Investigations and Treatments

Laparoscopic bowel surgery is a specialized ‘minimally invasive’ technique for performing major bowel surgery. The surgeon uses several 0.5-1 cm stab incisions (key-holes), a specialized camera and special keyhole instruments to perform the operation rather than the traditional ‘open’ technique which uses a single long up-down incision in the center of the abdomen (tummy). The camera transmits images to a high definition video monitor allowing surgeons to perform the operation through the key-holes.

Laparoscopic bowel surgery has been shown to result in less post-operative pain, quicker recovery and reduced complications ((i.e. safer that traditional open surgery). Patients are often able to go home within 3-5 days of major bowel surgery. It also results in lesser scarring. The surgeons at WBC are expert laparoscopic surgeons who undertake laparoscopic surgery for bowel cancer and a variety of other bowel conditions routinely. Up to 90% of patients who need bowel surgery are suitable for laparoscopic surgery. The surgery is performed using the latest equipment.

Hernias (also known as ruptures) are areas of weaknesses in the abdominal (tummy) wall, most commonly found in the groins. Most hernia repairs can be performed through keyhole surgery leading to a more comfortable and quicker recovery. Our surgeons are experts in all types of hernia surgery.

Transanal Haemorrhoidal De-Arterialisation (THD) is a minimally invasive surgical procedure used to treat haemorrhoids (piles). It can also be called Haemorrhoid Ligation, Haemorrhoidal Artery Ligation or Doppler guided Ligation. The THD procedure is an innovative surgical treatment for haemorrhoids, approved by the National Institute for Clinical Excellence (NICE) and designed to cure haemorrhoids in a gentle way while focusing on achieving excellent long term results:

The THD Procedure: The THD procedure does not cut or remove any haemorrhoidal tissue, minimising invasiveness and discomfort for patients. It is a day surgery procedure. During the THD procedure, the haemorrhoid’s feeding arteries are precisely located via a Doppler ultrasound probe, mounted on a specially designed proctoscope. Each of these arteries is then sutured through a small operating window of the same proctoscope, making this technique minimally invasive. The procedure is carried out in the area above the dentate line, (an area without sensory nerves); the patient doesn’t feel any stitches during or after the intervention. The THD procedure can also re-position prolapsed tissue, helping to restore “ normal” anatomy and physiology.

After the procedure:

THD does not cut or remove any haemorrhoidal tissue; hence pain and post-operative complications are significantly reduced, with a long term positive outcome.  In most cases, patients resume their normal activities within 24 – 48 hours. After the intervention, some patients might feel a slight discomfort in the rectal area which usually disappears within a few days. If any prolapse has been sutured, some patients might feel a slight urge to defecate, related to the repaired prolapse, which will gradually disappear. The patient can be discharged a few hours after the operation, with pain killer tablets to be taken for any mild discomfort.

This novel technique uses 1470 nm diode laser to treat common conditions such as fistulas and haemorrhoids. The technique is also used to treat pilonidal sinuses. This minimally invasive procedure is performed as a day-case operation, and causes minimal pain and discomfort. It also allows the treatment of fistulas in one sitting (previously fistulas required numerous operations).

An endoscopy is a procedure where the gut (or other tube-organ) is examined internally using an endoscope. An endoscope is a thin, long, flexible tube that has a light source and a video camera at one end. Images of the internal aspect of the gut are relayed and projected on an external television screen.

A gastroscopy is a camera examination of the stomach and first part of the small bowel. The endoscope is passed through the mouth into the gullet. The test is performed either with throat spray (a local anaesthetic spray that numbs your throat) or light sedation and normally takes about 5 minutes.

A colonoscopy is a camera examination of the large bowel. The colonoscope is passed through the back passage and around the large bowel which is roughly a meter in length. The test required cleansing of the bowel prior to the examination by the use of strong laxatives called bowel prep at home the day before. Colonoscopy is usually performed under light sedation but can also be performed un-sedated. The examination usually takes between 15 to 30 minutes.

A flexible sigmoidoscopy is similar to a colonoscopy but only the left part of the large bowel is inspected. The test can be done after administering an enema without bowel prep. It is usually performed without sedation, but some patients may choose to have sedation. The procedure takes about 5-10 minutes.

A computerised tomography (CT) scan, also known as a CAT scan, uses x-rays and a computer to create detailed images of the inside of your body.

Abdominal and pelvic CT scans allow the radiologist to visualise the different organs/ viscera within the abdomen and pelvis and inspect them for signs of disease.

The scan is usually performed with the patient lying on their back and involves only a part of the body entering a short tunnel. CT scans are painless and normally take about 15-20mins. They might sometimes involve an intravenous injection of a contrast (special dye) to help identify different structures within the body better.

A CT colonography/ CT enema/ virtual colonoscopy uses the CT scanner and special computer graphics to digitally reconstruct images of the large bowel akin to what is seen during a colonoscopy. The test involves full bowel preparation using strong laxatives (at home the day before) and an insertion of a soft tube into the back passage and insufflation of air into the bowel. The examination takes about 45 minutes.

Magnetic resonance imaging (MRI) scanners use strong magnetic fields and radio waves to produce detailed images of the inside of the body. An MRI scanner is a large tube/ tunnel that contain a series of powerful magnets. The patient has to lie inside the tube during the scan. It is a painless and harmless procedure but some patients may find it claustrophobic. The examination takes about 15 to 90 minutes.