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All surgery involves some risk. Risks can be broken down into two groups, those related to surgery in general and those specific to the operation being performed. Risks of surgery in general include risks of anaesthetics, infections inside the abdomen and in the wound, lung problems, blood clots in the leg or lungs and, very rarely, death. If you have other health problems such as heart or lung problems, diabetes, smoking the general risks of surgery are increased.
When assessing the risks of surgery you must also consider and balance the risks of NOT having the surgery and remaining significantly overweight.
These will be discussed in detail with you prior to the operation by your surgeon.
The following are the commonest of the complications but please note that this is not a comprehensive list of possible complications but does cover most events.
Anaesthetic risks are extremely low because when you come to your operation any conditions which might increase your anaesthetic risk such as high blood pressure, diabetes or sleep apnoea will have been brought under control. All of our anaesthetists are experienced with dealing with the specific problems of patients with excess weight and have full access to all of the tests and information gathered during your preoperative assessment.
Although uncommon, bleeding can occur during an otherwise routine operation and could require blood transfusion and possibly abandoning the laparoscopic (keyhole) approach for a major incision in the abdomen. Occasionally, after a routine operation, bleeding can commence some hours after an operation and require a return to the operating theatre.
Again these are uncommon with laparoscopic surgery, but occasionally one of the small keyhole wounds can become infected and require antibiotics or drainage. Uncommonly, an infection inside the abdominal cavity or the chest can occur.
Although uncommon, during laparoscopic surgery it is possible to inadvertently damage another organ such as the spleen or the bowel. Normally this can be diagnosed and repaired during the operation but very rarely this damage may not be obvious until some hours or even days after the procedure and will then require appropriate management.
Rarely, it is not possible to complete an operation with keyhole surgery and a full abdominal incision may be necessary. This is more likely to be the case if you have had previous surgery on your stomach such as a gastric band or stomach stapling.
Blood clots to the legs or the lungs are a very serious complication. At LapSurgery we use the maximum protection against this occurring. Shortly before the operation you will be given a blood thinning injection and have stockings placed on your legs. A further device will also be placed on your legs which keeps pumping blood through your legs whilst you’re asleep to minimise the chance of a clot forming whilst you are on the operating table.
Using these precautions and the early mobilisation after the surgery that is possible with the keyhole operation, these complications have been uncommon in our patients.
The following are the commonest of the complications but please note that this is not a comprehensive list of possible complications but does cover most events.
Anaesthetic risks are extremely low because when you come to your operation any conditions which might increase your anaesthetic risk such as high blood pressure, diabetes or sleep apnoea will have been brought under control. All of our anaesthetists are experienced with dealing with the specific problems of patients with excess weight and have full access to all of the tests and information gathered during your preoperative assessment.
Bleeding.
Although uncommon, bleeding can occur during an otherwise routine operation and could require blood transfusion and possibly abandoning the laparoscopic (keyhole) approach for a major incision in the abdomen. Occasionally, after a routine operation, bleeding can commence some hours after an operation and require a return to the operating theatre.
Again these are uncommon with laparoscopic surgery, but occasionally one of the small keyhole wounds can become infected and require antibiotics or drainage. Uncommonly, an infection inside the abdominal cavity or the chest can occur.
Although uncommon, during laparoscopic surgery it is possible to inadvertently damage another organ such as the spleen or the bowel. Normally this can be diagnosed and repaired during the operation but very rarely this damage may not be obvious until some hours or even days after the procedure and will then require appropriate management.
Rarely, it is not possible to complete an operation with keyhole surgery and a full abdominal incision may be necessary. This is more likely to be the case if you have had previous surgery on your stomach such as a gastric band or stomach stapling.
Blood clots to the legs or the lungs are a very serious complication. At LapSurgery we use the maximum protection against this occurring. Shortly before the operation you will be given a blood thinning injection and have stockings placed on your legs. A further device will also be placed on your legs which keeps pumping blood through your legs whilst you’re asleep to minimise the chance of a clot forming whilst you are on the operating table.
Using these precautions and the early mobilisation after the surgery that is possible with the keyhole operation, these complications have been uncommon in our patients.
Our operations are performed only in Private Hospitals. These costs can vary according to your particular private health cover. The out of pocket cost will depend on the operation performed and Medicare and Private Health cover rebates.
It may be possible to fund this out of pocket cost from your Superannuation.
Mesh infection is a very rare complication.
The chance of the hernia coming back later in your life is very low.
Occasionally patients can have ongoing pain at the site of the hernia but this is less common with keyhole surgery.
There are three main advantages to a keyhole surgery vs non-keyhole:
The small incisions result in less pain and earlier return to work, especially when hernias are present on both sides.
By positioning the mesh on the inside of the defect, the very sensitive nerves in the inguinal canal are not damaged or irritated by the mesh as can occur in the non-keyhole operation.
Costs vary depending on your health insurance. The funding provided by Medicare and Health Funds for this operation is no higher than for the non-keyhole method. However, there will be out of pocket costs involved. LapSurgery Surgeons do not operate in public hospitals but should you wish to pay to have your surgery done in a private hospital an estimate of costs can be provided following a consultation with one of our surgeons.
There will be a co-payment to the surgeon before the operation and the balance of the surgeon’s account is sent directly to the Health Fund. Full informed financial consent will be provided prior to your surgery.
There will be charges from both the Assistant Surgeon and Anaesthetist. Accounts for these services vary and are independent of LapSurgery Australia. We are able to advise you of the individuals providing these services once a date has been scheduled for your surgery.
Out of pocket costs for the Hospital vary depending on your Health Fund, level of cover, excess etc. For an accurate cost, please refer to your Health Fund or the Hospital.
The Medicare item number you will need to quote is 30609.
It is your responsibility to check that your health insurance is up to date and whether there will be any excess charges. LapSurgery Australia cannot check this for you.
The normal services required for your operation are listed above. Occasionally patients require additional medical care and may incur charges for pathology, radiology and other specialists.
LapSurgery Australia surgeons have a major interest in the management of patients with gallbladder disease and have many years of experience performing this procedure.
All surgery involves some risk. Risks can be broken down into two groups, those related to surgery in general and those specific to the operation being performed. Risks of surgery in general include risks of anaesthetics, infections inside the abdomen and in the wound, lung problems, blood clots in the leg or lungs and even death. Death from routine gallbladder surgery is exceptionally rare but has happened. If you have other health problems such as heart or lung problems, diabetes, smoking or excess weight the general risks of surgery are increased.
The major risk specific to the laparoscopic cholecystectomy operation is damage to the main bile duct system. This is a very major complication with potentially serious long term problems. Other possible complications specific to the laparoscopic cholecystectomy include bile leakages, bleeding and infection forming under or around the liver. LapSurgery Australia surgeons are able to deal with such complications to ensure recovery is complete. Please note that all risks mentioned are not all inclusive and a thorough discussion with your surgeon will occur.
Acute cholecystitis occurs when a gall stone gets stuck in the outlet of the gallbladder and does not release. This causes a build-up of bile in the gallbladder which causes a chemical reaction of the bile literally starting to digest the gallbladder causing inflammation and unremitting pain. Then bacteria, which naturally occurr in the gallbladder, can cause infection making the situation worse and possibly leading to gangrene of the gallbladder. Emergency surgery is usually recommended and keyhole surgery may not be possible.
If you have private health insurance there is no waiting list. If you wish, your operation can usually be performed within a week or two or planned at a time of your choosing. For most patients with full private health insurance there will be some extra costs not covered by Medicare or your health fund. The cover provided by your health fund will vary according to which fund and which level of cover you you have. In some cases you may have to pay an “excess”. It is your responsibility to check with your health fund prior to surgery. Full financial details will be provided to you prior to surgery unless the surgery is done as an emergency. Occasionally other tests, procedures or specialist consultations may be necessary and some other costs incurred.
Public hospital waiting lists may be very long. There is no choice of surgeon in the Public Hospital and your LapSurgery Australia surgeon cannot not be involved in your operation.
Hospitals used by LapSurgery Australia for gallbladder surgery are:
Facial blushing is a common condition affecting large numbers of people. Facial blushing is due to the overactivity of involuntary nerves. The nerves control the diameter of the blood vessels and when the nerves are over-stimulated the vessels open out and colour the skin red. Excessive blushing can occur under many circumstances including stress or embarrassment, but in many people it occurs in response to the most trivial event. Facial blushing is often accompanied by other symptoms including palpitations, feelings of excessive heat and anxiety.
Normal people sweat as a way of maintaining skin hydration and controlling body temperature. We have approximately 5 million sweat glands, many concentrated in the skin of the face, scalp and hands. Although it is not entirely understood why, some people sweat excessively due to overactive functioning of the involuntary (sympathetic) nervous system. The common places people sweat excessively are on their hands, face, scalp and armpits. ETS is highly effective at controlling excessive sweating of the hands, scalp and face.
We now have a new operation for axillary hyperhidrosis.
The new technique involves selectively isolating a small part of the sympathetic nervous system between the fourth and fifth ribs. This is done by clamping the nerve with small titanium clips which stay in place permanently. (These clips are routinely inserted in the body in numerous different operations and have no known side-effects.) This technique has a high success rate in eliminating or greatly reducing axillary hyperhidrosis with a low incidence of severe compensatory sweating. In addition, there is some evidence that, in those very few people in whom compensatory sweating is considered worse than the original condition, that removing the clips may reverse the operation. It must be emphasised that the possibility of reversal is theoretical and by no means guaranteed.
Other treatments are available for axillary hyperhidrosis and we recommend that some or all of these are discussed with your family doctor or dermatologist before considering sympathectomy. Other treatments include:
This distressing condition is not due to sympathetic nerve overactivity but is due to infection or problems with other types of glands in the armpit. ETS is usually not effective for this condition. We suggest treatment by a dermatologist.
ETS cannot help sweating on other areas. People suffering from this condition should have a thorough check up from their family doctor to exclude metabolic causes such as an overactive thyroid gland. Severe obesity is also a cause of excessive sweating. If this applies, you may be interested in reading the information on weight loss surgery elsewhere on this web site.
Lapsurgery Australia operations are performed only in Private Hospitals and therefore usually have an out of pocket cost. For more information about costs please call our rooms on (03) 9760 2777 or email us at: info@lapsurg.net.au
Carpal tunnel syndrome is caused by compression of the median nerve at the wrist. The median nerve supplies the sensation over most of the hand, with the exception of a small area on the little finger side.
Symptoms are numbness and tingling in the fingers often occurring when using the hands during the day and particularly annoying and sometimes very severe at night.
Other symptoms in the hand such as swelling, joint pains and various lumps are not due to carpal tunnel syndrome.
The common operation for Carpal Tunnel Syndrome involves quite a long incision on the palm of the hand, usually needing 6 – 8 stitches. It can take many weeks for recovery.
At LapSurgery we have been performing the minimally invasive (keyhole) technique for more than 15 years and have performed more than 1,500 of these procedures.
In the keyhole approach a small incision is made on the wrist, less than 1cm long. A further 3mm incision is made on the palm of the hand. The incisions are so small that in most cases a stitch is not required. A telescope is inserted between the incisions and the ligament squashing the nerve is divided fully under vision. In fact the vision we get is superior to naked eye vision as it is magnified in high definition on a computer monitor.
The procedure is done as a day case and takes about half an hour. It can be performed under full general anaesthetic or with just the arm numb and a mild sedation.
A bandage will be applied to the hand, but the hand can and should be used as soon after the operation as possible. Slings and plasters are not used! Bandages are removed after a few days and the hand can be used normally thereafter. There may be some swelling and tenderness for several weeks afterwards, but in most cases you can go about all but the very heaviest use of your hands with a week or two.
Relief of the nasty, sometimes painful tingling is immediate. However numbness in the tips of the fingers can take longer to resolve.
Where symptoms are mild and of recent onset, alteration of working conditions and night time splinting may be of assistance.
Injection of steroids into the carpal tunnel can help, but usually this gives only temporary relief.
There is no waiting list. If you wish, your operation can usually be performed within a week or two or planned at a time of your choosing. For most patients with full private health insurance there will be some extra costs not covered by Medicare or your health fund. The cover provided by your health fund will vary according to which fund and whichlevel of cover you have. In some cases you may have to pay an “excess”. It is your responsibility to check with your health fund prior to surgery. Full financial details will be provided to you prior to surgery unless the surgery is done as an emergency. Occasionally other tests, procedures or specialist consultations may be necessary and some other costs incurred.
Public hospital waiting lists may be very long. There is no choice of surgeon in the Public Hospital and your LapSurgery Australia surgeon will not be involved in your operation.
If you do not have private health insurance, you can expect to have a higher out of pocket cost depending on the hospital your surgery is performed at. Following your consultation with our surgeon our staff will be able to give you an informed financial consent prior to going ahead with surgery.
Hospitals used by LapSurgery Australia for this surgery are:
Risks of surgery include but are not limited to:
This is exceptionally rare in experienced hands such as ours. On very rare occasions one of the small branches of the nerve to one or other side of one finger can be damaged giving numbness in this area. Changes to the technique introduced many years ago have virtually eliminated this possibility.
About 1% of patients experience recurrent symptoms or don’t get relief from the initial operation. There can be many reasons for this and any such recurrence or failure will be investigated fully. Where a repeat operation is necessary it cannot be done with keyhole surgery and a larger incision is needed.
This is a rare condition where continuous burning pain affects the hand. It usually resolves with time and physiotherapy.
Infection is exceptionally rare.
**Delay in treatment of carpal tunnel syndrome may cause permanent damage to the median nerve