Haemorrhoids
Dr Evans specialises in treatment of haemorrhoids. Firstly it is worth mentioning that haemorrhoids are very common. Haemorrhoids are vascular cushions within the anal canal. With symptomatic haemorrhoids, patients may experience itchiness, pain, bleeding or prolapse. Haemorrhoid treatments often starts with increasing fibre in the diet to avoid constipation, drinking more water though the day to avoid dehydration or hard stools, avoiding straining excessively on the toilet and limiting toilet time. Dr Urquhart can also discuss different topical ointments to help with non surgical treatment of haemorrhoids. Sometimes surgery is required, but it is worth noting that surgery can offer great results. Modern techniques in haemorrhoid surgery aim at treating the underlying condition in a more comfortable way than they have been historically.
Injection of haemorrhoids: This is utilised for earlier/less severe haemorrhoids and involves either injecting oily phenol or almond oil into the haemorrhoids.
Banding of haemorrhoids: This is utilised from slightly larger haemorrhoids and involves placing small bands internally above the haemorrhoids to help shrink the haemorrhoids and limit blood flow to the haemorrhoids to help prevent bleeding.
Haemorrhoid Artery Ligation: For larger haemorrhoids, under general anaesthetic, Dr Urquhart utilises an ultrasound or other device to find the haemorrhoid vessel causing the issue and he subsequently places a dissolving stitch internally to prevent bleeding. During this procedure Dr Urquhart can also repair some of the prolapse associated with some larger haemorrhoids.
Haemorrhoidectomy: Occasionally haemorrhoids can be so sizable they require an operation where the require surgically excision under General Anaesthetic.
Colon & Rectal Cancer Surgery
Colorectal cancer is incredibly common, occurring in as many as 1 in 11 Australians and is the second most common cancer in Australia. Colon polyps can be a precursor to colorectal cancer, where growths of the bowel lining develop. It is a condition that has a good prognosis and a good chance of a cure, especially when detected early. Colorectal Cancer is treated principally with surgery however may require additional therapies with either chemotherapy or radiation therapy. Colorectal cancer treatment is constantly progressing and improving.
The cause of colorectal cancer is multifactorial. Colorectal cancer typically develops from polyps in the bowel where environmental and inherited factors are implicated. Diets high in red meat, obesity, smoking, lack of physical exercise, and excessive alcohol intake have all been shown to increase the risk of colorectal cancer. In contrast, diets high in fibre, vegetables and fruit have been shown to decrease the risk of cancer developing. However, some patients develop polyps or colon cancer without risk factors, where abnormalities of the colon lining develop on their own.
Polyps commence as outpouchings of the lining of the bowel. Given time, they may develop into bowel cancer. However, it is generally accepted that their rate of transition to cancer occurs over an extended period of time. Because they can turn into cancer, removing polyps is critical in cancer prevention. Removal is usually performed during a colonoscopy; however, occasionally, surgery may be required (see Surveillance & Complex Colonoscopy section above).
Bowel cancer may be present in patients with no symptoms; hence, screening is incredibly important. When symptoms are present, they may include a change in bowel habits (diarrhoea, constipation or bleeding). Anaemia (a low blood count) is another relatively common presentation. Pain and weight loss are usually late symptoms, as is a bowel obstruction or blockage.
Colorectal cancer is generally treated with surgery tailored to your specific case. Dr Urquhart will help manage your case with a team of cancer specialists.
Depending on your case, the best option for your surgical treatment may include laparoscopic (keyhole surgery), endoscopy, open surgery or robotic surgery. Dr Urquhart will discuss all the different options with you and ensure your treatment is completely evidenced based. Dr Urquhart operates through the St Vincent’s Health Campus (St Vincent’s Private, St Vincent’s Public and St Vincent’s Day Surgery) and consults through his speciality rooms in Paddington.
Hernia Surgery
Dr Urquhart specialises in laparoscopic hernia surgery, surgery for recurrent hernias and surgery for complex abdominal wall hernias.
A hernia is a bulging or protrusion of an organ or tissue through an abnormal opening. The more common abdominal hernias are groin hernias (which can be over the inguinal or femoral region) or abdominal wall hernias (ventral, umbilical/belly button, supraumbilical/above the belly button). Hernias can also develop after surgery if a weak point develops over the incision site.
Multiple factors contribute to the development of a hernia. There are genetic, environmental and patient-specific factors that all contribute to a hernia developing. Straining, chronic cough, smoking, constipation, heavy lifting, and many other activities may predispose to hernias forming. Once a hernia develops, most of the time, surgery is required.
Abdominal wall defects or hernias may develop spontaneously or following any abdominal procedures. These may be quite small or extensive, where the patient has a large defect in which abdominal contents bulge out. In small to moderate-size hernias, the repair may require a suture technique or, more commonly, a combination of a suture with either a graft or mesh may be required. Occasionally additional treatments such as preoperative botox, weight loss strategies and exercise plans may be required.
Dr Urquhart is a specialist in hernia repair surgery and can discuss all the options with you.
