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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