Answers to your questions

Dr Sandeep Kumar Verma is the Director of GI Surgery, GI Oncology & Bariatric Surgery at Medanta Hospital, Lucknow. He is a fellowship-trained surgical gastroenterologist (MCh) specialising in gastrointestinal cancer surgery, advanced laparoscopic surgery, bariatric (weight-loss) surgery, and gallbladder, hernia, liver and pancreatic surgery.

He treats the full range of gastrointestinal surgical conditions — including stomach, colon and rectal cancer, gallstones, hernias, obesity, piles and fissures, and diseases of the liver and pancreas. He offers laparoscopic (keyhole) surgery wherever it is the safest option.

Dr Verma consults and operates at Medanta Hospital, Lucknow, on Amar Shaheed Path (Golf City), which provides advanced operating theatres, intensive care and a multidisciplinary cancer programme.

You can book a consultation by calling or sending a WhatsApp message to the appointment number, or by using the enquiry form on the Contact page. New patients are advised to bring any previous scans, endoscopy reports and prescriptions.

Yes. Dr Verma is an advanced laparoscopic surgeon and performs the great majority of his operations — including gallbladder, hernia, bariatric, colorectal and many cancer procedures — using minimal-access techniques for less pain and faster recovery.

Please bring all relevant medical records — previous prescriptions, blood test results, ultrasound, CT or MRI scans, endoscopy or colonoscopy reports, and a list of your current medications. This helps Dr Verma give you the most accurate advice at the first visit.

No. Many GI cancers — including colon, rectal and some stomach cancers — can be operated using laparoscopic (keyhole) techniques, which mean smaller incisions, less pain and faster recovery. The cancer operation itself is never compromised: Dr Verma chooses the approach best suited to a safe, complete clearance for your specific tumour.

It depends on the type and stage of the cancer. Some patients have chemotherapy before surgery (to shrink the tumour), some after (to reduce recurrence risk), and some need surgery alone. This is decided in the multidisciplinary tumour board and explained to you clearly.

Dr Sandeep Kumar Verma is a fellowship-trained surgical gastroenterologist (MCh) and Director of GI Surgery, GI Oncology & Bariatric Surgery at Medanta Lucknow, with extensive experience in complex cancer operations including gastrectomy, colorectal resections and Whipple's procedure.

Robotic surgery offers greater precision and a magnified 3D view, which can be advantageous for complex and delicate operations. Safety depends most on the surgeon's experience. Dr Verma is a da Vinci proctor who trains other surgeons on the platform, operating within Medanta's dedicated robotic programme.

No. The robot does not operate independently. Every movement is controlled in real time by Dr Verma from a console beside you. The system simply translates his hand movements into more precise, tremor-free actions of the instruments.

Robotic surgery can cost more than conventional laparoscopic surgery because of the technology involved. Dr Verma will recommend it only where it offers a real benefit for your specific operation, and the team can explain the costs clearly during your consultation.

Modern laparoscopic bariatric surgery is very safe — comparable to gallbladder removal — when performed by an experienced bariatric surgeon in a well-equipped centre. Dr Verma performs these operations at Medanta Lucknow with full intensive-care backup and a dedicated multidisciplinary team.

Surgery is a tool, not a cure. Most patients keep off the majority of their excess weight long-term, provided they follow the nutritional guidance and stay engaged with follow-up. The structured post-operative programme is designed specifically to prevent regain.

Both are excellent. A sleeve gastrectomy is simpler and well suited to many patients; a gastric bypass is often preferred for severe reflux or poorly controlled type-2 diabetes. Dr Verma will recommend the option best matched to your health profile after a full assessment.

In most cases, no. Modern sphincter-preserving techniques allow many rectal cancer patients to avoid a permanent stoma. Sometimes a temporary stoma is used to protect a new join while it heals, and is reversed later. Dr Verma will explain exactly what your situation requires.

Many cases settle with medication and lifestyle measures. When surgery is needed, modern minimally invasive procedures treat piles, fissures and fistulas with less pain and a quick recovery, usually as day-care surgery.

Yes. For colorectal cancer, laparoscopic surgery gives equivalent cancer outcomes to open surgery, with the added benefits of smaller incisions, less pain and faster recovery, when performed by an experienced colorectal surgeon.

Discomfort is mild and well controlled with simple painkillers. Because the incisions are tiny, most patients are walking the same day and back to desk work within a few days.

Unfortunately not reliably. A gallbladder that forms stones will keep forming them, so removing the stones alone leads to recurrence. Removing the whole gallbladder (cholecystectomy) is the definitive, lasting cure.

No long-term special diet is needed. We suggest lighter, lower-fat meals for the first week or two, after which almost everyone returns to a completely normal diet.

No. Belts and trusses may control symptoms temporarily but cannot repair the defect. Surgery is the only way to cure a hernia and prevent it from enlarging or becoming an emergency.

Yes. Mesh repair is the international standard of care and dramatically reduces the chance of the hernia coming back compared with stitch-only repairs. Modern meshes are well tolerated and designed for permanent reinforcement.

Most people with desk jobs return within a few days to a week after laparoscopic repair. Heavy lifting and strenuous activity are usually restricted for a few weeks while the repair settles.

Whipple's surgery is major, but in experienced hands and a high-volume centre it is performed safely with good outcomes. The key to safety is specialist HPB expertise and a hospital equipped to support complex recovery — exactly the setting in which Dr Verma operates.

The liver has a remarkable ability to regenerate. A large portion can be removed safely, and the remaining liver grows back over the following weeks, provided enough healthy tissue is left. Careful pre-operative assessment ensures this is the case.

No. Many pancreatic and bile-duct conditions are managed medically or endoscopically. Surgery is recommended selectively — for tumours, certain cysts, and complications of pancreatitis — after careful assessment.

Most patients are suitable, but not all. Previous extensive surgery, certain emergencies or specific anatomical factors can make open surgery safer. Dr Verma assesses each case individually and always prioritises your safety over the approach.

For the vast majority of GI operations, laparoscopic surgery gives results equal to — and recovery far better than — open surgery, when performed by an experienced minimal-access surgeon.

Scarring is minimal. The keyhole incisions are small (typically 5–12 mm) and usually fade to barely noticeable marks over time.

Yes, especially when found early. Stage I and II colon cancers have high cure rates with surgery alone, and even more advanced cancers are often curable with a combination of surgery and chemotherapy. Early diagnosis makes the biggest difference.

No — piles and fissures are far more common causes. But rectal bleeding should never be ignored or assumed to be piles, because it can be the first sign of colon or rectal cancer. Always get it assessed.

No — there are several causes of swallowing difficulty, many of them benign. But because it can be the first sign of esophageal cancer, new or progressive difficulty swallowing should always be assessed promptly with an endoscopy. Early diagnosis makes treatment far more effective.

When found early and treated with a combination of surgery and, where needed, chemotherapy or radiotherapy, esophageal cancer can be cured. Outcomes are best with timely diagnosis and treatment by an experienced multidisciplinary team. Each plan is tailored to the stage of the disease.

No. While pancreatic cancer is serious, a significant number of cancers are caught while still confined to the pancreas and can be removed surgically with a real chance of cure, often combined with chemotherapy. Whether surgery is possible depends on the stage, which is why prompt, specialist assessment is so important.

The Whipple's procedure (pancreaticoduodenectomy) is the operation used for cancers of the head of the pancreas. It removes the head of the pancreas along with nearby structures and reconstructs the digestive connections. It is a major operation that is performed safely in experienced, high-volume centres such as Medanta.

For suitable patients, yes. When the tumour can be removed and enough healthy liver remains, surgical resection offers the best chance of cure. This applies both to primary liver cancer and, importantly, to cancer that has spread to the liver from the bowel. Careful assessment determines who is suitable.

The liver has a remarkable ability to regenerate, so a large portion can be removed safely provided enough healthy liver is left behind, which then grows back over the following weeks. Careful pre-operative assessment of the liver ensures this is the case before surgery.

A GIST is a tumour of the GI tract wall that can behave in a benign or a malignant way depending on its size, location and microscopic features. Small GISTs may simply be monitored; others need surgery. Specialist pathology determines how a particular GIST is likely to behave and guides treatment.

Often, yes. Because GISTs rarely spread to lymph nodes, many can be removed with a clear margin using minimally invasive (laparoscopic or robotic) surgery. The approach depends on the size and location of the tumour, which Dr Verma will assess.

In most cases, no. Modern sphincter-preserving surgery allows the majority of rectal cancer patients to keep normal bowel function. A permanent stoma is now reserved for tumours very close to the anal sphincter. Dr Verma will explain exactly what your tumour requires.

A pelvic MRI shows precisely how deep the tumour is and its relationship to surrounding structures. This guides whether you need radiotherapy before surgery and helps plan a sphincter-preserving operation.

Most acute attacks of pancreatitis settle with supportive medical treatment, not surgery. However, if gallstones are the cause, the gallbladder is removed to prevent further attacks, and severe complications or chronic pancreatitis may need procedures or surgery in selected patients. The right approach depends on the cause and severity.

Yes, if the underlying cause is not addressed. When gallstones are responsible, removing the gallbladder greatly reduces the risk of further attacks. Avoiding alcohol and treating other causes is equally important. Identifying and treating the cause is central to preventing recurrence.

A bile-duct stricture is a narrowing of the duct. Common causes include inflammation, stones, injury after previous surgery, and sometimes cancer. Accurate assessment — including imaging and, where needed, tests to exclude cancer — guides whether endoscopic treatment or surgery is the right approach.

Yes. A bile-duct injury — for example after gallbladder surgery — can usually be repaired, most often by reconstructing the duct (a hepaticojejunostomy). These are specialist operations best performed by an experienced HPB surgeon, which gives the best chance of a durable result.

Yes. After a total or partial gastrectomy the digestive tract is reconnected, and with some adjustments to eating smaller, more frequent meals, most people adapt well and live full lives. A dietitian supports you through the transition.

It is the systematic removal of the lymph nodes around the stomach that are most likely to harbour cancer spread. Performing an adequate D2 dissection is a hallmark of specialist gastric cancer surgery and improves survival.

The Gangetic belt, including Uttar Pradesh, has one of the highest rates of gallbladder cancer in the world. The reasons are not fully understood but involve a combination of long-standing gallstones, chronic inflammation, dietary and environmental factors, and possibly chronic infection. This is why gallbladder symptoms in this region deserve careful, timely assessment.

When gallbladder cancer is detected early and is confined to the gallbladder, specialist surgery offers a real chance of cure. Outcomes are best when treatment is timely and performed by a surgeon experienced in hepatobiliary cancer surgery. More advanced disease is managed with a combination of treatments planned by a multidisciplinary team.

This is not unusual in this region, and it does not necessarily mean further surgery is impossible — quite the opposite. You should be assessed promptly by a hepatobiliary surgical specialist, who will review the pathology and scans and advise whether an additional, more extensive operation or other treatment is needed.

No. Gallstones that never cause symptoms can often simply be observed. Surgery is recommended once stones cause pain or complications such as inflammation, jaundice or pancreatitis, because these tend to recur and can become serious.

Not reliably. Dissolution medicines work slowly, only for certain small cholesterol stones, and stones usually re-form once treatment stops. For symptomatic gallstones, removing the gallbladder is the definitive cure.

It is an urgent condition that needs prompt medical assessment, though it is not always operated on the same day. Early treatment relieves symptoms and prevents serious complications such as gangrene or perforation of the gallbladder. Severe or worsening abdominal pain with fever should be assessed without delay.

In most suitable patients, early laparoscopic removal of the gallbladder during the same admission is safe and is now the preferred approach, as it avoids repeated attacks and admissions. The decision depends on how unwell you are and how long the attack has been present, which Dr Verma will assess.

Most bile duct stones are removed endoscopically by ERCP, without an external cut, by passing a flexible scope to the duct opening. Because the stones originate in the gallbladder, the gallbladder is then usually removed by keyhole surgery to prevent recurrence.

They can be, if ignored. A stone blocking the bile duct can cause jaundice, an infection of the bile (cholangitis) or pancreatitis, which can become serious. Treated promptly, the outlook is very good. Any jaundice with abdominal pain and fever should be assessed without delay.

Most do not. Small polyps without worrying features are simply monitored with ultrasound. Removal of the gallbladder is advised for polyps of 10 mm or more, polyps that grow, or polyps with gallstones or other concerning features, because of a small risk of cancer. Dr Verma will advise based on your specific scan.

Most polyps are harmless and never become cancerous. However, larger polyps carry a small but real risk, which is why size and growth are watched carefully — particularly in this region, where gallbladder cancer is common. Removing the gallbladder when a polyp is concerning is a sensible, preventive step.

No. There is no medicine or exercise that closes a hernia — the gap in the abdominal wall can only be repaired surgically. Left alone, a hernia slowly enlarges and carries a risk of becoming trapped, which is an emergency.

Most hernias can be repaired electively at a planned time. However, if a hernia becomes suddenly painful, hard and irreducible, that may mean bowel is trapped and you need emergency surgery. Planned repair avoids this risk.

No. There is no medicine or exercise that closes the defect. A truss or belt may control symptoms temporarily but cannot repair the hernia. Surgery is the only way to cure an inguinal hernia and prevent it from enlarging or becoming an emergency.

After laparoscopic repair, most people with desk-based jobs return within a few days to a week. Heavy lifting and strenuous activity are usually restricted for a few weeks while the repair settles. Dr Verma will give you specific guidance for your job and recovery.

In adults, umbilical hernias do not resolve on their own and are usually repaired once they cause symptoms or are enlarging, because they tend to grow and carry a small risk of complications. A small, symptom-free hernia may sometimes be monitored — Dr Verma will advise honestly.

For most adult umbilical hernias, a mesh repair gives a stronger, more durable result and a lower chance of the hernia returning than stitches alone. Very small defects may occasionally be repaired without mesh; this is decided case by case.

A healed surgical scar is never quite as strong as the original abdominal wall. In some people — particularly after a wound infection, or in those who are overweight, diabetic or who lift heavily too soon — the repair weakens and a hernia forms. It is a recognised possibility after any abdominal surgery.

Yes. Even large and complex incisional hernias can be repaired, sometimes with abdominal-wall reconstruction techniques. Careful planning, often with a CT scan, allows a durable repair. Repairing a hernia while it is smaller is usually simpler, so earlier assessment is worthwhile.

No. The majority of hiatal hernias causing reflux are managed successfully with lifestyle measures and medication. Surgery is reserved for symptoms that medication cannot control, complications of reflux, or large paraoesophageal hernias. The decision is made after appropriate testing.

For suitably selected patients, laparoscopic anti-reflux surgery is very effective at controlling reflux and often allows medication to be stopped. Careful assessment beforehand — including endoscopy and, in some cases, specialised tests — helps ensure the right patients are offered surgery.

No. Most people with GERD are managed effectively with lifestyle measures and medication. Surgery is reserved for symptoms that medication cannot control, for complications, or for patients who prefer a long-term alternative to lifelong medication — and only after appropriate testing.

For patients who have both significant reflux and obesity, a gastric bypass can be very effective at controlling reflux while also treating obesity and its related conditions. Whether this is appropriate depends on a full assessment, which Dr Verma will carry out.

It is not a last resort but an evidence-based treatment for severe obesity when lifestyle measures have not succeeded. The earlier severe obesity and its complications are treated, the more health benefit surgery delivers.

For many patients with type-2 diabetes, bariatric surgery leads to remission or major improvement, often within weeks and sometimes allowing medications to be reduced or stopped. The metabolic benefit is one of the strongest reasons to consider surgery.

For many patients with obesity-related type-2 diabetes, metabolic surgery leads to remission or major improvement, often within weeks, and sometimes allows medications to be reduced or stopped. It works best when diabetes has not been present for many years. It is an option for selected patients, decided together with your diabetes physician — not a cure for all diabetes.

It is generally considered for adults with obesity-related type-2 diabetes and a BMI of 32.5 or above (Asian-Indian threshold), particularly when diabetes is hard to control. A full assessment with the surgical and medical team determines whether it is likely to benefit you.

In most people fatty liver remains stable and harmless. In a proportion, however, it can progress over years to liver inflammation and scarring, particularly with diabetes or significant obesity. The good news is that it is largely reversible by addressing its causes — especially weight — which is why assessment and lifestyle change are worthwhile.

Yes — for patients with significant obesity, bariatric surgery often leads to substantial improvement in fatty liver, alongside weight loss and better control of diabetes. Whether surgery is appropriate depends on a full assessment of your overall health.

No. The majority of piles improve with dietary changes, fluids and simple treatments. Surgery or banding is reserved for piles that keep bleeding, prolapse or fail to settle, and modern techniques make this far less painful than in the past.

You can't know for certain without assessment — which is exactly why rectal bleeding should always be checked by a specialist. In many people it is piles, but the only safe approach is to confirm it and rule out colon or rectal cancer.

Most polyps never become cancerous, but certain types can slowly progress to colon cancer over many years. Removing polyps during colonoscopy interrupts this process — which is why polyp removal is one of the most effective ways to prevent colon cancer.

No. Polyps are removed during the colonoscopy itself, painlessly and without any external cut, usually under sedation. The removed polyp is then examined to determine its type and guide your follow-up.

Usually not. Most attacks of diverticulitis settle with medical treatment, and a high-fibre diet helps prevent recurrence. Surgery is reserved for complications — such as an abscess, perforation or narrowing — or for recurrent severe attacks. Dr Verma will advise based on your situation.

The symptoms can overlap, which is why a colonoscopy is usually recommended after an attack of diverticulitis has settled — to confirm the diagnosis and rule out colon cancer. Proper assessment ensures nothing more serious is missed.

Rarely. Most anal fistulas do not heal on their own and need surgery to cure them, because the tunnel keeps the infection going. The good news is that with modern, sphincter-preserving techniques, most fistulas can be cured while protecting continence.

Protecting continence is the central goal of fistula surgery. Modern sphincter-preserving techniques — chosen after accurately mapping the fistula, often with MRI — allow most fistulas to be cured with a very low risk to continence. The right choice of operation, in experienced hands, is key.

No. Most people with IBD are managed with medication by a gastroenterologist. Surgery is needed for a proportion — for complications such as strictures, fistulas or bleeding, or when medical treatment no longer controls the disease. In ulcerative colitis, surgery can even be curative for the colitis.

Increasingly, yes. Many operations for inflammatory bowel disease are now performed laparoscopically, which means less pain and a faster recovery. The approach depends on the type and severity of the disease and is planned together with your gastroenterologist.