The field of gastroenterology focuses on disorders of the digestive system. Structures involved in the digestive system include the stomach, liver, gall bladder, pancreas, intestines, appendix and esophagus. Additionally, there is a variety of surgical procedures that a gastroenterologist performs. Below is a list of the most common types of gastroenterology surgical procedures as well as a little information about the procedure itself.
An appendectomy is the removal of the appendix from the body through surgery. The appendix is attached to the large intestine, and protrudes out from it like a finger. This procedure is normally done when the appendix becomes full of stool and then becomes infected. In some cases, the appendix is not removed in a timely manner and it ruptures. This can be a medical emergency, as infection-filled fluid will leak out into the abdominal cavity and quickly cause a condition known as sepsis. If not treated, the patient will expire.
Laparoscopy is a very popular surgical method because it is less invasive than traditional surgical methods. In addition to using laparoscope for surgeries, it can be used to diagnose different types of digestive disorders, including cancer. Biopsies can be taken while a patient is undergoing a laparoscopy as well.
When a gastroenterologist needs a more in-depth view of the internal abdomen of his patient, he will use a laparotomy. This procedure is more invasive than a laparoscopy. A large incision is made in the abdomen during a laparotomy. For patients who have had some sort of trauma to the abdomen, laparotomy is the first choice as it gives surgeons an intimate view of all the organs in the abdomen. Exploratory laparotomy has been used for decades because it not only allows for visualization; the surgeon can also make any needed repairs to organs at the same time.
When a patient has trouble with his or her bowels, particularly with the large bowel, or colon, an ileostomy may be performed. This surgical procedure involves severing the small bowel into two different pieces, and then attaching the top portion to the abdominal wall. The abdominal wall is opened to the outside and the bowel is formed into what is called a stoma. There are many different reasons a person may need an ileostomy, including bowel cancer, bowel obstruction, Crohn’s disease, congenital defects, perforation of the bowel and other injury to the intestinal tract.
There are a number of other procedures performed by the gastroenterologist. These procedures are generally done in an outpatient setting and are less risky than the surgical procedures listed above.
- Endoscopy – by using an endoscope, a gastroenterologist can view the digestive tract from the mouth down to the bowel. Endoscopy is commonly used to determine the cause of a patient’s complaint of continual stomach pain, ulcers, gastritis, bleeding from somewhere in the digestive tract and to diagnose polyps or other digestive diseases affecting the upper portion of the GI tract.
- Liver Biopsy – This procedure involves the use of ultrasound to locate the liver and then a large needle is inserted between the intercostal space and into the liver, where a piece of liver tissue is removed. This test is done to determine the grade and stage of liver inflammation and fibrosis. This is normally done to determine if a person is eligible for treatment of hepatitis C or B, or to determine if the liver is cirrhotic.
- ERCP stands for endoscopic retrograde cholangiopancreatography. This procedure is actually a combination of a traditional upper GI and x-rays, and is most often used to treat problems affecting the bile ducts and pancreatic ducts. This procedure can also be used to diagnose GI problems, but other less invasive procedures are normally used. ERCP is used when correction will likely be done during the examination.
- Colonoscopy – A small camera and light attached to the end of a semi-flexible hose makes up the scope that’s used in colonoscopy. Inserted through the anus and then rectum, this procedure is commonly used to diagnose problems in the lower part of the gastrointestinal tract, or large colon.
In addition to the procedures listed above, gastroenterologists are capable of performing a variety of other procedures. It should be known that a traditional gastroenterologist will not perform surgery himself, but will refer the procedure out to a surgeon. However, some surgeons specialize in this area, and they are the most knowledgeable about how things work in the digestive system.