Clinic Dr. César Gálvez

Polimedica Building, 198 Rafael Buelna Av
Suites 818-819, 8th floor,
Hacienda Las Cruces. Mazatlán, Sinaloa. ZC 82126

Phone (669) 112 0846

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APPENDECTOMY

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.

GALLBLADDER

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.

ANTIREFLUX SURGERY

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.

INGUINAL HERNIA

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.

COLON

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.

SPLEEN

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 SURGERY

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.

MINI-LAPAROSCOPY

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.

GASTRIC BAND

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.

Advantages:

• Reversible.- can be removed when the patient so wishes.
• Adjustable.- the band can be "tightened" or "loosen" based on the weight loss.
• There is no need to cut or staple the stomach or intestines.
• Minimal invasion (no large injuries are made).
• Short in-hospital stay (≤ 24 hrs).
• Rapid recovery.- The oral route starts on the same day of surgery.
• Almost no risk of malnutrition.

GASTRECTOMY IN SLEEVE

Colloquially known as "gastric sleeve". Surgery in which the left side of the stomach is removed (about 70-80% of its surface). This results in a new stomach similar to a sleeve or tube. Like the gastric band, it induces weight loss under a restrictive mechanism, limiting the amount of food that is ingested. In addition, it eliminates the portion of the stomach that produces an appetite-regulating hormone, ghrelin, causing the patient to NOT desire to continue eating.

Advantages:

• No foreign body is implanted in the body.
• Does NOT require adjustments.
• Stapling or reconnecting the intestines is NOT required.
• Minimum invasion.
• Average intrahospital stay 2 days.
• Quick recovery.
• Low risk of malnutrition and ulceration.
• Technically safer and easier than a gastric bypass.

GASTRIC BYPASS

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.

Advantages:

• It can be carried out safely by laparoscopic or conventional (small wound).
• It has many variants, which will be used based on the therapeutic needs of patients.
• No foreign body is implanted in the body.
• There is no need for adjustments.
• It is the procedure with the best response from diseases related to obesity, such as hypertension and diabetes mellitus type 2, which improve clinically in more than 90% of patients.
• Average intrahospital stay 3 days.

GASTRIC PLICATION

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.

MINI GASTRIC BYPASS

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.

ANUS AND RECTUM DISEASES

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.

SOFT TISSUES AND SKIN TUMORS

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.

COMPLEX HERNIAS OF THE ABDOMINAL AREA

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.

THYROID AND NECK TUMORS

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.

MAMMARY GLAND TUMORS

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

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.