General Surgery
General Surgery is a discipline that splits into a number of sub-specialties based on condition and severity.
General Surgery covers a number of specialties and treatment options, all with the singular goal of improving your health and wellbeing.
RYGB
OAGB
SADI-S
Sleeve Gastrectomy
What does a hernia operation involve?
Hernia surgery is often performed via minimally invasive keyhole (laparoscopic) or open surgery, depending on a number of factors that are assessed by your surgeon at time of consultation.
Some of those factors include the exact area of herniation, as certain hernias are best repaired with laparoscopic techniques, and other hernias are more durably repaired with open techniques. For example, groin hernias are well suited to keyhole surgery as we can often repair both sides at the same time. Major ventral hernias such as complex hernias after previous surgery can be repaired via both open and laparoscopic approaches, but they both have their specific pros and cons, and this is something that will be discussed in detail with you by your surgeon.
Depending on the type and location of the hernia and complexity involved in the surgery, some hernia repairs are day case suitable, and others may require a short stay in hospital for a few days to support your recovery.
Hernia Surgery
A hernia is an abnormal protrusion of contents through a weakness in the wall containing them.
In the common cases of abdominal wall hernias, this can manifest with a painful lump. The contents (either fat or bowel) are usually able to be pushed back into the cavity (aka reduced), but sometimes they can become irreducible, and subsequently threatened. This can then become a surgical emergency, particularly if the hernia contains bowel. This can result in a bowel obstruction, threatened bowel or perforation, which can be life-threatening.
What types of hernias can I have?
- Groin hernias such as inguinal or femoral hernias
- Umbilical/Paraumbilical Hernias
- Epigastric Hernias
- Major Ventral Hernias
- Rarer Hernias
- Spigelian
- Obturator
- Lumbar
Gallbladder Surgery
Gallstones are formed within the gallbladder, that can cause a wide spectrum of symptoms and conditions, ranging from intermittent pain to obstruction of the bile duct system and liver resulting in painful jaundice, to severe life-threatening pancreatitis.
Gallstones are a very common cause of recurrent abdominal pain, and thankfully the treatment required is very simple.
Recovery after a laparoscopic cholecystectomy is usually very simple, and one can a return to normal activities within a few days of surgery including work and driving.
A laparoscopic cholecystectomy (keyhole removal of gallbladder) is a minimally invasive surgery, where a camera is inserted into the abdomen along with ports to facilitate the operation. The gallbladder and key structures are carefully dissected, and an x-ray of the bile duct system is taken to confirm our operative anatomy and any variations, as well as ensure adequate bile flow through to the duodenum. If there are any stones in the bile duct, they are removed at time of surgery using advanced laparoscopic techniques of bile duct exploration.
This operation is often suitable for day case surgery in selected cases, but in the case of emergency surgery due to acute severe pain a bed is booked overnight to ensure that you have completely recovered prior to discharge.
Appendix
The appendix is an outpouching from the first part of the large intestine. When it is obstructed it can cause severe abdominal pain and perforate, resulting in a surgical emergency.
In the common cases of abdominal wall hernias, this can manifest with a painful lump. The contents (either fat or bowel) are usually able to be pushed back into the cavity (aka reduced), but sometimes they can become irreducible, and subsequently threatened. This can then become a surgical emergency, particularly if the hernia contains bowel. This can result in a bowel obstruction, threatened bowel or perforation, which can be life-threatening.
What does appendix surgery involve?
A laparoscopic appendicectomy (keyhole removal of appendix) is a minimally invasive surgery, where a camera is inserted into the abdomen along with ports to facilitate inspection and management of the problem. The appendix is removed protecting the surrounding structures, and removed in a bag. The appendix is sent to the pathology lab for analysis.
This surgery is often suitable for day case surgery, but in most cases if a patient is unwell prior to surgery, they will stay overnight to ensure that they have fully recovered from surgery.
Recovery after a laparoscopic appendicectomy is usually very simple, and one can return to normal activities within a few days of surgery including work and driving.
Benign Anorectal
Anal Fissures
Anal fissures are tears in the anal skin, usually as a result of direct trauma related to hard bowel movements, or conditions such as Crohn’s disease or radiation therapy.
They are exquisitely painful and cause bright red bleeding.
What does anal fissure treatment involve
Treatment depends on the severity of the anal fissure, and will be guided by your surgeon’s assessment.
In early cases, treatment starts with non-surgical methods such as stool management with high fibre and hydration along with topical oinments.
In more severe cases, or if the previous treatments have failed, treatment involves a minor incisionless procedure involving an examination under general anaesthetic and injection of botox only. This is usually curative in most instances.
In extreme cases, sometimes the sphincter muscle needs to be carefully divided under general anaesthetic.
Recovery is very fast, with return to normal activities by the following day. All anal fissure procedures are performed as day cases.
Haemorrhoids
Haemorrhoids are normal vascular plexuses that form internal anal cushions. These are involved in maintaining continence and support the anal sphincter mechanism.
Symptomatic haemorrhoids are often painful and prolapsing, and can result in bleeding and incontinence.
They are very common.
What does haemorrhoid treatment involve?
Treatment depends on the severity of the haemorrhoid problem, and your other health issues, which will be assessed at time of consultation by your surgeon.
In early cases, treatment starts with increasing dietary fibre and encouraging ‘no-strain’ bowel movements.
In addition to this, early haemorrhoids can be managed endoscopically with a painless rubber banding of the feeding vessel. This reduces the blood flow the haemorrhoidal pedicle resulting in ‘debulking’ and shrinking of the problem. We often combine this procedure with a complete colonoscopy to exclude any other causes of bleeding such as colonic polyps or cancer.
Larger, more complex haemorrhoids are managed surgically but still minimally invasive, incisionless and with minimal pain. This is utilising modern techniques of haemorrhoidal artery ligation aka dearterialization.
Rarely in selected cases, a traditional haemorrhoidectomy will be required, which your surgeon will explain to you in detail.
Recovery depends on the exact procedure required, but in most cases that don’t require a traditional surgical haemorrhoidectomy recovery is very fast with return to normal activities by the next day. All cases are performed as day case procedures.
