Surgical Specialties
A. Ear, Nose & Throat Centre of Excellence
Here are some of the reasons for pioneering a center of excellence in UMhlathuze region:
ENT PROBLEMS
•Over 20% of GP visits, and 50% of pediatric complaints, in South Africa, are as a result of ENT problems.
VERTIGO/DIZZINESS PROBLEMS
•The SA National 1-year prevalence of Vertigo (Dizziness) is 50%.
•Dizziness accounts for 4% of the presentations in the emergency department
•Dizziness accounts for 1% of presentations at primary healthcare settings.
•Dizziness occurs as a result of imbalance which can arise from the visual, cerebella, vestibular and joint position sense (proprioceptive) systems.
•Assessment of all these systems must be attempted when patients present with dizziness in order to locate where the problem is.
HEARING PROBLEMS
•Over 360 million people worldwide suffer from disabling hearing loss and 50% of them are in the low-middle income countries like South Africa. The proportion may be higher because there is generally poor screening in the resource-constrained low-middle income countries.
•Over 12 million South Africans have some form of hearing loss.
•Over 3.6 millions of these require treatment.
•Less than 10% of the 3.6 millions are able to access treatment.
•Poor screening practices result in late diagnosis of hearing impairment.
•The burden of HIV/AIDS & TB are some of the reasons why populations in the low-middle income countries like South Africa develop hearing loss.
HEAD AND NECK SQUAMOUS CELL CARCINOMA
•Head and neck squamous cell carcinoma (HNSCC) is on the rise in the low-middle income countries owing to increasing life expectancy, HIV, excessive alcohol consumption and tobacco smoking.
•HNSCC is the sixth commonest malignancy and eighth commonest cause of cancer-related deaths, globally.
•HNSCC has a fatality rate of more than 75% in low-middle income countries like South Africa.
The center will offer the following services:
HEARING
-Early screening for hearing difficulties
Advance hearing tests like ABR and BERA, which objectively elicit brain stem potential in response to audiological click stimuli.
Hearing Aids
-Bone Anchored Hearing Aid (BAHA), which is a hearing aid device that is surgically implanted on the bone behind the ear to assist people who have hearing loss.
-Cochlea implant, which is a small complex electronic device that bypasses the damaged part of the ear and connect directly to the nerve that is responsible for transmitting nerve impulses to the brain. It is particularly useful for people who have severe hearing loss.
SWALLOWING REHAB
-Patients are guided through various clinically proven physical maneuvers to improve or restore their swallowing ability.
VOICE REHAB & SPEECH THERAPY
-Voice production is a function of mind, vocal cords, breathing and speech muscles. When patients have had stroke, removal of nodules or polyps from the vocal cords, speech maybe affected. People like educators, preachers, politicians, lawyers, and salespeople, may adopt various techniques that may strain the voice and thus affect their occupational output. A voice therapist uses various techniques to help them restore their voice and/or help them select the right pitch and volume to preserve their voices.
VERTIGO ASSESSMENT
-Vestibular Nystagmography (VNG) – A test used to check if one has a problem with the balance system found in the inner ear (vestibular system).
-Vestibular Evoked Myogenic Potential (VEMP) – A test that evaluates the function of the parts in the inner ear that are responsible for balance and spatial orientation (Otolithic organs). It is used to diagnose Superior Canal Dehiscence Syndrome (SCDS), Benign Paroxysmal Positional Vertigo (BPPV), and Meniere’s disease.
-Video Head Impulse Test (v HIT) – A test that measures the integrity of the connection between the oculomotor muscles and the vestibular systema, also called vestibulo-occular reflex (VOR). vHIT uses high speed cameras to record and measure eye movements during the head impulse test.
GENERAL E.N.T. SURGERY
-Adenotonsillectomy – removal of tonsils and adenoids
-All functional endoscopic sinus surgery (FESS)
Direct Laryngoscopy
-Foreign body removal from the ear, nose or throat
-Lymph Node biopsy in the head and neck region
OTOLOGY
-Otoplasty – plastic surgery for the protruding ears
Eustachian tube dilatation
-Myringotomy – drainage of infected middle ear and insertion of grommets
Simple cortical mastoidectomy
-Auditory implant surgery (Bone conduction and Cochlea Implant surgery).
RHINOLOGY
Antrostomy – surgical drainage of maxillary sinuses by creating or enlarging the opening to the sinuses.
Rhinoplasty – Plastic surgery of the nose
Septoplasty – straightening of the nasal septum.
Polypectomy – removal of nasal polyps
Epistaxis – Involves cautery/ ablation/ ligation of the vessel that is causing nose-bleed.
Dacryocystorhinostomy (DCR) – done to relieve the flow of tears from the eyes into the nostril.
Turbinectomy – complete or part removal of turbinate bones to relieve nasal obstruction
Nasal Fracture Reduction Procedures – Straightening of the broken nose under local or general anesthesia.
LARYNGOLOGY
-Direct laryngoscopy and polypectomy
-PEDIATRIC – E.N.T. SURGERY
-Pediatric surgery includes removal of foreign bodies, frenectomies, repair of cleft palate and the repair of other head & neck birth defects.
ORAL CAVITY PROCEDURES
-Excision of benign mucosal lesions and other oral cavity lesions and abnormalities.
B. Center for Bariatrics & Other General Surgical Procedures
Bariatric Surgery
-Over 650 million people worldwide have a problem of obesity.
-Over 400 million people live with diabetes and over 95% are type 2 diabetics.
-Both obesity and type 2 diabetes support each other – “diabesity.”
-Both obesity and diabetes are risk factors for large and small blood vessels disease that may lead to stroke, kidney disease, heart attack, limb amputations and blindness.
-Many people on medical treatment are poorly controlled >44% in some settings.
-Surgical management of obesity and diabesity produces up to 90% remission in the first year of treatment.
-Surgical intervention includes Roux-en-Y gastric bypass and intragastric balloon.
General Surgical Procedures
-Intragastric Balloon for weight management
-Roux-e-Y gastric bypass
-Laparoscopic gall bladder removal
-Appendicectomy
-Cauterization of warts
-Inguinal hernia repair
-Insertion of Pec Tube
-Lipoma excision
-Mole excision
-Placement of Calcite Port
-Repair of Anal Fistula
-Resection of the Big Toenail
-Sigmoidoscopy
-Umbilical Hernia Repair
-Varicose Vein Surgery
-Anal Dilatation
-Breast Biopsy
-Breast Lump Removal
-Colonoscopy
-Ganglionectomy
-Gastroscopy
-Hemorrhoidectomy
-Incision and Drainage of Abscess
C. CENTRE FOR DIABETES AND WEIGHT MANAGEMENT
-Over 12.7% of South Africans live with diabetes, which is about 7.9 million people.
-Most people (90-95%) suffer from type 2 diabetes, which is known to be related to life-style.
-Diabetes and obesity (diabesity) have been shown to coexist in many instances.
-A 5-10% reduction in weight has been shown to improve the control of blood sugar levels in diabetics.
-Diabetes is ranked the 10th cause of death worldwide.
-Poorly controlled diabetes and its comorbidities like high blood pressure and abnormal blood lipids can lead to stroke, heart-attack, heart failure, kidney failure, blindness, and leg amputations.
-Early diagnosis through screening makes it possible for clinicians to intervene early and reduce the incidence of these complications.
-Effective and evidence-based management, focused on behavioral/ life-style change and compliance to medication, will also reduce the incidence of the complications.
The center will be:
1.Patient-centered: every diabetic patient has unique personal, social, economic and educational factors, which will be carefully considered when implementing an intervention strategy.
2.The center will focus on screening, early detection, and early intervention.
3.All newly diagnosed and poorly controlled patients will be enrolled in a diabetes education and self-management program in order for them to understand and be better able to manage the condition.
4.The intervention will be delivered by a team of a diabetologist, dietician, a physical therapist, a diabetes nurse, and a coordinator of care.
5.The center will offer the best available technology for our patients to enjoy the fullness of life.
6.The center will also implement the best possible communication methods to stay in touch with each and every one of our patients.
D. GYNAECOLOGY PROCEDURES
•Cauterization of vaginal warts
•Cervical Cerclage
•Cervical LLETZ
•Dilatation and Curettage
•Drainage of Bartholin’s Abscess
•Incision of Bartholin’s Cyst
•Endometrial Ablation
•Insertion of IUCD
•Evacuation
•Hysteroscopic Procedures
-Removal of Fibroids
-Removal of Adhesions
-Removal of lost IUCD
-Polypectomy
-Biopsy
-Removal of Cysts
-Removal of Ectopic Pregnancy
•Laparoscopic Procedures
-Hysterectomy
-Myomectomy
-Reversal of BTL
•Endometriosis Surgery
•Hymenectomy
•Endometrial Ablation
E. ORTHOPEDIC PROCEDURES
Arthroscopy
Amputation Coccyx
Coccygectomy is a surgical procedure in which the coccyx or tailbone is removed. … Coccygectomy is the treatment of last resort for coccydynia (coccyx pain) which has failed to respond to nonsurgical treatment.
Arthroscopy Shoulder Diagnostic
Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The rotator cuff is a group of muscles and their tendons that form a cuff over the shoulder joint.
Arthroscopy Knee Unilateral Or Bilateral
Knee arthroscopy is a surgical procedure that allows doctors to view the knee joint without making a large incision (cut) through the skin and other soft tissues.
Bunionectomy
Bunion removal
Surgery performed on the foot to excise and remove a bunion, an enlargement of the joint at the base of the big toe.
Bursectomy Knee Unilateral
A bursectomy is the removal of a bursa, which is a small sac filled with synovial fluid that cushions adjacent bone structures and reduces friction in joint movement. A bursectomy is usually carried out to relieve chronic inflammation (bursitis) or infection.
Carpal Tunnel Release
Wrist pressure relieve
A surgical procedure to relieve pressure on the median nerve.
Debridement Of Ankle And Reconstruct Ligament
This is minimally invasive surgery to the lining of the ankle joint (the area predominantly effected by arthritis). It works by removing areas of loose, mechanically redundant cartilage (joint lining) and inflamed tissue (synovitis) from the joint.
Exploration Of Tendon And Repair
Treatment of extensor tendon injuries may require operative intervention, depending on the complexity of the injury and the zone of the hand involved. [5] For treatment of injuries to specific zones of the hand, see Technique. The goal of repair is to restore tendon continuity and function, with a secondary goal of allowing early motion of the injured digit.
Ganglion/Carpal Tunnel Unilateral/Bilateral
When a ganglion cyst presses on a nerve it can be painful. And depending on its location, a ganglion cyst may restrict movement. Some cysts do not need treatment, but others must be surgically removed. During a ganglion cyst removal, a doctor removes the cyst capsule or stalk to completely remove the cyst During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome. An incision is made at the base of the palm of the hand
Ganglion/Carpal Tunnel Unilateral/Bilateral
When a ganglion cyst presses on a nerve it can be painful. And depending on its location, a ganglion cyst may restrict movement. Some cysts do not need treatment, but others must be surgically removed. During a ganglion cyst removal, a doctor removes the cyst capsule or stalk to completely remove the cyst During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome. An incision is made at the base of the palm of the hand
Insertion or Removal of K Wires or Other Internal Fixatives
K wire removal
Metal wires or plates often have to be surgically removed when the fracture has healed.
Manipulation Of Femur – Bilateral
Manipulations are more aggressive, high velocity techniques, or thrusts. They occur very fast, and at the end of available joint play. Manipulations are quick movements that occur beyond the available joint play range. The purpose of manipulations, or joint thrusts, is to increase the available range if it is not full. Secondly, manipulations are done to break adhesions that disrupt joint movement.
Morton’s Neuroma
Surgery for neuroma most often involves removing affected nerve in the ball of the foot. An incision is made on the top of the foot and the nerve is carefully removed. … As such, he finds simple neurectomy to be the best option for thesurgical treatment of Morton’s Neuroma.
Open Reduction And Internal Fixation (ORIF) Metacarpal
-Repair of broken or fractures metacarpals
Removal Of External Fixator
External fixation is a surgical treatment used to stabilize bone and soft tissues at a distance from the operative or injury focus. They provide unobstructed access to the relevant skeletal and soft tissue structures for their initial assessment and also for secondary interventions needed to restore bony continuity and a functional soft tissue cover.
Release Of Trigger Finger
Trigger finger, also known as stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis), is a condition in which one of your fingers gets stuck in a bent position. Your finger may straighten with a snap — like a trigger being pulled and released.
Small Toe Procedure
Procedure done to repair broken or fractures toes
F. OPHTHALMOLOGY PROCEDURES
Anterior Vitrectomy
Anterior vitrectomy entails removing small portions of the vitreous humor from the front structures of the eye.
Amniotic Membrane Grafting
A donated/purchased amniotic membrane is attached to the eye surgically.
Avastin Injection
Avastin treatment is an in-office procedure for macular degeneration, diabetic retinopathy and retinal vein occlusion.
Blepharoplasty Bilateral (Both Lids)
An “Eyelid lift”, Blepharoplasty, is a procedure to remove skin and to add or remove fat from the eyelids. A thin stitch is then used to bring the skin together to allow for a creation of an eyelid crease.
Cataract Unilateral with Phaco
A modern cataract surgery in which the eye’s internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye.
Cataract Unilateral under GA with Phaco
A modern cataract surgery in which the eye’s internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye.
Cataract Unilateral without Phaco (ECCE)
A modern cataract surgery in which the eye’s internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye.
Cataract with Anterior Vitrectomy
Lens is removed with Vitreous in certain conditions. An artificial lens may not be inserted.
Cornea Transplant
Corneal transplantation, also known as corneal grafting. It is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). The cornea is the transparent front part of the eye that covers the iris, pupil and anterior chamber.
Entropion Repair Unilateral
Entropion is the rolling inward of the lower eyelid and eyelashes towards the eye. The skin of the eyelid and the eyelashes rub against the cornea (front part of the eye).
Ectropion Repair Bilateral
Ectropion is the sagging and outward turning of the lower eyelid and eyelashes. The margin of the eyelid and the eyelashes turn out. Dryness and can cause irritation.
Eviseration with Silicone Implant
Evisceration is a surgical technique by which all intraocular contents are removed while preserving the remaining scleral shell, extraocular muscle attachments and surrounding orbital adnexa.
Examination under General Anaesthesia
The examination may consist of an intraocular eye pressure measurement (pressure inside the eye), a complete eye examination, including a refraction (to check for any type of refractive error or need for glasses).
Excision of Chalazion Meibomian Cyst
Chalazion is a painless chronic noninfective inflammation of the sebaceous glands (Meibomian glands) of the eyelid.
Posterior Vitrectomy with Silicon Oil
When a Retina detaches due to many causes: Diabetes, Trauma & Retina Holes
Probing and Dilatation of Tear Duct
Some adults have a tear duct probing done in the office using topical anaesthetic drops.
Pterygium (Conjunctiva)
Removal of obstructing eye tissue
The surgical removal of an abnormal mass of tissue arising from the conjunctiva (clear membrane covering the white part of the eye). This sometimes grows across part of the ornes, partially obstructing vision.
Ptosis Repair Unilateral / Ptosis Repair Bilateral
Ptosis is a drooping or falling of the upper eyelid, partly covering the pupil. Ptosis repair involves actually changing the height of the eyelid.
Pupilloplasty / Iris Reconstruction
A pupilloplasty is performed to repair damage to the iris and pupil.
Keratectomy
Procedure to correct errors of refraction in the eye by using an excimer laser to remove a portion of the anterior part of the cornea, which changes the refraction by creating a new radius of curvature.
Repositioning of Lens
Lens poorly positioned during cataract surgery. Lens dislocates after Cataract Surgery.
Strabismus Repair
Squint correction
Surgery to correct eye muscle disorders that cause squinting.
Scleral Transplant
The sclera is the white portion of the eye and can either be preserved whole or cut into thirds.
Trabectome
Trabectome surgery is a newer, minimally invasive procedure for the treatment of glaucoma. A tiny incision is made in the periphery of your cornea through which the surgery is performed.
Trabeculectomy with Ahmed Valve
Manage Glaucoma patient pressure with Surgical procedures.
Vitrectomy Membrane Peeling and Gas
Inter Posterior Vitrectomy. Peeling of ILM and insertion of Gas
Wedge Excision of Eye Lid
Lower lid evolutional entropion is a common eyelid pathology affecting the elderly population. Most of the reported surgical techniques are mainly based on
G. DENTAL SURGERY
Dental extractions
(also referred to as tooth extraction, exodontia, exodontics or informally, tooth pulling): is the removal of teeth from the dental alveolus ( socket) in the alveolar bone.
Dental filling
Is a way to restore a tooth damaged by decay back to its normal function and shape.
Frenectomies
A surgical procedure for excising a frenum or frenulum.
Pulpotomies
Removal of a portion of the pulp structure of a tooth
H. UROLOGICAL SURGERY
Biopsy testes
A testicular biopsy is a test to remove a small sample of tissue from one or both testicles
Circumcision
Circum
The surgical removal of the foreskin (the loose tissue) covering the glans of the penis
Cystoscopy
Diagnostic procedure that is used to look at the bladder (lower urinary tract), collect urine samples, and examine the prostate gland
Cystoscopy with prostate biopsy
Prostate biopsy – surgical procedure that involves removing a small piece of prostate tissue for microscopic examination.
Cystolithotomy
Removal of a stone from the bladder through an incision or endoscopic puncture in its wall
Epididymectomy
Surgical procedure to remove the epididymis, which is an essential part of the male reproductive system
Excision of hydrocele
A hydrocele testis is an accumulation of clear fluid in the tunica vaginalis, the most internal of membranes containing a testicle
Frenuloplasty
Correction of an abnormally attached frenum or frenulum, by surgically repositioning it.
Inguinal Hernia Repair
Hernia repair
The surgical correction of an inguinal hernia (opening, weakness, or bulge in the lining tissue of the abdominal wall in the groin area between the abdomen and the thigh).
Injection peyronies
A localized connective tissue disorder of the penis that may result in formation of plaque, penile deformity, pain, erectile dysfunction and emotional stress
Orchidectomy
Excision of one or both testes, done when a testis is seriously injured or diseased
Orchidectomy
Excision of one or both testes, done when a testis is seriously injured or diseased
Orchiolysis with orchiopexy
Orchiolysis – Correction of the Undescended Testicle without Fixation Orchiopexy – surgical fixation of an undescended testis in the scrotum.
Prostate Biopsy
*Prostate tissue examination*
A surgical procedure that involves removing a small piece of prostate tissue for microscopic examination.
Pyelogram
A radiographic picture of the kidneys and ureters taken after the IV or intraureteral injection of a radiopaque contrast medium
Scope and Pyelogram
Examining of prostate and bladder
Cystoscopy (cystourethroscopy) is a diagnostic procedure that uses a cystoscope, which is an endoscope especially designed for urological use, to examine the bladder, lower urinary tract, and prostate gland. A contrast agent can be injected and the kidneys and ureturs examined.
Scrotal cyst
A spermatocele (epididymal cyst) is a painless, fluid-filled cyst in the long, tightly coiled tube that lies above and behind each testicle (epididymis)
Varicocelectomy
Operation for the correction of a varicocele by ligature and excision and by ligation alone of the dilated veins
Vasectomy
Male sterilisation
A surgical procedure performed on males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterised (burned or seared) or otherwise interrupted so conception cannot occur.
Vasovasostomy
Anastomosis of the ends of the severed vas (ductus) deferens. Surgical anastomosis of vasa deferentia