Surgery is something we plan together.

What it is

Surgery to remove the gallbladder, usually through small cuts with a camera (laparoscopic). It is most often done for gallstones that cause pain or infection.

Before surgery

• Ultrasound of the abdomen and blood tests, including liver tests
• Tell me about all your medicines, especially blood thinners and diabetes medicines
• Follow the fasting instructions given by the anesthesia team

After surgery

• Most people go home the same day or the next day
• Walk a little every day and start with light meals
• Shoulder-tip pain for a day or two is common and settles

What it is

A hernia is a bulge where tissue pushes through a weak spot in the abdominal wall, often in the groin or near the belly button. Repair strengthens the weak spot, often with a mesh.

Before surgery

• Examination, sometimes with an ultrasound
• If you smoke, stopping before surgery helps healing
• Treat a long-standing cough or constipation, which strain the repair
• Tell me about blood thinners and other regular medicines

After surgery

• Walk early and often
• Avoid heavy lifting for the period I advise
• Some bruising and swelling around the area is common

What it is

Appendicitis is inflammation of the appendix. It is usually treated by removing the appendix, most often with keyhole surgery.

Diagnosis

• Typical signs: pain that starts near the belly button and moves to the lower right side, nausea, loss of appetite, fever
• Examination, blood tests, and an ultrasound or CT scan

Before surgery

• Do not eat or drink once appendicitis is suspected
• You may receive fluids and antibiotics through a drip

After surgery

• Most people stay one to two nights
• Return to light activity as comfort allows
• Keep the wounds clean and dry

What they are

Common problems around the anus and rectum: piles (hemorrhoids), a small tear (fissure), a painful collection of pus (abscess) and an abnormal channel near the anus (fistula). Many improve without surgery.

Diagnosis

• Your story and a gentle examination, sometimes with a short scope
• A colonoscopy may be advised if you have bleeding and are older or have other risk factors

Before surgery

• Eat more fiber, drink water, and avoid straining
• Tell me about your medicines, especially blood thinners
• Follow any bowel preparation and fasting instructions you are given

After surgery

• Warm sitz baths a few times a day
• Fiber and a stool softener so the first bowel motions are easy
• Take pain medicine as prescribed
• Small amounts of bleeding or discharge for some days are common

What it is

Most breast lumps are not cancer, but every new lump should be checked. Surgery may be advised to remove a lump or to get a clear diagnosis.

Diagnosis

• Examination of both breasts and the armpits
• Imaging: ultrasound, and mammogram when appropriate
• A needle biopsy to examine the cells
• See a doctor soon for a new lump, nipple discharge, or skin dimpling or redness

Before surgery

• Bring any previous scans and reports
• Tell me about breast or ovarian cancer in your family
• A small lump may need a marker placed beforehand to guide the surgeon

After surgery

• Wear a supportive bra and keep the wound clean and dry
• The tissue is sent to the laboratory, and results usually take several days
• We will go through the results together at your follow-up visit

What it is

A lipoma is a soft, slow-growing lump of fat under the skin. It is harmless and usually painless. Removal is offered if it is growing, painful, bothers you, or the diagnosis is uncertain.

Diagnosis

• Examination, and an ultrasound or MRI for lumps that are large or deep

Before surgery

• Usually done under local anesthesia as a day case
• Tell me about blood thinners and any allergies

After surgery

• Keep the dressing clean and dry
• Some bruising and mild swelling is common
• The lump is sent to the laboratory to confirm the diagnosis

What it is

A smooth lump under the skin, often with a tiny dark opening in the center. It can release a thick, cheesy material and sometimes becomes infected.

Treatment

• Best removed when it is calm, not inflamed, and the whole sac is taken out to reduce the chance of it coming back
• If it is infected, it may need drainage and antibiotics first, with removal later
• Usually done under local anesthesia as a day case

Before surgery

• Do not squeeze the cyst, as this can cause infection
• Tell me about blood thinners and allergies

After surgery

• Keep the wound clean and dry and follow the dressing instructions
• Stitches are removed at a follow-up visit if needed

What it is

A small opening or pit at the top of the buttock crease, which can become painful, leak fluid, or form an abscess. It is more common in people with a lot of body hair or who sit for long periods.

Treatment

• An abscess is drained
• A long-lasting sinus is treated by removing it, and in some cases the skin is reshaped to help healing

After surgery

• Keep the area clean and dry, and change dressings as advised
• Remove hair from the area regularly, as I advise, to lower the chance of it returning
• Healing can take several weeks