General Surgery Abroad

Angioplasty

Coronary Angioplasty is a surgical procedure to open up blocked or narrowed coronary arteries (blood vessels leading to the heart). It is used to treat coronary artery disease and is a fairly straightforward, minimally invasive (keyhole) procedure.

Coronary Angioplasty is most commonly used to treat angina, which is pain coming from the heart. It may also be carried out as emergency treatment after a heart attack.

Angioplasty involves using a catheter (a flexible tube) to insert a stent (a piece of stainless-steel mesh tubing) into the artery. A small balloon is inflated to open the stent, which pushes against the artery walls. This widens the artery and squashes the fatty plaques against the artery wall so that blood can flow through it more freely.

Bunion Removal

The medical name for a bunion is Hallux Valgus. A bunion is a bony swelling at the base of the big toe.

Sometimes, the big toe can become angled inwards, towards the middle of the foot and the second toe. This can force the top of the first metatarsal to protrude (stick out) from the side of the foot, at the base of the big toe. If this happens, a painful, swollen bunion forms.   

A bunion can cause discomfort, pain, swelling and redness in and around the big toe. If left untreated, it can make walking difficult. The exact surgery procedure will vary depending on the type and size of the bunion being treated. Often your surgeon will shave off the bone that is sticking out. The foot bone (the metatarsal) may be cut and repositioned, setting it in a better position. The ligaments and tendons in your foot may also be repositioned.

Cataract

Cataracts are cloudy patches in the lens of the eye that can make your vision blurry. They may eventually lead to blindness if they are left untreated.  

Cataracts can develop in one or both eyes, and over time the size of the cataract can get bigger until the whole lens is covered.  If you have a Cataract, it will continue to develop.

The only way to restore your vision is by having the Cataract removed by surgery.  

Cataract surgery is one of the most common and quickest surgeries performed, and many people are able to return to their usual daily routine after 24 hours.  

There are three types of replacement lens available:

Fixed strength lenses (monofocal) - set for one level of vision, usually distance vision.
Multifocal lenses - allow two or more different strengths, such as near and distance vision.
Accommodating lenses - allow the eye to focus on both near and distant objects, in a similar way to the natural human lens.

Circumcision

Circumcision is a procedure to remove the foreskin. The foreskin is a flap of skin that covers the head of the penis and can usually be pulled back over it.  

Sometimes, Circumcision has to be done for a medical reason. This may be because the foreskin is damaged or infected and will not slide back over the head of the penis. A tight foreskin can make it painful for you to have an erection or sexual intercourse.   

Circumcision may also be done for cosmetic, religious or social reasons.   

During surgery the foreskin is pulled forward and trimmed away. The skin edges are closed using dissolvable stitches and/or special glue.

Gastric Banding

Gastric banding is a surgical procedure that involves fitting a band around the upper part of your stomach.   

Once the Gastric Band is in place it can be adjusted externally (outside the body) at any time by a surgeon. This means the band can be made either tighter or looser, depending on the amount of food your surgeon wants to restrict you from eating.  

Your surgeon can make the band tighter by adding salt water (saline) into the band. This slows down the amount of food that can pass through your stomach - meaning your stay feeling full for longer.

To loosen the band, some of the salt water fluid is removed, meaning food passes through quicker to your digestive system.

Generally, a Gastric Band is loose to start and then tightened when you are used to eating less food.  

A Gastric Band is designed to remain permanently within your stomach. However, it can be removed, and in the majority of cases leaves you with no permanent changes to your stomach.   

It is usually recommended as a last resort for people who are morbidly obese (those with a BMI of over 40), or those with a BMI of between 30-40 who also have a condition that poses a serious health risk, such as diabetes, high blood pressure (hypertension), or heart disease.

Gallbladder Removal / Cholecystectomy

The Gallbladder is the small, pear-shaped pouch in the upper-right part of your abdomen that stores the bile produced by the liver. Bile, the digestive fluid that helps to break down fatty food, is carried from the gallbladder to the intestine through a tube called the bile duct.   

There are two ways of performing a cholecystectomy:  

Laparoscopic Cholecystectomy (Keyhole Surgery). This is the most common way of having your gallbladder removed.  Keyhole surgery means the surgeon can remove your gallbladder without having to make a large incision on your abdomen  
Open Cholecystectomy During this procedure the surgeon removes the gallbladder through a five- to eight-inch incision in your abdomen.

Gamma Knife / Radiosurgery

Radiosurgery (also known as Gamma Knife treatment) is a very highly focused type of radiotherapy.   
Radiotherapy is usually used either after surgery to kill any tumour cells that were not removed, or as an alternative to surgery.

It is a painless procedure.   

Radiotherapy uses radiation (powerful X-rays) to destroy cancer cells. Cancer cells are more sensitive to radiation than non-cancerous cells, which can recover from treatment.  

The patient wears a specialized helmet that is surgically fixed to their skull so that the brain tumour remains stationary at target point of the gamma radiation rays. An ablative dose of radiation is thereby sent through the tumour in one treatment session, while surrounding brain tissues are relatively spared.

Gastrectomy

A Gastrectomy is a medical procedure that involves surgically removing the stomach.  

Gastrectomies are often used to treat stomach cancer (also known as gastric cancer). Less commonly, the procedure may be used to treat stomach ulcers, non-cancerous (benign) tumours, and obesity.  

There are two different techniques that can be used to carry out a partial or total Gastrectomy:  

Open Gastrectomy - where the surgeon makes a large incision in your abdomen in order to remove some, or all, of your stomach. 
Laparoscopic or ‘Keyhole’ Gastrectomy - where the surgeon makes a number of smaller cuts in your abdomen, before using a special telescope and small surgical instruments to remove some, or all, of your stomach.

Gastric Bypass

A Gastric Bypass is a similar procedure to a gastric band as a band is used to create a smaller stomach pouch from the upper part of your stomach, separating it from the rest.

A section of your small intestine is then bypassed and re-connected to the pouch. Food takes a shorter route through your digestive system, and so less food is absorbed by your body. This means that you can only eat small meals and your body absorbs less food.

Gastric Bypass can be done using keyhole (laparoscopic) or open surgery.  

Gastric Bypasses have a higher risk of complications that gastric band surgery and are only recommended for people who have a BMI of 45 or above.

Haemmorhoidectomy

Haemorrhoids, also known as piles, are enlarged and swollen blood vessels in or around the lower rectum and back passage (anus).

When the pressure inside these blood vessels is increased, they swell and form small lumps.   

Haemorrhoids vary in size and can occur internally (inside) or externally (outside) the anus.   

Haemorrhoidectomy simply means removal of the haemorrhoids.

Heart Bypass (CABG)

A coronary artery bypass graft (CABG) is a surgical procedure used to divert blood around narrow or clogged arteries (blood vessels). This improves blood flow and oxygen supply to the heart.

CABG involves taking a blood vessel from another part of the body, usually the chest or leg, to use as a graft which replaces any hardened or narrowed arteries in the heart.

CABG is often used to treat coronary artery disease and can reduce the risk of having a heart attack.

The operation can also be done using keyhole (or minimally invasive) surgery. Instead of a large cut down the sternum, the operation is done through small cuts. Special instruments are passed through the cuts and the surgeon looks at a monitor to see inside your chest.

Heart Valve Replacement

Heart valve replacement is surgery to treat heart valve disease. It can replace a diseased or damaged heart valve.  

Aortic valve replacement is a type of open heart surgery designed to treat problems affecting your aortic valve, which lets the blood flow from the left ventricle of the heart to the aorta, the body’s main artery. Your chest is opened, allowing the surgeon to operate on your heart. During surgery, your heart is stopped and your circulation is taken over by a heart-lung machine.  

Your surgeon will remove your diseased valve and sew in a prosthetic (artificial) valve. There are two types:

Mechanical valves are artificial valves made from carbon fibre. They can last for a lifetime.
Biological valves are made from human or animal tissue. They wear out faster than mechanical valves so the surgery may need to be repeated every eight to 10 years.

After your valve has been replaced, your surgeon will restart your heart and blood will be allowed to flow back through your heart. Your sternum will be rejoined using wires and the skin on your chest will be closed with dissolvable stitches.  

The operation can also be done using keyhole (or minimally invasive) surgery.

There is also a new technique called Percutaneous Valve Replacement. In this procedure a tube is passed through an artery or in your groin or a vein in your leg to reach your heart.

Hernia Surgery

A hernia is when an internal part of the body, such as an organ, pushes through a weakness in the muscle or surrounding tissue wall.

Usually your muscles are strong and tight enough to keep your intestines and organs in place, but sometimes they aren’t which results in a hernia.  

A hernia can occur anywhere in the abdomen region. The most common types are:

Inguinal Hernia - This occurs when tissue (usually part of the intestines) pokes through your lower abdomen.
Femoral Hernia - This occurs when tissue pokes through into your groin, or the top of your inner thigh.
Incisional Hernia - This occurs when tissue pokes through a surgical wound or incision that has not fully healed.
Umbilical Hernia - This occurs when tissue pokes through the part of the abdomen near to the navel (belly button).

During surgery, the surgeon will place the protruding intestine or tissue back into the abdominal wall. The muscles of the abdominal wall will then be strengthened by fixing a synthetic mesh to the muscles.  

There are two ways that a hernia repair can be carried out:

Open Surgery - where the surgeon will make a large incision in your abdomen.
Laparoscopic (Keyhole) Surgery - where the surgeon will only make a very small incision in your abdomen.

Hiatus Hernia

A Hiatus Hernia is when the upper part of your stomach pushes upwards into the opening in your diaphragm through which the gullet (oesophagus) passes. The oesophagus is the tube that carries food to your stomach.  

The opening in your diaphragm is called the Hiatus and the part of the body that pushes through the hiatus is called a hernia. The hernia pokes through the hiatus, preventing the muscle fibres of the diaphragm from closing the lower end of the oesophagus.  

The result is that the sphincter that normally stops acid entering your gullet from your stomach can't work properly. The sphincter is designed to prevent stomach contents from flowing upwards, functioning as a one-way valve.  

Due to the hiatus hernia, highly irritating stomach contents, like acid, are able to move up into the oesophagus.  

The surgery involves the stomach being put back in the correct position and tightening the diaphragm around the lower part of the oesophagus.

Hysterectomy

A Hysterectomy is an operation to remove your womb (uterus).  

After the operation you will no longer be able to have children.   

Hysterectomies are performed to treat conditions that affect the female reproductive system, such as heavy periods (menorrhagia), non-cancerous tumours (fibroids) and types of cancer.  

There are three methods that can be used to perform Hysterectomies which are described below.

A Vaginal Hysterectomy – where the uterus is removed through the vagina.
An Abdominal Hysterectomy – where the uterus is removed through a cut in your abdomen.
A Laparoscopic Hysterectomy – in this technique the surgeon will make a number of small incisions in your abdomen, through which a small tube that contains a light and a tiny video camera (a laparoscope) is inserted. This allows the surgeon to see the inside of your abdomen in great detail without having to make a large incision (cut). The uterus can then be removed through the incisions.

There are three types of hysterectomy.

Subtotal Hysterectomy - the womb is removed but the cervix is left in place.
Total Hysterectomy - the womb and the cervix are removed.
Radical Hysterectomy - the womb, part of the vagina and the fallopian tubes are removed.

Intragastric Balloon

Gastric Balloons (sometimes called Intragastric Balloons) are one of the newer forms of weight loss surgery.   

An intra-gastric balloon is a soft silicone balloon that is surgically implanted in your stomach. This can help reduce your weight as it then takes less food to stop you feeling hungry.  

The balloon itself is made of silicone and is inserted via the mouth into the stomach using an endoscopic procedure. It is then filled with air or saline solution. With a saline filled balloon the fluid is actually coloured blue so that if it springs a leak and starts to deflate the patient will know as their urine will be green. 

The inflated gastric balloon works by partially filling your stomach so that you'll feel fuller more quickly when eating. It also reduces your ability to consume large amounts of food or fluids in one go. With the balloon in place a weight loss diet should be followed to retrain your eating habits so that you don't put the weight back on once the balloon is removed.   

Patients can expect their BMI to drop up to 10 points in the six months following the surgery.  

The balloon is usually removed after six months.  

If you have a BMI of 30 or more, Gastric Balloon surgery could be the solution for you

IVF

In Vitro Fertilization, often referred to as IVF, is a highly successful assisted reproductive technology.  

The term in vitro literally means “in glass.” It refers to the process by which a woman’s eggs are fertilized outside her body.  

It involves an egg being surgically removed from the ovary and fertilised outside the body. The woman is then given hormones to prepare her uterus for pregnancy, while the eggs are fertilised with the sperm in a laboratory.  The embryos are then implanted into the woman's uterus, and if all goes well, a normal pregnancy is achieved.

Laser Eye Surgery

Laser Eye surgery involves reshaping the cornea – the transparent surface at the front of the eye – using a type of laser known as an Excimer laser.   

Different techniques are used to correct short sight (myopia), long sight (hypermetropia) and astigmatism. 

LASIK (Laser In Situ Keratomileusis)

LASIK is the most common procedure. Most types of refractive error can be corrected with LASIK, but it may not be suitable for correcting high prescriptions (high degree of short-sightedness). Surgeons cut across the cornea and raise a flap of tissue. The exposed surface is then reshaped using the excimer laser, and the flap is replaced.

PRK (Photorefractive Keratectomy)

PRK is mainly used for correcting low prescriptions (low degree of short-sightedness). The cornea is reshaped by the excimer laser without cutting a flap.

LASEK (Laser Epithelial Keratomileusis)

LASEK is similar to PRK but the surface layer (epithelium) of the cornea is retained as a flap. Retaining the epithelium is thought to prevent complications and speed up healing.

Wavefront-guided LASIK

Wavefront-guided LASIK reduces the natural irregularities of the eye (which can cause light rays to focus incorrectly), and improve the visual result of the surgery.

Kidney Stone Removal

You normally have two kidneys which clean your blood, and filter out water and waste products to make urine.  

Small, solid masses called kidney stones may form when salts or minerals, normally found in urine, become solid crystals inside the kidney. Normally, these crystals are too small to be noticed, and pass harmlessly out of your body. However, they can build up inside your kidney and form much larger stones.  

If a stone becomes large enough, it may begin to move out of your kidney and progress through the ureter - a tube that carries urine from the kidney to your bladder. A kidney stone can become stuck at various parts of the ureter causing pain, infection and occasionally kidney damage.

Ureteroscopic Stone Removal

If your stone is lodged in the ureter, your surgeon will pass a narrow, flexible instrument called a Cystoscope up through your urethra and your bladder. A laser beam or shock waves generated by a device attached at the end of the Cystoscope removes or breaks up the stone. This procedure is usually done under general anaesthetic.

Percutaneous Nephrolithotomy (PCNL)

Large stones can be surgically removed from the kidney. Your surgeon makes a small cut in your back and uses a telescopic instrument called a Nephroscope to pull the stone out or break it up using a laser beam or shock waves. PCNL is performed under general anaesthesia.

Pelvic Floor Repair / Prolapse

When an organ drops from its normal position it is called a Prolapse. Your bladder, urethra, uterus and rectum can all prolapse through your pelvic floor. If they do, they will press against some part of the wall of your vagina causing a swelling. Any or all of these organs can prolapse at the same time. 

The different types of prolapse are:

Cystocele - A prolapse of the bladder into the front wall of the vagina.
Hysterocele - A prolapse of the uterus into the back, front or top of the vagina.
Rectocele - A prolapse of the rectum into the back wall of the vagina.
Urethrocele - A prolapse of the urethra into the lower front wall of the vagina.
Enterocele - A prolapse that contains loops of bowel.

A pelvic floor repair will remove the swelling in your vagina. It will stop any bleeding, pain or leak of urine. A cut in the wall of your vagina is normally made and your prolapsed organs will be pushed back into their normal positions above your pelvic floor. Then a repair operation is done, where the surrounding ligaments are tightened to hold your organs in place.

Restore Lenses

Everybody will notice that reading becomes increasingly difficult as they age, even those with normal vision. This usually begins at about 40 -45 years of age and is known as ‘prebyopia’. The solution for this is reading glasses or distance glasses.  

Today’s technology makes it possible to produce a lens which give good vision both from a distance and for reading.  Now there’s a revolutionary new way to potentially leave your glasses behind – introducing the AcrySof® ReSTOR® intraocular lens (IOL), a breakthrough in vision surgery.  

AcrySof® ReSTOR® has been uniquely designed to improve vision at all distances – up close, far away and everything in-between – giving patients their best chance ever to live free of glasses. The ability to quickly change focus throughout this range of vision is called accommodation (The ability of the eye’s lens to change shape to focus on objects at various distances).  Unfortunately, this ability diminishes as we grow older1, causing us to become dependent on bifocals or reading glasses.  

If you are suffering from Cataracts or are far-sighted this operation will suit you.  The surgical technique is the same as used for Cataract surgery.  

According to articles in major international journals, 90% of people operated manage completely without glasses after the Restore operation.

TURP – Prostate Surgery

TURP is the most common operation for an enlarged prostate (benign prostatic hyperplasia or BPH). BPH is an overgrowth of cells of the prostate that blocks the flow of urine, making it difficult to pass urine.  

TURP is performed using a narrow, flexible, tube-like telescopic camera called an Endoscope. The endoscope is inserted into your urethra (the tube that carries urine from the bladder and out through the penis). The surgeon will then cut out and remove the middle of your enlarged prostate using specially adapted surgical instruments.

Varicose Veins

Varicose veins are swollen and enlarged veins which are usually a blue or dark purple. They may also be lumpy, bulging or twisted in appearance.   

Varicose veins develop when the small valves inside the veins stop working properly. In a healthy vein, blood flows smoothly to the heart, and is prevented from flowing backwards by a series of tiny valves, which open and close to let blood through. If these valves weaken or are damaged, the blood can flow backwards and can collect in the vein, eventually causing it to be varicose.  

Large varicose veins may sometimes have to be surgically removed.   

The most common techniques are:-

Endothermal ablation – this is where heat is used to seal the affected veins
Sclerotherapy – this uses a special foam to close the veins
Ligation and stripping – this involves surgery to remove the affected veins

Vasectomy

A Vasectomy or 'male sterilisation' is a simple and reliable method of contraception. It is usually considered a permanent form of contraception, although in some cases the procedure can be reversed, if necessary, e.g. if you decide to have children later on in life.  

It works by preventing sperm from reaching the semen that is ejaculated from the man's penis during sex. It is a quick and painless surgical procedure.  

The 'conventional' and most widely used type of vasectomy involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles). The other type uses a newer 'no scalpel' technique.