General Surgery

Thyroid

The thyroid gland is a butterfly-shaped endocrine gland located in the front of the lower neck just below the Adam’s apple. The thyroid gland consists of left and right thyroid lobes connected by a bridge of thyroid tissue known as the thyroid isthmus. The thyroid gland produces a hormone called thyroxine which helps regulates the body’s normal metabolic processes.

Disorders of the thyroid gland are common. These include nodules, goitre, cancer and functional disorders of the thyroid due to excessive or insufficient thyroid hormone production (hyper- or hypothyroidism).

Thyroid Nodule Ablation

Dr Meyer-Rochow is the first New Zealand clinician to have completed thyroid nodule radiofrequency ablation (RFA) training and able to offer this innovative new treatment option for patients in New Zealand. RFA ablation of thyroid nodules is a non-surgical alternative for the treatment of thyroid nodules which uses heat to cause destruction of the thyroid nodule. However not all thyroid conditions or nodules are suitable for this procedure and the indications for and results of thyroid nodule ablation can often be exaggerated by unregulated internet content.

Parathyroid

Although the parathyroid glands have a similar name and and often attached to the thyroid they are unrelated to and have a very different function to the thyroid gland. There are usually 4 parathyroid glands normally each only a few millimetres in size. However with parathyroid disease a parathyroid gland can increase to several centimetres in size. The parathyroid glands are essential for maintaining calcium levels at optimal concentrations in blood and body fluids.

Adrenal

The adrenal glands (also known as suprarenal glands) are triangular shaped endocrine glands located on top of each kidney. These glands are important to the body’s endocrine (hormonal) system and produce hormones some of which we cannot survive without. There are two main parts to each adrenal gland – the Adrenal Medulla and the Adrenal Cortex.

Adrenal Medulla

The Adrenal Medulla is the central part of the adrenal gland and is responsible for the production of adrenaline (epinephrine) and nor-adrenaline (nor-epinephrine). These are the hormones underlying the “flight or fright” response and are normally secreted at times of stress.

Adrenal Cortex

The Adrenal Cortex consists of the outer layers of the adrenal gland and produces the hormones cortisol, aldosterone and adrenal sex hormones.

Gall Bladder Surgery

The gall bladder is part of the digestive system and is a storage bag for bile. Bile is produced by the liver and helps with the digestion of dietary fat.

The most common reason for surgery of the gallbladder is gallstones (cholelithiasis). Bile is a highly concentrated fluid and over time can precipitate resulting in the formation of gallstones. Gallstones may result in symptoms of indigestion or spasms of upper abdominal pain resulting from contraction of smooth muscle of the biliary system (biliary colic). Gallstones can also result in recurrent episodes of inflammation or infection of the gall bladder (cholecystitis).

Haemorrhoid surgery

Haemorrhoids are a common condition caused by the dilatation of veins within the anal canal.

Internal haemorrhoids are generally painless but can cause significant bleeding. These can often be improved or resolve with banding or injection of the haemorrhoid and can be done in clinic at the time of initial consultation. Persistence of symptoms or very large haemorrhoids are best dealt with by surgical excision under general anaesthesia.

External haemorrhoids occur more towards the outside of the anus and are typically very painful particularly when acutely inflamed. The skin overlying external haemorrhoids are exquisitely sensitive and so these haemorrhoids usually not amenable to banding or injection. General anaesthesia is required for excision of external haemorrhoids.

Skin lesions / lipomas

In most cases excision of skin lesions are performed when there is a suspicion of cancer. Benign skin lesions do not require excision unless troublesome for the patient or requested by a patient for cosmetic reasons. Skin lesions in critical areas (eg. involving eyelids or cartilage) may require referral to an ophthalmologist or plastic surgeon.

Hernia Surgery

A hernia is an abnormal protrusion of part of an organ through the tissues that normally contain it. A hernia can occur in almost any part of the body however abdominal hernias are most common. Depending on hernia site, size and type the hernia repair is repaired as either a laparoscopic (keyhole) or open incision. In most cases synthetic material (mesh) is used to repair and reinforce the abdominal wall defect as this provides the most durable result.

Neck Lumps

Neck lumps are common and can be caused by a large variety of conditions. In most cases the cause for a neck lump is benign however, more serious disease such as malignancy or chronic infection needs to be excluded. A thorough assessment and appropriate investigations is therefore required.