What is General Surgery? The role of the General Surgical Department varies from hospital to hospital, but in broad terms general surgery can be said to deal with a wide range of conditions within the abdomen, breast, neck, skin and, in many hospitals, vascular (blood vessel) system. While the name would suggest that the focus of general surgery is to perform operations, often this is not the case. Many patients are referred to surgeons with conditions that do not need surgical procedures, but merely require counselling or medical treatment. ARCH Main General Surgery Services Include: General surgery – Hernias – abdominal, umbilical, inguinal, femoral. Minor colorectal – haemorrhoids, anal fissure, fistulae Ingrown toenails Pilonidal disease Varicose veins- symptomatic (At the present time we are not offering Varicose Vein surgery. This may change in the future.) Gastrointestinal Disorders Conditions of the gut dealt with by general surgery include disorders of the oesophagus, stomach, small bowel, large bowel and anus. These range from complex conditions such as ulceration or cancer in the bowel through to fairly minor conditions such as haemorrhoids. Many of the more major conditions such as bowel cancer will require surgery, or sometimes treatment with medication, chemotherapy or radiotherapy. Haemorrhoids are a condition where the veins under the lining of the anus are congested and enlarged. Less severe haemorrhoids can be managed with simple treatments such as injection or banding which can be performed in the clinic while larger ones will require surgery. Hernias An inguinal hernia is caused by a connection between the scrotum and the abdomen (uncommonly a similar connection occurs in girls causing an inguinal hernia). The connection is present in all babies in the womb during development, but in most babies has closed over before birth. The connection allows some contents of the abdomen to pass down towards the scrotum causing a bulge in the groin. The bulge is often more noticeable when the baby cries. The bulge (or hernia) can usually be pushed back into the abdomen by gentle pressure when the baby is settled. Uncommonly the hernia cannot be pushed back (“reduced”), which can be a serious complication because the tissue trapped in the connection can become swollen and damaged. An inguinal hernia can be repaired with a simple operation. Your family doctor will have referred you to a children’s surgeon who is experienced in repairing inguinal hernias. An umbilical hernia is caused by a weakness in the muscles of the abdominal wall near the belly button or navel, which allows the contents of the abdomen to push through and form a bulge around the belly button. In most cases these hernias close by themselves before the age of 5 years, but if they are large or are causing problems, they may require surgery. Varicose Veins These are bulging veins that lie just beneath the skin (superficial veins). They occur when the walls of a vein are weak or damaged or if the valves in the vein that normally stop the blood from flowing backwards are impaired, resulting in pooling of the blood and stretched veins. Besides being unattractive, varicose veins can be painful and cause inflammation or ulceration. The following different types of surgery are available if varicose veins require treatment: Sclerotherapy – a tiny needle is used to inject a chemical solution into the vein that causes the vein to collapse. This approach is recommended for small varicose veins or spider veins that typically appear on the upper legs. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. Vein stripping – the varicose veins are cut out and the veins that branch off them are tied off. The cuts (incisions) made in the skin are closed with sutures. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia. Phlebectomy – small cuts (incisions) are made in the leg and the varicose veins are pulled out with a tiny hook-like instrument. The cuts are closed with tape rather than sutures and, once healed, are almost invisible. You will need to wear elastic bandages or stockings over the treated area for some time after surgery. This procedure requires anaesthesia.

What is Gynaecology? Gynaecology is the area of medicine that deals with health issues and conditions that are specific to women's reproductive organs and genitalia, excluding breast disease. The reproductive organs consist of: the ovaries that release an egg every month, the fallopian tubes that lead from the ovaries to the uterus (womb) which is where a baby will grow if the egg is fertilised during sexual intercourse, the cervix (opening of the uterus), the vagina and vulva. ARCH Main Gynaecological Surgery Services Include: Tubal ligations Incontinence Labioplasty Urinary incontinence Urinary incontinence or a loss of bladder control is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

What is Plastic Surgery? Plastic surgery covers a wide range of different surgical procedures that repair, reconstruct or replace structures in many different parts of the body including the skin, face and head, hands, breast and stomach. Plastic surgery does not involve the use of plastic materials. Plastic surgery can generally be divided into two main types: Reconstructive surgery: is performed on parts of the body that are abnormal or have been affected by a birth defect, accident or disease. This includes cleft lip and palate repair, scar revision or reconstruction (including skin grafts) following burns. Surgery is usually performed to improve function, but may also be performed to bring the appearance of a part of the body as close as possible to normal. Aesthetic or cosmetic surgery: improves appearance or body image by reshaping features of the face or body e.g. breast enlargement, face lift, liposuction. ARCH Main Plastic Surgery Services Include: Carpal tunnel Duputrens Lumps and bumps Skin lesions Carpal Tunnel Syndrome A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake). Dupuytren's Contracture Dupuytren's contracture is a hand disorder in which the fingers bend toward the palm and cannot be straightened. The little and ring fingers are most commonly affected but all the fingers can be involved. Dupuytren's contracture progresses slowly and is usually painless. In patients with this condition, the tissues under the skin on the palm of the hand thicken and shorten enough that the tendons connected to the fingers cannot move freely. Skin Lesions Skin lesions can be divided into two groups: Benign (non-cancerous): e.g. moles, cysts, warts, tags. These may be removed to prevent spreading (warts), stop discomfort if the lesion is being irritated by clothing/jewellery or to improve appearance. Malignant (cancerous): basal cell and squamous cell carcinomas are generally slow growing and unlikely to spread to other parts of the body. Melanoma is a serious skin cancer that can spread to other parts of the body. Urgent removal is recommended. Surgery to remove skin lesions usually involves an office or outpatient visit, local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic) and stitches. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.

What is Ophthalmology? Ophthalmology is the branch of specialist medicine that is focused on the health of eyes and their surrounding tissues, including muscles, bones, eyelids, and tear production/drainage systems. Your eye is the organ of vision and consists of the cornea (the outer clear layer), the sclera (the white of the eye), the iris (the coloured part), the lens (lies behind the iris) and the retina (the light-sensitive lining at the back of the eye). Your eyes ‘see’ by focusing light that enters the eye onto the retina which sends the image to the brain by the optic nerve. ARCH Main Opthalmology Surgery Services Include: Cataract surgery Cataracts Cataracts are the most common age-related occurrence in eyes. The lens becomes thicker and stiffer and appears yellow and cloudy. Eventually it may turn white, changing the colour of the pupil. A cataract may cause your vision to become fuzzy in a progressive fashion and may also be the cause of disabling glare. Once a cataract affects vision too much, a cataract removal operation is generally advised. This decision is usually made in consultation with an eye specialist. The operation is almost always done under local anaesthetic. Once the cataract has been removed an artificial lens is put in to replace it. It is relatively short in duration and an overnight stay in hospital is not required. Post-operative care consists of eye drops and a check at 1-2 days then after 2-4 weeks.

At this time ARCH is unable to offer this procedure to patients looking for assistance in this area.