Allergy desensitisation is a treatment that helps reduce sensitivity to substances that trigger allergic reactions, such as pollen, dust mites, or pet hair. It works by giving small, gradually increasing doses of the allergen (the substance you are allergic to) - usually as injections or drops under the tongue – over a long period.

This process trains the immune system to become less reactive, reducing symptoms and the need for other allergy medicines.

Your adenoids may be removed as part of a tonsillectomy. This operation is also performed through your mouth.

Laparoscopic: several small incisions (cuts) are made in the lower right abdomen (stomach) and a narrow tube with a tiny camera attached (laparoscope) in 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.

An insect allergy is an allergic reaction to the sting or bite of an insect, such as a bee, wasp, hornet, or spider.

For most people, stings cause only mild redness and swelling. However, those with an insect allergy may have a stronger reaction, including:

• Large swelling around the sting area
• Hives, itching, or flushing
• Difficulty breathing, dizziness, or swelling of the throat (signs of anaphylaxis) – seek medical attention immediately.

People with a history of severe reactions may be prescribed an adrenaline auto-injector and advised to avoid known insects and consider allergy desensitisation (immunotherapy).

A tiny camera attached to a long tube is inserted through your nose or mouth and passed down through the airways into your lungs. This allows the surgeon to make a diagnosis either by seeing directly what is causing the problem or by taking a small tissue (biopsy) or lung secretion sample.

A PillCam is a small, capsule-shaped device with a built-in camera that patients swallow. As it moves through the digestive system, it takes thousands of pictures, helping doctors examine areas like the small intestine without the need for surgery. The images are sent to a recorder worn by the patient for approximately 8 hours and the device passes out of the body naturally in a bowel movement.

The foreskin (flap of skin that covers the tip of the penis) may be removed for cultural, religious or medical reasons.

An incision (cut) is made behind your ear and the skin pulled back exposing the mastoid bone. A hole is drilled through this bone to expose the cochlear. The electrodes of the cochlear implant are inserted into the cochlear while the receiver part of the implant is embedded into the skull just underneath the skin. The skin is then replaced back over the implant.

Colonoscopy is the examination of your colon (large bowel) using a colonoscope (long, flexible tube with a camera on the end). The colonoscope is passed into your rectum (bottom) and then moved slowly along the entire colon, while images from the camera are displayed on a television monitor.

The procedure takes from 10 minutes to an hour. Sometimes a small tissue sample (biopsy) will need to be taken during the procedure for later examination at a laboratory.

A colonoscopy may help diagnose conditions such as polyps (small growths of tissue projecting into the bowel), tumours, ulcerative colitis (inflammation of the colon) and diverticulitis (inflammation of sacs that form on the walls of the colon).

Colonoscopy may also be used to remove polyps in the colon.

Risks of a colonoscopy are rare but include: bleeding if a biopsy is performed; allergic reaction to the sedative; perforation (tearing) of the bowel wall.

What to expect

It is important that the bowel is completely empty before the procedure takes place. This means that you will only be able to have liquids on the day before, and will probably have to take some oral laxative medication (to make you go to the toilet more).

When you are ready for the procedure, you will be given medication (a sedative) to make you go into a light sleep. This will be given by an injection into a vein in your arm or hand.

The colonoscopy will usually take 15 – 30 minutes, but you will probably sleep for another 30 minutes. Because you have been sedated (given medication to make you sleep) it is important that you arrange for someone else to drive you home.

Some patients may experience discomfort after the procedure, due to air remaining in the colon.

With CT you can differentiate many more things than with a normal X-ray. A CT image is created by using an X-ray beam, which is sent through the body from different angles, and by using a complicated mathematical process the computer of the CT is able to produce an image. This allows cross-sectional images of the body without cutting it open. The CT is used to view all body structures but especially soft tissue such as body organs (heart, lungs, liver etc.).

What to expect?

You will have all metal objects removed from your body. You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening.

You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner. You will be asked to remain still and hold your breath on command. There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner.

Some procedures will require Contrast Medium. Contrast medium is a substance that makes the image of the CT or MRI clearer. Contrast medium can be given by mouth, rectally, or by injection into the bloodstream.

The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.

This scan uses X-rays to measure the density of your bones and the amount of fat and muscle in your body.

A flexible tube with a tiny video camera attached (endoscope) is inserted through the mouth into the stomach and small intestine while you are under sedation (you have been given medication to make you drowsy). A smaller tube is then moved through the first tube into the bile duct (the tube that connects your gallbladder and liver to your intestines) through which dye is injected and an x-ray is taken to visualise the ducts. Problems in the bile and pancreatic ducts can be found and treated with this procedure.

A tiny camera attached to a tube (endoscope) is inserted into your nose. Very small instruments can be passed through the endoscope and used to remove small pieces of bone and soft tissue. This opens up the ventilation and drainage pathways in the outer wall of your nose.

A type of imaging that uses continuous X-rays to show how parts of the body work in real time.

Food allergies occur when the immune system reacts abnormally to certain foods, treating them as harmful.

Read more about food allergies on the Healthify website.

A fold of tissue (frenum) that attaches to the cheek, lips and/or tongue is surgically removed.

Gastroscopy allows examination of the upper part of your digestive tract i.e. oesophagus (food pipe), stomach and duodenum (top section of the small intestine), by passing a gastroscope (long, flexible tube with a camera on the end) through your mouth and down your digestive tract. Images from the camera are displayed on a television monitor. Sometimes a small tissue sample (biopsy) will need to be taken during the procedure for later examination at a laboratory.

Gastroscopy may be used to diagnose peptic ulcers, tumours, gastritis etc.

Complications from this procedure are very rare but can occur. They include: bleeding if a biopsy is performed; allergic reaction to the sedative or throat spray; perforation (tearing) of the stomach with the instrument (this is a serious but extremely rare complication).

What to expect

All endoscopic procedures are viewed as a surgical procedure and generally the same preparation will apply. You will not be able to eat or drink anything for 6 hours before your gastroscopy. When you are ready for the procedure, the back of your throat will be sprayed with anaesthetic. You will also be offered medication (a sedative) to make you go into a light sleep. This will be given by an injection into a vein in your arm or hand.

The gastroscopy will take approximately 15 minutes, but you will probably sleep for another 30 minutes. You will spend some time in a recovery unit (probably 1-2 hours) to sleep off the sedative and to allow staff to monitor you (take blood pressure readings etc). Because you have been sedated (given medication to make you sleep) it is important that you arrange for someone else to drive you home.

If biopsies are taken for examination, your GP will be sent the results within 2-3 weeks.

This operation is performed through the ear canal. A hole is made in the eardrum and the middle ear drained. A small hollow tube (grommet) is placed in the eardrum hole which allows air into the middle ear.

Umbilical Hernia

An incision (cut) is made underneath the navel (tummy button) and the hernia (part of the intestine that is bulging through the abdominal wall) is pushed back into the abdominal cavity. The weakness in the abdominal wall is repaired.

Inguinal Hernia

An abdominal incision is made and the hernia is pushed back into position. The weakness in the abdominal wall is repaired. Herniotomy: an incision is made in a skin fold in the groin and the hernia sac is cut out.

Herniotomy

An incision is made in a skin fold in the groin and the hernia sac is cut out.

A hydrocoele is a fluid-filled mass that forms in the scrotum. In many cases it will disappear by itself, but sometimes surgery is required to drain the fluid out.

Image guided procedures in radiology use imaging technologies such as ultrasound, CT, or MRI to help doctors perform minimally invasive procedures such as biopsies and injections. The imaging allows doctors to be more precise, which often means less pain and faster recovery for the patient.

There are two types of IBD, ulcerative colitis and Crohn’s disease. In these conditions, the immune system attacks the lining of the colon causing inflammation and ulceration, bleeding and diarrhoea. In ulcerative colitis this only involves the large intestine, whereas in Crohn’s disease areas within the entire intestine can be involved. Both diseases are chronic (long term) with symptoms coming (relapse) and going (remission) over a number of years.

Symptoms depend on what part of the intestine is involved but include:

• abdominal pain
• diarrhoea with bleeding
• tiredness
• fevers
• infections around the anus (bottom)
• weight loss can occur if the condition has been present for some time.

Diagnosis is made when the symptoms, examination and blood tests suggest inflammatory bowel disease, infection is ruled out, and you undergo a colonoscopy with biopsy.

Treatment depends on the severity of the symptoms and what part of the intestine is affected. Medication is aimed at suppressing the immune system, which is harming the lining of the bowel. This is done via oral or intravenous medication as well as medication given as an enema (via the bottom). Other treatments include changes in the diet to optimise nutrition and health. Treatment in some cases requires surgery to remove affected parts of the bowel.

A range of medications such as iron, bisphosphonates (for bone conditions) and biologic treatments are delivered by intravenous infusion (given by injection into a vein through a drip).

The best way to establish what type of liver disease is present and the extent of the disease, is a biopsy. It is usually performed by inserting a needle into the liver through the skin and taking a small sample of liver tissue. Examination of the sample under the microscope can demonstrate what damage or what type of disease is present. Before your doctor does this procedure, they will check whether or not you are at increased risk of bleeding by doing blood tests. Following the procedure, you will need to be monitored for several hours before you are discharged to go home.

An MRI machine does not work like an X-ray or CT; it is used for exact images of internal organs and body structures. This method delivers clear images without the exposure of radiation.

The procedure uses a combination of magnetic fields and radio waves which results in an image being made using the MRI’s computer.

What to expect?

You will have all metal objects removed from your body. You will lie down on a narrow padded moveable table that will be slid into the scanner, through a circular opening.

You will feel nothing while the scan is in progress, but some people can feel slightly claustrophobic or closed in, whilst inside the scanner. You will be asked to remain still and hold your breath on command. There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room, from where they will run the scanner.

Some procedures will require Contrast Medium. Contrast medium is a substance that makes the image of the CT or MRI clearer. Contrast can be given by mouth, rectally, or by injection into the bloodstream.

The scan time will vary depending on the type of examination required, but as a rule it will take around 30 minutes.

A minor surgical procedure is performed to widen the urinary meatus or opening (where the urine exits the body).

Nose surgery includes a range of procedures to change the shape, improve the function, or treat medical conditions of the nose. Common types include:

• Rhinoplasty – reshapes the nose for cosmetic or functional reasons.
• Septoplasty – straightens a deviated nasal septum (the thin wall between the nostrils) to improve breathing.
• Turbinoplasty – reduces swollen nasal tissues to ease airflow.
• Sinus surgery – treats chronic sinus infections or blockages.

This is a specialised scanning method using very small amount of low-level radioactive isotopes injected into the bloodstream. Once administered these radioactive tracers can localise to specific organs where the scanner, called a gamma camera, is used to measure the radiation levels given off from the isotopes. This allows assessment of the functional abnormalities in very specific parts of the body such as: assessment of thyroid function, location of tumours and possible spread, checking of bone fractures and assessing damage to the heart after coronary episodes.

When snoring is interrupted by episodes of totally obstructed breathing, it is known as obstructive sleep apnoea. The obstruction is caused by the relaxation of muscles that support the soft tissues at the back of the throat such as the uvula, soft palate, tongue and tonsils. These tissues then collapse and momentarily block the airway.

Episodes may last 20 seconds or more and may occur hundreds of times per night. While you are not breathing, the levels of oxygen in your blood drop which causes your blood pressure to go up and adds strain to your cardiovascular system. In addition, you are likely to feel overly tired during the day and your work, driving and overall performance may be affected.

The usual treatment for OSA is to wear a nasal mask that delivers pressurised air to keep the airways open while you sleep. This treatment is known as Continuous Positive Airway Pressure (CPAP).

A group of procedures used to assess how well the oesophagus (the muscular tube that connects the throat to the stomach) is working. These tests help diagnose conditions such as reflux or swallowing disorders.

Common oesophageal tests include:

• Oesophageal manometry: measures the muscle contractions in the oesophagus.
• BRAVO pH testing: measures the acidity (pH) in the oesophagus.
• Oesophageal pH impedance study: measures acid levels in the oesophagus over 24 hours.

A tiny camera attached to a long tube is inserted into your mouth and passed down through your pharynx into your oesophagus. This allows the surgeon to make a diagnosis either by seeing directly what is causing the problem or by taking a small tissue sample (biopsy).

A small incision (cut) is made in the groin on the side of the undescended testicle and the testicle pulled down into the scrotum. Sometimes a small cut will need to be made in the scrotum as well.

Audiometry is the electronic testing of hearing ability. You will sit in a special room wearing earphones and be asked to respond when you hear a noise through the earphones. These tests can measure your hearing levels as well as other aspects of hearing such as the ability to recognise speech against background noise.

Tympanometry uses sound and air pressure to check middle ear function. A small, soft probe is placed in your ear for a few seconds and a computer measures your ears response to sounds and pressure emitted through the probe. This test is often carried out in young children to assess for glue ear.

Nasal polyps are removed by inserting small instruments through your nostrils which can grasp and cut out the polyps.

RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown.

Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep.

Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis.

Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz

There are three large pairs of glands (parotid, sublingual and submandibular) in your mouth that produce saliva which helps break down food as part of the digestion process.

Salivary gland surgery involves the removal of one or more of the salivary glands for reasons including: tumours (benign or cancerous), chronic infections or blockages, salivary stones or injuries or cysts.

Care is taken to avoid damaging nearby nerves, especially those that control facial movement.

A long, narrow tube with a tiny camera attached (sigmoidoscope) is inserted into your anus and moved through your lower large intestine (bowel). This allows the surgeon a view of the lining of the lower large intestine (sigmoid colon). If necessary, a biopsy (small piece of tissue) may be taken for examination in the laboratory.

Shave Biopsy: the top layers of skin in the area being investigated are shaved off with a scalpel (surgical knife) for investigation under a microscope.

Punch Biopsy: a small cylindrical core of tissue is taken from the area being investigated for examination under a microscope.

Excision Biopsy: all of the lesion or area being investigated is cut out with a scalpel for examination under a microscope.

Incision Biopsy: part of the lesion is cut out with a scalpel for examination under a microscope.

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.

This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart. It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently and can have symptoms that come and go. Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz

A small cut is made in the scrotum, the cord supplying blood to the testicle is untwisted and both testes are sutured (stitched) to the scrotum to prevent another torsion.

Your tonsils are the oval-shaped lumps of tissue that lie on both sides of the back of the throat. Sometimes tonsils can become inflamed (red and swollen with white patches on them) as the result of a bacterial or viral infection; this is known as tonsillitis. If you have tonsillitis, you will have a very sore throat and maybe swollen glands on the side of your neck, a fever, headache or changes to your voice. In some cases, pus can be seen on the tonsils. Tonsillitis mostly occurs in young children and can be a recurrent condition (it keeps coming back).

If the tonsillitis is caused by bacteria, antibiotics will be prescribed. If the tonsillitis is caused by a virus, treatment will usually consist of medications to relieve symptoms such as a pain killer. If tonsillitis occurs often over a period of two or more years, then surgical removal of the tonsils (tonsillectomy) may be considered.

Tonsils are removed in an operation performed through your mouth. The tissue between your tonsils and throat is cut and your tonsils removed.

In ultrasound, a beam of sound at a very high frequency (that cannot be heard) is sent into the body from a small vibrating crystal in a hand-held scanner head. When the beam meets a surface between tissues of different density, echoes of the sound beam are sent back into the scanner head. The time between sending the sound and receiving the echo back is fed into a computer, which in turn creates an image that is projected on a television screen. Ultrasound is a very safe type of imaging; this is why it is so widely used during pregnancy.

Doppler ultrasound

A Doppler study is a noninvasive test that can be used to evaluate blood flow by bouncing high-frequency sound waves (ultrasound) off red blood cells. The Doppler Effect is a change in the frequency of sound waves caused by moving objects. A Doppler study can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). A Doppler study can help diagnose bloody clots, heart and leg valve problems and blocked or narrowed arteries.

What to expect?

After lying down, the area to be examined will be exposed. Generally a contact gel will be used between the scanner head and skin. The scanner head is then pressed against your skin and moved around and over the area to be examined. At the same time the internal images will appear onto a screen.

Undescended testes occur in less than 4% of children, and are more common in premature babies. Many “undescended” testes are simply lying very high in the groin and can be brought down by hand, and some true undescended testes will come down by themselves in the first year of life. After one year, undescended testes always remain so.

If not treated there may be problems in adult life with infertility or an increased risk of cancer of the undescended testis.

At the appointment, the surgeon will examine your child carefully to see if the testis can be felt in the body. If the testis can be felt, a simple operation under general anaesthetic (putting your child to sleep during the operation) would be performed between 9 and 12 months of age. If the testes cannot be felt, a different type of operation would be performed so that the surgeon can check where the testes are. In some cases, the testes are absent.

Both types of surgery involve an overnight stay in hospital.

An X-ray is a high frequency, high energy wave form. It cannot be seen with the naked eye, but can be picked up on photographic film. Although you may think of an X-ray as a picture of bones, a trained observer can also see air spaces, like the lungs (which look black) and fluid (which looks white, but not as white as bones).

What to expect?

You will have all metal objects removed from your body. You will be asked to remain still in a specific position and hold your breath on command. There are staff present, but they will not necessarily remain in the room, but will speak with you via an intercom system and will be viewing the procedure constantly through a windowed control room.

The examination time will vary depending on the type of procedure required, but as a rule it will take around 30 minutes.