Mr Shashank Gurjar offers a range of surgical and endoscopic procedures for gastrointestinal conditions such as bowel cancer, inflammatory bowel disease, haemorrhoids, hernia and pelvic floor dysfunction.

Fees

New consultation: £200

Follow-up consultati'on: £150

Clinic timings

Spire Harpenden Hospital

Thurs 6.00pm – 8.00pm (weekly)

BMI Clementine Churchill Hospital

Wed  6.00pm – 8.00pm (weekly)

BMI Bishopswood Hospital

Tues  8.00am – 10.00am (weekly)

One Hatfield Hospital

Tues  6.00pm – 7.30pm (weekly)

Cobham Clinic, Luton & Dunstable Hospital

As required

Treatments, operations and tests

Laparoscopy is an operation performed in the abdomen or pelvis through small incisions (usually 0.5–1.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery. There are two types of laparoscope: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system.
The aims are to find the track of a low fistula, cut down onto it and allow it to heal. Imagine a tunnel being changed into a trench, by taking the roof off. The wound heals from the floor of the trench to form a flat scar, which may take several weeks. .If you do nothing, the fistula may heal up by itself. More often, the discharge continues. Perianal abscesses may form in the same place over time.With some very complex high fistulas, just treating the abscesses that appear from time to time may be the best treatment.An older treatment was to pass a thread from the skin opening, through the fistula, out through the anus, and to tie the thread in a loop.
An appendectomy (sometimes called appendisectomy or appendicectomy) is the surgical removal of the vermiform appendix. This procedure is normally performed as an emergency procedure, when the patient is suffering from acute appendicitis. In the absence of surgical facilities, intravenous antibiotics are used to delay or avoid the onset of sepsis; it is now recognized that many cases will resolve when treated non-operatively.
Bowel cancer or "CRC", includes cancerous growths in the colon, rectum and appendix. With 655,000 deaths worldwide per year, it is the fourth most common form of cancer in the United States and the third leading cause of cancer-related death in the Western world. Colorectal cancers arise from adenomatous polyps in the colon. These mushroom-shaped growths are usually benign, but some develop into cancer over time. Localized colon cancer is usually diagnosed through colonoscopy.
Sigmoidoscopy is an examination of the lower intestine, including your rectum, using a flexible tube containing a camera or scope. It is a way of detecting colorectal cancer prolapse and diagnosing other bowel problems. The procedure usually takes around 15 minutes and can be done as an outpatient procedure.
Colorectal cancer (aka colon cancer); Many strains of colon cancers start as colon polyps which develop into their cancerous forms within a decade of appearing in the colon . As a result, many doctors advocate colon cancer screening and colon polyp removal for at-risk patients. The process of removing colon polyps is fairly straightforward. A colonoscopy or sigmoidoscopy tube with a wire loop is used to cauterize the polyp and its base completely. Larger polyps that cannot be removed using the flexible colonoscopy tube are typically removed via laparoscopy while the patient is under general anesthesia
Colonoscopy is a diagnostic procedure which enables a doctor, usually a gastroenterologist, to examine the appearance of the inside of the colon or large bowel. The doctor inserts a flexible tube into the anus, and then, into the rectum and through to the colon. The doctor controls the colonoscope by looking through the scope or by using a camera image projected onto a screen.
An upper gastrointestinal endoscopy uses a long endoscope to see the lining of the upper GI tract. This is used to identify the cause of many symptoms, from persistent heartburn to unexplained weight loss. There are a wide range of diseases that may be diagnosed by an Upper GI Endoscopy.
Flexible sigmoidoscopy is done to detect cancer in the portion of the colon, the sigmoid colon, close to the rectum and anus. A small tube containing viewing equipment is placed through the anus into the colon. As the tube is slowly removed from the colon, the doctor looks for any abnormalities. If a polyp or other abnormality is identified, a biopsy may be taken to test for the presence of cancer. Polyps may also be removed. If polyps are detected, a full colonoscopy may be recommended to check the entire colon and remove any additional polyps. There are rarely any major complications, but feeling bloated and cramping is normal. The procedure usually takes around 15 minutes, and can be done as an outpatient procedure.
Haemorrhoids (or piles) occur when a haemorrhoidal cushion of tissue is displaced such that it slides out of the anus. During injection treatment, a chemical solution is injected into the blood vessels around the anus, numbing the tissue and causing the haemorrhoid to decrease in size or shrivel up in four to six weeks.
The Haemorrhoidal Artery Ligation - Recto Anal Repair (HAL-RAR) operation is a new operation designed to eradicate piles without the need for cutting or a general anaesthetic. The Haemmorrhoid Artery Ligation operation uses a miniature Doppler ultrasound device to locate all the arteries supplying the haemorrhoids as they come down from the rectum under the lining of the bowel. The device also has a small window which allows a stitch to be placed around the artery thus cutting off the blood supply to the pile.
Haemorrhoids (or piles) occur when a haemorrhoidal cushion of tissue is displaced such that it slides out of the anus. One in ten haemorrhoids have to be treated with surgery, surgery is performed under local anaesthetic and aims to either remove the haemorrhoid directly, or to reduce the blood supply, causing them to shrink.
An epigastric hernia happens when a weakness in the abdominal muscle allows the tissues of the abdomen to protrude through the muscle. An epigastric hernia is usually present at birth, and may heal without treatment as the infant grows and the abdominal muscles strengthen. An epigastric hernia is similar to a umbilical hernia, except the umbilical hernia forms around the belly button and the epigastric hernia is usually between the belly button and the chest.
Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness called the femoral canal. Femoral hernias are a relatively uncommon type, accounting for only 3% of all hernias. While femoral hernias can occur in both males and females, almost all of them develop in women because of the wider bone structure of the female pelvis. Femoral hernias are more common in adults than in children. Those that do occur in children are more likely to be associated with a connective tissue disorder or with conditions that increase intra-abdominal pressure.
A hernia is a weakness in the stomach or abdominal wall. There are various forms of treatment - open hernia surgery using a mesh to repair the weakness, and keyhole surgery which may enable you to return to normal activities sooner.
A hernia occurs when the abdominal muscle weakens, resulting in a bulge or tear through which tissue can be pressed and cause extreme pain. Laparoscopic techniques require a small incision and the insertion of a camera/tool to repair the hernia through surgical staples and patches. While the incision is minimal and generally performed as an outpatient procedure it requires a general anaesthetic.
The hernia pouch or sac is the lining of the inside of the tummy wall. It pushes through the weakness at the tummy button. The sac has a fatty covering and inside there may be bowel or fatty tissue called omentum. The sac steadily gets larger and can be painful. The bowel and omentum may get stuck in the sac. Their blood supply can be cut off and the bowel and omentum can strangulate and die. This causes vomiting, great pain and is very serious. Umbilical hernias are very common and easily treated, particularly when small. If treated when they are small, this will prevent strangulation and make the strongest repair.
A hernia occurs when the abdominal muscle weakens, resulting in a bulge or tear through which tissue can be pressed and cause extreme pain. Surgical intervention uses a single long incision to allow access to the site of the hernia where the bulge can be removed or pushed back into the abdominal cavity and the muscle walls repaired with stitches or patches depending on the size of the rupture.
A hernia occurs when the abdominal muscle weakens, resulting in a bulge or tear through which tissue can be pressed and cause extreme pain. Laparoscopic techniques require a small incision and the insertion of a camera/tool to repair the hernia through surgical staples and patches. While the incision is minimal and generally performed as an outpatient procedure it requires a general anaesthetic.
MRI (magnetic resonance imaging) is a type of scan that is often used to diagnose health conditions that affect organs, tissue and bone. Virtual colonoscopy captures hundreds of exceptionally detailed images from outside the body. The images build up a complete picture of the colon, allowing for visualisation of any small polyps or changes in the bowel such as diverticular disease.
Branchial Cleft Cysts are congenital cysts, that arise in the lateral aspect of the neck when the second branchial cleft fails to close during embryonic development. These arches and clefts contribute to the formation of various structures of the head and neck. Branchial cleft cysts are the most common of congenital neck masses. They are bilateral in about 2-3% of the cases. Usually, they do not appear at birth, but become noticeable much later in life. If they get infected, they may form a deep neck abscess or a draining fistula. The treatment of branchial cleft cysts is surgical excision.
Gastroscopy is an examination of the upper digestive tract (the oesophagus, stomach and duodenum) using an endoscope — a long, thin, flexible tube containing a camera and a light — to view the lining of these organs.
A lower anterior resection, formally known as anterior resection of the rectum and anterior excision of the rectum or simply anterior resection (less precise), is a common surgery for rectal cancer and occasionally is performed to remove a diseased or ruptured portion of the intestine in cases of diverticulitis. It is commonly abbreviated as LAR.
Pilonidal disease was first described by Hodges in 1880 and is diagnosed by the finding of a characteristic epithelial track (the sinus) situated in the skin of the natal cleft, a short distance behind the anus and generally containing hair, hence the name pilonidal taken from the Latin, meaning literally 'nest of hairs'. During the Second World War the condition was common in jeep drivers, which led to it being known as 'jeep disease'. A similar condition arises in the clefts between the fingers of barbers or hairdressers caused by customers' hair entering moist, damaged skin.
A bowel resection is a surgical procedure in which a part of the large or small intestine is removed. It may be performed due to cancer, necrosis, enteritis, diverticular disease, or a block in the intestine due to scar tissue. Other reasons to perform bowel resection include ulcerative colitis, traumatic injuries, precancerous polyps, and familial polyposis. Large bowel resection is used to treat a many conditions. Some of these are: * Colon cancer Diverticular disease (disease of the large bowel) * A block in the intestine due to scar tissue
A common reason why skin lesions are often excised surgically is to fully remove a skin cancer. If certain cancers are not cut out they may spread to the surrounding skin and metastasise, or spread, to other parts of the body. However, other treatments such as freezing the affected skin (Cryotherapy), be it malignant or just an unsightly wart, can be treated medically with liquid nitrogen, which freezes and destroys the affected skin cells. This method is less time-consuming and it's cosmetic results are usually very good.
Anal fissure surgery's aim is to weaken the sphincter muscle by cutting one side of it. This is called a lateral sphincterotomy. This lets the fissure heal up within a week or so. The sphincter muscle will also recover in a week or two. The alternative first line of treatment is usually a course of bathing and special creams containing muscle relaxants or local anaesthetic. If they do not work, the sphincterotomy is usually the next step.Stretching the muscle is an alternative to cutting it, but there is a greater chance of poor control of your wind and motions after stretching, especially in older patients. There is also a higher chance of the fissure coming back.
The aim is to remove the abnormal nail and usually the nail bed too. If the nail only is removed, an abnormal nail will grow from the nail bed again. The way to do this operation depends on the problem. Wth ingrowing toenails only the narrow strips of the nail bed near the skin folds are to be removed. Severely thickened nails require the nail bed to be surgically removed with the help of chemicals.