The Department of General Surgery was formed in 2010 and is actively involved in the management of all general surgical problems including emergency services. The department has grown tremendously over the past several years. Over the years the department has evolved and has maintained pace with changing times and needs of the society. The Department performs state-of-the-art speciality clinical work including oesophagogastric, colorectal,breast, endocrine, head and neck minimal access surgeries.
The State of the art equipment available include, 3 high definition laparoscopic surgical unit (Karl storz, Germany) which includes a 3D Laparoscopic Unit (Karl Storz), 2 harmonic scalpel (Johnson & Johnson, USA) and 2 Laminar Operation Theatres dedicated only for Laparoscopic Procedures. We have a 30 bedded surgical ICU with trained
and dedicated nursing personnel for management of critically ill surgical patients. This surgical ICU is furnished with pulse oximeters, monitors, surgical ventilators and trained dedicated nursing personnel. Surgical ICU is manned by doctors round the clock. With this dedicated surgical ICU, component blood bank and an active anaesthesia team always at hand, the surgical care of these patients has reached new heights of perfection. As a well-equipped hospital with most advanced technologies, we have an efficient Medical and Para Medical team to handle and support the surgeries.
Dr. Mathews John, a vibrant surgeon, well known for laparoscopic and bariatric surgeries, is heading the Department. He owes a flamboyant, dynamic, adventurous nature and has an excellent leadership skill. After his Post graduation from Kempegowda Institute of Medical Science, Bangalore he was awarded the elite honour Fellowship in Laparoscopy.
He by then had earned fame as a much preferred surgeon but his unselfish nature prompted him to join Kasturba Medical College as an Assistant Professor in the Department of General Surgery. He was then trained under leadership of many starwards like Dr. James Hews (NHS, Bristol), Dr Haytham Sumrien (NHS, Leeds), Dr. Caroline Burt (Guy’s Hospital, London), Dr. Tran Ngoc Luong (Vietnam), Dr Palanivelu (GEM Hospital), Dr Rajesh Khullar (Delhi), Dr. Mohit Bhandari (Indore), and Dr. M Ramesh (Bangalore).
He has a particular interest in minimally invasive techniques, and has extensive experience in treating Obesity, Thyroid, and Hernia, using laparoscopic, endoscopic, and open approaches. He serves as the Head of Minimally Invasive and Bariatric Surgery department and the Medical Director of Lifeline Hospital, Adoor, Kerala, India which is a landmark hospital with a Global reckoning, to establish an Exclusive Department of Bariatric Surgeries and Minimal Access.
Department of General Surgery
- Bariatric Surgery for Weight loss.
- Thyroid Surgery
- Gallbladder stone
- Hernia Surgery
- Hiatus hernia
- Varicose vein surgery
- Small Intestine and Colorectal Surgery
- Appendix Surgery
- Surgery for Benign and Malignant breast disease
- Surgery for Anal Disorders
Bariatric Surgery for Weight loss
Bariatric surgery is an option if you have severe obesity and have not been able to lose enough weight to improve your health using other methods or have serious obesity-related health problems.
Obesity is defined as having a body mass index (BMI) of 30 or more. BMI is a measure of your weight in relation to your height. Class 1 obesity means a BMI of 30 to 35, Class 2 obesity is a BMI of 35 to 40, and Class 3 obesity is a BMI of 40 or more. Classes 2 and 3, also known as severe obesity, are often hard to treat with diet and exercise alone.
Major Bariatric Surgeries
- Laparoscopic Sleeve Gastrectomy
The outer margin of the stomach is removed to restrict food intake, leaving a sleeve of stomach, roughly the size and shape of a banana. A sleeve gastrectomy is a purely restrictive procedure. By reducing the size of
the stomach, allows the patient to feel full after eating less and taking in fewer calories. The surgery removes that portion of the stomach that produces a hormone that can makes a patient feel hungry.
- Laparoscopic adjustable gastric banding
The surgeon places a band around the upper part of your stomach to create a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food.
- Laparoscopic Mini Gastric Bypass(MGB)
A mini gastric bypass creates a long narrow tube of the stomach along its right border (the lesser curvature). A loop of the small gut is brought up and hooked to this tube at about 180 cm from the start of the intestine.
- Laparoscopic Gastric bypass (Roux-en-Y)
This type of weight-loss surgery involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine
Major Bariatric Cosmetic Surgeries
Liposuction is a suction technique to remove fat from specific areas of the body, such as the abdomen, hips, thighs, buttocks, arms or neck. Liposuction also shapes (contours) these areas.
Abdominoplasty is a procedure that flattens your abdomen by removing extra fat and skin and tightening muscles in your abdominal wall.
What are the benefits of bariatric surgery?
Bariatric surgery can help you lose weight and improve many health problems related to obesity. These health problems include – type 2 diabetes, high blood pressure, unhealthy cholesterol levels, sleep apnoea, urinary
incontinence, body pain, knee and hip pain. You may be better able to move around and be physically active after surgery. You might also notice your mood improve and feel like your quality of life is better.
Thyroidectomy is the removal of all or part of your thyroid gland. Thyroidectomy is used to treat thyroid disorders, such as cancer, noncancerous enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).
- Open Surgery (Traditional Surgery)
Conventional surgery of the thyroid gland uses a standard, open-surgery approach requiring an incision that is four to five inches in length. The result is a noticeable and sometimes prominent, life-long scar on the lower portion of the patient's neck.
- Endoscopic Thyroidectomy Surgery (No scar in the neck)
Conventional open thyroidectomy remains the treatment of choice for benign and malignant thyroid tumors since ages, the open thyroid surgical procedures leaves a scar line in the lower anterior neck. This incision line sometimes may develop in to dark scars, hypertrophic scars or keloid and may lead to parastheisa and hyperesthesia. After the advancement in technology of laparoscopic and endoscopic surgery, thyroid and parathyroid surgery has been attempted using endoscopic approach. Scarless endoscopic thyroidectomy
has evolved into a cosmetically preferred alternative to conventional thyroidectomy. With endoscopic surgery there is no mark in the neck. Any mark left by the procedure is nearly invisible after approximately six months.
Gallbladder stone – Laparoscopic cholecystectomy
Many patients have gallstones which do not cause symptoms and require no surgery. If, however, these stones attempt to pass out of the gallbladder and block the gallbladder outlet, severe upper abdominal pain can develop. This is known as colic.
Advantages of Gallbladder stone laparoscopic cholecystectomy
- Smaller incision – 4 small incisions, each 5 mm long, instead of a 5- to 7-inch incision for open surgery.
- Less pain than after open surgery.
- Quicker recovery than open surgery – You might go home the next day you have your surgery. You can also go back to regular activities more quickly.
A hernia is a weakness or tear in the abdominal muscle wall, which normally holds the inner lining of the abdomen and internal organs in place. The weakness or tear allows the inner lining to protrude and form a pouch. Surgery isthe only treatment for a hernia.
Open Hernia Surgery:
A single long incision is made where the hernia is seen. If the hernia is bulging out of the abdominal wall, the bulge is pushed back into place and if the hernia is going down the inguinal canal, the hernia sac is either pushed back or tied off and removed. It closes by using sutures, mesh, or both, and the surgical wound in the skin is closed with sutures or staples.
Laparoscopic hernia surgery:
Laparoscopic hernia surgery is similar to other laparoscopic procedures. A thin, lighted scope called a laparoscope is inserted through a small incision. The instruments to repair the hernia are inserted through other small incisions in the lower abdomen. Mesh is then placed over the defect to reinforce the belly wall.
We are able to do the following Hernia Surgeries depends on the surgeon's decision:
- Reduced postoperative pain
- Diminished requirement for narcotics
- Earlier return to work
- Inguinal Hernia
- Umbilical Hernia
- Incisional Hernia
- Ventral Hernia
- Hiatus hernia
Hiatus Hernia causing Gastroesophageal reflux disorder (GERD)
A hiatus hernia occurs when part of the stomach moves upwards into the chest. If the hernia causes severe symptoms or is likely to cause complications, then hiatus hernia surgery may be required. – Nissen fundoplication Surgery – This involves tightening the opening in your diaphragm with stitches to keep your stomach from bulging upward through the opening in the muscle wall. Some surgeons place a piece of mesh in the repaired area to make it more secure. This procedure is done laparoscopic.
Varicose Vein Surgery
Varicose veins can be surgically removed or by minimally invasive methods. This will not harm the blood supply in the legs, because the blood will re-direct into other healthy veins. Normally followed procedures:
- Open Vein stripping
- RFA ( Radio frequent ablation) – minimally invasive
- Incisional Hernia
- Laser – minimally invasive
Appendix Surgery – Laparoscopic Appendectomy
One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix. Traditionally, the appendix is removed through an incision in the right
lower abdominal wall.
But we practice Laparoscopic Appendectomy through 3 small incisions (5mm) or single incision laparoscopy (11mm) at the umbilicus. Hence there will not be any visible scar.
- Less postoperative pain
- May shorten hospital stay
- May result in a quicker return to bowel function
- Quicker return to normal activity
- Better cosmetic results
Small Intestine and Colorectal Surgery
The department carries out a variety of procedures and treats conditions including:
- Colorectal Malignancy – Colectomies, Low anterior resections and stapled pouch anastomosis
- Polyposis Syndrome
- Inflammatory Bowel Diseases
- Abdominal Tuberculosis
- Rectal Prolapse – Laparoscopic Rectopexy
Surgery for Benign and Malignant breast disease
- Ultrasound guided FNAC and Mammogram
- Excision Biopsy for benign tumour
- Wide local excision with axillary clearance for low grade malignancy
- Modified radicle mastectomy for CA Breast (MRM)
Surgery for Anal Disorders
Haemorrhoids are defined as an abnormally enlarged vein, mainly due to persistent increase in venous pressure, occurring within or just outside the anal sphincter of the rectum, and that is affected in the anal canal
b. Anal fissure
- Open Surgery
- Stapled haemorrhoidectomy (minimally Invasive – Painless)
Reduced postoperative pain
Earlier recovery time and
Early return to work
- Laser Surgery
An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement.
- Anal dilatation
c. Anal Fistula
An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus.
- Lay-open of fistula-in-ano
- Cutting seton
- Fibrin glue injection
- Endorectal advancement flap
- VAAFT (Video-assisted anal fistula treatment)
Dr. Mathews John
General & Laparoscopic Surgeon (Medical Director)
9 am – 5 pm on Monday to Saturday