General Surgery Treatments
An anal fissure is a painful condition where the skin around your back passage (anus) becomes cut or torn. It can occur when you pass hard stools, when you’re constipated and during childbirth. Symptoms of an anal fissure include: itching, a sharp pain when you pass stools and then deep burning afterwards and, you may also bleed when you have a bowel movement.
Anal fissures will normally heal on their own reasonably quickly. If they don’t heal after six weeks your doctor may suggest self-help remedies and prescription medications. If non-surgical treatments are ineffective then surgery will be advised.
A lateral sphincterotomy is the gold standard treatment for anal fissure. Your general surgeon will make a small cut to the ring of muscle surrounding your anal canal (sphincter) whilst you’re under general anaesthetic. Surgery should only take about 15 minutes and afterwards the tension in your anal canal should be reduced and your anal fissure can heal.
An anal fistula is an infected small tunnel that develops between the skin and the muscular opening at the end of the digestive tract (anus). Symptoms include: a constant throbbing pain that worsens when you sit down, swelling, redness and skin irritation around your anus and, the passing of puss or blood when you have a bowel movement.
Surgery is normally needed to treat an anal fistula. Anal fistula surgery also known as anal fistula repair will close the tunnel. The exact operation will depend on the type of fistula you have. Surgical options include: fistulotomy (cutting open the whole length of the fistula so that it can heal from inside out), seton suture (leaving surgical thread called a seton on the fistula for several weeks to help it heal) and ligation of intersphincteric fistula track (LIFT) procedure (new technique that involves tying your fistula off within your sphincter muscle and implanting a piece of biological mesh to stop the fistula reforming). Fibrin glue or collagen plug (to seal and close the fistula tract) are non-surgical options.
Haemorrhoids, also known as piles, are swollen veins and muscle inside or around your anus and rectum. They are associated with increased pressure in the blood vessels in and around your anus possibly as a result of straining on the toilet. Sometimes piles don’t give any symptoms but if they become damaged they may cause pain, itchiness and bleeding.
Initially self-help measures and medicines are normally recommended. If these aren’t successful, then non-surgical procedures such as banding and sclerotherapy will be advised.
If you’ve severe piles, other treatments haven’t worked or, your piles keep bleeding then surgery will be needed. There are different types of surgery for haemorrhoids that will either remove the haemorrhoids or reduce their blood supply so that they shrink. Haemorrhoidectomy removes any piles causing problems and stapled haemorrhoidopexy stitches the area of tissue with piles higher up your anal canal and your haemorrhoids will shrink.
A hernia happens when a part of your body protrudes through a weak spot in your muscle or surrounding tissue wall. They can appear as a bulge or swelling anywhere on your body but most often they are found between your chest and hips.
Common types of hernia include: inguinal hernias and femoral hernias (when fatty tissue or a part of your bowel pushes through into your groin), umbilical hernias (when fatty tissue or a part of your bowel pokes through your stomach near your navel) and hiatus hernias (when part of your stomach pushes up into your chest through the diaphragm).
Not all hernias require surgery but your surgeon may recommend it based on the severity of your hernia and where it’s located. There are several different approaches to hernia repair that all aim to push back the protruding body part to where it belongs and close the window through which the hernia came out in the first place. Tension free mesh procedure is preferred in most cases but other methods of repair may be advised such as stitching and keyhole surgery.
A lipoma is a soft, fatty and benign lump that grows under the skin. It’s caused by an overgrowth of fat cells and it can grow anywhere where there are fat cells. They are often found on shoulders, neck, chest, back, bottom, thigh and arms.
If they're small and painless they are normally left alone. They can cause embarrassment and self-consciousness and New Hall Hospital will remove lipomas for aesthetic reasons as well as if medically required. Lipomas are not treated on the NHS for aesthetic reasons.
Removal of lumps and bumps
Lumps and bumps can appear almost anywhere on your body. Most are harmless (benign) but it’s best to get them checked over by a consultant to ensure they aren’t malignant.
Moles are also often harmless. They can vary in shape, size and colour but if you notice any changes in colour or shape or find them irritating your skin then you should seek immediate medical attention.
Lumps, bumps and moles are classified as skin lesions. They aren’t routinely treated on the NHS for aesthetic purposes. We offer treatment of lumps, bumps and moles for aesthetic purposes at New Hall Hospital.
A skin lesion is normally removed under local anaesthetic. There are different procedures available and the choice will depend on the shape, size and location of your skin lesion.
A pilonidal sinus (PNS) is a small hole or tunnel in the skin usually located near the top of the buttocks. It can become infected and filled with pus and an abscess can develop which can be very painful. It often happens when hair punctures the skin and then becomes embedded.
If your pilonidal sinus becomes infected, then treatment commonly involves an operation. The pilonidal sinus can be drained through a small incision, sealed using fibrin glue or removed surgically.
Removal of gall bladder
The gallbladder is a small organ located in the upper right part of your tummy. It collects and stores bile, a liquid that helps your body to digest food. You can live without your gall bladder so if it becomes diseased, damaged or if you have gallstones then it may be removed.
Painful gallstones are the most common reason for gall bladder removal. They may vary in size from being as small as a grain of sand or as large as a golf ball. Gallstones can cause intense abdominal pain and discomfort, vomiting and jaundice.
Gall bladder removal is performed under general anaesthetic. A technique called laparoscopic cholecystectomy is most commonly used although it can be performed using open surgery.