Treatments

Abdominal wall reconstruction (AWR) is mostly used to repair damage caused by previous hernia surgery. This treatment can also be helpful following trauma, after surgery for the removal of cancers, or to correct birth defects.

We use a number of plastic surgery techniques including skin grafts and the creation of flaps of tissue. We may also use mesh implants to strengthen weaker areas and places where muscle has been lost.

If you have appendicitis, your appendix will normally need to be removed as soon as possible. This is called an appendectomy. While it's unclear why we have an appendix, we do know that removing it doesn't harm you.

There are two ways of performing the surgery:

• Keyhole surgery: This tends to be the preferred method as the recovery time is quicker. It involves making three of four small incisions in your abdomen, through which we insert special instruments including a laparoscope (a tube with a small camera on the end), to remove the appendix.
• Open surgery: In some instances you may require open surgery. This involves making a single large cut in the lower right-hand side of your abdomen, through which we can remove your appendix.

While most colorectal cancers start in the inner surface of the bowel wall, in some cases the cancer can spread to the lining of the abdomen (peritoneum).

Surgery has not traditionally been used for curing cancer of the peritoneum. However, there is evidence that if the size and spread of the cancer is limited, then a specialised surgical technique called ‘cytoreductive surgery’ can be used. This procedure removes all the visible cancer and may also involve removing organs in the abdomen and peritoneum.

Cytoreductive surgery is often used in combination with hyperthermic intraperitoneal chemotherapy (HIPEC). This is when heated chemotherapy drugs are introduced into the abdomen to kill any cancer cells we can’t see, but that could develop into tumours.

Gallbladder removal is usually carried out using keyhole surgery. We’ll typically make three or four small cuts in your abdomen, through which we’ll insert special instruments, including a laparoscope (a tube with a small camera on the end), to remove the gallbladder. We’ll then close up those cuts using dissolvable stitches.

This is a short procedure that usually takes between one and two hours.

If suffering from gallstones, you may require the following surgery:

• Endoscopic retrograde cholangio-pancreatography (ERCP): This is a procedure to diagnose and remove gallstones from the bile duct. It combines X-ray and the use of an endoscope – a long, flexible tube with a camera on the end – to look for gallstones. Once we’ve located the stones, we either break them up or remove them using small tools passed through the endoscope.
• Laparoscopic cholecystectomy: Your consultant may recommend the removal of your gallbladder (see gallbladder removal/cholecystectomy), a procedure carried out using keyhole surgery. If a gallstone has moved from your gallbladder to your bile duct, another procedure may be necessary. 

This is a procedure to repair a hernia and strengthen the supporting abdominal muscles. It is used to treat primary or recurrent hernias and is carried out as either keyhole or open surgery.

For keyhole surgery, we’ll make several tiny incisions in your abdomen, through which we’ll insert special instruments, including a laparoscope (a tube with a small camera on the end), into your abdomen. Your hernia will be repaired and tied back into your abdomen with synthetic mesh. One of the main benefits of keyhole surgery is a faster recovery time. 

If you’re having open surgery, we’ll make a single incision over your groin area. The hernia is repaired and the protruding tissue pushed back into your abdomen and reinforced with synthetic mesh. The incision will be glued or stitched together.

Laparoscopy, also known as keyhole or minimally invasive surgery, is a type of surgical procedure. It allows Mr Shankar to access either the abdomen or pelvis without the need for the large incisions seen in open surgery.

This is all down to an instrument called a laparoscope, a small tube with its own light source and camera. A small incision (typically 1-1.5cm) is enough to pass the laparoscope into the abdomen or pelvic area, from where it sends images to a monitor in the operating theatre.

Some key benefits of laparoscopy include:

• A shorter stay in hospital
• A faster recovery
• Less post-operative pain
• Less post-operative bleeding
• Less scarring

Lipomas are soft, fatty lumps that grow under your skin. They are harmless (benign), but some people like to have them removed if they’re prominent and easily visible.

Skin lesion is a general term for a lump, bump or unusual mark on your skin. Common skin lesions include birth marks, moles, freckles, warts, skin tags and cysts.

You may have a lesion removed for cosmetic reasons, or as a precaution against skin cancer. While these lesions are usually harmless, you may also have them removed to diagnose or treat skin cancer. This is usually a short procedure, and one you can attend as an outpatient.

When removing a skin lesion, we’ll give you a local anaesthetic to numb the area first. Depending on the type of skin lesion you have, we may remove it with specialised surgical scissors or a laser. Your consultant will then treat the area to minimise scarring. If there’s a concern that the lesion may be cancerous, we’ll send the tissue removed for analysis straight away.

If your spleen has become damaged, diseased or enlarged, you may have to have it removed.

This procedure, called a splenectomy, is usually done using keyhole surgery. We’ll make three or four small cuts in your abdomen, into which we’ll insert special instruments, including a laparoscope (a tube with a small camera on the end) to remove the spleen.

If your spleen is very large, we may need to perform open surgery in order to remove it. Your surgeon will advise you on the best procedure for you before your surgery.

Patients are generally required to remain as inpatients for one to two days following surgery. You may need to stay in hospital for longer if the procedure has been done in conjunction with resection of another organ (for example, the liver or pancreas).