Mr Stephenson is a fully trained general surgeon. General surgery is a broad specialty encompassing several body areas but particularly the abdomen. Mr Stephenson participates in a 1 in 3 on call consultant rota at Jersey General Hospital which, in addition to his extensive training in the UK, makes him very experienced at handling a wide range of conditions. The most common are hernias, gallstones, abdominal pains, lumps and bumps.
There are many different types of hernia, but the thing they all have in common is that they are a defect in the abdominal wall lining. They tend to start out with a bulge on the abdominal wall, most commonly in the groin, around or above the belly button and around old surgical scars. They can often be uncomfortable to begin with and at worst in some cases, bowel can get trapped in them necessitating emergency surgery.
Hernias can affect anyone. The commonest type is an inguinal hernia. Men have a 30-40% chance of developing one in their lives. Another groin hernia is called a femoral hernia, which is at particular risk of trapping bowel. Hernias around the belly button, paraumbilical hernias, are also very common.
The good news is that they can be easily fixed, often with the assistance of a mesh. Mr Stephenson often performs this surgery as a day case procedure. Depending on the type of surgery there is usually a fairly rapid return to normal activities.
Gallstones are extremely common, at least 15% of people will develop them. They develop within the gallbladder which is a small pouch under the liver that stores bile (which helps you digest food). When there are gallstones in the gallbladder they can block the outlet of the gallbladder causing severe pain, and the blockage can lead to infection. Gallstones can also slip out of the gallbladder into the tubes between the liver and the intestines where they can cause jaundice, pancreatitis and other problems. Most people who have gallstones though actually don’t have any symptoms, in which case they can be left alone.
If you have been diagnosed with problematic gallstones, the whole gallbladder needs to be removed, otherwise the gallstones will recur. Mr Stephenson performs this surgery using a keyhole (laparoscopic) technique. You would normally need to stay just one night, or occasionally can go home the same day.
Pain, lumps and bleeding from the bottom are extremely common. Usually the cause is simple like haemorrhoids (piles) or a fissure (tear). A careful history and examination can usually determine the cause and treatment can be started. Usually these problems can be corrected without surgery.
Skin lesions and other lumps under the skin are extremely common. The vast majority of these are benign, such as moles (naevi), epidermoid cysts and lipomas. Distinguishing between benign and malignant can sometimes be difficult just by looking. Mr Stephenson is part of the skin cancer Multi Disciplinary Team at Jersey General Hospital and operates regularly on the whole range of these skin conditions, including malignant melanomas.
Problems with toenails, especially when they grow/curl in at the edges can be extremely painful and difficult to manage, meaning minor surgery is sometimes needed. It is often sensible to seek the advice of a podiatrist/chiropodist in the first instance, but where this is unsuccessful, removing part (or occasionally all) of the nail permanently may be the best solution. This is a minor procedure performed under local anaesthetic.
There are a huge variety of causes of abdominal pain. Whilst sometimes it’s obvious, getting to the bottom of it sometimes requires careful detective work to identify the cause from a wide range of possibilities. In fact, the majority of cases of abdominal pain aren’t caused by something that requires an operation, but this is the first thing to identify. Mr Stephenson has published an article on this subject in the sBMJ which you can read hear if you’re interested. He is also part of the gastrointestinal Multi Disciplinary Team at Jersey General Hospital.