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Central Auckland, East Auckland, South Auckland > Private Hospitals & Specialists >

Mr Rishi Ram - General Surgeon

Private Service, General Surgery

Today

9:00 AM to 5:30 PM.

Description

Mr Rishi Ram
Fellow of The Royal Australasian College of Surgeons
Member of the Endocrine Section of The Australasian College of Surgeons
Member of Australasian & New Zealand Gastric and Oesophageal Surgeons Association

My current practice is as a General and Upper GI Surgeon both in the private sector (MercyAscot, Franklin and Southern Cross Hospitals) and public sector at Auckland Hospital.

My areas of expertise are laparoscopic hernia repair, including ventral and groin hernias and laparoscopic cholecystectomy (gall stones).

Other areas of expertise include stomach and bowel surgery, skin cancer surgery, haemorrhoids and pilonidal sinus disease.

Bariatric surgery is also an area of expertise, mainly doing sleeve gastrectomies.

I am a Southern Cross Affiliated Provider for initial consultation, hernia, gallbladder, varicose veins, skin lesions, fine needle biopsies, cryotherapy, drainage of abscesses, ingrown toenails and injection of haemorrhoids.

I am a preferred provider for NIB insurance company.

Consultants

  • Mr Rishi Ram

    General, Laparoscopic Gall bladder, Hernia and Upper GI Surgeon

Ages

Adult / Pakeke, Older adult / Kaumātua, Youth / Rangatahi

How do I access this service?

Contact us, Make an appointment, Referral

Referral Expectations

When you come to your appointment I 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 I 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 will be discussed with you at this time.
 
You will be seen within two weeks of referral but with urgent situations you can expect to be seen within 24 hours.

Fees and Charges Categorisation

Free, Partial fees apply, Fees apply

Fees and Charges Description

Preferred provider for NIB insurance

An estimated cost will be provided for other surgical procedures if required. 

Mr Rishi Ram is a Southern Cross Affiliated Provider for a range of services including :

  • Consultations
  • Open or laparoscopic repair of inguinal hernia
  • Laparoscopic cholecystectomy
  • Laparoscopic cholecystectomy with an intraoperative cholangiogram
  • Open or laparoscopic repair of umbilical hernia
  • Open repair of epigastric hernia
  • Open repair of incisional hernia
  • Open repair of femoral hernia
  • Fine needle aspiration (FNA)
  • Sigmoidoscopy
  • Skin lesion removal under LA or general anaesthesia
  • Curettage or diathermy
  • Skin biopsy
  • Varicose vein surgery
  • Injection of haemorrhoids
  • Drainage of abscesses
  • Ingrown toenails

Hours

9:00 AM to 5:30 PM.

Mon – Thu 9:00 AM – 5:30 PM
Fri 9:00 AM – 4:00 PM

Mauranui Clinic: regularly every week.

Public Holidays: Closed Labour Day (28 Oct), Auckland Anniversary (27 Jan), Waitangi Day (6 Feb), Good Friday (18 Apr), Easter Sunday (20 Apr), Easter Monday (21 Apr), ANZAC Day (25 Apr), King's Birthday (2 Jun), Matariki (20 Jun).

Languages Spoken

English, Fiji Hindi, Hindi

Common Conditions

Hernias

LAPAROSCOPIC HERNIA REPAIR Please click here to see a YouTube video to help understand the procedure. Most of my patients receive laparoscopic repair unless contraindicated. I have extensive experience in the laparoscopic approach. A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually straightforward and involves reducing the hernia contents where they belong and then reinforcing the abdominal wall with a mesh. A hernia occurs when part of the abdominal contents contained in its lining (sac) pushes through a muscular defect. For a long time hernia have been repaired by an open technique involving a long incision, approximately 10cms, over the hernia in the groin. This incision extends through the muscle layer, and the sac of the hernia is mobilised, is removed or reduced and then the muscular defect is closed and reinforced with a mesh. The laparoscopic technique avoids a large skin incision and the muscular cut as well as apposing the defect under some tension. In this way post-operative pain is less and one can return to doing heavy physical activities and work earlier compared with the open technique. Technique: The operation is done within the space between the muscle and the inner most lining of the abdominal wall which is created by placing a special small insufflating balloon through a small incision just below the umbilicus. A special camera (laparoscope) is placed in this space. Two small incisions (5 mms) are made below the umbilicus to allow the passage of long instruments into the space created by the balloon. Once the hernia has been reduced, a polyester or polypropylene mesh is placed behind the defect and fixed in place. The mesh is held very firmly by the special self-gripping mesh or screws. An early return to full activity is permissible without fear of inducing hernia recurrence. This is usually achieved within seven days following surgery. Laparoscopic surgery is certainly more technically demanding than the traditional open approach. Provided attention is applied to detail, damage to the intestine or major blood vessels or nerves is avoided. Although foreign material (mesh) is left in the body, problems with infection around this has been minimal. Bowel obstruction has been described following the earlier method of laparoscopic hernia repair but the risk of this is considerably reduced when using the technique described above. The laparoscopic procedure is the preferred approach, particularly in bilateral groin as well in recurrent hernia. POST OPERATIVE INSTRUCTIONS ACTIVITY: Following a laparoscopic hernia repair there really are no activity restrictions but you have to be sensible in what sort of activities you take part in. Your body is going to dictate as to how much you can or can't do. The average time to full activities is between 1 - 2 weeks after surgery. DISCOMFORT: There is usually some degree of discomfort in the groin as well as the sugical wounds. There may be some discomfort and increased sensitivity in the testicle/scrotum on the side of the repair. This usually only lasts around 24-48 hours and usually settles very quickly. The testicular discomfort may remain for a few weeks. BRUISING: Is common but do not be alarmed and it will certainly fade within one to two weeks. Sometimes swelling in the groin may occur on the same side as the hernia. This usually represents fluid collection in the space where the hernia once was and this fluid is absorbed slowly over the next few weeks. ANALGESIA: Panadol (Paracetamol) and Ibuprofen/Arcoxia are usually needed and are often sufficient. WOUND CARE: You will have small dressings over the small wounds allowing you to take showers immediately following surgery. These dressings need to be removed in seven (7) days after surgery but leave the steristrips to fall out by themselves. POST OPERATIVE APPOINTMENT: Your clinic appointment is usually within two to four weeks from your surgery.

LAPAROSCOPIC HERNIA REPAIR 

Please click here to see a YouTube video to help understand the procedure.

Most of my patients receive laparoscopic repair unless contraindicated. I have extensive experience in the laparoscopic approach.

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually straightforward and involves reducing the hernia contents where they belong and then reinforcing the abdominal wall with a mesh.

A hernia occurs when part of the abdominal contents contained in its lining (sac) pushes through a muscular defect.

For a long time hernia have been repaired by an open technique involving a long incision, approximately 10cms, over the hernia in the groin.  This incision extends through the muscle layer, and the sac of the hernia is mobilised, is removed or reduced and then the muscular defect is closed and reinforced with a mesh.

The laparoscopic technique avoids a large skin incision and the muscular cut as well as apposing the defect under some tension.  In this way post-operative pain is less and one can return to doing heavy physical activities and work earlier compared with the open technique. 

Technique:
The operation is done within the space between the muscle and the inner most lining of the abdominal wall which is created by placing a special small insufflating balloon through a small incision just below the umbilicus.  A special camera (laparoscope) is placed in this space.  Two small incisions (5 mms) are made below the umbilicus to allow the passage of long instruments into the space created by the balloon.  Once the hernia has been reduced, a polyester or polypropylene mesh is placed behind the defect and fixed in place.  The mesh is held very firmly by the special self-gripping mesh or screws.  An early return to full activity is permissible without fear of inducing hernia recurrence.  This is usually achieved within seven days following surgery.

Laparoscopic surgery is certainly more technically demanding than the traditional open approach. Provided attention is applied to detail, damage to the intestine or major blood vessels or nerves is avoided.  Although foreign material (mesh) is left in the body, problems with infection around this has been minimal.  Bowel obstruction has been described following the earlier method of laparoscopic hernia repair but the risk of this is considerably reduced when using the technique described above.

The laparoscopic procedure is the preferred approach, particularly in bilateral groin as well in recurrent hernia.

POST OPERATIVE INSTRUCTIONS

ACTIVITY:  Following a laparoscopic hernia repair there really are no activity restrictions but you have to be sensible in what sort of activities you take part in. Your body is going to dictate as to how much you can or can't do. The average time to full activities is between 1 - 2 weeks after surgery.

DISCOMFORT:  There is usually some degree of discomfort in the groin as well as the sugical wounds. There may be some discomfort and increased sensitivity in the testicle/scrotum on the side of the repair.  This usually only lasts around 24-48 hours and usually settles very quickly. The testicular discomfort may remain for a few weeks.

BRUISING: Is common but do not be alarmed and it will certainly fade within one to two weeks.  Sometimes swelling in the groin may occur on the same side as the hernia.  This usually represents fluid collection in the space where the hernia once was and this fluid is absorbed slowly over the next few weeks.

ANALGESIA: Panadol (Paracetamol) and Ibuprofen/Arcoxia are usually needed and are often sufficient.

WOUND CARE: You will have small dressings over the small wounds allowing you to take showers immediately following surgery.  These dressings need to be removed in seven (7) days after surgery but leave the steristrips to fall out by themselves.

POST OPERATIVE APPOINTMENT:  Your clinic appointment is usually within two to four weeks from your surgery.

Gallstones

General surgery covers some disorders of the liver and biliary system. The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.

General surgery covers some disorders of the liver and biliary system.

The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.

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.
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. I am a Southern Cross Affiliated Provider for assessment and treatment of skin lesions (skin cancers and benign lumps). Some lesions may need surgery to be done under Local + IV sedation or General Anaesthesia and this will be discussed at the time of the consultation.

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.

I am a Southern Cross Affiliated Provider for assessment and treatment of skin lesions (skin cancers and benign lumps). Some lesions may need surgery to be done under Local + IV sedation or General Anaesthesia and this will be discussed at the time of the consultation.

Varicose Vein Surgery

Vascular (blood vessel) disorders treated by general surgery include varicose veins, blockages and narrowings in the arteries or abnormal swellings of the arteries (aneurysm). The most common of these conditions facing the general surgeon is varicose veins. 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. 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.

Vascular (blood vessel) disorders treated by general surgery include varicose veins, blockages and narrowings in the arteries or abnormal swellings of the arteries (aneurysm).

The most common of these conditions facing the general surgeon is varicose veins. 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.

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.
Vasectomy - Office Procedure

This procedure is usually done as a day stay, under local anaesthesia in an office/procedure room setup. Patients are usually counselled in their first visit. The operation can proceed soon after or another appointment is made at a later date. The procedure takes on average 30 - 45 minutes and the patient is able return home. Follow up is done with phone contact or through the GP. Regular semen analysis is done to make sure it is all clear before stopping the use of contraception.

This procedure is usually done as a day stay, under local anaesthesia in an office/procedure room setup.

Patients are usually counselled in their first visit. The operation can proceed soon after or another appointment is made at a later date. The procedure takes on average 30 - 45 minutes and the patient is able return home.

Follow up is done with phone contact or through the GP. Regular semen analysis is done to make sure it is all clear before stopping the use of contraception.

Disability Assistance

Wheelchair access, Wheelchair accessible toilet, Mobility parking space, Quiet, low sensory environment

Additional Details

Face to face / Kanohi ki te Kanohi, Phone

Public Transport

Bus stop by the front of the building.

Parking

There is parking available on the grounds of Mauranui Clinic for patients for clinic appointments. If there is no on-site parking, parking is usually available on the streets around the clinic.

Other

SOUTHERN CROSS AFFILIATED PROVIDER

NIB PREFERRED PROVIDER

Contact Details

9:00 AM to 5:30 PM.

Suite 10
Mauranui Clinic
86 Great South Road
Epsom
Auckland 1051

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Street Address

Suite 10
Mauranui Clinic
86 Great South Road
Epsom
Auckland 1051

Postal Address

Suite 10
Mauranui Clinic
86 Great South Road
Epsom
Auckland 1051

This page was last updated at 3:22PM on August 15, 2023. This information is reviewed and edited by Mr Rishi Ram - General Surgeon.