Surgical Investigations

LAPAROSCOPY

Laparoscopy (key hole surgery) is a commonly performed procedure to investigate abdominal and pelvic organs.

Laparoscopy is direct visualisation of the abdominal cavity, ovaries, outside of the tubes and uterus by using a laparoscopy. The laparoscope is a long thin instrument with a light source at its tip, to light up the inside of the abdomen or pelvis. Fibreoptic fibres carry images from a lens, also at the tip of the instrument, to a video monitor, which the surgeon and other theatre staff can view in real time.

Carbon dioxide (CO2) is put into the abdomen through a special needle that is inserted just below the navel. This gas helps to separate the organs inside the abdominal cavity, making it easier for the physician to see the reproductive organs during laparoscopy. The gas is removed at the end of the procedure.

GASTROSCOPY

Upper Gastrointestinal endoscopy (gastroscopy) is a surgical procedure performed by a surgeon who uses the endoscope to diagnose and potentially treat issues within the upper digestive system. The endoscope is a long, thin, flexible device with a light and small camera on one end.

Through careful adjustment of the device, the surgeon can examine the inside lining of the upper digestive system.

Click here to find out all about endoscopy, in this interactive Web based movie.

Diagnostic Indications for Endoscopy

  • Swallowing difficulties
  • Persistent isolated nausea or vomiting. If this condition occurs for more than two days, we recommend this procedure for investigative measures to determine if there are any serious conditions you are unaware of.
  • Any Digestive disorders. We recommend an Upper gastrointestinal endoscopy in the following cases:
    • In subjects aged over 45 years and/or if there are any warning signs or symptom’s such as anaemia, difficulty swallowing, weight loss or any other warning signs and symptoms
    • In subjects aged under 45 years with no warning signs or symptoms, upper gastrointestinal endoscopy is recommended in the following situations:
      • Positive diagnostic test for Helicobacter pylori
      • When symptomatic treatment has failed or recurrence occurs at the end of treatment
  • Iron deficiency anaemia or chronic anaemia conditions. An upper gastrointestinal endoscopy is recommended in iron-deficiency anaemia. This is the case after any non-gastrointestinal origin has been eliminated.
  • Bleeding of an acute nature in the upper gastrointestinal tract. Upper gastrointestinal endoscopy is recommended as a diagnostic precaution.
  • Gastro-oesophageal reflux (GORD). Upper gastrointestinal endoscopy is recommended in the event of reflux in combination with loss of weight, anaemia, bleeding or if the patient is aged over 50 years. This is also recommended if there is a recurrence on withdrawal of treatment or a resistance to ongoing medical treatment.

COLONOSCOPY

Colonoscopy is an endoscopic (fibre optic camera) procedure to examine the large and small bowel.

The endoscope has a moveable tip and multiple channels for instrumentation, air, suction, and light. A colonoscopy procedure allows for a visual diagnosis of any existing condition and is vital if colorectal surgery is necessary.

Colonoscopy investigations are performed at Hobson Healthcare Centres in Altona, Sydenham, and Werribee.

BLOOD TESTS

After your visit to your surgeon, a blood test may be required. There are a series of common blood tests that might be requested. These are below.

Full Blood Count (FBC)

This test looks at the different blood cells in great deal using a microscope. The haemoglobin level is checked for anaemia as well as viral conditions like glandular fever. People on some medications require regular FBE’s.

Urea Electrolytes and Creatinine (UEC)

This test is designed to specifically measure the functionality of the kidneys. Your physician will be looking for signs of kidney impairment, dehydration or elevated levels of creatine or serum uera. Electrolyte levels are also measured – these include potassium, chloride, sodium and bicarbonate. For patients currently on diuretic medication, potassium levels are particularly important – to monitor the frequency of their levels within the bloodstream.

LFT – Liver function tests

Liver enzymes are a tell-tale sign of any damage sustained through infections like hepatits or prolonged alcohol or drug abuse. In a jaundiced patient where bile secretion from the liver is blocked, an elevated bilirubin enzyme will be evident. Protein and albumin levels are also measured; with chronic illnesses the albumin tends to gradually fall to quite low levels.

Click here to open an information sheet from Hepatitis C Council of NSW on Liver Function Tests.

High blood cholesterol is an important factor in determining a patient’s risk for coronary artery disease. Cholesterol, triglyceride and other blood lipid levels are monitored during this test.  A higher level of the HDL-cholesterol lipid is a measurement your physician will be looking for. LDL-cholesterol appears a major factor in the development of coronary artery disease and we like to see a low level. An elevated triglyceride level has an impact, as recent studies have shown.

RADIOLOGY

X-rays

In the event your doctor has scheduled you for an x-ray, it is necessary to understand the reason for such an exam, and the preparation required prior to undergoing the test.

Xrays of the bones or chest are a common general health check and to see if there has been any cancerous spreads to other parts of the body.

Barium Studies

Our internal digestive organs do not show up using Xray technologies unless their visibility on that spectrum is augmented using barium. This is called a barium meal. This examination determines the health/condition of various parts of the digestive system – including organs – through the use of barium sulfate. Barium sulfate is a white opaque powder that is often flavoured (since it is ingested first.) Once this powder passes into the digestive tract, its progress can be tracked via Xray allowing your physician to “see” various parts of your digestive system.

A barium meal is an examination allowing your physician to see the upper part of the bowel. This is done using barium to outline the shape of the stomach. A carbonated drink is ingested to help open up the stomach walls and enhance the vision.

Diagnosing reflux conditions is done using a barium swallow – an x-ray examination of the oesophagus.

A barium meal-barium swallow test is typically recommended for any unexplained vomiting or pain as it provides information to your doctor on the condition of the stomach and gullet. This information can help confirm, or direct an appropriate diagnosis and course of action.

An examination of the large intestine is completed using a barium enema. This test takes a little more preparation than barium meals or swallow tests. You are required to fast and ingest laxatives to ensure your bowels are clean prior to the enema being inserted rectally. This examination takes under an hour to complete.

Ultrasound

Ultrasound (US) imaging, (also called sonography or ultrasound-scanning), is a method of obtaining images of the internal organs through the emission of high-frequency sound-waves through the body. Organs within the body, (and other parts) reflect these sounds waves back forming a picture that is converted into a visual image that is used for diagnostic purposes. No x-ray dyes or radiation is needed for this examination.

Common Uses of Ultrasound

Ultrasound imaging is used extensively for evaluating the conditions of the liver, kidneys, pancreas, spleen gallbladder, and blood vessels of the abdomen. As it provides real-time feedback, it can also be used to:

  • View a sample of cells (biopsy) can be taken at the same time for examination under the microscope by a pathologist
  • Help a physician determine the source of many abdominal pains, such as stones in the gall bladder or kidney, or an inflamed appendix
  • Help identify the cause for enlargement of an abdominal organ e.g., liver and spleen

Doppler ultrasound is a special type of ultrasound that specifically examines major blood vessels. These images can help the physician to see and evaluate:

  • Blockages to blood flow, such as clots
  • Build-up of plaque inside the vessel
  • Congenital malformation

CT scan (CAT scan) 

A CT Scan performs in a similar manner to an x-ray. It is an ‘x-ray’ tube that rotates in a circle, taking a series of images during that rotation around The multiple x-ray pictures are then reconstructed by a computer in axial slice images at various levels. This allows the doctor to review each level individually.

A CT scan can show if cancer has spread beyond one organ to other parts of the body such as from the liver to the lymph nodes.

This scan takes between ten minutes to half an hour. An injection or drink containing dye might be required and will be administered prior to the test. If you have any allergies to iodine, or are asthmatic, be sure to let your physician know prior to anything being administered.

You will probably be able to go home as soon as the scan is over.

Magnetic Resonance Imaging (MRI or NMR scan) 

Magnetic Resonance Imaging (MRI) is an examination that is non-invasive. It is an imaging technique, similar to a CT Scan but does not use x rays to produce images. Magnetism is used to build up cross-sectional pictures of your body highlighting organs, bones, tissue, and internal body structures. For an abdominal MRI examination, the person’s body is exposed to radio waves while in a magnetic field. This allows cross-sectional pictures of the abdomen to be produced via energy emitted from hydrogen atoms in the body’s cells.

An individual is not exposed to harmful radiation during this test.

SLEEP STUDIES

Please visit Sleep Studies

CARDIAL INVESTIGATIONS

Please visit Echocardiogram Information