The digestive apparatus comprising of the stomach and the intestines is referred to as the gastrointestinal system. Surgeries performed in the gastrointestinal tract rectify maladies of the oesophagus, pancreas, stomach, liver and the intestines. Gastro surgery can be divided into three subtypes:
Upper GI surgery or upper gastrointestinal surgery: Some of the upper GI procedures are:
- Oesophagectomy - The procedure aims at removing part or the entire oesophagus and replacing it with part of the stomach, large intestine or small intestine. The common surgical manipulations are transthoracic oesophagectomy and laparoscopic transhiatal or thoracoscopic oesophagectomy where the oesophagus is removed after mobilizing it, making small wounds in the abdomen or chest.
- Laparoscopic surgery - For a hiatus hernia and Gastroesophageal Reflux disease in which the weak muscles around the lower end of the oesophagus is repaired through key-hole surgery.
- Gastrectomy - Part of the stomach or all of it is removed in a gastrectomy. When the complete stomach is eliminated, it is called a total gastrectomy and when only a part of the stomach is resected, it is called partial gastrectomy. These operations are usually done for cancer involving the stomach.
- Cholecystectomy - Routine gallbladder removals are conducted with the laparoscopic cholecystectomy. An open cholecystectomy may be performed only if there are any intraoperative difficulties during the laparoscopic procedure.
- Hepatectomy or liver surgery - Laparoscopic right hepatectomy is performed to remove benigntumours, or malignant tumorslike hepatocellular carcinoma, commonly known as liver cancer.
- Pancreatectomy - Partial or total pancreatectomy will remove some or all of the pancreas. Other types of pancreatectomy are segmental pancreatectomy, distal pancreatectomy and pancreaticoduodenectomy or Whipple procedure.Special modifications of pancreatic surgery is needed for chronic pancreatitis, a condition in which patients develop stones in the pancreas.
- Splenectomy - The spleen is surgically removed either partially or fully when encountered with a ruptured or damaged spleen causing internal bleeding, which can be life-threatening.
Lower GI surgery or lower gastrointestinal surgery: Some lower GI repairs conducted are:
- Colectomy Large bowel resection or colectomy is the removal of part or whole of the large intestine affected by cancer. In some situations, the entire colon along with the rectum may be removed.
- Rectopexy Rectal prolapse is corrected with laparoscopic rectopexy when the patient encounters Prolapse of the rectum.
- Low anterior resection The rectum is located at the far end of the bowel and functionally acts as the reservoirof the faeces before being released through the anus. When cancer affects the lower two-thirds of the rectum, a low anterior resection is done to remove it. This is usually done laparoscopically.
Hernia repairs: Minimally invasive surgical intervention is the best way to fix hernias. Inguinal hernia repairs and ventral hernia repairs are performed laparoscopically. Inguinal hernias are repaired using the TEP (totally extraperitoneal) or the TAPP (transabdominal preperitoneal) approach. Ventral or incisional hernia repair requires special mesh placement – a fixation device to avoid displacement of the mesh.
We have nearly 20 years of experience in the field of gastroenterology and is located in Kochi, India. Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)