What is General Surgery?
The Department of General Surgery at North Shore Hospital deals with a wide range of conditions within the abdomen, breast, neck, and skin, including trauma. There is no vascular surgery service, and patients from the Waitemata District Health Board (WDHB) area are sent to the vascular service at Auckland City Hospital.
While the name would suggest that the focus of general surgery is to perform operations, often this is not the case. Many patients are referred to surgeons with conditions that do not need surgical procedures, but merely require counselling or medical treatment.
The Team
The leader of the general surgical team is a consultant (specialist) general surgeon. When you are referred to a clinic or admitted to hospital you will be assigned to one specific consultant. However, consultants often work in teams of two or three, and to some extent your care may be shared between these consultants.
Other medical members of the team include the registrar(s). These are fully qualified doctors who are now training to become specialists. The house surgeons are more junior doctors who have usually only qualified recently. Often there will also be trainee interns attached to the team. These are final year medical students who have completed all of their examinations and are now spending a year working on the wards prior to becoming registered as doctors. Finally, there may also be fourth and fifth year medical students attached to the team.
The medical team is complemented by the nursing staff, and a number of other staff including dietitians, physiotherapists, occupational therapists, pharmacists, speech language therapists, social workers and clerical staff. On the ward there will be a charge nurse responsible for coordinating the care given by the various nursing staff. Many wards run a system where one particular staff nurse is designated as the primary caregiver for a specific patient, but this is not always the case and it is likely that you will come into contact with a number of nurses during your stay. As with the medical staff, there are often nursing students attached to the ward whose work is being supervised by their tutors and the regular nursing staff.
Acute Referrals
If you have an urgent problem requiring immediate surgical assessment you are referred acutely to the General Surgical Department at North Shore Hospital where you will initially be seen by the junior medical staff who will decide whether you need to be admitted to hospital. Investigations will be performed as required, and the more senior members of the team involved where necessary.
Elective Referrals
If the problem is not urgent, the GP will write a letter to the Department requesting an appointment in the outpatient clinic. One of the consultant surgeons working in the Department reviews these letters to determine who should be seen first, based on the information provided by the GP. Very urgent cases are usually seen within a couple of weeks, but other cases may have to wait a much longer time. Outpatient clinics are run at both North Shore and Waitakere Hospitals.
When you come to your clinic appointment please bring any relevant x-rays, scans, or results with you. Your surgeon will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before your appointment to try to speed up the process.
Once a diagnosis has been made, your surgeon will discuss treatment with you. In some instances this will mean surgery, while other cases can be managed with medication and advice. If surgery is advised, the steps involved in the surgical process and the likely outcome are usually discussed with you at this time.
If surgery is advised you will be placed on the elective surgery waiting list. Most surgery is performed at North Shore Hospital, but some more minor surgery can be performed at Waitakere Hospital. The waiting lists are ordered according to the urgency and severity of the condition.
You may be required to attend a preadmission clinic before your surgery. The aim of this clinic is to confirm that you are fit and well enough to undergo the surgery. The process involves junior medical staff working in consultation with anaesthetists, pharmacists, physiotherapists etc.
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Skin Disorders
Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues...
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Endocrine Disorders
Abnormalities of the endocrine system treated by general surgery include disorders of the pancreas and adrenal glands in the abdomen and the thyroid and parathyroid glands in the neck. These are often very complex conditions requiring extensive investigations...
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Breast Disorders
General surgery covers breast diseases including breast cancer. These conditions are often initially dealt with in a specialised breast clinic which is able to perform a number of investigations (e.g...
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Gastrointestinal Disorders
Conditions of the gut dealt with by general surgery include disorders of the oesophagus, stomach, small bowel, large bowel and anus...
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Salivary Gland Disorders
Disorders of the salivary glands may be dealt with by the general surgical department or the ENT (ORL) department depending on the local policy.
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Gallstones
General surgery covers some disorders of the liver and biliary system...
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Hernias
A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside...
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Vascular Disorders
Vascular (blood vessel) disorders treated by general surgery at WDHB include varicose veins...
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Visiting hours are 2pm-8pm daily.
Charge Nurse Ward 8: Kim Bowden
Charge Nurse Ward 4: Susan Johnston
Charge Nurse Ward 6: Desmae Earl
Colorectal Nurse Specialist: Karen Pollock
Breast Nurse Specialists: Janice Wood and Marilyn Bellingham
Trauma Co-ordinator: Jodie Orchard
