General surgery is the branch of medicine that focuses on the surgical part of specific diseases related to the abdominal area, thyroid, breast, hernias and often skin.
As many archaeological findings show general surgery must have been the first form of medicine. It was difficult to heal a disease or a trauma, thus ancient physicians removed the diseased part that caused the anomaly. Since then, many folks have been involved with this field and managed to offer significant contribution to the development of the treatments. Modern general surgery was born in the 18th century where many surgery schools opened and through study, experiments covered imperfections and weaknesses of science. During the 19th century many issues related to anesthesia, tools’ and patients’ disinfection were solved. Moreover the morality rate was significantly reduced, whereas the after-surgery part was improved with the use of antibiotics.
Nowadays, the purpose of surgery is not the cure by removing the diseased part, but the treatment through correction.
Hemorrhoids is one of the most common conditions that occur in the general population of Western societies. A significant percentage, over 45% of men and women, is estimated to experience Hemorrhoids at some time in their lives. Of these cases about 15% will require surgery.
All people have a net of veins in their anus, the rectal veins. When swollen develop internal or external hemorrhoids. The problems start when, mainly due to constipation, pregnancy or childbirth, drugs and alcohol the swollen veins appear outside the anal canal. Along with possible deterioration of the varicose dilatation of the venous plexus we have the main causes of Hemorrhoids.
The main symptoms of hemorrhoids can be: pain and pressure in the anal canal, a bulge in the anus, itching and pain in and around the anus occasionally with blood in the underwear, the toilet paper, or in the toilet itself.
Internal hemorrhoids are usually not painful but often cause bleeding.
External hemorrhoids occur when the veins under the skin of the anus swell and hurt. Sometimes there may be also bleed.
The main types of hemorrhoids are:
1st grade without prolapse: usually treated with diet, drug prescription, sclerotherapy, or photocoagulation
2nd degree prolapse: hemorrhoids occur outside the anus, but can be pushed back in automatically. Can be treated with sclerotherapy, photocoagulation or hemorrhoidectomy.
3rd grade prolapse: hemorrhoids occur outside the anus and can be pushed back in by the patient. Usual treatment with hemorrhoidectomy.
4th grade prolapse: hemorrhoids occur outside the anus and can not be pushed back in by the patient. Treatment with hemorrhoidectomy.
The method to be followed is always discussed and agreed with the attending physician and always based on the condition of each patient.
Hernias of the abdominal wall is one of the most common problems that require the intervention of a surgeon. A hernia is not restored by itself. It worsens in time, even to the point of emergency surgery. Hernia surgery is usually without any complications, solving once and for all the problems of pain suffering.
A hernia occurs when an organ or fatty tissue falls out of place or sticks out of its thin enclosing membrane creating a small lump. The patient can actually touch the lump or even push it back inside. That is a "reversible" hernia or sliding hernia, ie to be able to restore the content into the abdomen. It appears when the person is standing and disappears when lying. It can also be "irreversible". A "non-reversible" hernia requires immediate surgery, because it can cause constriction or even necrosis of the content. In the case of strangulated hernia, there may be severe pain, fever, bowel obstruction, vomiting, or, in very severe cases, even shock.
It is perhaps the most common type of hernia. The most common symptoms are continuous presence or recurrent swelling with pain in the groin. Sometimes hernia is completely with no symptoms and is diagnosed accidentally during a clinical examination by a doctor. In other cases complications may occur, such as strangulated hernia mentioned above. The patient feels severe pain and sometimes fever. There is also the danger necrosis of the content in the suffering area.
The navel is a weak area of the abdominal wall. The “umbilical ring”, which is normally almost closed is weak and the organs push through this wall and create a small hernia that is usually painless. It can be seen in both adults and babies.
Another weak area of the body is located between the abdomen and our thigh, below the groin and appears like a swell at the base of the femur. This type is more common in women, usually of older age.
This type of hernia occurs in a former section of a surgery. The abdominal contents push forward the weak point of the intersection and appear as a lump. Postoperative hernia can occur months or even years after a surgery.
Under general anesthesia a small incision is made in order to suture the weak point and amplify it by using tissue from the patient himself.
It is the same procedure as the hernia surgery mentioned. The only difference is that we strengthen the abdominal wall by using synthetic mesh. It minimizes the chances of relapse and the wall is better than the one of the patient.
Making only two small holes and using an optical system the doctor places the mesh from the inside of the abdominal wall. The entire procedure is virtually painless, and the pain from the incision lasts three to four days and is easily treated with painkillers.
Surgery is the only indicated treatment of hernia. There is no other method that can “repair” the gap from which the hernia appears.
The thyroid gland is one of the most important glands of the endocrine system. Located in our neck, just in front of the cartilage of the larynx, consists of two lobes, left and right, which are connected by the isthmus.
The thyroid gland produces three main hormones, thyroxin (T4), the triiodothyronin (T3) and calcitonin. Calcitonin plays an important role in the regulation of calcium in our body. It is also prescribed in women after menopause to treat osteoporosis.
Main diseases of the thyroid: hypothyroidism, hyperthyroidism, goiter, inflammation of thyroid, nodules (small lumps) and thyroid cancer.
In this case the gland is “hyperactive”, which means that it excretes more hormones than normal. Hyperthyroidism can be caused by the development of nodules (small tumors)on thegland, or other causes, such as a viral infection or use of iodinated products. Main symptoms are fatigue withoutapparent cause, weakness, weight loss, palpitations, arrhythmias, difficulty sleeping, irritability, or difficulty in swallowing. If hyperthyroidism is not checked regularly it could lead to osteoporosis, or eye pressure.
In the case of hypothyroidism we experience the exact opposite of Hyperthyroidism, ie the gland has a reduced hormone production. In this case we may see problems in the mental alertness of the person or in his bodily strength. An increase of weight, fatigue, muscular weakness or cramps may occur, whereas in advanced hypothyroidism the face appears pale. Puffy eyelids and hair loss may be observed, an irregular cycle, hypercholesterolemia or hyponatremia.
Goiter - Thyroid nodes
The goiter is swelling of the gland itself. Sometimes it is associated with many of the above, but this is not necessary. The goiter is more about the anatomy of the gland itself (size) rather than its function. In fact, when the pressure of the gland to the trachea is high enough, the patient will have to visit a specialist for evaluation and treatment, depending on the size of the problem. There is also the case of small lumps, known as "nodes” appearing in the thyroid gland. In that case, close monitoring and possibly puncture of the suspicious nodules must be performed.
In the last decades there has been a significant increase of thyroid cancer cases. This increase is likely due to either environmental factors or to better and faster detection of small tumors, which previously were unnoticed. Thyroid cancer usually appears as a nodule or a mass, but does not necessarily cause pain. The thyroid nodules are frequent in general population, but only 5-10% are malignant. In most thyroid cancer cases, when the diagnosis is early, they can be treated easily and in full recovery with surgery.
There are four types of thyroid cancer:
The papillary carcinoma: the most common type and perhaps with the best prognosis. The cure rates are very high.
The follicular carcinoma: much more rare type of cancer. This type also has a good prognosis, but unfortunately not as much as the papillary carcinoma.
Medullary carcinoma: refers to cells of the thyroid gland that produce thyrocalcitonin. It usually has moderate prognosis. In some cases it can co-exist with other forms of cancer.
The anaplastic carcinoma: it consists only 3% of all thyroid carcinomas and is probably the type with the weaker prognosis. Usually, it appears at the age 65 or later.
Early diagnosis is the only way!
Breast self-examination is a simple routine that can make a significant contribution to the early diagnosis of breast cancer and can actually save women from this disease.
A woman's breast changes during her lifetime. Menstruation, pregnancy, breastfeeding, hormonal treatments, contraceptives and even small injuries can cause changes to the breast. Shortly before and during your period, the breasts become more firm, while there can be pain or small masses may appear. This is a normal condition and is caused by fluids that accumulate in breasts.
Self examine your breasts every month, so you will know how your breasts are. That way you will be able to notice any changes, if and when they appear. For women before menopause it is best to self-examine 3 or 4 days after their period, when the breasts are “calmed” and any possible swelling due to menstruation is gone. If you have been through menopause, choose a day of the week- the same each month (ie the first week) to self examine.
You should not be afraid to visit your doctor, or even better a Breast specialist. Early diagnosis saves lives!
Although there are several risk factors that may suggest that someone could suffer from breast cancer sometime in their lives, little is known about its causes. When we say that a person is at greater risk of developing cancer, or having a risk factor, it means that you may have a certain “vulnerability” to the disease. However, risk factors do not "predict" whether a woman will develop breast cancer or not. Many people who have indications do not develop the disease and others, without any of the following factors, do actually suffer from Breast cancer.
- Sex: Unfortunately women are the first to suffer from the disease, with only one man in 100 female patients.
- Age: The risk of developing breast cancer increases with age. It usually occurs in women after the age of 50.
- Family History: When a woman has a first-degree relative (mother, sister) with breast cancer, it almost doubles the chances of developing breast cancer herself.
- No Children
- Breast lumps (papillomatosis)
- Delayed menarche or early menopause.
- Radiation: Especially radiotherapy to the chest before the age of 30 increases significantly the chances.
- Obesity: Obesity increases the risk of breast cancer after menopause, by increasing the levels of estrogen.
- Alcohol: also increase the concentration of estrogen in the blood.
- Oral contraceptives and hormone replacement therapy: it seems to slightly increase the risk of developing breast cancer in women at the time of their use or shortly after