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One of the greatest advantages of the minimally invasive approach is the low incidence of infection in wounds, especially in the most frequent abdominal surgical emergency in the world, acute appendicitis. With this technique a greater protection of the wounds is achieved, which is also included in a direct contact with them. In addition, the appendix is placed in a special bag to avoid pollution of other organs, even if it is ruptured. Recovery is far superior to the classic approach.
This technique is the main responsible for spreading and corroborating the success of Laparoscopy. Laparoscopic cholecystectomy has become the "gold standard" for the treatment of stones in the gallbladder. It really does not have a substitute. Its main advantages are: less pain, faster recovery and less incidence of complications. The vast majority of patients remain in the hospital for 24-36 hours.
Another one of the interventions that have almost completely displaced conventional surgery. Gastroesophageal reflux ("acidity or heartburn") is a common clinical entity whose management some years ago was exclusively medication. Currently, it is proven that in a significant number of those affected, surgical (laparoscopic) treatment offers better results, avoiding the use of long-term and expensive treatments. In practical terms, the technique used is called fundoplication, which consists of "sheltering" the esophagus with the upper portion of the stomach. In cases where there is a hiatal hernia, it is repaired simultaneously.
Hernias are a fairly common problem, however, their actual incidence is unknown. It is estimated that around 5% of the world's population will develop a herniated abdominal wall at some point in their lives, but the prevalence may be even higher. About 75% of all hernias occur in the INGUINAL REGION. Men are 25 times more likely than women to develop an inguinal hernia.
Laparoscopic surgery has been a widely accepted alternative for several years in the repair of inguinal and abdominal wall hernias, with proven safety and high efficacy. They are used on average 3 "mini-incisions" of 5-10 millimeters through which the camera and instruments are handled. In this way the hernia is repaired and a special mesh is also introduced to reinforce the previous defect.
Laparoscopic surgery represents a widely accepted technique in the management of benign colon diseases, especially diverticulosis (small sacs that protrude from the wall of the colon). Diverticular disease of the colon is a very common entity and in most cases does not give symptoms. The fact of resecting the affected segment or laparoscopically allows a faster recovery, an earlier start of the oral route and a more soon re-establishment of the colonic function.
Splenectomy (resection of the spleen) is a very useful therapeutic resource in hematological diseases, in which the spleen acts as an organ of destruction of the elements of the blood (red blood cells and platelets). Since its development in 1991, laparoscopic splenectomy has almost completely replaced the conventional modality. In addition, its high safety and efficiency over time have been proven.
Single port surgical procedures belong to the group of interventions called "surgeries without scars or without fingerprints" because all the instruments used are introduced by a single small wound that leaves practically no trace or evidence of it. Cholecystectomy and appendectomy are the main techniques carried out using this laparoscopic alternative.
The mini-laparoscopy as it is deduced from its name, consists of reducing as much as possible the size of the incision necessary for the performance of the surgery. That is, the current trend could be called classical. If the evolution of the large wounds was to adjust the incision to the one that was merely necessary, we have now traveled the same path in laparoscopic surgery.
The 12 mm incisions can be reduced to 5 mm and the 5 mm incisions are being converted into 2 and 3 mm incisions. All this trajectory less and less invasive has been possible thanks to the skill previously acquired by the surgical community in laparoscopic management and the technological development of surgical instruments. Today all laparoscopic procedures can benefit from the "mini" evolution: cholecystectomy (gallbladder), appendectomy (appendix), colectomies (colon), obesity surgery (gastric band and sleeve), Nissen (anti-reflux) and many more. The advantages of "mini" surgery are the same as those that occurred with conventional laparoscopy, such as faster recovery, less trauma to tissues, fewer complications of the abdominal wall and in this case it is to emphasize the aesthetic improvement that we can perform interventions with practically imperceptible wounds.
Shaped silicone, it is placed around the upper portion of the stomach laparoscopically (small incisions). The gastric band represents a modern method with proven safety and efficacy for weight reduction. Its mechanism consists of limiting the amount of food that is ingested, by decreasing the functional size and emptying of the stomach (restrictive procedure). This forces the patient to eat less.
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In this type of intervention a small stomach is created, which is reconnected directly to the small intestine in a more distal portion, thus decreasing the absorption surface of the food. For this reason, it is considered a poorly absorbing procedure. In addition, by reducing the capacity of the stomach, patients have a feeling of fullness with less food. It is excellent for reducing weight in a sustained manner, especially in patients with a BMI ≥ 50. Even though it is the most technically demanding, it is the one that provides the best long-term results in terms of weight loss.
The gastroplication or also known as "gastric plication" is a restrictive, innovative and safe procedure that offers patients an alternative to lose weight in a sustained and effective way. It is a new technique in bariatric surgery. It is a merely restrictive procedure, that is, it limits the amount of food you can eat. It is also performed by minimally invasive surgery (laparoscopy) without the need to use implants (band or balloons) that generate rejection and without drying out or using staples in the stomach or intestine.
The Mini Gastric Bypass is a Mixed type procedure since it combines 2 mechanisms: Restriction (when creating a "small and thin stomach") and Malabsorption (when creating a "bridge" between the stomach and the intestine).
It is done through laparoscopic surgery (through small incisions, without opening the abdomen) under general anesthesia. Intestinal staplers are used that place titanium staples (biocompatible) and are reinforced with suture to ensure an adequate seal and section the stomach to form a very small one and the intestine is sectioned to create a bridge between it and the stomach. The patient stays in the hospital for 2 or 3 days and usually returns to their daily activities in a week.
The pathologies that affect the anus-rectum represent one of the most frequent reasons for consultation for the general surgeon. Hemorrhoids (piles), fissures, abscesses (acute infection), fistula (chronic infection), incontinence (no retention) fecal and rectal prolapse, in their different degrees of severity, can be managed successfully by the Dr. Gálvez. Many people are ashamed to talk about their anal or rectal problems, however, it is extremely important to consult about them, especially if there are symptoms such as pain or bleeding. The treatments vary widely depending on the particular problem.
The skin is the most extensive organ of the human body, which is why it deserves our full attention. The vast majority of skin tumors are benign: warts, moles or nevi, cysts, lipomas (small balls of fat), hemangiomas (red spots), among others. The treatment of these is the simple extirpation + primary closure of the wound. However, in some cases we can find pre-malignant or malignant lesions (cancer) that warrant a more specialized treatment by a qualified surgeon.
In some cases, inguinal and abdominal wall hernias are of such magnitude or severity that the laparoscopic approach is impossible to perform. In other cases, patients simply because of their state of health would not tolerate undergoing general anesthesia. In such situations, conventional general surgery is established as the most viable option and the safest therapeutic resource.
Age is an important consideration in the evaluation of neck tumors. In children and young adults, these are usually benign in 90% of cases. However, in people over 40, we are accustomed to applying the "80s rule". This establishes that 80% of neck masses that do not originate from the thyroid gland are neoplastic (tumor origin). Of these, 80% are classified as malignant (cancer). Of the malignant ones, 80% are squamous or squamous cell carcinomas.
The Thyroid is a hormone-producing gland that regulates the body's metabolism and its sensitivity to other hormones. It can be affected by functional disorders (hypo and hyperthyroidism), inflammatory (thyroiditis) and neoplastic (nodules or tumors). Thyroid nodules are tumors that in turn can be benign or malignant (cancer). They are usually present in 5-7% of the population, being more common in women. 4-5% of all thyroid nodules are malignant, which is why we should not underestimate their existence. Requesting the help of a specialist like Dr. Gálvez becomes imperative. In cases of thyroid cancer, the success rate (cure) after surgery is very high and the long-term prognosis is quite good.
There are many causes of breast tumors, ranging from normal changes in the human body to pathological changes (diseases). These tumors are classified into two large groups: benign and malignant (cancer). It is important to know and remember that between 80-85% of mammary tumors are benign, especially in women under 40 years of age. Among these are abscesses (infections), fibroadenoma and fibrocystic disease of the breasts. On the other hand, we must bear in mind that in men there may be a unilateral or bilateral growth of the breasts by hormonal stimulation, this condition is benign and is called gynecomastia.
With regard to breast cancer, in our country it represents the second cause of death in women over 25 years. On average die a little more than 10 Mexican women a day for this condition, which is alarming. The American Cancer Society predicts that 1 in 8 women will get breast cancer during their lifetime. Reason why we must keep in mind the main risk factors to develop it: being a woman, family history of breast cancer, beginning of menstruation before age 12, menopause after age 50, first pregnancy after age 35, have suffered from cancer of the womb, prolonged use and in high doses of estrogen, among others.
Most patients tend to detect tumors by themselves, so the practice of self-examination could help detect breast cancer in the early stages. The earlier the tumor stage is detected at the time of its detection, the greater the chances of cure. Therefore, all women between 20 and 40 years of age should see a doctor every 2-3 years in an ordinary way. Those over 40 years, it is advisable to do it at least once a year. An early intervention by the indicated specialist increases the chances of success.
Diabetic foot, in particular, is defined as infection, ulceration and destruction of deep tissue, associated with neurological abnormalities (loss of sensitivity to pain) and peripheral vascular disease (damage to the circulation) in the lower extremities. The foot is highly vulnerable to circulatory and neurological damage, and the least trauma can cause ulcers or infections. When arteries that carry blood to the feet are occluded, gangrene occurs.
This is how diabetes can cause problems in your feet; Even a small cut can have serious consequences. Diabetes can cause nerve damage, which reduces sensitivity in the feet. Diabetes can also reduce the flow of blood to the feet, so that a wound takes longer to heal or is unable to resist infection. For these reasons, it is possible that patients with diabetes do not perceive a stone in their shoe, causing a blister, an ulceration and finally a chronic infection that causes the loss (amputation) of the feet or even the limb. It is estimated that every 30 seconds a limb is amputated in the world due to diabetic foot complications. Taking into account the aforementioned, it is highly recommended that every diabetic patient check their feet daily and in case of any anomaly detected, go immediately to the specialist.
Dr. César Gálvez gives you the most cordial welcome and puts at your disposal a highly specialized service in Gastrointestinal and General Minimally Invasive Surgery, as well as Obesity Surgery (Bariatric), based on a formal training in our country as abroad and with the desire to offer you the highest quality standards.
He is certified by the Mexican Council of General Surgery, is a Fellow of the American College of Surgeons (FACS), an active member of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the American Society for Metabolic and Bariatric Surgery (ASMBS).
Surgeon, "Ignacio A. Santos" School of Medicine of the Tecnológico de Monterrey.
Professional Certificate: 3579301.
General Surgery and Laparoscopy, School of Medicine of the Tecnológico de Monterrey-Postgraduate Area.
Mexican Council of General Surgery, A.C.
Advanced Bariatric Life Support (ABLS) by the American Society of Metabolic and Bariatric Surgery.
Advanced Trauma Life Support (ATLS) by the American College of Surgeons.
Advanced Cardiac Life Support (ACLS) by the American Heart Association.
2017 - 2022 - Certification in force by the Mexican Council of General Surgery, A.C.
2014 - Instructor of the ATLS Course, American College of Surgeons.
2012-2017 - Certification in force by the Mexican Council of General Surgery, A.C.
2007 - Honorable Mention in Basic and Advanced Laparoscopy, School of Medicine of Tecnológico de Monterrey, Postgraduate Area.
2006-2007 - Chief Resident of the General Surgery Program, School of Medicine of Tecnológico de Monterrey.
2000 - Honorable Mention Medical Surgeon, School of Medicine of Tecnológico de Monterrey.Full Curriculum
Considered the "epidemic of the 21st century". It is defined as the increase in total body fat that results from an exaggerated intake of calories that exceeds the total amount of energy used.
According to the World Health Organization (WHO), in 2017, more than 2.3 billion adults were overweight and more than 700 million were overweight. Every year at least 2.8 million people die from obesity or overweight worldwide. In 2020 it is estimated that we will reach the figure of 2.4 billion adults who are overweight.
It is estimated that more than 400,000 people die prematurely each year in the United States due to diseases related to obesity. In regards to our country, 7 out of every 10 Mexicans suffer from overweight. On the other hand, around 30% of Mexicans suffer from obesity, which gives us the unprofitable first place in the world in this field.
In Mexico, the direct complications of obesity such as cardiovascular diseases (heart infarction) and type 2 diabetes mellitus represent the first and third causes of death in the adult population.
In order to classify a person as obese and classify it among its different grades, it is important to know the body mass index (BMI), a quotient that results from dividing the weight in Kg between the height in meters squared.
RISK OF OBESITY. - With a BMI greater than 30 the risk of the following conditions is increased: 55% in mortality, 70% in coronary artery disease (eg angina pectoris), 75% in acute myocardial infarction and 400% in type 2 diabetes mellitus.
DISEASES RELATED TO OBESITY. - Type 2 diabetes mellitus, hypertension, osteoarthropathies (joint damage), hyperlipidemias (high cholesterol and triglycerides), heart disease, gallstones (gallstones), gastroesophageal reflux, sleep apnea, asthma, infertility, urinary incontinence, some types of cancer (breast, uterus, colon).
PSYCHOLOGICAL PROBLEMS RELATED TO OBESITY. - Depression, low self-esteem, social isolation, discomfort in public, decreased sexual appetite.
BENEFITS OF OBESITY SURGERY. - Improve the general health of the patient, improve the quality of life, increase life expectancy, prevent and correct diseases, achieve greater self-esteem, provide a sense of well-being.
CANDIDATES FOR OBESITY SURGERY. - All patients with a BMI ≥ 40. Those patients with a BMI ≥ 35 + coexisting diseases (diabetes mellitus, hypertension, sleep apnea, joint damage, etc.)
What is digestive endoscopy and what is it done for? - Gastrointestinal endoscopy or gastroscopy is a medical test designed to detect problems in the upper digestive system, mainly the stomach, esophagus and duodenum (detect diseases such as helicobacter, gastric problems, etc ...). It is a fairly common test that helps diagnose and even treat digestive problems at the same time.
How is a digestive endoscopy done? - Digestive endoscopy is a test similar to colonoscopy, except that, in this case, the tube is inserted through the mouth and not through the anal canal.
Indeed, to perform gastroscopy the doctor introduces a flexible tube through the mouth, with the aim that the tube reaches the upper digestive system. This tube has a thickness of about one centimeter and a length of about one meter. In addition, it incorporates a micro-camera at the end that is inserted, with the aim of allowing the doctor to explore the interior of the patient. Also, this device called endoscope can also be coupled with other small work tools with which the doctor can perform another series of operations, such as the removal of polyps. It is a test usually done by the main doctor with the help of an assistant. First, they will open a way in the arm to administer to the patient some medication that makes them relaxed and drowsy during the test. It is likely that in many cases the patient does not remember anything.
The doctor will place a device in the mouth to prevent the patient from closing it during the process. An anesthetic spray will also be administered in the area of the mouth and throat, to minimize discomfort at the time of introducing the endoscope. The doctor will advance the endoscope little by little to the duodenum, asking the patient little by little to swallow, to facilitate the passage of the tube. It is advisable not to swallow unless the doctor asks for it. On the other hand, endoscopy is usually done lying on the left side of the body, but during the process it is likely that the doctor makes us change position but better explore some area.
Throughout the process, the doctor can see on a screen attached everything that is registering the endoscope. Also, you can also add other tools to the device, to perform biopsies or other tests or operations at the same time.
It is a test that lasts about 15-20 minutes, although it can be extended in case the doctor finds something suspicious or needs to perform some additional task.
It is also important to note that before performing a high digestive endoscopy it is necessary to be without eating the previous 6-8 hours so that there are no remains and the exploration is easier. If an emergency endoscopy is performed, it is likely that the doctor has to introduce a nasogastric tube before cleaning the stomach. Unlike colonoscopy, it is not necessary to perform a complete preparation and evacuation of the digestive system.
In addition, it should be noted that to carry out the test it is not necessary to take any medication.
What risks does a gastroscopy involve? - Many people are scared at the prospect of performing a high digestive endoscopy. However, there is nothing to worry about since it is a very usual and very safe test.
It is true that it is a medical test that can be somewhat uncomfortable and that we notice some discomfort or strange sensations. for example, swelling and tingling in the throat from the anesthetic spray. It can also happen that the person feels a sensation of suffocation when introducing the endoscope, but it is not common and is usually more caused by the nerves than by the test itself. During the examination, the patient may feel gas, abdominal pain or desire to vomit. Be careful with vomiting, as it could enter the respiratory tract and reach the lungs, causing pneumonia. Finally, endoscopy could also produce cardiac arrhythmias, but this is already a very remote possibility.