Upper GI & General Surgery
Mr John Saunders is an accomplished Upper GI and General Surgeon, well recognised for his quality and expertise. He specialises in minimally invasive (laparoscopic) surgery for the treatment of common problems such as gallstones, hernias, acid reflux, hiatus hernia and achalasia.
Gallbladder & Gallstones
Gallstones can form in the gall bladder where bile is stored. In some people gall stones do not cause any symptoms and can remain undetected. However, gallstones can cause upper abdominal pain particularly after eating and symptoms of nausea & vomiting. They can become infected (cholecystitis) and cause fever.
Symptomatic patients can have their gall bladder removed under general anaesthetic with a day case keyhole surgery called a laparoscopic cholecystectomy.
You can continue to live a normal life without your gallbladder, however if left untreated, gallstones can cause complications such as jaundice (obstruction of the bile duct) and pancreatitis (inflammation of the pancreas gland).
Having your gallbladder removed is a common procedure in the UK, and many patients will know a family member or friend that has had a laparoscopic cholecystectomy.
Reflux & Hiatus Hernia Surgery
Acid reflux occurs when stomach acid washes up the gullet (oesophagus). If this is to occur on a regular basis, then the oesophagus can be exposed to excess acid and a burning pain (heartburn) can occur. Many associated symptoms can also be experienced such as water brash, regurgitation, beltching, horse voice and chest pain. This is called Gastro Oesophageal Reflux Disease or GORD for short.
Most patients will have mild symptoms which are usually controlled by lifestyle changes and medications. However some patients will have severe symptoms which are not well controlled and can be helped by laparoscopic (keyhole) anti-reflux surgery called a fundoplication.
Some patients may also have a hiatus hernia. This is where there is a weakness at the diaphragm allowing the stomach to move into the chest and the stomach acid to more easily wash back up into the oesophagus and cause acid-reflux symptoms. If you have a hiatus hernia then this can also be corrected at the time of the laparoscopic anti-reflux surgery, by bringing the stomach down out of the chest cavity to sit in is usual position in the abdomen. The diaphragmatic weakness causing the hiatus hernia is then closed and the fundoplication performed to stop the acid refluxing back up into the oesophagus.
Gastroscopy (Upper GI endoscopy)
Gastroscopy allows your consultant to directly look with a flexible camera inside your oesophagus, stomach and duodenum (your upper gut), and take targeted biopsy samples of tissue which can be analysed in the laboratory to help make a diagnosis.
The procedure is swift and safe, and you can watch and be explained the images on the screen if you wish. It is usually performed with a local anaesthetic throat spray and also some intra-venous sedation as required, so that you don’t need to be put to sleep.
Mr Saunders is a skilled diagnostic and accomplished therapeutic endoscopist and will ensure that your procedure is smooth and well tolerated.
Hernias
A hernia is where there is a weakness in the groin or abdominal wall and a lump can be felt or seen pushing through. These come in many different types depending upon where they are situated: inguinal (groin), umbilical / paraumbilical (belly button), incisional (at the site of a previous scar), epigastric (in the upper abdomen), femoral (lower groin by the leg).
A hernia is where there is a weakness in the groin or abdominal wall and a lump can be felt or seen pushing through. These come in many different types depending upon where they are situated: inguinal (groin), umbilical / paraumbilical (belly button), incisional (at the site of a previous scar), epigastric (in the upper abdomen), femoral (lower groin by the leg).
These are repaired using either a laparoscopic key hole or open approach depending upon the position and size of the hernia. Once the hernia lump is reduced, the weakness is usually repaired using a mesh material to provide strength and prevent recurrence.
Achalasia treatment
Achalasia cardia is an uncommon condition that affects swallowing in two ways; by weakening of the muscle in the oesophageal wall so there is poor propulsion of food down the gullet, and also by causing an unnaturally tight muscle at the junction of the stomach and oesophagus which can prevent food from entering the stomach.
Patients with achalasia can have symptoms which are common in other conditions such as difficulty swallowing, regurgitation, reflux type symptoms, chest pain and weight loss. Achalasia can therefore be misdiagnosed, and indeed patients can have variable symptoms according to how advanced the achalasia has become or a symptom predominance according to their sub-type of achalasia.
There are 3 different main subtypes of achalasia, and these can be separated out from other conditions and the more rare oesophageal motility disorders with specific investigations such as gastroscopy, barium swallow and high resolution manometry.
Achalasia cardia can be treated with a number of different modalities including temporary endoscopic Botox injections, pneumatic balloon dilatation, lapraroscopic cardiomyotomy, and per oral endoscopic myotomy (POEM). The best approach is decided according to the type of achalasia, symptoms, patient wishes, age and other medical problems. Importantly no treatment will reverse the underlying condition, but they will improve your symptoms.
Mr Saunders has specific expertise in the field of achalasia and sees patients referred from around the northwest of England. He is happy to guide you through the complexities of diagnosis, specifics of treatment and longer term follow up.
Practice Manager
Francesca Mcgowan
Liaise with Francesca directly to make an appointment
Company Registered In England And Wales No: 15709078
Registered Office Address: 9 Portland Street, Manchester, M1 3BE