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Physiotherapy in abdominal surgery
A.THANGAMANI RAMALINGAM
PT, MSc (PSY), MIAP
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Other operations
Laryngectomy
Thyroidectomy
Prostatectomy
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Prostatectomy
Radical prostatectomy
Supra pubic approach
Trans urethral approach
Retro pubic approach
Perineal approach
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Pfannenstial incision
Foley’s indwelling supra pubic catheter acts as drain-10 days
A retro pubic drain also used for 2 days
An inverted u shaped incision for peri neal approach
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Complications
Excessive hemorrhage Impotence Incontinence Bladder neck contracture Infection Tear into the rectum Deep venous thrombosis (DVT) and pulmonary embolismOsteitis pubis
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Alternative Therapies
Cryosurgery of the prostate External radiation /Interstitial radiation Hormonal Therapy Orchiectomy Administration of female
hormone, diethylstilbestrol
LHRH analogs Androgen blockade
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Physiotherapy
A catheter is left in the urinary bladder to drain urine and may remain for as long as 3 weeks 3 - 7 days are spent in the hospital Blood thinners or calf compression devices/stockings are used to prevent clot forming until the patient is walkingNaso gastric tube for few daysPT as per protocol
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Laryngectomy
Complete Laryngectomy Partial Laryngectomies
Supraglottic laryngectomy
Vertical hemilaryngectomy
Carcinoma
supraglottic / subglottic / glottic
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Incisions
Sorenson’s incision
Gluck’s incision
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Naso gastric tube for few days
Drains may be removed on the 3rd or 4th day after surgery
Tracheotomy care
Speech Rehabilitation
Esophageal speech
Electro larynx.
Tracheo esophageal puncture (neoglottis formation)
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Complications
Cardiac arrest
Hemorrhage
Pulmonary embolism
Pulmonary pneumonia
Atelectasis
Fistula
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Thyroidectomy
Lobectomy and isthmusectomy
Bilateral subtotal thyroidectomy
Near total thyroidectomy
Total thyroidectomy
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Causes
Carcinoma
Large nodular thyroid compressing the airway
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Complications
Recurrent laryngeal nerve paralysis Bleeding
Hypoparathyroidism Infection
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Physiotherapy
Mostly 2nd day discharge
Encourage mobility
General PT