St. George Obesity & General Surgery

Investigations

St George Private Hospital performs investigative gastroscopy, colonoscopy and laparoscopy procedures in Sydney.

Gastroscopy

A gastroscopy, also known as an endoscopy, is a procedure performed by a doctor. This well-trained subspecialist uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.

The endoscope is a long, thin, flexible tube with a tiny video camera and light.

By adjusting the various controls on the endoscope, the doctor can safely guide the instrument to examine the upper digestive system’s inside lining carefully.

Diagnostic Indications for Endoscopy:

Colonoscopy

Colonoscopy is a procedure used to view the large intestine (colon and rectum) using an instrument called a colonoscope, a flexible tube with a small camera and light source attached to its tip. Colonoscopy can be performed for screening or diagnostic purposes. While a diagnostic colonoscopy is performed to confirm the presence of colorectal cancer or colorectal polyps from a person showing symptoms (blood in stools, anaemia, etc.), screening colonoscopy is performed on an asymptomatic person without any prior history of the two conditions.

Screening colonoscopy is indicated for the following:

Colonoscopy is usually performed under sedation on an outpatient basis. You will be given a laxative or enema preparation to clear your bowels before the procedure. Air will be pumped into the colon to expand it for better visibility. The colonoscope is inserted into the rectum and gently moved up the colon until it reaches the caecum (junction of small and large intestine). The colonoscope is then withdrawn slowly as the camera relays pictures of the colon and rectum lining onto a large screen for your doctor to view. Any polyps or growths detected by the colonoscope can be removed and sent to the lab for determining whether it is cancerous or not (biopsy).

Screening colonoscopy is a very sensitive test. However, some cancers, small polyps or non-polypoid lesions may go unnoticed, and the procedure may be associated with the risk of bleeding, tearing or perforation of the colon lining, especially during polypectomy.

Age 50

Screening is recommended if you are 50 years of age or older, with no risk factors. The test is ordered earlier if you have a family history (first-degree relative: parent, sibling or child) of colorectal cancer or polyps. If the relative was diagnosed at <60years of age or if two relatives were diagnosed at any age, you are advised to have a screening colonoscopy at 40 years of age or 10 years before the age of the earliest diagnosis (whichever comes first). The screening needs to be repeated every 5 years. If the relative was diagnosed at ≥60 years of age or if two relatives were diagnosed at any age, you are advised to have a screening colonoscopy at 40 years of age, and repeat every 10 years.

Laparoscopy

Laparoscopy is a procedure that enables your surgeon to look inside the abdominal cavity and pelvis to diagnose and treat a variety of abnormal conditions. A laparoscope is a long, narrow telescope with a light source and video camera at the end. The scope is passed through a tiny incision into the abdomen where images from the camera are projected onto a large monitor for the surgeon to view the abdominal cavity.

Laparoscopes have channels inside the scope enabling the surgeon to pass gas in and out to expand the viewing area or to insert tiny surgical instruments for treatment purposes. The surgical instruments used in operative laparoscopy are very small but appear much larger when viewed through a laparoscope.

Laparoscopy may be diagnostic, operative, or both:

Diagnostic Laparoscopy

A laparoscopy is diagnostic when the surgeon is viewing the abdominal cavity and pelvis to make a diagnosis, without any treatment administered at that time. This is particularly useful when other tests such as X-rays, scans, or blood work are inconclusive. The laparoscope is usually smaller as no channel is needed for surgical instruments.

Operative Laparoscopy

A laparoscopy is considered operative when the surgeon is treating a problem that is found during diagnostic laparoscopy with surgical instruments through the laparoscope.

If your surgeon sees an opportunity to treat a problem during a diagnostic laparoscopy, an operative laparoscopy will usually be performed at that time depending on the patient’s condition and the surgeon’s preference.