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DSC_1612-min Dr. Bhikhubhai Patel
General & Laparoscopic Surgeon, MBBS, MS, FMAS

­INTRODUCTION

Digestive system surgery, or gastrointestinal surgery, can be divided into upper GI surgery and lower GI surgery.

1. Upper gastrointestinal Surgery :

Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of surgery that focuses on the upper parts of the gastrointestinal tract. Upper GI surgeons would have an interest in, and may exclusively perform, the following operations:

  • Pancreaticoduodenectomy
  • Esophagectomy
  • Liver resection

1.1. A pancreatoduodenectomy, Whipple procedure, or Kausch-Whipple procedure, is a major surgical operation involving the removal of the head of the pancreas, the duodenum including the duodenal papilla or ampulla of Vater, the proximal jejunum, gallbladder, and often the distal stomach. This operation is performed to treat cancerous tumours of the head of the pancreas, malignant tumors involving the common bile duct, duodenal papilla or ampulla of Vater, or duodenum near the pancreas, some precancerous lesions, some cases of pancreatitis with or without a definitive cause, and rarely, severe trauma.

1.2. Oesophagectomy is the surgical removal of all or part of the esophagus. In most cases, the stomach is transplanted into the neck and the stomach takes the place originally occupied by the esophagus. In some cases, the removed esophagus is replaced by another hollow structure, such as the patient's colon. Another option which is slowly becoming available is minimally invasive surgery (MIS) which is performed laparoscopically and thoracoscopically. After surgery, patients may have trouble with a regular diet and may have to consume softer foods, avoid liquids at meals, and stay upright for 1–3 hours after eating. Dysphagia is common and patients are encouraged to chew foods very well or grind their food. Patients may complain of substernal pain that resolves by sipping fluids or regurgitating food.

1.3. Hepatectomy is the surgical resection (removal of all or part) of the liver. This term is often employed for the removal of the liver from a liver transplant donor.

2. Lower gastrointestinal Surgery:

Lower gastrointestinal surgery includes colorectal surgery as well as surgery of the small intestine.

It refers to a sub-specialisation of medical practise whereby a general surgeon focuses on the lower gastrointestinal tract.

A lower GI surgeon might specialise in the following operations:

  • Colectomy
  • Low or ultralow resections for rectal cancer, etc.

Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology.

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