General surgery covers breast diseases including breast cancer. These conditions are often initially dealt with in a specialised breast clinic which is able to perform a number of investigations (e.g. mammography, ultrasound, needle biopsy) during the initial outpatient clinic visit.

This may be: Simple or Total: all breast tissue, skin and the nipple are surgically removed but the muscles lying under the breast and the lymph nodes are left in place. Modified Radical: all breast tissue, skin and the nipple as well as some lymph tissue are surgically removed. Partial: the breast lump and a portion of other breast tissue (up to one quarter of the breast) as well as lymph tissue are surgically removed. Lumpectomy: the breast lump and surrounding tissue, as well as some lymph tissue, are surgically removed. When combined with radiation treatment, this is known as breast-conserving surgery.

When a breast has been removed (mastectomy) because of cancer or other disease, it is possible in most cases to reconstruct a breast similar to a natural breast. A breast reconstruction can be performed as part of the breast removal operation or can be performed months or years later. There are two methods of breast reconstruction: one involves using an implant; the other uses tissue taken from another part of your body. There may be medical reasons why one of these methods is more suitable for you or, in other cases, you may be given a choice. Implants A silicone sack filled with either silicone gel or saline (salt water) is inserted underneath the chest muscle and skin. Before being inserted, the skin will sometimes need to be stretched to the required breast size. This is done by placing an empty bag where the implant will finally go, and gradually filling it with saline over weeks or months. The bag is then replaced by the implant in an operation that will probably take 2-3 hours under general anaesthesia (you will sleep through it). You will probably stay in hospital for 2-5 days. Flap Reconstruction A skin flap taken from another part of the body such as your back, stomach or buttocks, is used to reconstruct the breast. This is a more complicated operation than having an implant and may last up to 6 hours and require a 5- to 7-day stay in hospital.

Oncoplastic surgery merges the principles of oncologic surgery, in which cancerous tissue is removed, with those of plastic surgery which reconstructs an area following surgery. In oncoplastic breast surgery, plastic surgery techniques such as breast reduction, breast lift, use of tissue from the lower chest or side of the chest, are used at the time of lumpectomy to restore a natural appearance to the breast shape.

Laparoscopic: several small incisions (cuts) are made in the lower right abdomen (stomach) and a narrow tube with a tiny camera attached (laparoscope) is inserted. This allows the surgeon a view of the appendix and, by inserting small surgical instruments through the other cuts, the appendix can be removed. Open: an incision is made in the lower right abdomen and the appendix removed.

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall in some way.

General surgery covers some disorders of the liver and biliary system. The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.