Upper Gastro Intestinal

Upper Gastrointestinal Surgery. This refers to endoscopic and surgical procedures performed on the Upper Gut (the Oesophagus, Stomach, Small Bowel, Gallbladder, Spleen, Liver and Pancreas). Surgeons who perform these procedures are referred to as Upper GI Surgeons. Increasingly these procedures are being performed using minimally invasive techniques, which allow quite complex operations to be performed with minimal scarring and recovery time. The majority of procedures, including those for treatment of cancer can be done safely with these techniques.

Oesophageal and Gastric disorders.

Endoscopy. Diagnosis and treatment of many disorders of the oesophagus, such as reflux, difficulty swallowing, Barrett’s oesophagus and early and late cancers can be undertaken using flexible endoscopy under light anaesthesia. An endoscopy is a nonsurgical procedure which examines a person’s digestive tract using a flexible tube with a light camera attached to it. This allows the surgeon to view pictures of the digestive tract on a TV monitor.

Disorders and treatments

Anti-reflux surgery and Hiatus Hernia Repair - A hiatus hernia occurs when the normal opening in the diaphragm is too large. If the problem is not repaired, the stomach or other abdominal contents may bulge (herniate) into the chest, causing heartburn (acid reflux) and serious damage to the oesophagus. Hiatus hernia repair is almost always performed laparoscopically.

Gastrectomy - gastrectomy is a partial or full surgical removal of the stomach. This is done for both benign and malignant (cancerous) conditions. Depending on the reason for, and the type of gastrectomy, it may be performed as an open or laparoscopic procedure.

Oesophagectomy - An oesophagectomy is a surgical procedure that removes part or most of the oesophagus, usually for cancer. All or part of the surgery can be performed laparoscopically.

Disorders of the Gallbladder, Liver and Pancreas

Endoscopy - Gallstones, inflammatory conditions and some tumours can be diagnosed and treated with an endoscopic treatment called ERCP (endoscopic retrograde cholangio-pancreatography). This allows minimally invasive and scarless access to these deeply situated organs and provide effective treatments with minimal adverse impacts on the patient.

Laparoscopic Cholecystectomy - a minimally invasive keyhole procedure used to remove the gall bladder when patients suffer from gallstones or other gall bladder diseases. The Upper GI surgeons performing this operation are specially trained to do this operation and have extremely low complication rates. The majority of patients stay in hospital for less than 24hrs. Patients with very complex gallstone problems and gallbladder infections can still be treated laparoscopically with similar hospital stay and recovery.

Hepatectomy (Liver surgery) – This involves surgical removal of a part of the liver and is usually done for the treatment of malignant tumours. In the old days Liver surgery was viewed as extremely dangerous, but improved training and techniques now mean that the majority of patients can undergo surgery without needing a blood transfusion or a long hospital stay. Many patients are able to have tumours removed laparoscopically which further reduces the potential negative impacts of major surgery.

Pancreatectomy - A pancreatectomy is the surgical removal of part of the pancreas. The most common reason to require removal of part of the pancreas is to treat cancerous or pre-cancerous tumours. Some of these procedures can be performed laparoscopically and others require open surgery as other organs attached to the pancreas may also need removal (otherwise known as a “Whipples” procedure). Pancreatectomy was once viewed as being highly dangerous but improved training, expertise and post-op care now mean that the risks have dramatically reduced over the last decade or so.

Splenectomy – This involves removal of the spleen and is most often performed for the treatment of patients with haematological conditions. In most cases this can be done as a “keyhole” procedure as long as the spleen is not too large. Patients usually remain in hospital for 3-5 days following this operation.

Hernia Surgery. While not strictly “Upper GI Surgery” many Upper GI Surgeons have become expert at hernia surgery because their exposure to keyhole techniques allow them to offer minimally invasive surgery for this common condition. Hernias are defects in the abdominal wall that often cause pain, discomfort and unsightly cosmetic deformity. The only successful treatment is surgical where a range of techniques can be used fix the defect. The most common hernia types are inguinal and incisional. Inguinal and small body wall hernias are usually repaired laparoscopically, while larger hernias can require quite complex abdominal wall reconstructive techniques.