SERVICES
LAPAROSCOPIC SURGERY:
This has advanced significantly in the last ten to fifteen years with the advent of high quality optics and cameras.
The procedures are performed by placing a number of small ports through the abdominal wall into the abdominal cavity. Fibreoptic telescopes can be passed through the ports and transmit a digital image to a screen which is viewed by the surgeon. Specially developed instruments are placed through the remaining ports to allow the surgeon to carry out the procedure.
Many operations that previously required a large incision in the abdomen can now be done laparoscopically. Procedures such as removal of the gall bladder, appendix or part of the bowel, gastric banding and mini gastric bypass are commonly performed.
The advantages of laparoscopic surgery are the avoidance of large abdominal wounds. This reduces the risk of infection and the length of hospital stay, reduces post-operative pain and allows the patient to return to their normal activities much more quickly.
LAPAROSCOPIC FUNDOPLICATION (HIATUS HERNIA REPAIR)
This is an operation to relieve the symptoms of significant reflux (heartburn). Reflux refers to the stomach contents travelling back up the gullet into the chest area. This produces (usually) a burning sensation in the central chest region, or persistent coughing or wheezing, particularly at night when the patient lies down in bed. (It is important to establish the symptoms are not due to heart problems or asthma.)
Essentially, the muscles in the diaphragm need repairing. There are several techniques for doing this. The type of procedure required can be determined by investigations performed prior to surgery. This surgery is successful in relieving the symptoms in about 90% of cases.
HERNIAS:
Hernias occur when there is a weakness in the muscles of the abdominal wall. This leads to the formation of a gap which other structures, such as a part of the bowel or omentum, can enter. (The omentum is an important fatty structure inside the abdomen that guards against infection.)
The hernias occurring most commonly in the abdomen are inguinal hernias (in the groin), femoral hernias (near the upper thigh and mostly in females), umbilical hernias (around the belly button), epigastric hernias (usually in the centre of the upper abdomen between the belly button and chest) and incisional (at the site of a previous operation).
Hernias usually show up as a lump or bulge, which may come and go. Usually there is associated pain or aching. If the bowel or other structure becomes stuck because of swelling, this requires immediate medical attention.
Hernias can be repaired either by the laparoscopic technique or by an open repair involving an incision.
For laparoscopic repairs, the recovery time is greatly reduced. For example, after inguinal hernia repair, golfers can generally return to their game in ten days.
Open procedures generally result in more post-operative pain and a longer recovery period.
ENDOSCOPIC PROCEDURES:
This refers to the use of flexible fibreoptic telescope to directly visualise the interior of the intestinal tract. A gastroscopy examines the gullet (oesophagus), stomach and first part of the small bowel. A colonoscopy examines the large bowel.
These procedures are performed to examine the structures named and establish or eliminate a diagnosis – for example, abdominal pain which may be due to inflammation or ulcers, hiatus hernia or Crohn’s disease.
Associated procedures such as taking a biopsy or removing a polyp may be performed during the examination.
Sedation or anaesthetic is required.