Introduction

Department has come into existence in August 1995 with the aim to provide comprehensive treatment for complex gastrointestinal diseases. It has since come a long way and made enormous strides in providing complete and comprehensive management for various problems in Gastroenterology. Surgical Gastroenterology department is the only one of its type in the government sector in Andhra Pradesh. Currently, it is providing OP and IP services to patients from all 13 districts of Andhra Pradesh and also neighbouring states which includes diagnosis and treatment of functional, inflammatory and malignant diseases of Esophagus, stomach, small and large bowel, Liver and Biliary tract and the Pancreas. There has been steady increase in the number of patients approaching SVIMS for GI disorders.

Currently the department runs OPD services daily. In addition to managing surgical patients, department is currently doing diagnostic and therapeutic endoscopic procedures. There has been steady increase in both OP and IP patient numbers since 1995. Increase was tremendous with the introduction of PDS, Aarogyasri and Dr.NTR Vaidyaseva schemes. Currently about 2500 – 3000 patients are attending Outpatient department, and about 150 in patients are treated monthly. Department performs about 1100 surgeries yearly. Currently about 3600 diagnostic and therapeutic endoscopies are performed annually. The department has 11 Post op/Recovery Beds, 5 ICU beds and 23 General ward beds. It provides treatment at highly subsidized rates.

The Department of Surgical Gastroenterology provides service to patients with complicated diseases of pancreas, biliary tract, gastrointestinal tract, liver and spleen. The department is equipped with state-of-art operation theatres, and supported by critical care ICUs equipped with latest monitoring and excellent preoperative and post operative nursing care by well trained nurses. Department has expertise in performing both open and laparoscopic GI procedures.

Services provided

1. Esophagus:

·         Treatment of benign esophageal diseases – Achalasia cardia, Gastroesophageal reflux disease, hiatus hernia, foreign body removal - Laparoscopic fundoplication, Hellar’s cardiomyotomy

·         Provides comprehensive treatment for corrosive esophageal injuries – management of both acute and chronic complications. Endoscopic dilatations, surgical procedures such as esophagocoloplasty, pharyngocoloplasty

·         Treatment of malignant diseases – Transhiatal or transthoracic esophagectomy, Esophagogastrectomy for GE junction tumors, palliative procedures such as esophageal stenting.

2. Stomach:

·         Surgical management of acid peptic disorders and its complications.

·         Comprehensive management of malignancies – Radical gastrectomy (distal, subtotal, total), wedge resections

3. Small bowel:

·         Treatment of benign diseases like tuberculosis, perforations, obstructions, enterocutaneous fistulas, malrotations, duplications

·         Malignant diseases – cancers, lymphomas

4. Colorectal:

·         Benign diseases - Inflammatory bowel diseases (IBD) – surgical procedures such as Total proctocolectomy with ileal pouch anal anastomosis. Surgery for diverticular diseases, colonic polyposis, colonic volvulus and rectal prolapsed, Appendicectomy

·         Malignant diseases – Cancers and lymphomas – Both emergency and elective surgical procedures – Right hemicolectomy, left hemicolectomy, extended colectomies, sigmoid colectomy, Anterior resections, Abdominoperineal resections, stoma creation

5. Liver:

·         Benign disease of liver such as liver abscess, hydatid cyst, simple cyst, hemangiomas, stone disease

·         Surgery for malignant disorders such as Hepatocellular carcinoma, cholangiocarcinoma, biliary cystadenomas – Right hepatectomy, Left hepatectomy, Extended hepatectomies, central hepatectomy, segmentectomies, wedge resections

·         Surgery for portal hypertension – Splenectomy, Devascularization procedures, shunts such as portocaval, proximal splenorenal, distal splenorenal, atriocaval shunts

6. Gall Bladder:

·        Surgery for stone diseases in Gall bladder, common bile duct – Laparoscopic cholecystectomy, CBD exploration, choledochoduodenostomy

·         Surgery for benign diseases such as choledochal cyst, biliary strictures-  Cyst excision and hepaticojejunostomy

·         Surgery for malignant diseases – Radical cholecystectomy, Hepatopancreaticoduodenectomy

 7. Pancreas:

·         Surgery for acute and chronic pancreatitis – Necrosectomy, pseudocyst drainage, Lateral pancreaticojejunostomy, Frey’s procedure

·         Surgery for malignant diseases – Whipple’s pancreaticoduodenectomy, Central pancreatectomy, Distal pancreatectomy

8. Spleen: Splenectomy for haematological disorders, portal hypertension, tumours

9. Bariatric: Laparoscopic sleeve gastrectomy, Mini Gastric bypass

10. Hernia surgeries: Both laparoscopic and open hernia surgeries – Inguinal, Incisional, Ventral hernias, diaphragmatic hernias

Endoscopy Unit: 

Endoscopies are performed daily. Endoscopy room is equipped with upper GI scope, side viewing and lower GI scope and paediatric scope. Both diagnostic and therapeutic scopies are performed. The therapeutic procedures include esophageal stricture dilatation, variceal ligation, variceal injection, polypectomy and biopsy.