Dr Boitumelo Nkgudi

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PLEASE FEEL FREE TO CONTACT US FOR MORE INFORMATION ON ANY OF THE PROCEDURES BELOW

THYROIDECTOMY

RIEF DESCRIPTION
Thyroidectomy is an operation to remove part or all of the thyroid gland. Typically, the operation removes the lobe of the gland containing the lump and possibly the isthmus. A general anesthetic is required.

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ABOVE KNEE AMPUTATION

The leg is amputated about 15 centimeters above the knee joint. This operation is only done if the foot is already dead or has lost too much tissue to still be

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GASTROSCOPY

A gastroscopy is an endoscopic examination of your stomach. On the way we examine your oesophagus (gullet, food-pipe) which runs from the back of the mouth, through your chest, and into your stomach. We also examine beyond your stomach into the first part of the gut called the duodenum (part of the small bowel).

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Patient Info hub

BRIEF DESCRIPTION
An anal fissure is a small tear running from the skin near the back passage and opening into the anal canal higher up. This is a painful condition usually associated with fresh bleeding after bowel actions. The fissure is aggravated by spasm of the circular anal muscle. The operation involves either streching or cutting into the sphincter muscle a little to relive the spasm and thus the pain, allowing the fissure to heal. Any associated anal skin tags are removed.

WHY IS THIS OPERATION NECESSARY?
The blood supply in this area is often poor, and this prevents healing. An acute fissure can then become chronic and continue causing pain or bleeding

BRIEF DESCRIPTION

A peri-anal abscess is an infection next to the anus. Pus builds up under the skin causing swelling and pain. It can sometimes start to drain pus or blood-stained fluid and there is sometimes a connection with the inside of the back passage.

During the procedure the pus is let out through a cut in the skin next to the anus. The surgeon will try to determine if there is a fistula or tunnel connecting the inside of the anus with the abscess cavity. The wound is then washed out and usually it is left open without any sutures. The surgeon may decide to leave a plug made of gauze or sponge in the wound to be removed later. Sometimes antibiotics are given to help the healing.

WHY IS THIS OPERATION NECESSARY?

An abscess near the anus can become a very serious problem if the infection spreads to surrounding tissues or progress to sepsis. If a tunnel is present connecting the inside of the anus to the abscess it will prevent healing and become chronic in about 80% of cases.

BRIEF DESCRIPTION

An anal fistula is a narrow tunnel or tract running from the skin near the back passage and opening into the anal canal higher up. This discharges pus irregularly and may be uncomfortable. It often shows up after there has been an abscess near the anus. During the operation the fistula tract is identified and is opened along its length, and the exposed inside of the tract is then cleaned out. The wound is usually left open without suturing it. The wound becomes shallower as it heals, and ends up as a flat scar after a month or two. If it is too deep a drain can then be placed as a seton.

THIS OPERATION NECESSARY?

The tunnel opening on the skin is connected to the inside of the anus and stool as well as organisms continues to travel along this tract, preventing healing. It becomes chronic and causes infection with intermittent pain or bleeding. It can cause repeated infections or abscesses and there is ongoing drainage or leakage from the fistula opening.

BRIEF DESCRIPTION

Pruritus is a latin word meaning itching. Pruritus ani means itching around the back passage (anus). These notes should help you understand how it happens and how to deal with it.

WHAT CAUSES PRURITUS ANI?

The main cause is stool irritating the nearby skin. This is made worse by:

  • Looseness of the bowels
  • Poor control of the bowels
  • Lumpy skin around the back passage
  • Skin infection or eczema
  • Infection in the stool
  • Sweating aggravated by synthetic underwear
  • Overheating
  • Scratching leading to more itching
  • Over enthusiastic cleansing with irritant soap
  • Some trouble with the back passage such as piles

WHAT IS A TOE AMPUTATION?

The infected, dead or painful toe is amputated at its base so that the foot is preserved. Occasionally, part of the foot may have to be removed as well. The surgeon will only amputate a toe if it cannot be saved and if he believes That the blood supply is adequate to allow the wound to heal.

PRE-ADMISSION AND REGISTRATION

Many patients requiring amputation are already in the hospital before the decision is taken to amputate. If you are at home, the day of your admission you should register your details with the hospital’s Pre-admission Clinic. This allows the hospital to register all your personal and medical aid details, which greatly reduces the time and paperwork it takes to admit you on the day of your operation. If you are not a member of a medical aid you will be required to pay a deposit for the hospital costs on admission.

BRIEF DESCRIPTION

A toenail can become very thick, curved and painful or the nail curls over and grows into the toe, most commonly affecting the big toe but it may happen with other toes as well. Surgical treatment involves either a wedge excision where a part of the nail is removed or it can involve removing the whole nail. You may decide to allow the nail to grow back afterwards but in some cases it is necessary to also remove the growth plate to prevent the nail growing back.

 

WHY IS THIS OPERATION NECESSARY?

An ingrown nail can cause infection and painful swelling with granulation tissue. It may prevent you from wearing shoes or even make it difficult to walk.

BRIEF DESCRIPTION

A colonoscopy is a day-case procedure in which the inside of the large intestine, (colon and rectum) is examined using a 1.5 metre flexible instrument with a diameter of less than 1cm.

WHY IS IT DONE?

A colonoscopy is commonly used to evaluate gastro-intestinal symptoms, such as, rectal and intestinal bleeding or changes in bowel habit or anaemia. Colonoscopy is also advised in individuals without symptoms to check for colo-rectal polyps or cancer. A screening colonoscopy is recommended for anyone aged 45 years or older and persons with a family history of colon polyps or cancer should be screened at an age 10 years younger than the age it was diagnosed in the family member. Patients with a family history of colon cancer or polyps, or patients in who polyps are found, will need regular colonoscopy follow up checks. Polyps may be removed and tissue samples taken to be sent to the pathologist for analysis

BRIEF DESCRIPTION

A bowel fistula is an abnormal communication between the small or large bowel or both and the skin. Its causes are multiple and your surgeon will discuss this with you. The principle of the operation is to remove the fistula and a segment of bowel and anastomose (join) the ends of the bowel together. Occasionally it may be necessary to carry out a temporary stoma (bag) which is closed at a second operation. These operations are invariably more complex than one expects.

WHY IS THIS OPERATION NECESSARY?

Fistulae do close spontaneously and surgery is used as a last resort.

WHAT IS ABOVE KNEE AMPUTATION?

The leg is amputated about 15 centimeters above the knee joint. This operation is only done if the foot is already dead or has lost too much tissue to still be functional or if there is an infection that is too severe to control with antibiotics. Occasionally the pain from severe blockage of the arteries is so severe that an amputation is the only thing that will get rid of the pain. Most amputation patients are diabetics because diabetes blocks the circulation to the foot and allows sever infections to occur. The operation will be performed above the knee because the surgeon believes that an amputation below the knee will not heal properly and in addition an established contracture at the knee will hinder rehabilitation in any knee sparing procedure.

PRE-ADMISSION AND REGISTRATION

Many patients requiring amputation are already in the hospital before the decision is taken to amputate. If you are at home, the day of your admission you should register your details with the hospital’s Pre-admission Clinic. This allows the hospital to register all your personal and medical aid details, which greatly reduces the time and paperwork it takes to admit you on the day of your operation. If you are not a member of a medical aid you will be required to pay a deposit for the hospital costs on admission.

WHAT IS A BELOW KNEE AMPUTATION?

The leg is amputated about 15 centimeters below the knee joint. This operation is only done if the foot is already dead or has lost too much tissue to still be functional or if there is an infection that is too severe to control with antibiotics. Occasionally the pain from severe blockage of the arteries is so severe that an amputation is the only thing that will get rid of the pain. Most amputation patients are diabetics because diabetes blocks the circulation to the foot and allows sever infections to occur.

PRE-ADMISSION AND REGISTRATION

Many patients requiring amputation are already in the hospital before the decision is taken to amputate. If you are at home, the day of your admission you should register your details with the hospital’s Pre-admission Clinic. This allows the hospital to register all your personal and medical aid details, which greatly reduces the time and paperwork it takes to admit you on the day of your operation. If you are not a member of a medical aid you will be required to pay a deposit for the hospital costs on admission.

WHAT IS THROUGH KNEE AMPUTATION?

The leg is amputated through the knee joint. But the skin is much longer to allow it to heal in a wound behind the end of the thigh bone. This operation is only done if the foot is already dead or has lost too much tissue to still be functional or if there is an infection that is too severe to control with antibiotics. Occasionally the pain from severe blockage of the arteries is so severe that an amputation is the only thing that will get rid of the pain. Most amputation patients are diabetics because diabetes blocks the circulation to the foot and allows sever infections to occur. The operation will only be done through the knee if the surgeons believes that an amputation below the knee will not heal properly.

PRE-ADMISSION AND REGISTRATION

Many patients requiring amputation are already in the hospital before the decision is taken to amputate. If you are at home, the day of your admission you should register your details with the hospital’s Pre-admission Clinic. This allows the hospital to register all your personal and medical aid details, which greatly reduces the time and paperwork it takes to admit you on the day of your operation. If you are not a member of a medical aid you will be required to pay a deposit for the hospital costs on admission.

BRIEF DESCRIPTION

A cut is made around the stoma to free the bowel from the skin and muscles of the abdominal wall. The bowel is then joined up (anastomosed) and returned to the abdominal cavity. Faeces and gas will then drain the normal way to the back passage (anus). The stoma wound is then closed off. Occasionally, there are difficulties and the main wound in your abdomen has to be reopened to join the bowel up safely.

WHY IS THIS OPERATION NECESSARY?

As you know, you have a stoma. This is an opening of the bowel draining bowel fluid or faeces into a bag on your abdomen instead of the normal way into the anus. You and your surgeon have agreed that it is an appropriate time to close the stoma restoring normal continuity of the bowel and allowing you to defaecate through the anus.

BRIEF DESCRIPTION

Haemorroids (piles) are abnormal swollen veins that develop in the anal canal. Mostly they are small and have no symptoms, but they can become painful and inflamed. There may be bleeding when you pass stool or a sensation of something pushing out the anus when you strain. During the haemorroidectomy operation the swollen veins are cut away and the resulting wound is either left open or absorbable sutures are used to close the raw area.

WHY IS THIS OPERATION NECESSARY?

An operation is mostly necessary when all other treat-ments have failed.

BRIEF DESCRIPTION

A mastectomy is an operation to remove the entire breast. The operation may involve removal of the lymph nodes (glands) in the axilla (armpit). No muscles are removed. The end result is smooth skin across the chest with a barely visible scar across it. Alternative names: total mastectomy, simple mastectomy, modified radical mastectomy. Radical mastectomy is not performed anymore these days.

WHY IS THIS OPERATION NECESSARY?

The commonest indication is for breast cancer

BRIEF DESCRIPTION

A gastrectomy is an operation that removes either part of the stomach (partial) or the entire stomach (total). The small bowel or intestine can be used to join the remaining stomach to the oesophagus as needed. Your surgeon will discuss the procedure with you in detail and will answer any questions you may have before the operation.

WHY IS THIS OPERATION NECESSARY?

The commonest indication for this operation is for cancer. Other indications include benign (non-cancerous) tumors or complicated stomach ulcers.

WHAT IS A HERNIA?

A hernia is a bulge or weakness in the muscles which form the lower front of the stomach in the groin region.

WHAT DOES THE OPERATION CONSIST OF?

A cut is made into the skin overlying the hernia. The bulge is pushed back and the sac is cut off. The weak part is mended and strengthened, usually with nylon stitches or a mesh patch which is used to strengthen the defect. The cut in the skin is then closed up.

WHAT IS AN UMBILICAL HERNIA?

This is a weakness or swelling of the navel (belly button). It may become bigger, more uncomfortable or become unsightly. Sometimes fat or bowel gets stuck in the hernia causing severe pain and illness.

WHAT DOES THE OPERATION CONSIST OF?

A cut is made around the navel. Any fat or bowel that is inside the hernia is pushed back or removed. The weakness in the muscles is mended with strong stitches or a prosthetic sheet (mesh). The skin is then closed usually with dissolving stitches.

BRIEF DESCRIPTION

There are many types of lumps or lesions on the skin or in the deeper tissue that can cause you symptoms or can be worrying. They can occur on any location on your body and these include lipomas, fibromas, dermal cysts, and skin blemishes or warts. In most cases these are completely innocent and can safely be ignored. If the lump needs removal, an excision will be performed. The lesion is cut out using an incision which is planned to leave the best possible scar afterwards. Whenever possible this means using natural skin lines and creases. The wound is closed usually with stitches.

WHY IS THIS OPERATION NECESSARY?

There are three good reasons for having the lump or lesion taken out. Firstly, you will be freed from the symptoms, secondly it will no longer be there to worry you and thirdly we can examine the tissue under a microscope to find out exactly what it is.

BRIEF DESCRIPTION

A hernia is a bulge or weakness in the muscles of the stomach in the groin region. There is a weak spot on either side where the arteries and veins run in a tunnel down to your legs and in the case of a hernia some tissue from the inside of your abdomen will protrude along this canal to form a sac that bulge in the groin. It usually contains fatty tissue but it could also contain part of your intestine. During the operation a cut is made into the skin overlying the hernia. The bulge is pushed back and the sac is cut off. The weak part is mended and strengthened, usually with stitches or a mesh patch which is used to strengthen the defect. The cut in the skin is then closed up.

WHY IS THIS OPERATION NECESSARY?

Once a hernia is present it will not resolve by itself. Although many people simply live with the discomfort, there is a risk of the hernia getting bigger and more symptomatic. There is also a risk that the contents of the hernia can get trapped in the hernia sac and then cause extreme pain with eventual strangulation or perforation of the bowel inside. This may lead to sepsis and can even be fatal. 30% to 40% risk of this hernia complicating and presenting as an emergency

BRIEF DESCRIPTION

An incision (cut) is made across the upper abdomen (tummy) below the ribs on both sides. The pancreas is exposed and freed from the adjacent organs. The tail (distal) half of the pancreas is then removed. Since the blood vessels that go to the spleen pass through the pancreas, the spleen is also removed. This operation is often performed laparoscopically by surgeons experienced with this type of surgery. This technique is less invasive as 3-4 small incisions are used rather than the usual large incision. It may be necessary to convert from laparoscopic surgery to an open cut if difficulties arise during surgery

WHY IS THIS OPERATION NECESSARY?

The operation is usually performed for tumours located within the tail of the pancreas. It is intended to remove the tumour completely, and thus achieve cure of the tumour

BRIEF DESCRIPTION

You and your surgeon have decided that your rectal prolapse is severe enough or troublesome enough to need an operation. A Delorme’s procedure aims to repair the prolapse. This operation involves the surgeon removing some of the prolapsed lining of the rectum (mucosa) and reinforcing the muscle of the rectum by placating stitches. This is done via the anus. No external incision is needed.

WHY IS THIS OPERATION NECESSARY?

The lowest part of the bowel, the rectum, in your case has become rather slack. When you strain, the lining of the rectum and finally the walls of the rectum pout out through the back passage (anus). As well as the pouting bowel, many people have soiling and cannot control the wind. A rectal prolapse occurs when the normal supports of the rectum become weakened, allowing the muscle of the rectum to drop down through the anus to the outside. Sometimes this only happens when you open your bowels, and goes back on its own. In more severe cases, the rectum may need to be pushed back after opening the bowels, or may even stay outside all the time. While not a dangerous or life-threatening condition, this can be very uncomfortable, a considerable nuisance, and may cause loss of bowel control. There may also be a mucus or blood -stained discharge.

BRIEF DESCRIPTION

An incisional hernia is an area of weakness in part or all of the muscle closure after a previous abdominal operation. It can occur soon after the previous operation or sometimes years later. The hernial sac bulges through the muscle defect and can include bowel and even other abdominal organs.

WHY IS THIS OPERATION NECESSARY?

The hernias tend to increase in size over time and the larger they become the more difficult they are to repair. There is a risk of bowel becoming trapped or twisted within the hernial sac which can lead to obstruction and impairment of the blood supply to the bowel , requiring an emergency procedure to salvage the bowel and avoid a life threatening condition.

WHAT IS A HERNIA?

A hernia is a bulge or weakness in the muscles which form the lower front of the stomach in the groin region.

WHAT DOES THE OPERATION CONSIST OF?

A cut is made into the skin overlying the hernia. The bulge is pushed back and the sac is cut off. The weak part is mended and strengthened, usually with nylon stitches or a mesh patch which is used to strengthen the defect. The cut in the skin is then closed up.

BRIEF DESCRIPTION

You and your surgeon have decided that your rectal prolapse is severe enough or troublesome enough to need an operation. This operation aims to repair the prolapsed by hitching up the rectum and stitching it to the inside of the pelvis so that it cannot prolapse out through the anus any more. Usually a nylon mesh is placed on the rectum to help secure it. Sometimes the section of bowel above the rectum may have become very slack and elongated and may require to be removed . This procedure is often done laparoscopically (key-hole surgery).

WHY IS THIS OPERATION NECESSARY?

The lowest part of the bowel, the rectum, has become rather slack. When you strain, the lining of the rectum and finally the walls of the rectum pout out through the back passage (anus). As well as the pouting bowel, many people have soiling and cannot control the wind. A rectal prolapse occurs when the normal sup-ports of the rectum become weakened, allowing the muscle to drop down through the anus to the outside. Sometimes this only happens when you open your bowels, and goes back on its own. In more severe cases, the rectum may need to be pushed back after opening the bowels, or may even stay outside all the time. While not a dangerous or life-threatening condition, this can be very uncomfortable, a considerable nuisance, and may cause loss of bowel control. There may also be a mucus or blood -stained discharge.