Procedures

Laparoscopic Surgery

Dr Gandy can provide many treatments using keyhole surgery (Laparoscopic). Laparoscopic surgery has the advantages of smaller scars and can aid the earlier return to work or normal activities. If performed laparoscopically, some procedures may involve less pain and a shorter hospital stay.

Laparoscopic Ventral Incisional Hernia Surgery

Different methods are used for managing ventral hernia, with the laparoscopic repair being the most commonly chosen.

Laparoscopic Mesh Repair of Inguinal Hernia

A hernia occurs when the internal organs of the abdominal cavity push through a weakened spot in the abdominal wall to form a bulge.Hernias may be repaired surgically by closing the defect and using mesh to strengthen the weakened area.

Repair of Umbilical (bellybutton) Hernia

A hernia is a bulge that has formed when the internal organs of the body push through a weak spot in the abdominal wall.Umbilical hernia is the bulge that forms near the navel or belly button, when a part of the intestine, fat or fluid is pushed out through a weakened muscle of the abdomen. Umbilical hernia can be found in both children and adults.

Gallbladder Surgery

The gallbladder is a pear-shaped organ, connected with the bile ducts arising from the liver and adjoining the small bowel. The gallbladder stores and concentrates bile which is produced by the liver and helps in digestion of fats and certain waste products by releasing the bile into the common hepatic duct. Bile is a yellow-green liquid, composed of water, lecithin, cholesterol, bile salts, and bilirubin.

Laparoscopic Cholecystectomy

The gallbladder is a small pear-shaped storage organ located under the liver on the right side of the abdomen. It stores bile (yellowish-brown fluid) produced by the liver, which is required to digest fat. As food enters the small intestine, cholecystokinin (a hormone) is released, which signals the contraction of the gallbladder to release bile into the small intestine through the common bile duct (a small tube connecting liver and intestine).

Laparoscopic Anti-Reflux Surgery

Anti-reflux surgery or Fundoplication (folding of the stomach) surgery is a procedure to treat gastroesophageal reflux disease (GORD). It is also incorporated in to hiatus hernia operation. GORD occurs when stomach contents reflux and enter the lower end of the oesophagus (LES) due to a relaxed or weakened sphincter or hiatus hernia. GORD is treatable disease and can have serious complications may occur if left untreated.

Endoscopy

An endoscope is a long, thin, flexible tube with a tiny video camera and light attached on its end. Endoscopy is a procedure used to diagnose and treat problems of the digestive system. It is usually indicated for patients having trouble with swallowing, having persistent isolated nausea or vomiting, chronic anaemia and/or iron deficiency anaemia, acute gastrointestinal bleeding and gastroesophageal reflux.

Traditionally, physicians refer patients to a GI endoscopist to evaluate necessity for endoscopy. Open access endoscopy is when a patient is referred to have a routine gastrointestinal endoscopic evaluation without consulting with a specialist doctor first. To qualify, you need to have few or no medical problems. The common procedures that are performed on an open access basis are colonoscopy, where the scope is introduced through the anus to view the colon or large intestine, and gastroscopy, where the scope is introduced through the mouth to view the oesophagus, stomach and small intestine.

Although open access endoscopy is becoming more common, it may be associated with certain drawbacks such as poorly informed patients and inappropriate or unnecessary referrals. However, it can be used safely when patient safety, transfer of information and medical complexities are properly addressed.

Gastroscopy

Gastroscopy or upper gastrointestinal endoscopy is a procedure to visualise the inside of the oesophagus, stomach and duodenum (first part of the small intestine). It involves the use of a thin flexible tube called an endoscope that is inserted through the mouth to reach the intestines. The endoscope contains a camera and light source to provide a clear magnified view of these structures.

Colonoscopy

Colonoscopy is a procedure used to view large intestine (colon and rectum) using an instrument called colonoscope (a flexible tube with a small camera and lens attached). The procedure can detect inflamed tissue, ulcers, and abnormal growths. It is used to diagnose early signs of colorectal cancer, bowel disorders, abdominal pain, muscle spasms, inflamed tissue, ulcers, anal bleeding, and non-dietary weight loss.

The procedure is done under general anaesthesia. The colonoscope is inserted into the rectum which gently moves up through the colon until it reaches the cecum (junction of small and large intestine). Colonoscopy provides an instant diagnosis of many conditions of the colon and is more sensitive than X-ray.

The colonoscope is then withdrawn very slowly as the camera shows pictures of the colon and rectum onto a large screen. Polyps or growths can also be removed by colonoscopy which can be sent later for detection of cancer.

Instructions for colonoscopy

Your physician may provide you written instructions and will be communicate verbally on how to get prepared for the colonoscopy procedure. The process is called bowel prep.

Gastrointestinal (GI) tract should be devoid of solid food or opaque liquid to improve the chances of the whole colon being visualised. Please follow the links to information sheets on bowel preparation for a morning or afternoon colonoscopy.

Certain medications such as aspirin,other blood thinning medications, may cause bleeding if polyps are removed at your colonoscopy. However, these medications are sometimes essential and should not be stopped unless instructed by your doctor. Iron medications produce a dark black stool, and this makes the view inside the bowel less clear.

A laxative or an enema may be required the night before a colonoscopy. Laxative is medicine that loosens stool and increases bowel movements. Laxatives are usually swallowed in pill form or as a powder dissolved in water.

Driving, operating heavy machinery or signing legal documents should not be performed for 24 hours after colonoscopy, due to the sedative medications used.

Pancreatic Surgery

The pancreas is an organ that is located behind the stomach at the back of the abdomen. The pancreas makes hormones that regulate blood sugar and produce digestive juices that help the body break down food. Tumours from the cells that produce digestive juices are pancreatic cancers (adenocarcinoma). Tumours from the hormone producing cells are pancreatic neuroendocrine tumours.

Laparoscopic (Keyhole) Pancreatic Surgery

Laparoscopic surgery is a more minimally invasive approach which involves the use of a lighted viewing tube called a laparoscope, introduced through a small incisions (keyholes) on your abdomen and can provide a well-illuminated and magnified view of the structures within. A miniature camera present inside the tube displays images on a high definition screens which guide your surgeon to perform operations. Special long thin instruments are inserted though other 5mm keyholes to act as the hands of the surgeon.

Liver & Bile Duct Surgery

The liver is the largest solid organ in the body. It has several functions (see below). The liver receives its blood from the heart and filters blood coming from the intestines. The outflow of the liver returns blood to the heart and lungs and excretes bile to the bowel.

Laparoscopic (Keyhole) Liver Surgery

Laparoscopic surgery is a more minimally invasive approach which involves the use of a lighted viewing tube called a laparoscope, introduced through a small incisions (keyholes) on your abdomen and can provide a well-illuminated and magnified view of the structures within. A miniature camera present inside the tube displays images on a high definition screens which guide your surgeon to perform operations.

Stomach Surgery

Stomach surgery (gastrectomy) may be required for several cancerous and non-cancerous conditions. These include;

Laparoscopic (Keyhole) Stomach Surgery

Laparoscopic surgery is a more minimally invasive approach which involves the use of a lighted viewing tube called a laparoscope, introduced through a small incisions (keyholes) on your abdomen and can provide a well-illuminated and magnified view of the structures within. A miniature camera present inside the tube displays images on a high definition screens which guide your surgeon to perform operations.

Laparoscopic Splenectomy

The spleen is a delicate fist sized organ that lies under the ribs on the left side of the body, next to the pancreas and colon.

Oesophageal Surgery

The oesophagus is the muscular tube that passes from the back of the mouth to the stomach. It starts in the neck, passes through the chest and into the abdomen to meet the stomach. It job is to transport food, liquids and saliva to the stomach for digestion.

ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic tool that enables your physician to diagnose and treat problems of the liver, gallbladder, bile ducts and pancreas. ERCP combines X-rays and endoscopy, which includes the use of a long, thin, flexible tube with a tiny video camera and light on the end to carefully examine the inside of the upper digestive system.

ERCP is usually indicated to diagnose and treat conditions of the bile or pancreatic duct which include blockage or narrowing of the ducts due to gallstones, tumours, infection, valves that don’t open properly, scarring, accumulation of tissue debris and fluid, or inflammation of the pancreas. ERCP is also considered for obtaining a biopsy.

ERCP is performed on an outpatient basis under heavy sedation or general anaesthesia. You are placed on an X-ray table, on your back or side. Your doctor inserts the endoscope through your mouth, down into the stomach and into the upper part of the small intestine (duodenum). Once the endoscope reaches the orifice of pancreas and bile ducts, a thin tube called a catheter will be inserted through the endoscope and a dye is injected into the ducts. X-ray images are taken to diagnose any problem related to the ducts. When a problem is detected, your doctor may choose to treat your condition immediately by:

• Opening narrowed duct regions with an inflatable balloon, and placing stents (plastic or metal tubes) to keep the duct open
• Enlarging a narrowed or hardened sphincter muscle (regulating the flow of bile and digestive juices into the small intestine) using an electrically heated wire that is passed through the endoscope

As with any procedure, ERCP may involve certain risks and complications which include pancreatitis (inflammation of the pancreas), infection, bleeding and tissue damage.

Laparoscopic Adrenal Surgery

Adrenal surgery involves removal of one or both adrenal glands. The adrenal glands are paired endocrine glands located above each kidney. The surgical procedure of adrenal gland removal is known as adrenalectomy and is indicated in patients with benign or malignant tumour-like mass within the adrenal glands.

Irreversible electroporation (Nanoknife^®)

Nanoknife^® is a technique of tumour ablation which uses very high voltage electricity to destroy cancer cells. The electrical current is passed through electrodes inserted directly into the tumour. The most important feature of Nanoknife® is that it does not destroy blood vessels and bile ducts.

Laparoscopic Appendicectomy

The appendix is a finger like pouch attached to the large intestine and located in the lower right area of the abdomen. Scientists are not sure what the appendix does, if anything, but removing it does not appear to affect a person’s health.