Gastrointestinal Surgery

Amrita Hospital, Faridabad has a highly skilled group of gastrointestinal and pancreaticobiliary surgeons who work in close coordination with other departments.

• Oncological Surgery of the GI Tract.
• Pancreatic surgery
• Complex Biliary Surgery
• Gastric and Oesophageal Surgery
• Advanced Laparoscopic Surgical Procedures.
• Specialized Colorectal Surgery including Sphincter Saving
• Stapled and Pouch Procedures
• Retroperitoneal Tumor Excisions.
• Intra-Abdominal Trauma.

Gastric and Oesophagal Surgery

All major gastric and oesophageal surgeries are undertaken. Minimally invasive gastric and oesophageal surgeries are offered to patients where appropriate. The following conditions are treated on a regular basis:

• Gastric Cancer – Palliative and curative resections for gastric and gastro-esophageal junction cancers are performed frequently, along with gastrectomy with extended lymph node dissections.
• Achalasia Cardia – The initial work up is done in the esophageal motility lab in the Medical Gastroenterology department, then the GI Surgery department sees patients who need surgery. Laparoscopic myotomy is performed so that patients can avoid the risk of open surgery with its attendant morbidity.
• Esophageal Cancer – Transthoracic and transhiatal oesophagectomies are also performed regularly. Inoperable patients are palliated by expandable metallic stents or endoscopic feeding gastrostomies. The management of these patients is generally undertaken in consultation with an oncologist to plan the adjuvant treatment that may be needed.
• Gastro Esophageal Reflux Disease –The treatment is begun only after extensive evaluation in the motility lab of the Medical Gastroenterology department. Optional minimally invasive anti-reflux surgery is offered to the patient.
• Ulcer Disease – With the current advances in medical treatment, it is rare for patients to need surgical intervention. When such cases do arise, the department offers the options of laparoscopic as well as open acid reduction procedures.

Small Intestine and Colorectal Surgery

• Colorectal Cancers – Low anterior resections and stapled pouch anastomosis are carried out routinely. All attempts are made at sphincter preservation. Laparoscopic colorectal resections are being taken up on depending on patient preference and suitability.
• Polyposis Syndrome – Patients with polyposis syndrome are evaluated fully in the department for coexisting pathology and are offered sphincter-preserving procedures like Ileal Pouch Anal Canal Anastomosis.
• Inflammatory Bowel Diseases – Inflammatory bowel disease like ulcerative colitis and Crohn’s Disease are handled in consultation with the Medical Gastroenterology department. Advanced procedures like Ileal Pouch Anal Canal Anastomosis are done regularly. Staged procedures for complicated IBD and management of fistulas utilize the services of the integrated stoma care services.
• Abdominal Tuberculosis – The advanced facilities available in the hospital permit noninvasive or minimally invasive confirmation of this often-obscure pathology.
• Rectal Prolapse – Rectal prolapse is being treated routinely by Laparoscopic Rectopexy, thus allowing early return to activity for the patients.
• Complicated Perianal Conditions – the evaluation and management of complex perianal fistulae is aided greatly by the excellent imaging modalities of conventional and MR fistulograms done in the Radiology department. Stapler hemorrhoidectomy is offered to patients at their choice, avoiding the painful and prolonged convalescence after piles surgery.
• Anal Sphincter Reconstruction and Augmentation –Reconstruction of anal sphincter with muscle transfer procedures are done for patients with incontinence due to traumatic injuries to the sphincter.

Laparoscopic Surgery

The unit operates with two fully equipped laparoscopic suites, which are also equipped with advanced equipment like Harmonic Scalpel, Ligasure, Ultrasonic dissectors, endoscopic stapling devices and endoscopic suturing devices. The unit can perform:

• Lap cholecystectomy
• Lap common bile duct exploration for stone disease
• Lap appendicectomy
• Laparoscopic hernia repair
• Diagnostic laparoscopy for the evaluation of obscure abdominal symptoms, pain or ascites
• Lap assisted colorectal resections for cancer
• Lap directed small bowel surgeries
• Lap myotomy for Achalasia Cardia
• Lap splenectomy
• Lap cysto-gastrostomy
• Lap bariatric surgery

Pancreatic Biliary Services

• Pancreas – The unit has carried out more than 120 major pancreatic resections with results being comparable with the best centres in the world. Surgical treatment is offered to patients with pancreatic cancers as well as chronic pancreatitis.
• Disorders of the biliary system – The treatment of gallstone disease is done in coordination with the Medical Gastroenterology Department so as to allow planning of combined and sequential treatment procedures that would help in reducing the hospital stay. Surgical management of complicated benign biliary disorders is done by biliary reconstructive procedures.
• Bile duct and gall bladder cancer – Palliative and curative resections for biliary cancer and palliative drainage procedures are performed. Combined liver and bile duct resection for advanced bile duct cancers are being performed regularly with excellent results. Patients who have inoperable diseases are offered various palliative measures like stenting or bypass procedures.

Gastrointestinal Oncology

The department works in close association with the Departments of Medical and Radiation Oncology. Management of cancers is handled on the basis of protocols already in place and after discussion in tumor boards. This close association between the departments allows the patients to get integrated care for their diseases. Adjuvant treatment for colorectal cancers, cancers of the stomach and pancreas, cholangiocarcinoma, etc. are taken up after detailed discussions between the surgeon and the oncologist. This interaction helps in the optimisation of the treatment for each patient.

Trauma and Emergency Services

The GI Surgery unit functions as a tertiary referral center for hepatobiliary and pancreatic trauma. Complicated postoperative GI and biliary fistulas can also be admitted through the emergency services. The GI bleed team composing of the critical care specialist, the medical gastroenterologist, interventional radiologist and the GI surgeon manage the patient with a well-coordinated approach. The excellent conventional and interventional radiological facilities available in the hospital allow conservative treatment for many major intra-abdominal injuries especially major intra-abdominal vascular trauma.