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Jacques Marnewick – General, Laparoscopic & Thyroid Surgeon

Private Service, General Surgery

Today

8:00 AM to 5:00 PM.

Description

Mr Jacques Marnewick is a New Zealand-trained general surgeon in private practice in Tauranga. He is also a consultant surgeon in the Department of General Surgery at Tauranga Hospital and the Trauma Medical Director for the Bay of Plenty.  
 
The emphasis in his practice is on quality and care. He recognises that the surgical process is often a daunting journey and considers it a privilege and professional duty to support his patients throughout that journey. 


Conditions Mr Marnewick treats include: 

  • thyroid and parathyroid disease
  • hernias
  • gallbladder, gallstone and biliary disease
  • skin cancers
  • melanoma
  • intra-abdominal diseases
  • pilonidal disease
  • urgent lymph node biopsies 
  • other general surgical problems including haemorrhoids and peri-anal disease
 
 
What is General Surgery?
The role of the general surgeon is broad and includes managing disorders of the intestines, gallbladder, breast, neck and skin. It also covers peri-anal problems.
 
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.
 
What is Laparoscopic Surgery?
Laparoscopic (or keyhole) surgical procedures are performed through several small cuts (incisions) usually only 5-10mm long, rather than through one larger incision.

A long, narrow surgical telescope (laparoscope) that has a tiny camera and light source attached, is inserted through one of the incisions so that the surgeon can view the inside of the body on a TV monitor.

The surgeon then passes specially designed surgical instruments through the other incisions and carries out the procedure using the TV monitor to guide the instruments. Gallbladder surgery, hernias and a number of other intestinal operations can be performed in this way.

Laparoscopic surgery is usually associated with less blood loss during surgery and less pain and scarring following surgery. In most cases, time spent in hospital is less and overall recovery time from the operation is less than with conventional open surgery.
 

Consultants

Referral Expectations

When you come to your appointment, 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.
 
Read more about your consultation with Mr Marnewick here and, if surgery is required, find out what would be involved here
 

Charges

Jacques is a Southern Cross Affiliated Provider under the General Surgery (gallbladder, hernia) and Skin categories.

Jacques is an nib First Choice Provider.

Hours

8:00 AM to 5:00 PM.

Mon – Fri 8:00 AM – 5:00 PM

Procedures / Treatments

Thyroid & Parathyroid Surgery

Thyroid and parathyroid diseases are very specialised areas of general surgery, that cover the small glands located in the front of the neck. Functional problems of the thyroid often respond well to medical treatment, although surgery is a potential treatment option in many cases. For nodules, masses, enlargement of the thyroid gland or cancer, surgery is usually the only treatment option, but does require very careful and expert judgement. Parathyroid diseases are often managed for a long time with medications or observation. More often than not, it can be cured with surgery, which avoids the long-term complications (kidney stones, kidney damage, osteoporosis and mood problems) caused by parathyroid gland disease. The two operations performed most often are: Thyroidectomy (or Hemi-thyroidectomy) A small incision (cut) is made in the front of and at the base of the neck and part or all of the thyroid gland is removed. Parathyroidectomy A small incision (cut) is made in the front of and at the base of the neck and one or more of the parathyroid glands are removed.

Thyroid and parathyroid diseases are very specialised areas of general surgery, that cover the small glands located in the front of the neck. Functional problems of the thyroid often respond well to medical treatment, although surgery is a potential treatment option in many cases. For nodules, masses, enlargement of the thyroid gland or cancer, surgery is usually the only treatment option, but does require very careful and expert judgement. 

Parathyroid diseases are often managed for a long time with medications or observation. More often than not, it can be cured with surgery, which avoids the long-term complications (kidney stones, kidney damage, osteoporosis and mood problems) caused by parathyroid gland disease.  

The two operations performed most often are:

Thyroidectomy (or Hemi-thyroidectomy)
A small incision (cut) is made in the front of and at the base of the neck and part or all of the thyroid gland is removed.

Parathyroidectomy
A small incision (cut) is made in the front of and at the base of the neck and one or more of the parathyroid glands are removed.

Hernias

A hernia exists where part of the abdominal wall is weakened and the contents of the abdomen push through to the outside. Occasionally, this occurs following surgery for another disease, in which case it is referred to as an incisional hernia. An inguinal hernia forms when part of the intestine pushes through the abdominal wall, causing a bulge in the groin. Hernias may also form around the umbilicus (bellybutton) or along the middle of the abdominal wall. Repair of hernias may be done through open operations or laparoscopically - both options have benefits and disadvantages. The operations can often be performed as day-stay procedures and may require the use of a mesh - best to speak to your surgeon about which options are best for you.

A hernia exists where part of the abdominal wall is weakened and the contents of the abdomen push through to the outside. Occasionally, this occurs following surgery for another disease, in which case it is referred to as an incisional hernia.

An inguinal hernia forms when part of the intestine pushes through the abdominal wall, causing a bulge in the groin. Hernias may also form around the umbilicus (bellybutton) or along the middle of the abdominal wall. 

Repair of hernias may be done through open operations or laparoscopically - both options have benefits and disadvantages. The operations can often be performed as day-stay procedures and may require the use of a mesh - best to speak to your surgeon about which options are best for you.

Gastrointestinal Disorders

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.

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.
Gallstones

Sometimes, some of the watery fluid (bile) stored in the gallbladder hardens into pieces of stone-like material known as gallstones. Gallstones may vary from the size of a grain of sand to a golf ball and there may be one or hundreds of stones. Gallstones can cause abdominal pain, fever and vomiting if they block the movement of bile into or out of the gallbladder. Laparoscopic Cholecystectomy is the surgical removal of the gallbladder. A laparoscope is inserted into the abdominal cavity at the level of the tummy button. Surgical instruments are inserted through other incisions and the gallbladder removed.

Sometimes, some of the watery fluid (bile) stored in the gallbladder hardens into pieces of stone-like material known as gallstones. Gallstones may vary from the size of a grain of sand to a golf ball and there may be one or hundreds of stones.

Gallstones can cause abdominal pain, fever and vomiting if they block the movement of bile into or out of the gallbladder.

Laparoscopic Cholecystectomy is the surgical removal of the gallbladder. A laparoscope is inserted into the abdominal cavity at the level of the tummy button. Surgical instruments are inserted through other incisions and the gallbladder removed.

Skin Disorders

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

Skin Cancers

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun. Risk factors for developing skin cancer are: prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal Cell Carcinoma (BCC) This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body. Sometimes BCC’s can ulcerate and scab so it is important not to mistake it for a sore. BCCs occur more commonly on the face, back of hands and back. They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour. Treatment Often a BCC can be diagnosed just by its appearance. In other cases it will be removed totally and sent for examination and diagnosis, or a biopsy may be taken and just a sample sent for diagnosis. Removal of a BCC will require an appointment with a doctor or surgeon. It will be termed minor surgery and will require a local anaesthetic (numbing of the area) and possibly some stitches. A very small number of BCCs will require a general anaesthetic (you will sleep through the operation) for removal. Squamous Cell Carcinoma (SCC) This type of skin cancer also affects areas of the skin that have exposure to the sun. The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body. The spreading (metastasising) can potentially be fatal if not successfully treated. A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges. SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown. Sometimes it can appear like a recurring ulcer that does not heal. All SCCs will need to be removed, because of their potential for spread. The removal and diagnosis is the same as for a BCC. Malignant Melanoma This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease. A melanoma usually starts as a pigmented growth on normal skin. They often, but not always, occur on areas that have high sun exposure. In some cases, a melanoma may develop from existing pigmented moles. What to look for: an existing mole that changes colour (it may be black, dark blue or even red and white) the colour pigment may be uneven the edges of the mole/freckle may be irregular and have a spreading edge the surface of the mole/freckle may be flaky/crusted and raised sudden growth of an existing or new mole/freckle inflammation and or itchiness surrounding an existing or new mole/freckle. Treatment It is important that any suspect moles or freckles are checked by a GP or a dermatologist. The sooner a melanoma is treated, there is less chance of it spreading. A biopsy or removal will be carried out depending on the size of the cancer. Tissue samples will be sent for examination, as this will aid in diagnosis and help determine the type of treatment required. If the melanoma has spread more surgery may be required to take more of the affected skin. Samples from lymph nodes that are near to the cancer may be tested for spread, then chemotherapy or radiotherapy may be required to treat this spread. Once a melanoma has been diagnosed, a patient may be referred to an oncologist (a doctor who specialises in cancer). A melanoma that is in the early stages can be treated more successfully and cure rates are much higher than one that has spread.

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun.

Risk factors for developing skin cancer are:  prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds.

There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. 


Basal Cell Carcinoma (BCC)
This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body.  Sometimes BCC’s can ulcerate and scab so it is important not to mistake it for a sore.

BCCs occur more commonly on the face, back of hands and back.  They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour.

Treatment

Often a BCC can be diagnosed just by its appearance.  In other cases it will be removed totally and sent for examination and diagnosis, or a biopsy may be taken and just a sample sent for diagnosis.

Removal of a BCC will require an appointment with a doctor or surgeon.  It will be termed minor surgery and will require a local anaesthetic (numbing of the area) and possibly some stitches. A very small number of BCCs will require a general anaesthetic (you will sleep through the operation) for removal.

 

Squamous Cell Carcinoma (SCC)
This type of skin cancer also affects areas of the skin that have exposure to the sun.  The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body.  The spreading (metastasising) can potentially be fatal if not successfully treated.

A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges.  SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown.  Sometimes it can appear like a recurring ulcer that does not heal.

All SCCs will need to be removed, because of their potential for spread.  The removal and diagnosis is the same as for a BCC.


Malignant Melanoma
This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease.

A melanoma usually starts as a pigmented growth on normal skin.  They often, but not always, occur on areas that have high sun exposure.  In some cases, a melanoma may develop from existing pigmented moles.

What to look for:

  • an existing mole that changes colour  (it may be black, dark blue or even red and white)
  • the colour pigment may be uneven
  • the edges of the mole/freckle may be irregular and have a spreading edge
  • the surface of the mole/freckle may be flaky/crusted and raised
  • sudden growth of an existing or new mole/freckle
  • inflammation and or itchiness surrounding an existing or new mole/freckle.

Treatment

It is important that any suspect moles or freckles are checked by a GP or a dermatologist. The sooner a melanoma is treated, there is less chance of it spreading.

A biopsy or removal will be carried out depending on the size of the cancer.  Tissue samples will be sent for examination, as this will aid in diagnosis and help determine the type of treatment required.  If the melanoma has spread more surgery may be required to take more of the affected skin.  Samples from lymph nodes that are near to the cancer may be tested for spread, then chemotherapy or radiotherapy may be required to treat this spread. 

Once a melanoma has been diagnosed, a patient may be referred to an oncologist (a doctor who specialises in cancer).

A melanoma that is in the early stages can be treated more successfully and cure rates are much higher than one that has spread.

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Contact Details

8:00 AM to 5:00 PM.

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Tauranga Specialist Centre
752 Cameron Road
Tauranga South
Tauranga
Bay Of Plenty 3112

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Street Address

Tauranga Specialist Centre
752 Cameron Road
Tauranga South
Tauranga
Bay Of Plenty 3112

This page was last updated at 12:50PM on November 22, 2023. This information is reviewed and edited by Jacques Marnewick – General, Laparoscopic & Thyroid Surgeon.