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General Surgery | Counties Manukau | Te Whatu Ora

Public Service, General Surgery, Bariatric (Weight Loss) Surgery

Description

Formerly Counties Manukau Health General Surgery
 
The General Surgical Department at Counties Manukau Health deals with a wide range of conditions within the abdomen, breast, neck, skin, vascular (blood vessel) system and endocrine (endocrine glands and the hormones they release) system. Trauma (physical injury) surgery is also performed at this hospital.
 
In many cases, these conditions cross over into other medical specialties, and often doctors from surgical and medical teams will work together to diagnose and treat a patient’s problems. This is particularly true when considering disorders of the breast, endocrine system, gut, and liver.

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 doctors who have usually qualified more recently, in the last 1-2 years. 

General Surgery Services Provided by Counties Manukau Health
General Surgery services are provided at Middlemore Hospital, Manukau SuperClinic™ and Manukau Surgery Centre.

Consultants

Referral Expectations

If you have an urgent problem requiring immediate surgical assessment you are referred acutely to the General Surgical Department where you will initially 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.
 
If the problem is not urgent, the GP will write a letter to the Surgical Department requesting an appointment in the outpatient clinic. Waiting times for the clinics depend on the urgency of each case. Urgency is assessed from the information in the GP's referral letter. 
 
When you come to the outpatient clinic you will be seen by a member of the surgical team who 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 clinic visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before you are seen at the hospital to try to speed up the process.
 
Once a diagnosis has been made, the medical staff 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 you will be put on the elective surgical waiting list. Again these waiting lists are ordered according to the urgency and severity of the condition. The steps involved in the surgical process and the likely outcome are usually discussed with you at this time.
 
In order to minimise the amount of time of that you have to spend in hospital, many surgical departments run a preadmission process. This is usually done through a clinic where you are seen prior to hospital admission. The aim of this clinic is to confirm that you still need to have the planned surgery and that you are currently fit and well enough to undergo the operation. This process usually involves the junior medical staff working in consultation with the anaesthetists, pharmacists, physiotherapists etc. Often the consultant surgeon will also take this opportunity to review your condition.
 
Outpatient clinics are run at Manukau SuperClinic™.

Charges

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health.
If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website.

For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.

Common Conditions / Procedures / Treatments

Bariatric Surgery

Welcome to the official website for the CM Health Bariatric Service. Bariatric Surgery - Surgical Options for Morbid Obesity In March 2007, CM Health General Surgery commenced Bariatric surgery at Counties Manukau Health (CM Health). It is estimated up to one in five people in New Zealand could be considered obese. The term "Morbid Obesity" does not describe the size of a person, but rather that the weight has become such a problem it is causing morbidity. It is recognised that morbid obesity is not just the result of excess eating, but is a chronic disease with many complex contributing factors. Individuals are considered severely overweight or morbidly obese if the Body Mass Index (BMI) is 30 or over. Surgical weight loss procedures have shown to have the best long term results in dealing with morbid obesity. Surgery is generally considered for obesity only after all other interventions have been exhausted. At CM Health we aim to treat obesity like any other medical condition – in a sensitive, empathetic and non-judgemental way. Please complete the Bariatric Referral Assessment Questionnaire when referring patients to Counties Manukau Health for consideration of Bariatric Surgery. Information on the Bariatric pathway process is also linked below. For further information please refer to the General Surgery website and please direct any queries to our Bariatric Nurse Specialist. Tereapii.VaviaNore@middlemore.co.nz Bariatric Nurse Specialist General Surgical Department Middlemore Hospital CMDHB Bariatric Assessment Questionnaire (PDF, 212.3 KB) Please complete this form when referring patients to Counties Manukau Health for consideration of Bariatric Surgery. Bariatric Pathway (PPTX, 75.2 KB) The timeline for the Bariatric Pathway outpatient appointments

Welcome to the official website for the CM Health Bariatric Service. 

Bariatric Surgery - Surgical Options for Morbid Obesity
In March 2007, CM Health General Surgery commenced Bariatric surgery at Counties Manukau Health (CM Health).

It is estimated up to one in five people in New Zealand could be considered obese.  The term "Morbid Obesity" does not describe the size of a person, but rather that the weight has become such a problem it is causing morbidity.  It is recognised that morbid obesity is not just the result of excess eating, but is a chronic disease with many complex contributing factors.  Individuals are considered severely overweight or morbidly obese if the Body Mass Index (BMI) is 30 or over.   Surgical weight loss procedures have shown to have the best long term results in dealing with morbid obesity.   Surgery is generally considered for obesity only after all other interventions have been exhausted.

At CM Health we aim to treat obesity like any other medical condition – in a sensitive, empathetic and non-judgemental way.

Please complete the Bariatric Referral Assessment Questionnaire when referring patients to Counties Manukau Health for consideration of Bariatric Surgery. Information on the Bariatric pathway process is also linked below.

For further information please refer to the General Surgery website and please direct any queries to our Bariatric Nurse Specialist.

Tereapii.VaviaNore@middlemore.co.nz
Bariatric Nurse Specialist
General Surgical Department
Middlemore Hospital CMDHB

  • Bariatric Assessment Questionnaire (PDF, 212.3 KB)

    Please complete this form when referring patients to Counties Manukau Health for consideration of Bariatric Surgery.

  • Bariatric Pathway (PPTX, 75.2 KB)

    The timeline for the Bariatric Pathway outpatient appointments

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. mammography (breast x-ray) and needle biopsy (small samples of tissue taken from any lumps found in the breast)] during the initial outpatient clinic visit.

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. mammography (breast x-ray) and needle biopsy (small samples of tissue taken from any lumps found in the breast)] during the initial outpatient clinic visit.

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. If surgery is required it is often quite complicated and will usually mean a stay in hospital for several days or even longer. For more information about thyroid operations click here.

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. If surgery is required it is often quite complicated and will usually mean a stay in hospital for several days or even longer.

For more information about thyroid operations click here.

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.
Hernias

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 quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall. Hernia operations are very common and may be performed either with a standard open operation or laparoscopically (keyhole surgery).

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 quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall. Hernia operations are very common and may be performed either with a standard open operation or laparoscopically (keyhole surgery).

Liver and Biliary System Disorders

General surgery covers 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 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.

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.

Disorders of the salivary glands may be dealt with by the General Surgical Department or the ENT (ORL) Department depending on the local policy.

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.

Vascular Surgery

Vascular Surgery is a surgical subspecialty that deals with all diseases that can affect the arteries and veins. The exceptions are the coronary arteries (heart), that the Cardiothoracic Surgeons operate on and the cerebral brain arteries (brain arteries), that the Neurosurgeons are responsible for. There are five main areas in which we work: Aortic Surgery Carotid Surgery Peripheral Vascular Disease Renal Access Surgery Venous Surgery Other areas that we are involved in include: Hyperhidrosis Visceral Artery Thoracic Outlet Syndrome Diabetic Foot Vascular Trauma Click here for more information about the Counties Manukau DHB Vascular Surgery Service

Vascular Surgery is a surgical subspecialty that deals with all diseases that can affect the arteries and veins. The exceptions are the coronary arteries (heart), that the Cardiothoracic Surgeons operate on and the cerebral brain arteries (brain arteries), that the Neurosurgeons are responsible for. There are five main areas in which we work:

Other areas that we are involved in include:

  • Hyperhidrosis
  • Visceral Artery
  • Thoracic Outlet Syndrome
  • Diabetic Foot
  • Vascular Trauma

Click here for more information about the Counties Manukau DHB Vascular Surgery Service

Visiting Hours

Restricted Visiting Policy

To protect patients, whaanau and staff, public access to our hospitals and units will continue to be only on essential (such as carer education to support discharge) or compassionate grounds (such as for critically unwell or palliative care cases) during Alert Level 2.

Click here for more information.

Contact Details

Middlemore Hospital

South Auckland

Middlemore Hospital
Hospital Road
Otahuhu
Auckland

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Street Address

Middlemore Hospital
Hospital Road
Ōtāhuhu
Auckland

Postal Address

General Surgery Department
Private Bag 93311
Ōtāhuhu
Auckland 1640

This page was last updated at 8:04PM on December 22, 2021. This information is reviewed and edited by General Surgery | Counties Manukau | Te Whatu Ora.