Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of surgery that focuses on the upper parts of the gastrointestinal tract. The upper gastrointestinal surgical service at The Princess Grace Hospital provides the full range of operations for benign and malignant diseases of the oesophagus and stomach.
An inflamed gallbladder and gallstones can cause acute or chronic abdominal pain. This can be accompanied with a feeling of bloating, dyspepsia, nausea and an intolerance to fatty foods.
Surgical Treatment - Laparoscopic Cholecystectomy
This surgery is performed for the treatment of symptomatic gall stones, caused by the presence of gall stones in the gall bladder. Usually a storage for the excess bile production, the bile can sometimes become thick and clump together, creating stones. These stones can in turn cause inflammation or irritation in the biliary system and cause abdominal discomfort. This is often located on the right side of the abdomen and normally intermittent in nature. A simple ultrasound scan, undertaking in radiology at the Princess Grace, can confirm the presence of gall stones.
Although these stones can be treated with medication, they will most likely recur, and the best treatment is to have your gall bladder removed. This is done through a keyhole method, (laparoscopic) leaving only a few small scars behind. Living without your gall bladder is not usually a problem, as the body is able to adapt, although this may take a little time.
Reflux disease/Hiatus Hernia
Reflux occurs when the acid in the stomach enters into the lower part of the oesophagus causing heartburn. Other symptoms that can occur is the feeling of acid in the back of the mouth, particularly when bending or stooping, chronic cough, particularly at night, and a difficulty in swallowing. Prior to surgery a pH manometry study is undertaken to establish the extent of the reflux disease, and undertaken by one of the gastroenterologists at the PG.
Surgical Treatment - Laparoscopic Anti-Reflux Surgery
This is surgery that is performed for the treatment of GORD (gastro-oesophageal reflux disorder).
Surgery is performed using a keyhole (laparoscopic) method and involves narrowing the opening between the chest and abdomen through with the oesophagus passes. Wrapping the top part of the stomach around itself creates a ‘valve’ to stop acid travelling up the oesophagus.
The first symptoms often noticed with an oesophageal cancer is a difficulty in swallowing, a burning or squeezing pain when swallowing, a sore throat, feeling of choking and hoarseness. Some weight loss can also occur. These symptoms tend to occur in the late stages of disease with few symptoms in the early stages.
Surgical Treatment (1) - Oesophagectomy
This is surgery undertaken in the early stages when the cancer does not involve any of the stomach. The diseased part of the oesophagus is removed and a graft is inserted in its place.
Surgical Treatment (2) - Oesophagogastrostomy
For more advanced stages of cancer this removes the diseased oesophagus along with lymphnodes and the top of the stomach creating a join (anastomosis) between the remaining stomach and oesophagus.
Early stage symptoms can be vague and are similar to stomach ulcers with indigestion, a feeling of fullness and mild discomfort. Anaemia related chronic blood loss and weight loss is also common.
Surgical Treatment – partial/total gastrectomy
Surgery is the best treatment for this type of cancer. The extent of disease will dictate the extent of surgery which may remove only the cancerous lesions, or involve totally removing the stomach creating a join between the oesophagus and jejunum of the small intestine (oesphagojejunostomy).