WHAT IS SURGICAL GASTROENTEROLOGY (SGE)?
The surgery of digestive tract namely liver, pancreas and bile duct surgery, colo-rectal and esophago-gastric surgerycomes under the domain of surgical Gastroenterology(SGE) has witnessed significant advancements during the last decade both in the management of benign diseases as well as cancers. Several new surgical procedures were introduced and existing ones were refined to provide excellent immediate postoperative and long term results.
Most of the surgical work is now done by the Minimal Access (Laparoscopic) Approach.
In order to assimilate these developments, similar to cardiac surgery and neurosurgery, specialized digestive tract surgery has been established as the superspeciality of surgical gastroenterology
The surgical gastroenterologist is equipped to treat surgically all benign and cancerous conditions of the digestive tract.
WHAT SERVICES ARE PROVIDED BY SURGICAL GASTRO ENTEROLOGY?
Some of the common diseases and operative procedures that come under the domain of this superspeciality and these are routinely performed at PSRI include:
LIVER: Complete range of therapeutic options for removal of liver tumors and control of their spread can be performed. While resections are indicated for removal of tumors; adjunctive procedures such as radiofrequency ablation, transarterial chemoebolisation and portal vein embolization can be used to control of spread of these tumors to surrounding organs. Surgery for liver cysts especially hydatid cysts is rewarding.
PORTAL HYPERTENSION: Esophagogastric devascularization and shunt surgery for refractory variceal hemorrhage.
PANCREAS: Surgery for Cancer of pancreas (Whipple’s procedure or Pancreaticododenectomy for tumor in the pancreatic head and distal resection for tumors in body and tail, surgery for chronic pancreatitis (Frey’s procedure and duct drainage procedures) and surgery for acute pancreatitis (necrosectomy and pseudocyst drainage).
Billary System: Radical cholecystectomy for carcinoma gallbladder, surgery for bile duct cancers, postcholecystectomy bile duct strictures, complex bile duct stones and choledochal cyst is performed with excellent results.
Esophagus: Esophagectomy for cancer of esophagus, cardiomyotomy for achalasia cardia, fundoplication for hiatal hernia
Small Bowel: Intestinal fistulae, gangrene, postoperative adhesive obstruction, strictures and tumors of small bowel.
Stomach: Gastrectomy for stomach cancer/ GIST( Gastrointestinal Stromal Tumor)/ refractory peptic ulcer, bleeding and perforations.
Colon & Rectum: Pouch surgery for ulcerative colitis, sphincter saving surgery for rectal cancer, surgery for lower GI bleed, resections of cancer colon.
Obesity Surgery: Obesity surgery/bariatric surgery also called as weight loss surgery has not only helped for reducing weight but also allowed control of severe diabetes mellitus in obese patients and thus decreasing need of insulin. Also called as metabolic surgery, it is commonly performed laparoscopically at PSRI.
Minimal Invasive Surgery: Laparoscopy key hole surgery is minimally invasive technique which has been used for various procedures and has revolutionized the way surgery is performed. With growing expertise and confidence, laparoscopy is being applied more and more to all procedures performed in surgical gastroenterology.
Who is better eqquiped to treat digestive cancers - Gastroentrology Surgeon or General Cancer Surgeon?
In the current era of explosion of information and increasing specialization, just as brain tumors are treated by neurosurgeons and heart and lung tumors by cardiac surgeons, digestive tract cancers are best treated by a multidisciplinary team led by a dedicated Gastroenterology Surgeon.
In partnership with one of the finest medical gastroenterology departments in the country, the department of SGE provides comprehensive state of art, multidisciplinary management of digestive diseases. This combination is well backed by excellent conventional & interventional radiology, oncology, pathology, and stoma clinic services.
The SGE facility is manned by highly trained surgeons with experience of international repute and is provided with top of line operation rooms, anesthesia and pain management services, intensive care unit and minimal access surgery technology.