Mr Majid Hashemi

Mr Majid Hashemi
Consultant bariatric & gastrointestinal surgeon
Central London


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Mr Majid Hashemi

Consultant bariatric & gastrointestinal surgeon in
London

MB ChB FRCS(Gen)

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Mr Majid Hashemi areas of expertise:

Professional statement

Mr Majid Hashemi is a prolific London-based consultant surgeon, specialising in anti-reflux surgery and laparoscopic (keyhole) bariatric surgery. As one of London's most esteemed surgeons, he has wide experience in a range of surgical treatments, including surgery for hiatal hernia, anti-reflux surgery, bariatric surgery, and oesophageal & gastric cancer surgery. Mr Hashemi holds a notable safety record, with over 3,000 stomach and oesophagus operations performed at a zero mortality rate. Mr Hashemi has performed a range of 'firsts' in surgery, including the first laparoscopic gastric bypass and first laparoscopic sleeve gastrectomy in North London in 2004 and the first LINX implant for reflux in London in 2013. In 2017, he performed the first ever implant of a LINX device on top of a sleeve gastrectomy.

Mr Hashemi is one of the only 12 surgeons in the UK who can currently offer the LINX procedure as a method of treatment for acid reflux. His significant experience allows him to give a focused, patient-centred approach, tailoring treatment for each individual and their specific needs.

Through his dedication to innovation in surgery, Mr Hashemi established and chaired one of the country's first bariatric surgery services with a multidisciplinary approach, providing patients with 'one-stop' care, diagnosis and treatment from a range of specialties. The establishment of the first bariatric surgery team in North London allowed Mr Hashemi to develop surgical approaches, and provide training for many of today’s bariatric and upper GI surgeons.

He currently is Chair for the National Achalasia Patient Support Group, and has one of the longest and most extensive experience in the surgical treatment of achalasia in the capital. Mr Hashemi is also an active researcher, and maintains a strong interest in education, having previously held tutoring and lecturing positions at University College and the Whittington Hospital. He is published extensively and is regularly invited to speak at conferences both on a national and international level. He continues to be involved in training for laparoscopic and bariatric surgery, and acts as supervisor for a number of research projects.

 Doctor's articles

The LINX procedure: cutting-edge treatm...

 Credentials

GMC: ‍3297377

 Professional experience

• More than 30 years of experience
• Consultant Surgeon, St John's and St Elizabeth's Hospital (present)
• Consultant Upper Gastrointestinal Surgeon, University College London Hospitals (present)
• Honorary Consultant Upper Gastrointestinal Surgeon, Royal Free Hospital and University (2001 - 2007)

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 Sub-specialties

• Laparascopic anti-reflux surgery
• Laparascopic LINX implant
• Laparascopic hiatus hernia repair
• Laparascopic sleeve gastrectomy
• Laparascopic gastric bypass
• Hernia repair

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 Positions in public associations

• Charitable organisations:
• Lead Surgical Advisor and Board Member, Oesophageal Patient Association (2008 - 2014)
• Founder of the first Achalasia Support Group
• Advisory Board Member, Faith

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 Teaching posts

• Honorary Senior Lecturer, University College London (2007 - present)
• Chair, Surgery Module Management Group, University College London Medical School (2007 - 2010)
• Senior Lecturer in Surgery and Surgical Tutor, Royal Free University College Medical School London (2001 - 2007)

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 Education

• FRCS (England) Fellow of the Royal College of Surgeons Part II (1993)
• FRCS (England) Fellow of the Royal College of Surgeons Part I (1991)
• MB ChB (1988)
• MB BS, Bachelor of Medicine, Bachelor of Surgery (1983 - 1988)

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 Prizes and awards

• Nominated and selected, Celebrating Excellence Awards UCLH (2014)
• Deans Award for Teaching (2001 / 2002, 2003 / 2004)

 Professional membership

• Royal College of Surgeons
• Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland
• Society for Academic and Research Surgeons (ASGBI)
• Society for Surgery of the Alimentary Tract (SSAT)
• British Obesity Medicine and Surgery: Treasury Committee (2011 - 2013)
• British Obesity Medicine and Surgery: Foreign Affairs Committee (2011 - 2013)

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Languages spoken

  • English
  • Farsi
  • French

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Diseases, Medical Tests and Treatments

Achalasia

What is achalasia? Achalasia is a rare disorder that effects the oesophagus (food pipe), making it very difficult to swallow food and drink and for ...

Gastric bypass

What is a gastric bypass? Gastric bypass surgery is a type of bariatric surgery. Bariatric surgery aims to reduce the patient’s food and/or ca ...

Gastric reflux

Gastroesophageal reflux is a digestive disorder where acid from the stomach leaks back into the oesophagus. It usually occurs because of weakness in t ...

Gastric sleeve

The gastric sleeve is a surgical technique in bariatric surgery for obesity.

Hernia

A hernia appears as a lump, most commonly in the abdominal or groin area. The occur when an organ, often the bowel, protrudes through the cavity which normally contains it. ...

Hiatal hernia

A hiatal hernia occurs when a portion of the stomach ascends to the thorax, through an opening located in the diaphragm, the barrier that separates the thorax from the abdomen. When the stomach moves to the thorax, the aforementioned separation loses its function and a gastroesophageal reflux occurs, that is, the gastric contents return to the oesophagus and irritate it. Symptoms caused by this condition may be burning in the chest or throat, hoarseness, asthma or breathing problems. The symptoms worsen after eating, when sleeping or bending over. The treatment of hiatal hernia depends on its severity, and sometimes it does not require any type of therapy. In mild cases, the aim is to control the symptoms, which improve with changes in the diet and postural changes. In the most severe cases, an operation, usually performed with fundoplication technique (minimally invasive laparoscopy), may be chosen. ...

Appendicitis

What is appendicitis? Appendicitis is an inflammation of the appendix, which is a small pouch of tissue attached to the colon, located in the lower right abdomen. It is formed at the junction of the small and large intestines. What are the symptoms? A sudden pain around the middle of the abdomen that moves to the lower right abdomen or a pain in the lower right abdomen (where the appendix is located) are common symptoms of appendicitis.  Other symptoms include nausea, vomiting, loss of appetite, diarrhoea and a fever. A pain that becomes worse all of a sudden and spreads across the abdomen is a sign that the appendix may have burst and requires immediate medical attention. What causes appendicitis? Appendicitis is caused by a blockage or obstruction in the appendix that leads to infection. The appendix gets filled with a build-up of mucus, causing swelling. How can it be prevented? Appendicitis is very hard to prevent, although there is evidence that it is less prevalent in people with high fibre diets. Appendicitis can lead to the appendix rupturing, which is a very dangerous complication and it is important to prevent the condition reaching this stage. A ruptured appendix spreads potentially life-threatening infection. Peritonitis occurs when the peritoneum (tissue which lines the abdomen) becomes infected and can cause long-term problem and even death. What is the treatment? In most cases, the appendix is removed by surgery. The operation is referred to as an appendectomy and is performed to prevent the appendix from bursting. The operation is performed as either open or keyhole surgery. Keyhole surgery is preferred over open surgery and will be carried out where possible. Keyhole, or laparoscopic, surgery is less invasive than open surgery and has shorter recovery times.  Several small incisions are made in the abdomen, which is then inflated with a gas to make it easier to perform the surgery. The operation is done with the aid of a laparoscope, which is a small tube with a camera that relays images back to the surgeon. In cases where the patient has previously had abdominal surgery or the appendix has already burst in might not be possible to perform keyhole surgery. In these cases, open surgery might be preformed, which consists of a single, much larger cut in the lower right abdomen. If the appendix has burst and an abscess has formed, it will be necessary to drain the abscess before performing an appendectomy.  ...

Bariatric surgery

Bariatric surgery uses of a set of techniques and surgical procedures that help fight obesity and improve the patient's health. It is not to be mistaken as cosmetic surgery and does not come without risk, so the specialist must always advise the patient of the best type of treatment and optimal aftercare. ...

Bowel surgery

What is a colectomy? Colectomy is a surgical procedure that involves the removal of all, or the partial sectioning, of the large intestine (colon). The colon is a long tube-shaped organ at the end of the digestive tract. A colectomy is necessary to treat or prevent diseases and conditions that affect the colon. Diseases and conditions treated with a total or partial colectomy The following conditions may require a colectomy: Bowel obstruction – when the colon is blocked. Bowel perforation – a torn colon, or where bleeding cannot be controlled. Crohn’s disease – removing the affected part of the colon. Colon cancer – early-stage cancers may need a small section of the colon to be removed, whilst cancers at a later stage may require more to be removed. Lynch Syndrome Precancerous colon polyps – those with a high-risk of developing cancer. Ulcerative colitis – a colectomy is required if medications are not working. Different types of colectomy operations A total colectomy removes the entire large intestine. A partial colectomy, also known as a subtotal colectomy, removes only part of the colon. A hemicolectomy removes either the right or the left portion of the colon and a proctolectomy removes both the colon and the rectum. Open vs. laparoscopic procedure for colectomy During an open colectomy, a long incision is made in the wall of the abdomen and doctors can see the colon. In a laparoscopic-assisted colectomy, a lighted tube with a video camera is in inserted through one of several small incisions to guide the surgery. Risks of a colectomy The procedure carries a risk of serious complications, which depend on the patients' general health and the type of colectomy used to perform the operation. These complications can include: Bleeding Deep vein thrombosis (blood clots in the leg) Infection Injury to organs near your colon, such as the bladder and small intestines Pulmonary embolism (blood clots in the lungs) Tears in the sutures that reconnect the digestive system. How to prepare for a colectomy In the days leading up to the colectomy, the doctor will suggest that the patient stops taking certain medications. Fasting before surgery is also required and drinking a solution such as a laxative that clears your bowels. In some cases, a doctor may prescribe antibiotics to prevent any infection from occurring. ...

Colorectal surgery

What is colorectal surgery?  Colorectal surgery is a field in medicine that treats conditions of the colon, anus and rectum. Sometimes treatment involves a team of specialists to treat conditions that affect numerous areas of the body. The conditions treated within the field of colorectal surgery vary and include: haemorrhoids anal fissures anal fistulas rectal prolapse Inflammatory bowel disease (Crohn’s disease, ulcerative colitis) colorectal cancer bowel incontinence gallstones pilonidal sinus infections irritable bowel syndrome (IBS) pelvic floor disorders constipation  diverticular disease hernias  Why would you need colorectal surgery? You would see a colorectal surgeon if you were being diagnosed or treated for the above conditions, as well other conditions relating to the colon, anus and rectum.  What does colorectal surgery involve? The different surgical procedures carried out by colorectal surgeons include: colonoscopy flexible sigmoidoscopy laparoscopy haemorrhoid surgery (haemorrhoidectomy) fistula surgery gallstone removal hernia surgery What to expect from colorectal surgery Much of the above diagnostic and surgical procedures are carried out under local or general anaesthetic and involve a hospital stay of some description. Minimally invasive techniques (laparoscopy, colonoscopy) generally allow for faster recoveries and fewer complication risks, however, whether or not your condition can be treated in such a way depends on the circumstances surrounding your diagnosis.  ...

Diabetes surgery

Type 2 diabetes is a condition where a person has a high blood sugar level, and is often associated with obesity, and is more common as people get older. There are a number of surgical options that can be used to lose weight that have a direct effect on how the body uses insulin, and improves blood sugar levels, making the diabetes much more manageable.   Types of diabetes surgery   There are a number of surgical options which can help you to manage your diabetes. These surgical options were originally only used as a solution to excessive obesity, as they cause weight loss in the patient. More recent studies have found that this surgery, known as bariatric surgery, has not only led to a loss of weight, but also that insulin and blood sugar levels become more normalised following surgery. The types of bariatric surgery available that have been shown to improve blood sugar levels are:   Gastric bypass A procedure where the stomach is made smaller, and food bypasses parts of the small intestine, giving the patient the sensation of feeling full quicker. Gastric band Surgery where an adjustable band is placed around the top of the stomach, creating a pouch which holds less food and causes the patient to feel fuller quicker. The less food held in the stomach, the easier it is to lose weight. Gastric sleeve A large section of the stomach is effectively stapled closed, which causes the stomach to reduce in size, again causing the patient to feel fuller quicker, and therefore reduce their intake of food. Biliopancreatic diversion This is a two-step procedure where a pouch a quarter of the size of the stomach is initially created using staples, as with the gastric sleeve, the remaining part of the stomach is then removed. The small intestine will then be joined to the end of the pouch, closer to the large intestine than before. This then causes food absorption to be greatly reduced, and weight loss becoming easier following the procedure.   Benefits of diabetes surgery   Surgery is not fully recognised as a standard option for the treatment of diabetes, however it is increasingly being chosen as the most suitable option, especially in patients where changes to lifestyle and diet, alongside diabetes medication hasn’t sufficiently controlled diabetes and blood sugar levels. The benefits of this type of surgery are that positive results are almost guaranteed, and much more instantaneous than with lifestyle and diet management, with medication. Once the weight has initially been lost in the patient, it becomes much easier to manage the weight afterwards, and therefore the blood sugar levels become more manageable.   Risks of diabetes surgery   The surgery carries the usual risk of complications that any form of surgery carry, namely risk of infection, but the surgery is commonly performed and is a standard procedure. Outside of the surgical procedure, there are risks of nutritional deficiencies as a result of the stomach not having the capacity to take in as many nutrients. These can be managed with nutritional supplementation. If you would like to discuss diabetes surgery with a specialist, you can make an appointment here. ...

Diverticulitis

  What is diverticulitis? Diverticulitis is a condition affecting the large intestine, or bowel. It is closely related to another condition affecting the bowel, called diverticular disease. Diverticulitis is more likely to occur in those who do not get enough fibre through their diet.   What causes diverticulitis? As we get older, small pockets or bulges called diverticula may develop in the lining of the intestine. These do not often cause symptoms and can go entirely unnoticed, but when they do cause symptoms, this is referred to as diverticular disease. Once symptoms become more severe, and the diverticula become infected, or inflamed, this is referred to as diverticulitis. What are the symptoms of diverticulitis? Diverticulitis symptoms include: Severe, constant tummy pain Feeling sick/vomiting Fatigue (feeling tired) Blood in your stool Rectal bleeding A high temperature (over 38 degrees Celsius) If you experience symptoms of diverticulitis, without any previous diagnosis of diverticular disease, you should contact your GP as soon as possible. If you have a previous diagnosis of diverticular disease the symptoms can be managed and treated from home. However, if you notice bleeding, or are experiencing severe pain, it is best to seek medical attention. How is diverticulitis diagnosed? Your doctor will take your medical history and make an assessment of your symptoms. This is because they will want to rule out other conditions which can display similar symptoms, such as IBS (irritable bowel syndrome), or bowel cancer. The doctor may also take blood tests and refer you for a colonoscopy or CT scan. What is the treatment for diverticulitis? Diverticulitis is most commonly treated at home using medication to relieve symptoms of pain, and antibiotics. In more severe cases, diverticulitis can be treated at the hospital so the doctor can monitor your progress and symptoms. Treatment in hospital may involve antibiotics administered through injections, and an intravenous drip to provide hydration and nourishment. If you have already been diagnosed with diverticular disease, a high-fibre diet may help to ease any symptoms you experience with the condition. The ideal amount of fibre for an adult is 30g per day, and your doctor will discuss targets and ways to include fibre in your diet. In more extreme cases, diverticulitis can be treated with surgery. This type of treatment is rare, and it involves removing the affected section of intestine. However, before any type of surgery, your surgeon will discuss the benefits and risks implied. ...

Dysphagia

Dysphagia, or discomfort when swallowing, refers to difficulty in swallowing or swallowing food, and is most common in elderly patients. In many cases it is a consequence of cerebrovascular accidents, Alzheimer's, Parkinson's or tracheotomies, diseases that cause problems in the tongue, the muscles of the throat and the oesophagus. Practical treatments focus on preventing food from getting stuck: exercises to strengthen the jaw muscles, sitting upright, waiting for three hours after eating in order to go to sleep, ingesting food in small amounts and accompanying it with plenty of liquid, and eating meals slowly. ...

ER surgery

ER or emergency surgery is performed in situations like heart attacks, strokes, appendectomies or to treat wounds from accidents. 

Fistula

A fistula is when a connection forms between an organ and another structure, and usually develop when an organ becomes inflamed or injured. Fistulas are very common in people who suffer with Crohn’s disease, an inflammatory bowel disease, with around 35% of people with Crohn’s disease having at least one fistula.   What are the different types of fistula?   Fistulas can appear in numerous places in the body, but they are most commonly found around the anus. These kind of fistulas are called perianal fistulas. Another common form of fistula is the kind that develops between loops of intestine. Fistulas can also form between the rectum and vagina, between the intestine and the skin, between the intestine and the bladder, between the trachea and the oesophagus, and in other places.   What causes a fistula?   Fistulas can form in a number of different ways, depending on the type of fistula and the position. With anal fistulas, they most commonly form because of an anal abscess. If the abscess hasn’t healed properly, it can lead to the development of a fistula. It is estimated that up to 50% of people with an anal abscess can then go on to develop a fistula. Fistulas that form in the digestive tract can do so following surgery, radiation therapy for cancer, or due to a traumatic injury. Some diseases can also cause fistulas such as STIs and diverticulosis. Some fistulas such as tracheoesophageal fistula (TOF) can form in the baby during pregnancy.   How are fistulas treated?   Fistulas can often be repaired with surgery. The appropriate medical professional will diagnose the fistula and decide on the best course of action, depending on the kind of fistula and the position. Another way of treating a fistula is with a catheter used to drain the fistula. These are usually used on small fistulas to control infection. Fistulas may also be repaired with a kind of glue called fibrin glue, which can be adopted to seal the fistula where appropriate. A plug can also be used to fill a fistula. The symptoms of a fistula may be managed with medication in some cases, and to treat infection caused by a fistula. Treatment for most kinds of fistula is fairly successful. ...

Gallbladder surgery

Gallbladder surgery is the removal of the gallbladder, an organ located under the liver that produces bile. Removal is necessary when the patient has pain or symptoms caused by the formation of calculi (stones) in the gallbladder. The operation can be minimally invasive or open. In the first case, the surgeon will make three or four incisions in the abdomen and insert a laparoscope (a thin, lighted tube connected to a camera that enables the interior of the organ to be viewed) and other instruments for the procedure. Gas is injected to expand the abdomen so the bile duct and blood vessels that lead to the gallbladder can be cut. The organ is then removed. When the disease is more severe or there are complications during gallbladder surgery, an open operation is performed. This involves making a small cut in the abdomen to open it and remove the gallbladder through the incision. ...

Gallstones

What are gallstones? Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the gallbladder.   The gallbladder is a small organ situation underneath the liver which releases bile (produced by the liver but stored and concentrated in the gallbladder) into the digestive system to help the body breakdown fats into fatty acids for absorption. What are the symptoms? Gallstones don’t always produce symptoms and do not always need treating. In fact, the vast majority of people will not experience symptoms as the gallstones themselves do not cause pain. In certain circumstances however, a gallstone might become trapped, causing intense pain known as biliary colic. The pain usually starts in the upper right part of the abdomen and radiates to the shoulder. Further complications can arise whereby the gallbladder becomes inflamed - symptoms can include jaundice (a yellowing of the eyes and skin), fever, persistent pain, nausea and vomiting. What causes gallstones? The development of gallstones is thought to be due to too much cholesterol or bilirubin in the bile, leading to the formation of stones. In the majority of cases gallstones are made of cholesterol, however if the liver is producing too much bilirubin (often due to damage) this can result in the formation of stones also. Improper emptying of the gallbladder is also thought to cause stones, as the bile becomes too concentrated. How can gallstones be prevented? Risk factors for the development of gallstones include being overweight, a lack of exercise, a diet containing too much cholesterol and fat that is also low in fibre, and rapid weight loss. It stands to reason therefore that maintaining a balanced diet and a healthy weight can help to prevent the development of gallstones.  Other risk factors for the disease include liver problems and diabetes. What is the treatment? Gallstones don’t always need treatment and in many cases the best option is to monitor them and only treat them if symptoms appear. If, however they are causing complications it might be necessary to treat them immediatley. Additionally, patients who have conditions which increase the risk of complications, such as portal hypertension (high blood pressure in the liver), cirrhosis of the liver or diabetes may need more urgent treatment. In most cases, keyhole surgery is performed to remove the gallbladder, in an operation known as a cholecystectomy. Following the operation, patients can lead a normal life without the gallbladder as the liver will continue to produce bile.  ...

Gastric balloon

The gastric balloon is a spherical silicone device that is introduced into the stomach of obese patients, particularly those who suffer from morbid obesity. The gastric balloon is introduced endoscopically and is filled with serum to let it reach the size of a ball. This way, it takes considerable room in the stomach, causing a feeling of satiation in the patient and its consequent decrease of hunger. Therefore, it is easier to maintain a diet aimed at slimming, reducing the intake of food. It is especially suitable for those patients who are obese and have tried to lose weight through other means. The gastric balloon is usually removed after six months, which is the maximum time indicated. ...

Gastric band

What is a gastric band? Getting a gastric band is a type of bariatric surgery (weight loss surgery). Bariatric surgery aims to reduce the amount of food or calories the patient eats via operations on the upper digestive system (particularly the stomach), which physically and psychologically affect the patient’s approach to food. A gastric band is a device placed around the upper part of the stomach, creating a small pouch at the top. As there is less space for food in this pouch, the patient gets full quicker when eating, and so eats less.   Why would you have a gastric band? Gastric bands are principally used to treat obesity, and also can be used to treat type 2 diabetes, sleep apnoea and hypertension. The idea is to force the patient to eat less or reduce calorie intake, so it may be an option in treating any condition that is negatively affected by overeating. Surgical options for weight loss are usually not the first choice of treatment, as losing weight through exercise or dietary change carries minimal risk. However, if this doesn’t work, your doctor may discuss surgical options, such as installing a gastric band.   What does it involve? The patient is given general anaesthetic to put them to sleep and prevent them from feeling pain during the surgery. Gastric bands are usually implanted using laparoscopy – a minimally invasive surgical technique utilising small incisions, through which a tiny camera is inserted to allow the surgeon to see inside the body. The surgery is then performed by inserting the instruments needed through these small incisions, rather than cutting the patient open. The surgeon places the band around the stomach, creating a small pouch in the top half, with a narrow “bottle-neck” for food to drain into the larger lower section of the stomach. The operation may only take half an hour to an hour if your surgeon is experienced with the procedure. Installing a gastric band doesn’t involve any cutting or stapling inside the body. A small device connected to the band is placed under the skin (usually in the middle of the chest), which allows your doctor to tighten the band after the surgery is complete. This is usually done for the first time about four to six weeks after surgery. It is usually tightened a few times until the ideal tightness is found.   Is it safe to have a gastric band? There are always certain risks when undergoing surgery, but as it doesn’t involve any cutting inside the body, and (when performed via laparoscopy) only small incisions are made on the outside, gastric band surgery is generally regarded as the safest surgical weight loss procedure, carrying less risk than a gastric bypass or a sleeve gastrectomy. The other advantage is that gastric bands are removable, so if there are complications, the procedure can be reversed. ...

Gastric cancer surgery

Gastric cancer is a growth of abnormal cells in the stomach that can spread to other organs such as the oesophagus and small intestine. It is a malignant tumour whose origin can be genetic, by infection with the bacterium helicobacter pylori, from different components in the diet or environmental factors. Gastric cancer is difficult to detect in its early stages and sometimes there are no symptoms. In general, when the symptoms occur, the tumour is usually well advanced. The most common symptoms are heaviness after meals, heartburn, abdominal pain, nausea, vomiting, loss of appetite and weight, difficulty swallowing or bleeding, among others. The most common treatment is the removal of part or all of the stomach, and when necessary, other organs or lymph nodes draining the stomach. Other treatment options include radiation and chemotherapy.   ...

Hiatal hernia surgery

What is hiatal hernia surgery? A hiatal hernia happens when a section of your stomach pushes up through an opening (called a hiatus) in your diaphragm. The diaphragm is a sheet of muscle located between the abdomen and chest. Hiatal hernia surgery involves pulling the stomach down into the abdomen and then making the hiatus opening in the diaphragm smaller. Why is hiatal hernia surgery performed? Surgery is required when a hiatal hernia does not respond to medication or lifestyle changes. Sometimes surgery is required for emergency cases. Surgery is also recommended if you have persistent symptoms, but do not want to be on medication long-term. What does it involve? Hiatal hernia surgery is usually performed using a laparoscope, which is a form of key-hole surgery. It involves a number of small abdominal cuts and the use of carbon dioxide to inflate a section of the abdomen. This allows the surgeon room to work. The laparoscope has a tiny camera on it, allowing the surgeon to see the inside of your body whilst they operate. During this surgery, the stomach is returned to its correct position, and the diaphragm around the oesophagus is tightened to ensure no more acid moves back out of the stomach. Surgery is performed under general anaesthetic to ensure there is no pain. This form of surgery takes 1-2 hours to complete. How to prepare for it Before surgery it is likely that your doctor will want to run tests on both how well the oesophagus moves, and how much acid is refluxed in a 24 hour period. Prior to surgery happening, the surgeon will explain fully the procedure and what to expect, as well as any possible side effects. Such side effects include: Bloating and flatulence Dysphagia (difficulty swallowing) Post-operative care Patients who have had hiatal hernia surgery can leave the hospital after the general anaesthetic has worn off, which usually takes two to three days. Most patients are able to return to work after three to six weeks post-surgery. It is also recommended that after surgery soft foods are eaten, such as soup or pureed vegetables for the first six weeks.   ...

Inguinal hernia

What is an inguinal hernia? A hernia occurs when part of the internal organs or tissue pushes through a weakness in the muscle wall. An inguinal hernia is said to occur when part of the bowel or fatty tissue pushes into the groin at the top of the thigh. It is also the most common type of hernia, particularly in a male. Inguinal hernias are rare in females. What are the symptoms of an inguinal hernia? Symptoms of an inguinal hernia are a swelling or a lump in the groin or an enlarged scrotum. There may also be associated pain or discomfort, pain when coughing or lifting, or a dragging sensation in the groin. A bulge either side of the pubic bone could also be a sign of an inguinal hernia. The hernia may be pushed back in when lying down, however complications can occur whereby the hernia gets stuck or trapped and obstructs the bowel, or the hernia becomes strangulated, whereby the blood supply gets cut off. This is potentially very serious, even life-threatening and requires immediate attention. Symptoms of a strangulated hernia include vomiting and nausea, fever, sudden pain, a bulge that turns red or purple, or an inability to pass stools or gas. What causes an inguinal hernia? In males the testicles descend during development via a small opening in the groin. This process leads to a weakness in the abdominal wall and is the cause for inguinal hernias. In a boy there is usually a sac which accompanies the testis. Generally it is supposed to close but occasionally the sac remains, leading to a hernia. In adults, undue straining such as heavy lifting, violent coughing or prolonged straining on the toilet may cause the hernia to develop due to the underlying weakness in the groin. Loss of elastic tissue due to the ageing process also leads to inguinal hernias. It is not unusual for hernias to occur in both groins.  How can an inguinal hernia be prevented? Avoiding undue pressure in the abdomen by straining when passing stool or urinating or carrying and moving heavy loads can reduce the risk of an inguinal hernia, however many hernias may be unavoidable as they have no apparent cause. Strain on the abdominal muscles can be reduced by maintaining a healthy weight, eating a high-fibre diet and stopping smoking. What is the treatment for an inguinal hernia? Surgery is the usual treatment for inguinal hernias. In some patients a non-surgical option, such as a hernia truss, may be appropriate. Occasionally it may be appropriate to wait and watch and monitor the hernia. Surgery becomes an emergency for hernias that cause severe pain or that have developed complications. Strangulation, where the bowel has become trapped, is one such complication and it requires immediate treatment to restore the blood supply via surgery.  ...

Laparoscopy

Laparoscopy is a surgical technique used to inspect the abdominal cavity, allowing the surgeon not to make large incisions. During the procedure, a laparoscope,  which is a tube containing an optical system coupled with a light source, is inserted into the abdomen. The camera allows the doctor to inspect the pelvic organs from a monitor and, if necessary, to introduce other instruments through the same laparoscope to correct a problem. The advantages of laparoscopy are many, such as the patient requiring shorter hospitalisation and recovery time, fewer chances of infectious complications, less postoperative pain and no visible scars. Laparoscopy is used primarily in processes such as prostate cancer or some kidney diseases. ...

Lipoma

A lipoma is a benign lump that forms under the skin, usually made from fatty tissue. They usually grow slowly and are situated between the skin layer, and the muscle layer beneath. Lipomas are more common in middle age, are usually painless, and most commonly appear on the upper back, shoulders and abdomen.   What causes a lipoma?   The cause of lipomas is unknown. It is believed that they may be genetic, so if your parents or other members of the family had lipomas, then you may also be prone to developing them. They can often appear after an injury, though the reason they form is unknown.   What are the symptoms of a lipoma?   As previously mentioned, lipomas are usually painless, though can cause some pain if they press on nearby nerves. They appear as soft, doughy lumps ranging in size from around the size of a pea to as big as a grapefruit. The lumps may move slightly if pressed.   Who is more at risk of developing lipomas?   Although people of any age can develop lipomas, they are more prevalent in adults aged between 40 and 60 years of age. People with the following conditions are more at risk of developing one or more lipomas: Madelung’s disease Gardner’s syndrome Cowden syndrome Adiposis dolorosa   What is the treatment for lipomas?   Lipomas don’t usually cause any problems if left alone, however they can be treated if required. The most common way of treating lipomas is to have them surgically removed. This can be done by either a dermatologist, or by a plastic surgeon. Surgery involves making an incision to remove the fatty tissue, before suturing the opening. Though there is a risk that the lipoma may return, it is uncommon. Another treatment option to reduce the size of the lipoma is liposuction, where a needle is used to remove some of the fat from within the lipoma. Finally, steroid injections may be used to treat the lipoma. The steroid injection works to shrink the lipoma, though this treatment doesn’t completely remove the lipoma. ...

Morbid obesity

Morbid obesity is also known as severe obesity or class III obesity. People are considered morbidly obese when their body mass index is above 40, or even 35 if the patient has a disease or severe disability as a result of being overweight. In many countries it is a public health problem due to the new eating habits of the society. Morbid obesity can be treated with a low calorie diet and regular exercise. In extreme cases patients can have bariatric surgery. ...

Obesity

Obesity is defined as having an abnormal or excessive accumulation of fat on the body, enough so that it can be a risk to the health of the person. There most common way of classifying the amount of weight on the body, and what constitutes as a healthy balance, is the body mass index (BMI), which is calculated by dividing your weight in kilograms, by your height, squared. The NHS classifies obesity as having a body mass index of 30 to 39.9, with those over 40 being classified as severely obese, though it is not necessarily the case as those with a large amount of muscle could be classified as obese due to their weight, when it may not actually be accurate. Another way of measuring excess fat is to measure waist circumference, for men, obesity is generally considered as being larger than 94cm (37in), and 80cm (21.5in) for women.   What causes obesity?   Simply speaking, obesity is caused by consuming more calories than are burned off through physical activity. When food is consumed, especially excessive amounts of fat and sugar in the diet, the body stores it as energy, in the form of fat. There are some health conditions that can lead to obesity and weight gain, such as problems with the thyroid, especially hypothyroidism.   How is obesity treated?   The best ways of treating obesity is to increase the amount of physical activity you perform on a regular basis, and to reduce the amount of calories eaten, along with eating a healthy, balanced diet. There are a number of ways that you can do this, such as joining a weight loss group to help you manage your diet and motivate you to continue sticking to it. You can also start activities such as walking, swimming or running. You can begin with exercising for short periods of time, before building up to longer periods. There are a number of surgical procedures available to help deal with weight loss in more severe circumstances, such as gastric band, gastric bypass, and biliopancreatic diversion.   What problems can obesity lead to?   Obesity can be detrimental to the health, leading to problems in different areas of the body. It can cause strain on the heart, leading to coronary artery disease, high blood pressure, high cholesterol, and other conditions. It is one of the leading causes of diabetes type 2, polycystic ovarian syndrome (PCOS), and infertility and can also have detrimental psychiatric effects such as depression along side often having a social stigma. To see a specialist to help with obesity, click here. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. ...

Obesity surgery

What is obesity surgery? Obesity surgery, otherwise known as bariatric or weight-loss surgery, describes a range of procedures that are designed to treat people with obesity. Whilst there are different types of gastric surgery, the aim of the procedure is always to reduce the size of the stomach. Why would you do it? Bariatric surgery is a type of treatment for people who are obese. The surgery helps a person to lose weight and is generally carried out to reduce the risk of serious weight-related health problems which can be potentially life-threatening. Over time obesity can lead to multiple conditions such as heart disease, diabetes, high blood pressure and an increased risk of stroke. As a general rule, bariatric surgery is usually for those with a BMI of over 40 or those with a BMI of over 35, accompanied by a serious weight-related health problem. What does it involve? Some of the most common procedures, aimed at reducing the size of the stomach and making the patient feel full sooner and/or decreasing the ability to absorb nutrients are as follows: A gastric band can be fitted around the stomach in order to reduce its size. The band is usually placed around the top part of the stomach and is adjustable. A gastric bypass joins the top part of the stomach to the small intestine, thereby bypassing most of the stomach and small intestine. A sleeve gastrectomy removes part of the stomach, decreasing its volume significantly. All types of weight-loss surgery are done under general anaesthetic. Depending on the circumstances, the operation can be performed using open surgery or laparoscopically using smaller incisions and cameras to guide the process. The latter is also known as keyhole surgery. How to prepare for it Preparation for obesity surgery will depend on the individual to an extent. Restrictions are often placed on food and drink prior to surgery and certain medications may also need to be stopped for a period. Post-operative care Obesity surgery is a major operation and patients will normally wake up in a recovery room before being moved to a ward. There is no food or drink allowed for the first couple of days to allow the stomach and digestive system time to heal. After that, patients can progress to clear liquids and are often discharged around three days after surgery, providing everything goes well. A specific diet will then need to be followed for some weeks after surgery, usually centered on liquids and soft foods. Permanent lifestyle changes after surgery are also required to help keep weight off. Regular exercise and a balanced diet should be maintained to ensure that patients don’t put the weight they have lost back on. ...

Oesophageal cancer

This is a cancer of the oesophagus, also known as the gullet or food pipe. The first symptoms are usually difficulty swallowing, the sufferer may also experience indigestion, weight loss or vomiting. ...

Oesophageal cancer surgery

What is oesophageal cancer surgery? Oesophageal cancer is a form of cancer that affects the oesophagus which is the tube that takes food from the throat to the stomach. Cancer of the oesophagus occurs when cancer cells develop, starting in the inner layer of the oesophagus, and can spread into the other layers, and to other parts of the body. Surgery aims to remove the part of the oesophagus affected by the cancerous cells. Why is oesophageal cancer surgery performed? Surgery for this type of cancer will be recommended for patients in stages one to three of oesophageal cancer. Those with stage four oesophageal cancer would not benefit from surgery as it is extremely unlikely to be effective. Often surgery will be combined in a treatment plan with other measures such as chemotherapy and sometimes radiotherapy which are usually given prior to surgery. What does it involve? There are three types of oesophageal cancer surgery. The first is called oesophagectomy and involves surgically removing the part of the oesophagus containing the tumour. Sometimes a part of the stomach is also removed, and some of the lymph nodes located close to the oesophagus as these may also contain cancerous cells. This measure increases chances of the cancer not returning. This surgery is done for earlier stages of oesophageal cancer. If oesophageal cancer is detected very early on, then the cancerous cells can be removed using endoscopic mucosal resection (EMR). This involves removing the tumour with a wire loop at the end of an endoscope, which is a narrow, flexible tube. This tube is passed through the throat, meaning there are no incisions made on the skin. For the later stages of oesophageal cancer, where swallowing can become difficult, it may become necessary for a stent to inserted into the oesophagus, which helps to hold it open, making swallowing easier. How to prepare for it Prior to surgery, the patient would be examined by their doctor to ensure they are well enough to undergo the operation. The surgeon will explain the procedure in detail, and exactly what to expect. The patient will have opportunities to ask any questions about the procedure. The patient should not eat or drink a few hours prior to surgery, and they may need to bathe and remove body hair from the area undergoing surgery. The patient may also be asked to wear a pair of compression stockings during and immediately after the operation to reduce the risk of blood clots forming in the leg. Post-operative care After surgery, the patient is likely to stay in the intensive care unit for a number of days. Here the patient will be given painkillers to manage the pain. There will also be a number of drips attached to the body, which must be kept for a few days. These keep the patient hydrated. After surgery, the patient will begin by trying to drink very small sips of liquid. It is also common for the patient to have a temporary feeding tube inserted into the small bowel. This allows the patient to be fed until they can eat and drink normally. This can take up to six weeks. Some weight loss is to be expected after surgery as a result.  ...

Robotic surgery in surgery

What is robotic-assisted surgery? Robotic-assisted surgery, or robotic surgery, with the da Vinci System allows doctors to perform surgical procedures in a very accurate way. Operations are performed with more precision, flexibility and control compared to using conventional techniques. Robotic-assisted surgery is commonly associated with minimally invasive surgery, where procedures are performed using tiny incisions. How does robotic- assisted surgery work? Robotic-assisted surgery with the da Vinci Surgical System uses a camera arm and mechanical arms with surgical instruments attached to them.  The surgeon is able to control the arms whilst seated at a computer console near the operating table. The surgeon has a high-definition 3D view of the surgical site and leads other team members who assist them during the surgery. The surgeon makes small cuts to insert the instruments in the patient’s body. A thin tube with a camera attached to the end of it, as with an endoscopy, enables the surgeon to view enlarged 3D images of the patient’s body during the surgery. The robot corresponds and matches the hand movements of the doctor to perform the procedure using tiny instruments. What is da Vinci Surgery used for? Cardiac surgery Colorectal surgery General surgery Gynaecological surgery Head and neck surgery Thoracic surgery Urological surgery What are the advantages and risks of robotic-assisted surgery? Surgeons who use the robotic system find that for many procedures it enhances control during the operation and allows them to see the site more clearly. The benefits of minimally invasive surgery using the da Vinci Surgical System include:   Fewer complications, such as infections Reduced blood loss and transfusions Reduced pain and discomfort Quicker recovery time – shorter hospitalisation and faster return to normal activities Less noticeable scars   Robotic-assisted surgery has small risk factors, which may be similar to those of conventional open surgery. The risks could include:   Infections Bleeding Mechanical failure – unlike traditional surgery Who are the best candidates for robotic-assisted surgery? The ideal patient for the robotic-assisted procedure is someone who has not had many abdominal surgeries. Typical abdominal surgeries such as an appendectomy, gallbladder removal and hernia repair do not exclude individuals from having robotic surgery. The decision will be made by the surgeon. Patients with prevalent cardiovascular and pulmonary diseases may require more consideration beforehand. How long does it take to recover from robotic-assisted surgery? Traditional open surgery recovery time can last several months, including several days of hospitalisation. Even though every case of surgery is unique, the return to everyday activities for a patient following robotic-assisted surgery can occur in as little as two to three weeks. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Spleen removal

What is spleen removal surgery? The spleen is a small, fist-sized organ located underneath left rib cage, close to the stomach. The spleen is a key component of the immune system as it contains white blood cells that kill bacteria and fight infections. The spleen also filters out old red blood cells from the bloodstream. Spleen removal surgery is called a partial splenectomy if just part of the spleen is removed, or a splenectomy if the whole spleen is removed. Why would you need spleen removal surgery? The reasons you might need a splenectomy include: A ruptured spleen – which could be caused by injury and can lead to internal bleeding which could be life-threatening. Cancer involving the spleen – cancers that affect the blood cells, such as leukaemia or lymphoma, will likely result in the spleen needing to be removed. Certain diseases – such as sickle cell disease can cause the spleen to stop functioning, and it therefore needs removing. Infection – if an infection around the spleen does not clear up with other treatments, then a splenectomy will be recommended. What does it involve? Splenectomies can either be performed laparoscopically (keyhole surgery) or as open surgery. Most are carried out laparoscopically. During a laparoscopic splenectomy, a special instrument guided by a camera is inserted via small incisions and allows the surgeon to access the abdomen and spleen without the need to make large cuts and scars. General anaesthetic is still required for this type of splenectomy. Open surgery involves a large cut being made in the abdomen, to allow the extraction of the spleen. Open surgery is usually chosen if the spleen is very damaged or large and will often be done in an emergency case. General anaesthetic is also required. How to prepare for it Before surgery, you may be advised to stop taking certain medications, avoid eating and drinking, receive certain vaccines to prevent infection after the spleen is removed, and it may be necessary to have a blood transfusion to ensure that you have enough blood cells post-splenectomy. Post-operative care After a laparoscopic splenectomy, the small incisions are either stitched together or glued. Often patients are able to leave the same day or the following day. If the patient does return the same day, it is necessary for them to be accompanied by a family member or friend. After an open surgery splenectomy, it will be necessary to stay in hospital for two to six days. It is normal to feel some pain, which can be managed with painkillers. During the hospital stay, you will be given some exercises to keep moving, to avoid blood clots. You can expect to recover and return to normal activities within six weeks. Once you have healed fully, the other organs in the body are able to take over the functions that the spleen performed, however, you can be more prone to infection and sickness. ...

Stomach reduction

What is stomach reduction? A stomach reduction is an operation to reduce the size of the stomach; it is mainly performed in people who are morbidly obese. Different techniques exist, some of which involve removal of specific parts of the stomach.   Why is it done? The operation is performed to eliminate excess weight in people who are morbidly obese. It is performed when the specialist the patient cannot lose weight via dieting and physical activity, and their BMI is higher than 40 or 35. What does it involve? Currently, there are operations that do not require traditional open surgery; rather they can be carried out using an endoscopy. Stomach reduction by endoscopy, also known as POSE (Primary Obesity Surgery Endoluminal), is a new minimally invasive technique that does not require incisions and is performed orally. Specifically, an endoscope is inserted through the mouth until it reaches the stomach. In the stomach, folds are created to reduce its size and capacity, and to slow emptying. Endoscopic stomach reduction has several advantages: it provides a permanent result without external scars and does not require a hospital stay.  How to prepare for the operation You will have to follow a strict diet for a few weeks before the operation, in order to reduce cardiac risk during the operation. It is also advisable to perform breathing exercises and physical activity. Post-operative care As a result of the operation, your body will have undergone a major change, in terms of how you digest food. You will, therefore, have to change your lifestyle. After the operation, your stomach will be about the size of a walnut, have a lower capacity and will absorb nutrients differently. Your stomach will increase in size over time; during this period, you should not eat excess food. A normal stomach can receive up to 1 litre of food, whereas a “reduced” stomach should not exceed 250 ml of food. ...

Stomach surgery

What is stomach surgery? Stomach surgery describes the group of surgical procedures that remove, repair or modify the stomach, depending on what the underlying illness or problem is. Stomach disorders that can require surgery include: Stomach acid disease – a condition in which the stomach overproduces stomach acid, and can lead to stomach ulcers forming. Stomach cancer Gastroparesis – a condition where the stomach cannot properly empty itself of food due to a damaged vagus nerve which controls the digestive system. Stomach dumping – a condition in which food moves too quickly along the small intestine. Dysphagia – a condition where patients are unable to swallow food properly. Gastric bypass for weight-loss – some patients suffering from obesity will undergo gastric bypass surgery (a type of bariatric surgery) to help them lose weight. Why would you need stomach surgery? Surgery is generally required if other means of treatment and lifestyle changes have not worked to cure or overcome a problem. For emergency problems, or later stage stomach cancer, surgery will usually be the best option for treatment. What does it involve? The various procedures for treating bad cases of stomach acid disease are: Vagotomy – a procedure where the vagus nerve, which stimulates stomach acid production, is cut. Pyloroplasty – a procedure that widens the opening in the lower part of the stomach, which allows food to empty into the small intestine more easily. Partial gastrectomy – this procedure involves removing a section of the stomach. This may be required when part of the stomach tissue is badly damaged by stomach acid. Surgery for treating stomach cancer will usually be combined with other treatments, such as chemotherapy or radiation therapy. To treat stomach cancer surgically, usually the stomach will need to be partially or completely removed. Often, nearby lymph nodes will also be removed. When the stomach is completely removed, the oesophagus will be connected directly to the small intestine. If gastroparesis is severe and nutrients and medications cannot reach the bloodstream, surgery will be recommended. For this condition, a gastrostomy tube might be inserted through the abdominal skin and into the stomach. This should decompress the stomach, and allow feeding through the tube. To surgically treat stomach (gastric) dumping, the pyloric sphincter muscle can be reconstructed to improve the controlled release of food into the small intestine from the stomach. Patients suffering from dysphagia may require a tube to be implanted into the stomach to allow the intake of nutrition and hydration. This tube can either be inserted endoscopically through the throat or via an incision made in the abdomen. Bariatric surgery is a group of procedures that assist in weight-loss for obese patients. Gastric bypass surgery is one of the most common options and involves decreasing the size of the stomach by stapling a section of the stomach together, thereby limiting the amount of food that can enter the stomach. Next, the small intestine is attached to this section of the stomach, meaning food bypasses a section of the digestive system and fewer calories and nutrients are absorbed. How to prepare for it Most of these surgical interventions require general anaesthetic and are relatively intensive procedures, each with their own sizeable recovery period. As these surgeries are dealing with the digestive system, a period of fasting will generally be necessary before surgery. Post-operative care Many of these stomach surgeries will result in necessary lifestyle changes, including dietary adjustments, portion control, the need to use a feeding tube, and being aware of taking in enough of the right nutrients. Each procedure will have its own set of adjustments to make after surgery with the support of a specialist to assist in these being actioned.  ...

Stomach ulcer

  Gastric ulcer is a sore or erosion that occurs in the stomach or upper duodenum, in this case as a peptic ulcer. This is a very common gastrointestinal ailment and whose size usually varies between 0.5 and 1.5 centimeters in diameter. The causes stomach ulcers are multiple, being intimately related to stress and health status of each patient. As for symptoms, gastric ulcer is characterized by an acute stomach pain, changes in bowel habits, nausea and vomiting. Your treatment begins mitigate their symptoms through gastric protectors and antacids and, in the case in question of a bleeding ulcer, it is necessary to stop the bleeding by endoscopy. Also, in the most serious cases it will be resorted to surgery, either by removing part of the stomach as intervening in the vagus nerve, responsible for monitoring the production of gastric acid in the body. ...

Umbilical hernia

What is an umbilical hernia? An umbilical hernia is a type of hernia, which refers to when part of the internal organs protrude through a weakness in the surrounding cavity. In the case of an umbilical hernia, abdominal fat or part of the bowel passes through an area around the navel. What are the symptoms of an umbilical hernia? Umbilical hernias are very common, particularly in babies and are characterised by a bulge around the navel that might get bigger when laughing or coughing. They are usually painless in infants and children, however, in adults who develop an umbilical hernia, the swelling may also be accompanied by pain and discomfort. What causes an umbilical hernia? An umbilical hernia develops as a result of a weakness in the abdominal wall at the navel. If the hole through which the umbilical cord passes through during pregnancy doesn’t close properly after birth, it can cause a hernia either at birth or later on in life. In adults, too much pressure in the abdominal cavity can increase the possibility of an umbilical hernia. How can an umbilical hernia be prevented? There is little that can be done to prevent umbilical hernias at birth, however, there are certain risk factors for adults. Anything that increases pressure in the abdominal cavity, such as obesity, straining while moving or lifting heavy objects, a persistent heavy cough, ascites (fluid in the abdomen, and having multiple pregnancies (i.e. twins, triplets, etc.), can increase the risk of an umbilical hernia. What is the treatment for an umbilical hernia? In infants, an umbilical hernia very often clears up on its own – the hernia goes back in and the muscle reseals over it. In adults, an umbilical hernia will generally get worse over time. In most cases, it is advised to wait until a child has reached four of five years of age to see if the hernia disappears before considering surgery, except in cases where the hernia is very large or there are other complications. In most adults, umbilical hernias are treated with surgery to push the abdominal tissue back into place and seal the abdominal wall. Complications can include obstruction where a section of bowel gets stuck outside the abdomen and can cause nausea, vomiting and pain and discomfort. Strangulation, whereby the blood supply to the section of bowel forming the hernia is cut off, is a potentially serious complication and needs emergency treatment to prevent the trapped tissue from dying.  ...

Upper GI surgery

Upper gastrointestinal (GI) surgery is surgery performed to treat pathologies of either the upper gastrointestinal tract (small bowel), gall bladder, liver, pancreas or oesophagus.  ...

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