Everything About Robotic Knee Replacement
A robotic knee replacement is similar to a standard knee replacement in that it replaces the knee joint. Damaged tissue in your knee is removed and replaced with an artificial joint by your surgeon. The only difference is that it’s made with the help of a robotic arm.
Everything About Robotic Total Knee Replacement and its Treatment
A robotic knee replacement is similar to a standard knee replacement in that it replaces the knee joint. Damaged tissue in your knee is removed and replaced with an artificial joint by your surgeon. The only difference is that it's made with the help of a robotic arm.
What is Piles?
Hemorrhoids or piles are a pretty common anorectal condition, The anal area has collections of veins and tissues called piles that can swell and itch. Inside the rectum or surrounding the anal skin, piles can form. Both women and men frequently have piles. According to international medical data, one in four adults experiences hemorrhoids or piles at some point in their lives. Although they can affect persons of all ages, haemorrhoids are most common in people between the ages of 50 and 60. To yet, no medical professional has been able to pinpoint the precise source of piles. However, a number of risk factors have been found to dramatically raise a person’s likelihood of getting piles. At first, piles can be somewhat controlled with home remedies, but when they worsen or progress, medical assistance is urgently require
What is Piles?
Hemorrhoids or piles are a pretty common anorectal condition, The anal area has collections of veins and tissues called piles that can swell and itch. Inside the rectum or surrounding the anal skin, piles can form. Both women and men frequently have piles. According to international medical data, one in four adults experiences hemorrhoids or piles at some point in their lives. Although they can affect persons of all ages, haemorrhoids are most common in people between the ages of 50 and 60. To yet, no medical professional has been able to pinpoint the precise source of piles. However, a number of risk factors have been found to dramatically raise a person’s likelihood of getting piles. At first, piles can be somewhat controlled with home remedies, but when they worsen or progress, medical assistance is urgently require
How do piles form?
Constant pressure in the lower rectum is the main reason of piles. Due to factors like lifting heavy weights, constipation, or continual pressure in the area around the anus and rectum, the blood vessels in that area swell and bulge, which results in piles. The veins may often become larger and engorged with more blood than usual as a result of continual stress. One or more piles may form from these veins.
How do piles form?
Constant pressure in the lower rectum is the main reason of piles. Due to factors like lifting heavy weights, constipation, or continual pressure in the area around the anus and rectum, the blood vessels in that area swell and bulge, which results in piles. The veins may often become larger and engorged with more blood than usual as a result of continual stress. One or more piles may form from these veins.
Recovery Rate
The duration of recovery post surgery varies from person to person. Everybody has a different capacity for healing, so everyone's recovery time following hemorrhoid surgery is unique. Most of the time, recovery from open surgery or any other type of invasive haemorrhoid surgery takes two to three months, whereas full recovery from laser surgery takes 1month to 45 days.
Recovery Rate
The duration of recovery post surgery varies from person to person. Everybody has a different capacity for healing, so everyone's recovery time following hemorrhoid surgery is unique. Most of the time, recovery from open surgery or any other type of invasive haemorrhoid surgery takes two to three months, whereas full recovery from laser surgery takes 1month to 45 days.
Causes
- Lifting heavyweights
- Obesity
- Pregnancy
- Constipation
- Chronic diarrhoea
Symptoms
- There is discomfort and anal pain while sitting.
- Blood in the stool
- Pain when passing a stool
- swelling , redness, and redness near the anus
- Even after passing a stool, having an unclear bowel feeling
Causes
- Lifting heavyweights
- Obesity
- Pregnancy
- Constipation
- Chronic diarrhoea
Symptoms
- There is discomfort and anal pain while sitting.
- Blood in the stool
- Pain when passing a stool
- swelling , redness, and redness near the anus
- Even after passing a stool, having an unclear bowel feeling
Diagnosis
Test
Self Diagnosis
Diagnosis by Doctor
Test
The anorectal specialist will be able to identify external haemorrhoids based solely on a physical examination. The doctor may inspect your rectum and anal canal if the piles are internal. The following two procedures are frequently used to identify haemorrhoids:
Digital examination – A gloved, lubricated finger is inserted into the rectum during a digital examination to look for any abnormal growths.
Visual inspection – since internal piles are too soft to be touched, thus the piles specialist may do a proctoscopy, sigmoidoscopy, or anoscope to visually investigate the lower rectum. The doctor will thoroughly inspect the lining of your anal tissues using one of these tools to determine the severity and progression of your piles.
Self Diagnosis
The most obvious sign of piles is a lump around your anus. Even after passing a stool, a person who has piles may feel as though their bowels are still empty. Another approach to self-diagnose piles is that the colour of the stool may vary noticeably in the presence of piles. The colour of the stool may become obviously red or turn bright red if you acquire the issue. Around the anal region, you could suffer itching, discomfort, and redness. In addition, you might notice blood in your stool or experience extreme pain while going to the bathroom.
Diagnosis by Doctor
To identify your piles, the doctor could also perform a digital rectal examination. To check for any gastrointestinal diseases, the haemorrhoids expert may also recommend tests including sigmoidoscopy, colonoscopy, and anoscopy. The doctor inserts a tiny camera during each of these exams to look for any anus, rectum, or colon anomalies. If the doctor concludes that you have early-stage piles, he or she may suggest making certain diet and lifestyle modifications. However, if your diagnosis reveals the severity of your issue, surgery for piles may be advised.
Diagnosis
Test
Self Diagnosis
Diagnosis by Doctor
Test
The anorectal specialist will be able to identify external haemorrhoids based solely on a physical examination. The doctor may inspect your rectum and anal canal if the piles are internal. The following two procedures are frequently used to identify haemorrhoids:
Digital examination – A gloved, lubricated finger is inserted into the rectum during a digital examination to look for any abnormal growths.
Visual inspection – since internal piles are too soft to be touched, thus the piles specialist may do a proctoscopy, sigmoidoscopy, or anoscope to visually investigate the lower rectum. The doctor will thoroughly inspect the lining of your anal tissues using one of these tools to determine the severity and progression of your piles.
Self Diagnosis
The most obvious sign of piles is a lump around your anus. Even after passing a stool, a person who has piles may feel as though their bowels are still empty. Another approach to self-diagnose piles is that the colour of the stool may vary noticeably in the presence of piles. The colour of the stool may become obviously red or turn bright red if you acquire the issue. Around the anal region, you could suffer itching, discomfort, and redness. In addition, you might notice blood in your stool or experience extreme pain while going to the bathroom.
Diagnosis by Doctor
To identify your piles, the doctor could also perform a digital rectal examination. To check for any gastrointestinal diseases, the haemorrhoids expert may also recommend tests including sigmoidoscopy, colonoscopy, and anoscopy. The doctor inserts a tiny camera during each of these exams to look for any anus, rectum, or colon anomalies. If the doctor concludes that you have early-stage piles, he or she may suggest making certain diet and lifestyle modifications. However, if your diagnosis reveals the severity of your issue, surgery for piles may be advised.
Risks & Complications
During the surgery
If left untreated
During the surgery
Hence, the probability of any problems is low. The severity of the condition and the surgeon’s experience play a major role in the success or risks of treating piles, just like with any other surgical procedure. Rarely, a patient may experience any of the following issues following a haemorrhoids surgery:
Bleeding – Open surgery for haemorrhoids increases the risk of bleeding during the procedure.
If the surgeon is inexperienced enough to execute a precise removal of the inflammatory tissues, the patient can experience bleeding. At any point throughout the procedure for piles, infections could surface.
Infection – Infections can appear at any stage of the haemorrhoids surgery. The likelihood of success is better with rubber band ligation therapy for haemorrhoids.
Reaction to anaesthesia – Many patients list anaesthetic adverse effects. The patient may feel sleepy and queasy for longer than normal as a result of the reaction.
Rectal prolapse – Hemorrhoidectomy or hemorrhoid surgery has been linked to a long-term risk of rectal prolapse, according to a research on ScienceDirect that cites 12 random randomised trials.
If left untreated
The most common issue with piles is that, if ignored for a long time, they can become strangulated. The tissues in piles that get strangulated lose their blood supply. Because of this, venous thrombosis inside the piles may occur. This could result in excruciating discomfort and perhaps make the treatment difficult. When piles are strangulated, the victim may feel agonizing pain for 48–72 hours before it gradually goes away after about a week.
Anemia is a serious concern that a person who neglects to treat haemorrhoids may have. When they become large, piles can result in both stool and blood loss. The frequent blood loss could lead to anaemia, which could lead to a number of other health issues if the issue is not addressed quickly.
Risks & Complications
During the surgery
If left untreated
During the surgery
Hence, the probability of any problems is low. The severity of the condition and the surgeon’s experience play a major role in the success or risks of treating piles, just like with any other surgical procedure. Rarely, a patient may experience any of the following issues following a haemorrhoids surgery:
Bleeding – Open surgery for haemorrhoids increases the risk of bleeding during the procedure.
If the surgeon is inexperienced enough to execute a precise removal of the inflammatory tissues, the patient can experience bleeding. At any point throughout the procedure for piles, infections could surface.
Infection – Infections can appear at any stage of the haemorrhoids surgery. The likelihood of success is better with rubber band ligation therapy for haemorrhoids.
Reaction to anaesthesia – Many patients list anaesthetic adverse effects. The patient may feel sleepy and queasy for longer than normal as a result of the reaction.
Rectal prolapse – Hemorrhoidectomy or hemorrhoid surgery has been linked to a long-term risk of rectal prolapse, according to a research on ScienceDirect that cites 12 random randomised trials.
If left untreated
The most common issue with piles is that, if ignored for a long time, they can become strangulated. The tissues in piles that get strangulated lose their blood supply. Because of this, venous thrombosis inside the piles may occur. This could result in excruciating discomfort and perhaps make the treatment difficult. When piles are strangulated, the victim may feel agonizing pain for 48–72 hours before it gradually goes away after about a week.
Anemia is a serious concern that a person who neglects to treat haemorrhoids may have. When they become large, piles can result in both stool and blood loss. The frequent blood loss could lead to anaemia, which could lead to a number of other health issues if the issue is not addressed quickly.
When to consult a doctor ?
It is essential to understand when to seek medical care for any health issue, and piles are no exception. Receiving hospital treatment when necessary can help you avoid unnecessary complications. It's time to consult an anorectal surgeon if you have any of the following issues or ailments.
You have excruciating pain and discomfort in your rectum and anal area.
The stool that you pass is tar-like in color, maroon, or dark red. This can be a sign of internal bleeding.
No amount of prescription medications or home treatments will be able to relieve your discomfort.
If you experience weakness and dizziness as a result of ongoing blood loss through your stool.
Every time you have a bowel movement, there is blood on the toilet paper.
Our Specialist
***
When to consult a doctor ?
It is essential to understand when to seek medical care for any health issue, and piles are no exception. Receiving hospital treatment when necessary can help you avoid unnecessary complications. It's time to consult an anorectal surgeon if you have any of the following issues or ailments.
You have excruciating pain and discomfort in your rectum and anal area.
The stool that you pass is tar-like in color, maroon, or dark red. This can be a sign of internal bleeding.
No amount of prescription medications or home treatments will be able to relieve your discomfort.
If you experience weakness and dizziness as a result of ongoing blood loss through your stool.
Every time you have a bowel movement, there is blood on the toilet paper.
Our Specialist
***
Insurance coverage
Insurance does cover the cost of the surgical procedure for a hysterectomy performed due to adenomyosis because it is on the list of procedures that are "medically required." The cost capping, however, may change from instance to case. Please get your healthcare or insurance company to validate this.
Insurance coverage
Insurance does cover the cost of the surgical procedure for a hysterectomy performed due to adenomyosis because it is on the list of procedures that are "medically required." The cost capping, however, may change from instance to case. Please get your healthcare or insurance company to validate this.
Frequently Asked Questions
Frequently Asked Questions
Facts and figures around robotic hip replacement
Why choose Aasra for robotic knee replacement treatment?
AASRA Hospital has the state of the art technology for performing joint replacement surgeries i,e MAKO Robitic joint replacement technology.
There is less post operative pain, reduced hospital stay ,patient can walk early and early recovery .
How to book appointment for aasra
Booking an appointment with a Aasra Orthopedician is easy.
Simply give us a call directly or complete our online appointment booking form. The only four questions it would ask you are “Your name,” “Contact,” and “tell us a little more about yourself.” Simply complete the form and press “submit.” One of our medical coordinators will give you a call soon to assist you in speaking with the doctor of your choice.
Facts and figures around robotic hip replacement
Why choose Aasra for robotic hip replacement treatment?
AASRA Hospital has the state of the art technology for performing joint replacement surgeries i,e MAKO Robitic joint replacement technology.
There is less post operative pain, reduced hospital stay ,patient can walk early and early recovery .
How to book an appointment for aasra?
Booking an appointment with a Aasra Orthopedician is easy.
Simply give us a call directly or complete our online appointment booking form. The only four questions it would ask you are “Your name,” “Contact,” and “tell us a little more about yourself.” Simply complete the form and press “submit.” One of our medical coordinators will give you a call soon to assist you in speaking with the doctor of your choice.
Severity
Grade I
Grade II
Grade III
Grade IV
Grade I
The hemorrhoids are generally in minor inflammations and are found outside the anal lining. They are not visible to naked eyes.
Grade II
They remain outside the anus. While passing stool, they may get pushed out of the anus and return without much ado.
Grade III
These haemorrhoids are prolapsed and appear outside the anus. They hang out of the rectum but can also be re-inserted easily.
Grade IV
They remain outside the anus and cannot be pushed back easily. They are the most painful in nature.
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How to prevent piles?
Myths and facts about piles
Famous People With Hemorrhoids
How to recover after piles surgery?
How to prevent piles?
In the words of Steven Kussin, a gastroenterologist based in New York, “hemorrhoids are normal features of anatomy. We all have them.” Though people find it extremely discomforting to talk about piles, they are very common and can happen to anyone. There are no definite ways that can help prevent hemorrhoids , but the condition can definitely be managed. Adopting the following can surely go a long way in helping you prevent the painful anal disorder at bay.
- Swear by fiber in your diet
Piles or hemorrhoids is most common in people who do not consume enough fiber in their regular diet. To prevent piles, one of the best and natural ways is to stock up your diet with fiber-rich food. If you wish to keep piles at bay, it is crucial to eat at least 25-30 grams of fiber per day.
- Whole grains, oatmeal, and brown rice
- Beans and lentils
- Vegetable and Brussel sprouts
- Fruits such as pears bananas, berries, bananas, and apples
- Drink sufficient water
Water along with a fiber-rich diet is very important for the prevention of hemorrhoids . Drinking sufficient water prevents constipation which in turn decreases the need to strain while passing a bowel movement. If you want manage your current condition of piles from becoming worse or prevent piles , add 6-8 glasses of water to your system. It will aid your digestive system function properly.
- Don’t hold the urge to pass stool
Do not hesitate to use the restroom if you feel the need.. Going to the toilet when the system calls is actually a very simple way to prevent hemorrhoids Ignoring nature’s cries might lead to complexities and consequences of its own. Go, don’t hold when your body signals that you must use the restroom and sit on the toilet seat. Preventing piles from getting worse is lot easier and simpler when you pay attention to your body’s signals.
- Stop sitting on the toilet seat for too long
Don’t spend a lot of time on the toilet seat reading a book or scrolling through your phone. You are more likely to strain and have worse bowel motions the longer you sit on the toilet seat. The anus blood vessels directly experience pressure and tension from the position of sitting on the toilet seat, which causes them to protrude.
- Stay physically active
piles have a direct relation with physical activities and how you keep your body active. Staying physically active keeps the colon functions and active in a regular manner. Having said that, you should be aware of which forms of exercise are healthy for you and which are not. Avoid engaging in any activity that strains or presses on your abdomen region. Do not lift weights. Do not sit in one place for long time. Moderate exercises like yoga, swimming , walking , and jogging can help the piles tissues from flaring.
Myths and facts about piles
Myth 1: Spicy foods cause piles.
Fact: piles are caused by strain on the veins near the anus. The straining might be caused due to hard stool or constipation or by spending more time on the toilet seat. Spicy foods have no direct correlation with piles. But since spicy foods might be hard on the digestive system, people might need to exert more pressure while passing the bowel after having any spicy food.
Myth 2: piles generally happen to old people.
Fact: Age is not a factor for this disease. Yes, it is common in older people as the tissues get weaker but it can happen to anyone who has strains during a bowel movement or chronic constipation.
Myth 3: piles can cause cancer.
Fact: There is no such study or evidence that says piles cause cancer. But you must visit a doctor if there is rectal bleeding as both colon cancer and hemorrhoids have the same symptoms.
Myth 4: All kinds and sizes of piles need surgical intervention.
Fact: No, not all pilesneed surgery as treatment. Hemorrhoids which are at an early stage, i.e, Grade 01 and Grade 02 piles can be easily managed with medication and regular home remedies. piles that get bigger in size, protrude out of the anal opening, and cannot be pushed back even after trying hard may need to be surgically removed since medicine and home remedies won’t be effective in such cases.
Myth 5: piles is recurrent
Fact: piles is not recurrent if you undergo the best treatment. With a success rate as high as 98%, laser surgery is considered to be the most effective treatment for piles. If you undergo laser piles removal, there are almost no chances that your piles will appear again. It is the best , most effective, and considered to be the only permanent treatment for piles.
Famous People With Hemorrhoids
While you may think that you are the only one suffering from the dreadful symptoms of piles , the reality is not so. There are many celebrities and well-known public figures who have suffered from this disease. If everyone was honest and open about their condition of piles, the list would have been much longer. Here are the names of a few famous people who have suffered from piles:
George Clooney
Famous actor, screenwriter , director, and producer, George Clooney was diagnosed with piles and he had a hard time hiding his disease condition from the public. Although he never went on to comment on it in public, the news was almost all over the media.
Marilyn Monroe
Not many people are aware of the fact that Marilyn Monroe, who is known for eternal beauty, suffered from insomnia and hemorrhoids. Like other celebrity, she tried hard to keep it a secret but the fact could not be kept hidden for long.
Ernest Hemingway
American novelist Ernest Hemingway was once diagnosed with piles. Along with piles, he was also diagnosed with several other health conditions including torn groin muscle, anthrax infection, kidney trouble etc.
Elizabeth Taylor
Famous British-American actress Elizabeth Taylor suffered from persistent piles. Although she never went to speak about it in open, the fact could not be kept under wraps for too long.
How to recover after piles surgery?
The recovery route after piles surgery is usually simple with no major complications. If you diligently follow the doctor’s recommendations and tips, you will not experience any complications.
- Avoid lifting heavyweights.
- Eat a high-fibre diet.
- Do not strain while passing a stool.
- Use a stool softener that can aid you in having smooth bowel movements.
- Stay hydrated. Drink at least 8-10 glasses of water every day.
Questions to ask your doctor.
FAQ
Irrespective of age and gender, any individual can suffer from hemorrhoids. Globally, over half the population suffers from piles by the time they turn 50. Hemorhhoids can equally affect both men and women. But the risk is a bit greater in the case of pregnant women and people over 3 years who do not follow healthy dietary and lifestyle habits.
Piles is a condition in which the anal tissues get swollen and inflamed and often protrudes out of the anal opening. An anal fissure is a tear that is caused by long periods of hard stool or diarrhea. Both the conditions are associated with common symptoms such as rectal bleeding, anal itching, and painful bowel movements. It can often be confusing to distinguish between the two. The best way to understand whether the condition is piles or fissures, the best way is to consult with an anorectal expert and get a detailed consultation to rule out potential complications.
Hemorrhoids generally do not increase the risk of anorectal cancer in any person. However, there are cases where people with piles have developed anorectal cancer. According to medical research, 2.3 percent of patients suffering from severe hemorrhoids have developed colorectal piles. But since there are symptoms that can be common in the case of both conditions, it is important to determine whether there is the presence of any cancerous tissues.
Home remedies can only manage the symptoms of piles from getting worse but not provide permanent relief to the condition. At-home remedies like topical ointments, sitz baths provide temporary relief from painful piles symptoms rather than fixing the cause of the disease. The only effective permanent treatment for piles is the surgical removal of the hemorrhoid itself.
If you are suffering from piles or any anorectal disease, you can first consult with a general physician. If the general physician finds any major problem in your health condition, the doctor is likely to refer you to an anorectal expert. In that case, you can consult with an experienced and trained colorectal surgeon, proctologist, and anorectal surgeon.
Facts and figures around Piles
- Approximately 40,723,288 people in India are reported to have piles.
- Annually, one million new cases of haemorrhoids are reported in India
- Most people with piles in India are between the age groups of 45-65 years.
- Anyone can develop piles regardless of age, race sex[gender] , immune system, body stature, and overall health condition.
- It is estimated that 50-85% of people around the world are suffering from hemorrhoids.
- A study found that the incidence of constipation and piles is much more common in Arab countries
Why Choose Aasra Care for Piles Surgery?
- Aasra Care is a certified Centre of Excellence for anorectal treatments including diseases like piles, anal fissure, and anal fistula.
- Aasra Care houses some of the top anorectal surgeons of the country who have years of experience in delivering surgical treatment for colorectal diseases with a high success rate.
- Aasra Care is associated with some of the top hospitals across India that are equipped with state-of-the-art facilities required to perform advanced anorectal surgeries.
- Proctologists/ General Surgeons working with Aasra Care do a thorough consultation in the case of every patient to understand the health condition and then determine the treatment method that will work best.
- A dedicated ‘care buddy’ is assigned to every patient on the day of the surgery. We work hard to ensure that every aspect of the surgical procedure for our patients goes smoothly. Your specialised medical assistant, often known as a “care buddy,” will handle all paperwork and formalities on your behalf once you arrive at the hospital.
- To make the commute easier for our patients, we also offer complimentary taxi services to take you from your house to the hospital and assist you in getting back home after the procedure.
- Within the first week following surgery, patients receive a complimentary follow-up visit.
FAQ
Irrespective of age and gender, any individual can suffer from hemorrhoids. Globally, over half the population suffers from piles by the time they turn 50. Hemorhhoids can equally affect both men and women. But the risk is a bit greater in the case of pregnant women and people over 3 years who do not follow healthy dietary and lifestyle habits.
Piles is a condition in which the anal tissues get swollen and inflamed and often protrudes out of the anal opening. An anal fissure is a tear that is caused by long periods of hard stool or diarrhea. Both the conditions are associated with common symptoms such as rectal bleeding, anal itching, and painful bowel movements. It can often be confusing to distinguish between the two. The best way to understand whether the condition is piles or fissures, the best way is to consult with an anorectal expert and get a detailed consultation to rule out potential complications.
Hemorrhoids generally do not increase the risk of anorectal cancer in any person. However, there are cases where people with piles have developed anorectal cancer. According to medical research, 2.3 percent of patients suffering from severe hemorrhoids have developed colorectal piles. But since there are symptoms that can be common in the case of both conditions, it is important to determine whether there is the presence of any cancerous tissues.
Home remedies can only manage the symptoms of piles from getting worse but not provide permanent relief to the condition. At-home remedies like topical ointments, sitz baths provide temporary relief from painful piles symptoms rather than fixing the cause of the disease. The only effective permanent treatment for piles is the surgical removal of the hemorrhoid itself.
If you are suffering from piles or any anorectal disease, you can first consult with a general physician. If the general physician finds any major problem in your health condition, the doctor is likely to refer you to an anorectal expert. In that case, you can consult with an experienced and trained colorectal surgeon, proctologist, and anorectal surgeon.
Facts and figures around Piles
- Approximately 40,723,288 people in India are reported to have hemorrhoids.
- Annually, 1 million new cases of piles are reported in India
- Most people with piles in India are between the age groups of 45-65 years.
- Anyone can develop hemorrhoids regardless of age, sex [gender], race, body stature, immune system, and overall health condition.
- It is estimated that 50-85% of people around the world are suffering from hemorrhoids.
- A study found that the incidence of constipation and piles is much more common in Arab countries
Why Choose Aasra Care for Piles Surgery?
- Aasra Care is a certified Centre of Excellence for anorectal treatments including diseases like piles, anal fissure, and anal fistula.
- Aasra Care houses some of the top anorectal surgeons of the country who have years of experience in delivering surgical treatment for colorectal diseases with a high success rate.
- Aasra Care is associated with some of the top hospitals across India that are equipped with state-of-the-art facilities required to perform advanced anorectal surgeries.
- Proctologists/ General Surgeons working with Aasra Care do a thorough consultation in the case of every patient to understand the health condition and then determine the treatment method that will work best.
- A dedicated ‘care buddy’ is assigned to every patient on the day of the surgery. We strive to make the whole surgical experience for our patients a seamless one. Once you reach the hospital, your dedicated medical attendant or ‘care buddy’ will take care of every paperwork and formality on your behalf.
- To ease out the commuting process for our patients, we also provide free cab facilities to bring you from home to the hospital and help you return back home after the surgery.
- A free-of-cost follow-up is provided to the patients within the first seven days after the surgery.