Auckland Regional Charity Hospital (ARCH)
What is General Surgery?
The role of the General Surgical Department varies from hospital to hospital, but in broad terms general surgery can be said to deal with a wide range of conditions within the abdomen, breast, neck, skin and, in many hospitals, vascular (blood vessel) system.
- General surgery – Hernias – abdominal, umbilical, inguinal, femoral.
- Minor colorectal – haemorrhoids, anal fissure, fistulae
- Ingrown toenails
- Pilonidal disease
- Varicose veins- symptomatic (At the present time we are not offering Varicose Vein surgery. This may change in the future.)
Conditions of the gut dealt with by general surgery include disorders of the oesophagus, stomach, small bowel, large bowel and anus. These range from complex conditions such as ulceration or cancer in the bowel through to fairly minor conditions such as haemorrhoids. Many of the more major conditions such as bowel cancer will require surgery, or sometimes treatment with medication, chemotherapy or radiotherapy.
Haemorrhoids are a condition where the veins under the lining of the anus are congested and enlarged. Less severe haemorrhoids can be managed with simple treatments such as injection or banding which can be performed in the clinic while larger ones will require surgery.
An inguinal hernia is caused by a connection between the scrotum and the abdomen (uncommonly a similar connection occurs in girls causing an inguinal hernia). The connection is present in all babies in the womb during development, but in most babies has closed over before birth. The connection allows some contents of the abdomen to pass down towards the scrotum causing a bulge in the groin. The bulge is often more noticeable when the baby cries.
The bulge (or hernia) can usually be pushed back into the abdomen by gentle pressure when the baby is settled.
Uncommonly the hernia cannot be pushed back (“reduced”), which can be a serious complication because the tissue trapped in the connection can become swollen and damaged.
An inguinal hernia can be repaired with a simple operation. Your family doctor will have referred you to a children’s surgeon who is experienced in repairing inguinal hernias.
An umbilical hernia is caused by a weakness in the muscles of the abdominal wall near the belly button or navel, which allows the contents of the abdomen to push through and form a bulge around the belly button.
In most cases these hernias close by themselves before the age of 5 years, but if they are large or are causing problems, they may require surgery.
These are bulging veins that lie just beneath the skin (superficial veins). They occur when the walls of a vein are weak or damaged or if the valves in the vein that normally stop the blood from flowing backwards are impaired, resulting in pooling of the blood and stretched veins. Besides being unattractive, varicose veins can be painful and cause inflammation or ulceration.
The following different types of surgery are available if varicose veins require treatment:
Sclerotherapy – a tiny needle is used to inject a chemical solution into the vein that causes the vein to collapse. This approach is recommended for small varicose veins or spider veins that typically appear on the upper legs. You will need to wear elastic bandages or stockings over the treated area for some time after surgery.
Vein stripping – the varicose veins are cut out and the veins that branch off them are tied off. The cuts (incisions) made in the skin are closed with sutures. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.
Phlebectomy – small cuts (incisions) are made in the leg and the varicose veins are pulled out with a tiny hook-like instrument. The cuts are closed with tape rather than sutures and, once healed, are almost invisible. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.