Incision and Drainage of Abscess

Dr. Sean Yuan of Potts Surgical Associates in Pottstown, Pennsylvania offer his patients treatment for abscesses including incision and drainage.

What is an abscess?

An abscess is an area of inflammation surrounding a pocket of pus or debris that is irritating the surrounding tissue. Abscess are painful, swollen and warm to the touch, and can develop on any part of the body. They are most common in the armpits, genital and anal area, and the base of the spine. Abscesses are caused when bacteria get into a break in the skin and stimulate an inflammatory response from the body. As the inflammation puts pressure on the small wound, the middle of the abscess begins to liquefy the dead skin cells, bacteria, and other debris causing a buildup of pus.

How are abscesses treated?

Dr. Yuan can make an incision into the abscess, drain any pus, and clean the wound. He will use a local anesthetic to numb the area, making the procedure virtually painless. Before making an incision, Dr. Yuan will clean the area and cover it with an antiseptic solution. Once the abscess has been completely drained and cleaned, it is packed with sterile gauze to minimize any bleeding. Depending on the size of the abscess, the packing may need to be changed during the healing process. Dr. Yuan will provide specific instructions on aftercare to each patient.

When should I see a doctor about an abscess?

Most abscesses do not get better without medical care. They are more common in people who have a compromised immune system, the abscess forms because the body’s immune response isn’t strong enough to fight off the bacteria. However, if you have an abscess that is more than a centimeter across, or if you have a fever higher than 101F, or any red streaks leading away from the wound, you should seek medical care. If the abscess is in the genital or groin area, you should seek medical attention no matter the size. If your fever reaches higher than 102F, if you have other medical issues including needing chemotherapy or dialysis, if you have pain in your lymph nodes, or if the abscess is on your face, you should seek emergency care.

A person may tolerate the various lumps and bumps on their body until they become painful or affect their appearance. There are dozens of types of cysts that can form in the body. They can appear anywhere and the majority have no symptoms. A visit to a Pottstown, PA specialist will uncover the type of cyst involved and whether it is one that should be removed right away.

What is a Cyst and Why They Occur

Cysts are small sacs that contain liquid, gas or semi-solid material. They can be the result of an infection, illness, injury, or genetics. They can occur under the skin where they are easy to see or on the internal organs, where they remain undetected unless they develop symptoms. Most cysts are benign, meaning that they will likely cause no health problems. But a few can be malignant and pose a danger to one’s health, so these should be seen immediately to prevent any serious issues from developing. Dr. Sean Yuan can examine any cyst or mass to determine if it is a problem and should be removed.

A common cyst is a sebaceous cyst which appears as a swelling under the skin. It poses no health issues but may be a cosmetic concern for a person. They are filled with a yellowish fluid and, if they become large, can be painful to the touch.

Removing a Cyst

Cysts can be removed as an outpatient at the Bariatric Surgeon/Weightloss Surgery clinic by staff who specialize in dealing with cysts and other masses in the body. The two common ways that cysts are removed include:

Needle Aspiration

The doctor deadens the area and inserts a large needle attached to a syringe. The material in the cyst is pulled out of the sac into the syringe. The doctor will examine the material extracted to determine if there is any further health risk. They may send some of the material to a laboratory for a more detailed analysis.

Surgical Removal

The surgeon makes a small incision over the cyst and extracts the contents. If the material is contained in a sac, the entire sac is removed without disturbing the contents. The doctor will examine the sac and contents to determine if it may be malignant.

After the Cyst Removal

The doctor and staff will instruct the person on how to watch the area for signs of infection. They may prescribe antibiotics as a proactive measure, if the cyst was large or the extraction complicated. Needle aspirations and small incisions will heal without leaving a scar. Once removed, a cyst rarely recurs.

While the presence of a cyst or other small mass is likely nothing to become concerned about, all lumps on the body should be seen by a doctor. On a rare occasion, a benign lump can become something more dangerous, and the sooner it’s removed, the less health complications a person will have.

Dr. Sean Yuan provides diagnostic laparoscopy services for his patients from his practice, Potts Surgical Associates in Pottstown, Pennsylvania. This minimally invasive procedure allows him to see inside his patients’ bodies in more detail and less risk than traditional open surgeries.

What is laparoscopy?

Laparoscopy is a minimally invasive surgical technique where the surgeon inserts a laparoscope and specially designed surgical instruments into a patient’s body through small incisions. A laparoscope is a camera mounted on the end of a slim tube that is used to send images and video to a monitor for the doctor to look at organs and tissues as well as to watch any surgical procedures. Laparoscopy is a powerful diagnostic tool because of the clear visuals available to the surgeon throughout the procedure. It is a preferred diagnostic technique because the risks of traditional open surgery are significantly reduced and patients have quicker recovery with less scarring.

How is diagnostic laparoscopy used in bariatric surgery?

Laparoscopy is used by Dr. Yuan to diagnose medical issues and conditions. If a patient is experiencing abdominal pain, the doctor can determine the cause of the pain which could range from appendicitis, intra-abdominal scarring, abdominal bleeding, and in rare cases cancer. Similarly, if a patient has a lump in their abdomen, the doctor can use this procedure to see what is in more detail than an x-ray or other imaging tool could reveal. The doctor can also take biopsies during laparoscopy for further testing.

What happens during the procedure?

The patient will usually be sedated for the procedure. The abdomen will be prepared and the surgeon will make a couple of small incisions. He will then place cannulas, or small tubes into the incisions. The laparoscope and other instruments will be inserted through the cannulas into the body. The abdomen is inflated with air to create space for Dr. Yuan to see clear images. For diagnostics, the surgeon will look at the organs and tissues to determine what condition or issue is present. He may also take a biopsy, or tissue sample. When the diagnostic exploration is complete, the instruments and cannulas are removed and the small incisions stitched closed.

What are the benefits of diagnostic laparoscopy?

The patient benefits from this minimally invasive procedure in many ways. First, in most cases, he or she is able to go home on the same day. The incisions take less time to heal and are less painful than traditional surgeries, allowing the patient to return to normal activities in less time. Also, since the incisions are so small, there are fewer and smaller scars.

When an illness or disease affects the large intestine or colon, sometimes the best cure is to remove part of them. A colon resection is major surgery done in a Pottstown, PA, hospital and requires staying over for several days before being sent home. Once they have fully recovered, most people find that they can continue to live their lives normally after a colon resection. When a person’s doctor has recommended this procedure to cure an illness or disease, here is what they need to know.

Why Colon Resections Are Done

There are several reasons why this procedure is considered, such as:

  • Scar tissue in the colon creates a blockage
  • Cancerous cells have grown in the colon
  • An irritable bowel disease, such as diverticulitis, has set into the colon
  • persistent bleeding in the colon

These all leave the person with a dysfunctional colon which will plague them until a portion of it is removed.

Types of Colon Resection

The colon carries bodily waste from the intestine to the rectum and out of the body. How much of the colon is removed depends on where the illness or damage resides. The procedure may include:

  • Removing all of the colon and the rectum
  • Removing all of the colon but leaving the rectum intact
  • Removing only a portion of the colon

The surgery is done with the person under a general anesthetic by a specialist, such as Dr. Sean Yuan. The procedure may be done in one of two ways:

Laparoscopic Surgery

The diseased part of the colon is removed through a tube inserted into small incisions made in the person’s abdomen.

General Surgery

Large incisions in the abdomen are made so the surgeon can work directly with the diseased colon and rectum.
To allow the large intestine to continue doing its job of removing waste from the body, one of the following procedures are done:

The healthy portions of the colon are sewn back together so the waste leaves the body through the rectum.
An opening is made in the abdomen and the intestine is attached to this opening so the waste can be collected in a bag outside of the body.

The person must stay in the hospital under careful observation of the doctors and staff to make sure the remaining colon and large intestine are functioning properly.

Returning to Normal Daily Activities

The staff at a facility such as the Bariatric Surgeon/Weightloss Surgery center are available to address any concerns that a person has as they return to their normal daily activities. Most people who have had a colon resection can go back to work and continue such activities as playing sports, traveling, and working around the house and yard.

If the person had the colon resection to treat the presence of cancer or an irritable bowel syndrome (IBS), such as Crohn’s disease, they may need follow up treatment with their doctor.

Sometimes it is necessary to provide a person with an alternative way to get nutrition into their body. Whether it is a nutritional supplement or a full diet, a feeding tube placed directly into the stomach can help a person to receive the nutrition they need. A feeding tube placement is a common procedure, one that can be done in the office of a Pottstown, PA, doctor.

Why Feeding Tubes are Used

There are several reasons why a person may need a feeding tube:

  • Has difficulty swallowing
  • Can not eat or drink enough to sustain their body
  • Frequently chokes while they are eating
  • Had mouth or throat surgery and can’t use them to eat during recovery

The feeding tube gets around these problems because it bypasses the mouth and throat and goes directly into the stomach.

Feeding Tube Procedure

The procedure can easily be done in the Bariatric Surgeon/Weightloss Surgery clinic with the person going home shortly after the feeding tube insertion. The doctor will numb the person’s mouth and throat, and may offer a mild sedative for comfort. A small tube with a camera on the end is then slowly inserted down into the person’s stomach through their mouth and throat.

A small incision is made in the abdomen through which the feeding tube is inserted into the stomach. The feeding tube may have a balloon at the tip which inflates to prevent the tube from being pulled out of the stomach. The doctor then stitches the incision closed around the feeding tube.

The incision in the abdomen will heal in a few days. Any discomfort can be treated by over-the-counter pain medication. There may be a slight discomfort in the mouth and throat for a few hours where the tube with the camera was passed down into the stomach.

Caring for the Feeding Tube at Home

Specialists, such as Dr. Sean Yuan, have years of experience with feeding tubes and will instruct the family on how to care for it so the person will have no complications. Some of these instructions will include:

  • Using the tube properly to provide food and water to the person
  • Caring for the skin around the feeding tube
  • Spotting signs of infection
  • Dealing with a feeding tube that is leaking
  • How to handle a tube that has been pulled out
  • How to use the tube to empty the stomach

Protecting the feeding tube during normal daily activities

If there are any questions regarding the use or care of the feeding tube, the clinic and staff are available to help. They understand the concerns that family members and caregivers have about feeding tubes, so the staff want to make this experience as easy as possible for everyone involved.

Hernias are common medical conditions in the United States with approximately 600,000 hernia repair operations performed each year. Dr. Sean Yuan offers expert hernia repair services from his practice, Potts Surgical Associates, located in Pottstown, Pennsylvania.

What is a hernia?

A hernia occurs when there is an opening in a person’s abdominal wall that occurs when the muscle has weakened. This weak spot or hole allows interior tissue or organ, such as the intestine, to bulge through the space, resulting in a small sac. This condition is painful and could result in serious medical issues requiring emergency care. Hernias can be congenital, meaning you are born with it, or they can develop over time. Hernias develop following heavy strain on the abdominal wall from heavy lifting, constipation, or even coughing too much or too hard. Once a hernia appears, it will need medical attention. They do not get better or go away on their own.

How are hernias repaired?

While some hernias require traditional open surgeries, Dr. Yuan tries to perform laparoscopic hernia repairs whenever possible. Laparoscopic procedures allow the doctor to access the hernia and place a biocompatible mesh support onto the weakened or torn area through small incisions with specially designed instruments. The mesh acts like a scaffold in the body and supports the abdominal muscles. Laparoscopic surgeries are preferred because they present less risk than traditional open surgeries and patients have faster and easier recoveries.

What happens after surgery?

After the hernia repair is complete, you will spend a few hours in recovery until the sedation wears off completely. Once you are awake and able to drink liquids, urinate, pass wind, and walk, you will be able to go home. Most patients experience some soreness after surgery, but it can typically be managed with over the counter pain medication. You should be able to move around without assistance within 24 hours of the procedure and return to normal activities within a week. Dr. Yuan will recommend that you avoid strenuous activity or heavy lifting for a few weeks. You will have a follow-up appointment approximately two weeks after the surgery to confirm success and check in on your health.

Hiatal Hernia: What is going on in the body?

Separating the abdomen and chest cavity is a wall of muscle known as the diaphragm. The hiatus is an opening in the diaphragm through which the esophagus passes to connect to the stomach. Oftentimes, a hiatal hernia exists and there are no clear cut symptoms. It is important to know what to look out for in case the hiatal hernia becomes cut-off from its blood supply and is essentially strangled.

Is there one particular cause of hiatal hernias? Some hiatal hernias are caused by injury to the area. Speculation also exists that there are just some people born with a larger hiatus. Pregnancy and obesity are also known to contribute to pressures in the abdomen which cause hiatal hernia. Occasionally, straining to have a bowel movement or coughing can result in similar pressures. The good news is that regardless of exact cause, Dr. Sean Yuan in Pottstown, PA works with his patients to find solutions.

Risk Factors, Signs, and Surgery

While anyone can get a hiatal hernia, there are a few factors that put people at risk. Women affected tend to outnumber men, but those over 50 are also more prone to hiatal hernias. One additional risk factor individuals actually have the ability to change is obesity. Dr. Yuan may use endoscopy or a specialized x-ray with a barium swallow to see whether surgery is necessary.

There are signs and symptoms to be aware of that may indicate it is time for surgery. If heartburn is a persistent problem and is accompanied by chest or abdominal pain, it is time to visit the doctor. Even excessive belching or difficulty swallowing warrant a check-up. Of course, blood in vomit or black stools can mean there is gastrointestinal bleeding. If unsure, the dedicated staff at Potts Surgical Associates will provide guidance.

Minimally Invasive Laparoscopic Surgery

The laparoscope is a device used to transmit pictures of internal organs to a monitor. It is inserted through small incisions (5-10mm) to provide access to the affected area. Surgical instruments are also inserted through the incisions. This surgical method has many advantages, of which rapid recovery is on top of the list. Smaller incisions help decrease risk of infection and result in less pain and scarring.

How quick is recovery?

Generally speaking, patients are up and about within a day. It takes about a week to be ready for normal activities, but there are often no dietary restrictions. It only takes about two to three weeks to recover fully. Patients should avoid hard labor and heavy lifting for approximately three months to minimize risk of reoccurrence.

Because Dr. Yuan is a Bariatric Surgeon who specializes in weight loss management, he is well versed in correcting hiatal hernias. Weight is the only risk factor of the three that patients can change with guidance and support. Dr. Yuan sees patients through many hurdles, like hiatal hernias, that accompany extra weight. His goal is to help people reach a new version of healthy.

Cholecystectomy is another term for gall bladder surgery. A person with sudden, sharp pain in the back may not be dealing with simple back pain, but a problem with their gall bladder. This can become a serious health issue if it is the gall bladder and it’s infected or full of gall stones. Any pain in the upper right abdomen, back or right shoulder should be seen by a Pottstown, PA, doctor to rule out the possibility of a gall bladder issue.

Why Gall Bladder Problems Happen

The gall bladder is a tiny organ which stores bile produce by the liver. Bile is used in the digestion of fat. Tiny mineral deposits, called gallstones, can collect in the gall bladder. These stones don’t pose a problem until they become lodged in the tiny ducts which carry the bile to the intestines.

The blockage of these ducts causes sharp pains whenever the gall bladder tries to push bile into the intestines. The stones irritate the gall bladder and ducts, and can cause a painful infection.

Treating a Painful Gall Bladder

Infected gall bladders are surgically removed, called a cholecystectomy. Surgeons, such as Dr. Sean Yuan, use various techniques for removing this organ:

Laparoscopic Surgery

This is the preferred method for gall bladder removal because it is the least invasive. The person can have this procedure done at the Bariatric Surgeon/Weightloss Surgery clinic and go home shortly after the procedure. A small incision is made in the navel and a tube is inserted through which the doctor removes the gall bladder.

General Surgery

In a few cases, laparoscopic surgery cannot be used and a large incision must be made through which the gall bladder is removed. This requires staying in the hospital for a few days following the surgery.

After the Surgery

A person can live well without their gall bladder. The liver will continue to produce bile, but the mechanism will be less effective at digesting fat. One will need to watch their fat intake to avoid diarrhea and other uncomfortable digestion issues.

Failure to Treat a Gall Bladder Infection

If allowed to continue, the gall bladder will become more inflamed and painful. The person will have difficult eating without a painful flare up. In advanced cases, the gall bladder can rupture, releasing the infected contents into the abdomen, creating an emergency situation.

Pain associated with gall stones should not be ignored. The person may pass the stones out of their body, but if the gall bladder is infected, the pain will continue. Persistent pain in the abdomen should not be ignored to prevent serious health issues.

Dr. Sean Yuan provides appendectomy procedures to patients from in and around Pottstown, Pennsylvania from his practice, Pottstown Surgical Associates.

What is an appendectomy?

An appendectomy is the surgical removal of a person’s appendix. This procedure is completed when a patient’s appendix is infected and at risk of bursting and releasing bacteria and stool into the abdomen.

What does the appendix do?

For years it was believed that the appendix is an organ with little importance to a person’s health and wellbeing. While a body can function without an appendix, the seemingly insignificant organ helps to regulate or ‘reboot’ the bacteria levels in a person’s digestive system. For example, when a person suffers from an illness that causes evacuation of the bowel and intestine, like gastroenteritis, or less commonly cholera or dysentery, the good bacteria is flushed out with the bad. The appendix is believed to help the body regrow the good bacteria and support the immune system.

What happens during an appendectomy?

In most cases, an appendectomy is completed laparoscopically. This means that the surgeon makes small incisions in the patient’s abdomen and inserts specially designed instruments through those cuts to remove the appendix. One of the instruments used is a laparoscope, which is a small camera mounted on the end of the tube. This camera provides a live video feed from inside the body, allowing Dr. Yuan to see the organs and monitor the procedure without having to make a large incision in the body.

What happens after surgery?

When an appendectomy is laparoscopic, the patient typically goes home within a day or so of the procedure, unless there are complications. Laparoscopic appendectomies are minimally invasive, so recovery is often quicker with less chance of complications than a traditional open surgery. Patients will typically be back to normal activities within a week, although strenuous activity is discouraged until after the patient has a follow-up appointment with the surgeon to check the success of the procedure. Dr. Yuan will provide specific aftercare instructions to each patient, depending on his or her specific needs and condition.

For the millions of Americans who are obese or morbidly obese, weight loss surgery can be life-changing. At Potts Surgical Associates, we have seen first-hand how powerful the effects of weight loss surgery can be on a person’s confidence, health, and quality of life. Though weight loss surgery has been around for a long time, technology has evolved and improved dramatically in recent years. Today, there are more options for surgery-assisted weight loss than ever before. Examples include:
Gastric bypass
Gastric sleeve
Gastric band
• Gastric balloon

Though each of these weight loss solutions works in its own way, they all help to produce a sensation of fullness very quickly after eating begins. The first three make surgical changes to both your stomach and digestive system to restrict the amount of food you can consume. Over time, this leads to weight loss. The gastric balloon is similar, but the changes are not permanent. Instead, a balloon is inserted and inflated within the stomach to provide a sensation of fullness. It will remain there for several weeks or months before being removed.

Is Weight Loss Surgery Right for You?

Only you and your physician can determine if weight loss surgery is a potential step toward meeting your weight loss goals. However, you may be a good candidate for weight loss surgery if you have a body mass index of over 35, suffer from a weight-related healthy problem, and have been unsuccessful in your attempts to lose weight using diet and exercise. If you meet preliminary requirements, you may still need to undergo a comprehensive screening to ensure you are ready for surgery based on your health, motivation, psychological status, and more.

Keep in mind that weight loss surgery is not intended to be a quick fix for obesity. It can, however, provide a starting point from which to build a new foundation for a healthy future. The success of your own weight loss surgery will depend on your ability and commitment to make permanent changes in your diet and lifestyle.

Come and join Dr. Yuan for an informational seminar in Pottstown, Collegeville, and Phoenixville.

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