Upper GI surgeon Perth
A complete list of the surgical procedures performed by Upper GI and Hepato-Pancreato-Biliairy surgeon Dr Suresh Navadgi.
Hernia & Upper GI surgery
Hernia surgery
A hernia is a general term used when an organ or tissue protrudes through a weakness or opening in the surrounding muscle or tissue. Hernias can occur in various parts of the body but are most commonly found in the muscle wall of the tummy (abdomen).
This can happen because of previous surgery, giving birth, lifting heavy objects, or coughing,... but sometimes they happen for no reason at all.
Here’s a list of the most common types of hernias:
- Inguinal hernias: occur in the groin area, often on one or both sides of the pubic bone.
- Femoral hernias: occur in the upper thigh, just below the groin.
- Umbilical hernias: occur around the belly button or navel area, usually in infants or young children, but can also occur in adults.
- Incisional hernias: occur at the site of a previous surgical incision or scar.
- Epigastric hernias: occur in the upper part of the abdomen, between the belly button and the lower part of the ribcage.
- Spigelian hernias: occur in the lower part of the abdomen, below the belly button and to the side of the rectus muscle.
- Hiatal hernias: occur when a part of the stomach bulges up through the diaphragm into the chest cavity.
Hernia surgery, also called hernia repair, is the only treatment option. There are two ways surgery can be carried out:
- Laparoscopic hernia surgery (keyhole surgery): this involves making three small incisions in the abdomen and using a laparoscope (a thin, flexible tube with a camera and light) to guide the repair of the hernia from inside the body. We may use sutures or mesh to reinforce the weakened or torn muscle or tissue. Recovery time is typically shorter compared to open surgery, and there may be less pain and discomfort during the recovery period. Usually admitted for one day overnight stay.
- Open hernia surgery: this involves making a single, slightly larger incision near the site of the hernia to access and repair the weakened or torn muscle or tissue. We may use sutures or mesh to reinforce the area and prevent the hernia from recurring. Typically, it takes longer to recover from open surgery compared to laparoscopic surgery, and there may be more pain and discomfort during the recovery period.
Hiatus hernia surgery
Hiatus hernia surgery treats a condition called hiatal hernia.
A hiatal hernia occurs when part of the stomach protrudes upward into the chest through the diaphragm. Common symptoms are heartburn, chest pain, and difficulty in swallowing.
Hiatus hernia surgery can help alleviate symptoms of GORD or gastro-oesophageal reflux disease, a condition where stomach acid flows back into the oesophagus. This causes inflammation, irritation, and other symptoms.
Hiatus hernia surgery and reflux surgery are not exactly the same, but they are closely related.
Reflux surgery
Reflux surgery is often referred to as anti-reflux surgery and treats gastro-oesophageal reflux disease (GORD).
GORD is a common condition where stomach acid leaks up into the oesophagus, causing heartburn, difficulty swallowing, bad breath, and regurgitation.
Reflux surgery aims to improve or alleviate these symptoms. There are several types of operations, but the most common one is the laparoscopic fundoplication.
Gallbladder removal (cholecystectomy)
Gallbladder removal, also known as cholecystectomy, is a surgical procedure to remove the gallbladder. The most common reason is the presence of gallstones, which can cause pain, inflammation, and other complications. Other indications for removing gallbladder include gallbladder polyps and gallstone pancreatitis.
The most common procedure to remove a gallbladder is laparoscopic surgery. This involves making four small incisions in the abdomen and using a laparoscope to guide the removal of the gallbladder. In some cases, open surgery may be necessary, due to previous surgeries and this involves making one large incision in the abdomen.
Spleen removal (splenectomy)
Spleen removal, or splenectomy, is a surgical procedure to remove the spleen, a small organ in the upper left side of the abdomen.
The most common reason for spleen removal is due to injury or disease, such as a ruptured spleen, blood disorders, or certain cancers and splenic cysts.
Most splenectomies are carried out using laparoscopic surgery. This involves making several incisions in the abdomen and using a laparoscope to guide the spleen removal.
Partial splenectomy may be performed in certain benign conditions such as cysts.
The incisions will then be stitched up or sometimes glued together.
Achalasia surgery
Achalasia is a disorder that affects the oesophagus and makes it difficult for food and liquids to pass into the stomach.
Achalasia surgery involves either cutting or dilating the lower oesophageal sphincter to help it relax and allow food and liquids to pass more easily.
Different techniques may be used, such as Heller myotomy or Peroral endoscopic myotomy. I will explain which procedure is best for your case, during consultation.
Cancer surgery
Gallbladder cancer surgery
Gallbladder cancer surgery is a surgical procedure to remove cancerous cells and tissues in the gallbladder. The type of surgery performed depends on the stage and location of the cancer.
In some cases, minimally invasive laparoscopic surgery can be used to remove the gallbladder, while more advanced cases may require open surgery and removal of surrounding tissues and lymph nodes. After surgery, other treatments such as chemotherapy or radiation therapy may be necessary to further treat the cancer.
Pancreatic cancer surgery
Pancreatic cancer surgery is a surgical procedure to remove cancerous cells and tissues in the pancreas. The type of surgery performed depends on the stage and location of the cancer. In some cases, we may perform the Whipple procedure. This involves removing the head of the pancreas, part of the small intestine, the gallbladder, and the bile ducts.
The remaining pancreas, stomach, and small intestine are then reconnected to allow digestion to occur normally.
In more advanced cases of pancreatic cancer, we may need to remove additional tissues or organs.
After surgery, other treatments such as chemotherapy or radiation therapy may be necessary to further treat the cancer.
Liver cancer surgery
Liver cancer surgery is a surgical procedure to remove cancerous cells and tissues in the liver. The type of surgery performed depends on the location and stage of the cancer.
In some cases, minimally invasive laparoscopic surgery can be used to remove a portion of the liver, while more advanced cases may require open surgery and removal of larger portions of the liver.
Microwave ablation is a technique that involves the destruction of cancer cells by thermal energy – this may be required as a combination procedure along with resection in certain cancers.
After surgery, other treatments such as chemotherapy or radiation therapy may be necessary to further treat the cancer.
Liver surgery may also be required for other conditions such as liver cysts and hepatic adenomas.
Neuroendocrine tumours
Neuroendocrine tumours are rare tumours that commonly arise from the pancreas and small bowel and can metastasise to the liver and other organs. Preoperative workup includes a Gallium Octreotate PET scan and surgery can be performed with laparoscopic or open surgery depending on the extent of tumour.
Stomach cancer and GIST (Gastrointestinal Stromal Tumours)
Stomach cancer is usually diagnosed with an endoscopy. Treatment involves staging investigations including CT scans and diagnostic laparoscopy. Treatment involves chemotherapy along with surgery in the form of partial or total gastrectomy depending upon the tumour location.
GIST are tumours that are usually benign but can rarely metastasise. Surgery can involve laparoscopic or open resection depending on the size and location of these tumours.
Infusaport for chemotherapy
Patients on chemotherapy can often struggle with difficult venous access for their chemotherapy. Infusaport insertion is a day procedure and the port is located under the skin and allows patients to carry on with their routine activities. The port can be kept for as long as required even after completion of treatment and can be removed when desired.
Pancreatitis and pancreatic cysts
Pancreatitis is a condition most commonly caused by gallstones and alcohol intake. In certain cases the exact cause cannot be identified and this requires specialist investigations including MRI and endoscopy. In case of gallstones, cholecystectomy is usually recommended.
Pancreatic cysts can be identified as incidental findings or sometimes can be symptomatic with pain or jaundice. Smaller cysts can be monitored, however larger cysts require further investigations and sometimes surgery depending on size and cyst related risk factors.