operation is performed under general anesthesia , is , with appropriate variations , in the intestinal section upstream and downstream of the tumor and subsequent anastomosis of the stumps. Our experience has taught us that traditional ( possibility of manual abdominal exploration in the initial phase of the intervention associated with a better visualization of the operative field and better radical surgery when necessary) manuale suture ( avoiding the trauma of the staples of staplers) offers the best results in the short and long term.

Conclusions relating to the intervention

Duration intervention: 60 /120 my ( in relation to the indication)

Type of anesthesia: General

Dressings: 3

Length of stay: 5 gg.

Resumption of normal activities: 15 gg.

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BREAST CANCER

DEFINITION: For cancer refers to an uncontrolled proliferation of cells , this may be benign if it remains confined to the site of development , malignant if it invades surrounding tissues or spread through remote metastases. Tumors can be benign breast ( fibroadenomi , papillomi intra duttali , adenoma and phyllodes tumors) or maligni ( carcinomas). In the following descriptions we will consider mainly breast cancer
The intervention
The operation is performed under general anesthesia ( quadrantectomy and mastectomy with axillary lymph node removal). In the first case consists in removing one quadrant of the breast and in the second the entire breast along with underarm lymph nodes generally. Remembering always that you're fighting against cancer , Quadrantectomy leaves the best aesthetic results while with the mastectomy , more disfiguring , can be done in the same surgery a breast.
Conclusions relating to the intervention
Duration intervention: 60 /100 my ( in relation to the type of intervention)
Type of anesthesia: General
Dressings: 3
Length of stay: 3 gg.
Resumption of normal activities: 10 gg.

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THYROID CANCER

DEFINITION: Thyroid gland tumors are divided into benign and malignant. In the first case we are dealing with solitary or multiple nodules that can only cause problems hyperthyroidism or compressive. In the second case, i tumori maligni , can spread by contiguity to the trachea, all'esofago, the muscles of the neck or recurrent nerve or to metastasize via the blood that is lymphatic. The most common malignancy is followed by papillary carcinoma follicular carcinoma while the other varieties hold only 10% delle malignant neoplasia.
The intervention
Usually carried out under general anesthesia and includes total thyroidectomy ( removal of all of the thyroid), lobo istmectomia ( removal of one lobe and the isthmus) , subtotal thyroidectomy ( removal of the thyroid gland leaving a residue). The lobe-isthmusectomy is indicated for nodular disease for unilateral. The thyroidectomy total for multinodular goiter and carcinomas in which, in selected cases, is useful lymphadenectomy. For some years there is a video-assisted technique, MIVAT that with some limitations indication does not offer any advantage over the usual technique. The scar usually in a matter of time remains almost invisible.
Conclusions relating to the intervention
Duration intervention: 60 - 90 my
Type of anesthesia: General
Dressings: 2
Length of stay: 2 gg
Resumption of normal activities: 7 gg.

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Cutaneous Melanoma

DEFINITION: Means for melanoma skin cancer characterized by a malignant proliferation of melanocytes able to metastasize at a distance.

The intervention

It is performed under local anesthesia and can last depending on the extent of the lesion by 10/30 minutes. The surgical technique is the only one that allows for histological examination , now essential for the diagnostic assessment.

Conclusions relating to the intervention

Duration intervention: 10-30 my

Type of anesthesia: Local

Dressings: 1/2

Length of stay: 30 my

Resumption of normal activities: 1 gg. ( consistent with the anatomical region and the extension)

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Preputial frenulum brevity

DEFINITION: For brevity of the frenulum foreskin means a shortening of the flap of skin that joins the glans (the distal part of the penis) the foreskin ( the skin covering the glans).

The intervention

It is performed under local anesthesia and takes only a few minutes. It consists of the section and in the subsequent reconstruction of the "thread". It 'completely painless and definitive than the partial lacerations post traumatic sexual intercourse.

Conclusions relating to the intervention

Duration intervention: 10-30 my

Type of anesthesia: Local

Dressings: 1

Length of stay: 15 my

Resumption of normal activities: 10 gg. ( sexual intercourse)

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VARICOCELE

DEFINITION: For varicocele is defined as a dilatation of the pampiniform venous plexus. It manifests as a worm-like appearance of swelling , Expandable to coughing , at the level of the scrotum ( much more frequent on the left).

The intervention

The main techniques to intervene in the varicocele are: Binding plexus pampinifiorme , ligation of the spermatic vein sclerotherapy or. Depending on the indication you can make the pampiniform plexus ligation or ligation by removal of part of the spermatic vein ( modified according to Palomo). The first is executable under local anesthesia , while the second requires spinal anesthesia. We do not carry out sclerotherapy because of the discouraging results in the personal.

Conclusions relating to the intervention

Duration intervention: 40 my

Type of anesthesia: Local / cord

Dressings: 1

Length of stay: 60my / 1 daytime

Resumption of normal activities: 10 gg.

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