Procedures and Conditions
DR LINKS OFFERS COMPREHENSIVE SURGICAL SERVICES IN THREE AREAS
Weightloss and Metabolic Surgery (Bariatric Surgery)
Dr Links works with a comprehensive multidisciplinary team based at The BMI Clinic in Double Bay to achieve success with weightloss surgery and metabolic surgery. With the help of our experienced dieticians, psychologists, exercise physiologist, bariatric nurses, bariatric physicians and gastroenterologists we will guide you every step of the way.
Dr Links performs both primary and revision surgery including:
- Laparoscopic sleeve gastrectomy
- Removal of laparoscopic adjustable gastric band (LAGB)
- Revision surgical procedures
- Laparoscopic gastric bypass
The BMI Clinic provides expertise in all treatment options for obesity and associated metabolic conditions such as diabetes. This includes surgical interventions, endoscopic interventions, dietary and lifestyle programs, clinical psychology and the optimal supervised use of weightloss medications.
We run an interactive program with structured visits, support and education to enable you to achieve enduring success after weightloss surgery.
Benefits include a 24 hour emergency phone contact with our highly trained practice nurses and our online weight tracking app, GBA Active.
Find out more information regarding our program at www.BMIclinic.com.au
Upper GI Surgery
Oesophageal and gastric (stomach) cancer
Dr Links has expert training in the diagnosis and management of cancer of the oesophagus and stomach. The decision as to how to best treat these tumours can be dependent on many factors, such as the stage (how far it has spread) and location of the tumour, and the health of the individual. Often surgery may be the mainstay of treatment but other treatment options such as radiotherapy and chemotherapy may be of benefit. Each individual diagnosed with an oesophageal or gastric cancer requires a personalised treatment plan.
Diagnostic tests such as endoscopy, endoscopic ultrasound, CT, PET, MRI and laparoscopy (keyhole surgery) may be required to help decide the best treatment path.
Dr Links performs therapeutic endoscopy to manage early oesophageal cancer and Barrett’s oesophagus. He is experienced in minimally invasive surgery (also known as keyhole or laparoscopic) to enable a faster recovery and reduce postoperative problems such as pain and chest infections.
Dr Links collaborates with a dedicated team of oncologists, radiation oncologists, radiologists, pathologists and allied health professionals to manage complex Upper Gastrointestinal cancers and provide a world class standard of care.
Motility disorders of the oesophagus include problems where the muscular contractions of the oesophagus can be uncoordinated, too brisk or weak and ineffective. This can lead too difficulty swallowing, pain when swallowing, chest pain, regurgitation and weightloss. Dysmotility disorders such as achalasia require expertise for both diagnosis and treatment. Investigations may include endoscopy, barium swallow, oesophageal manometry (measuring oesophageal muscle contraction pressures) and oesophageal pH studies. Some dysmotility disorders are best managed with medications and dietary changes, whilst others are best managed with endoscopic or surgical intervention.
Reflux is a condition where gastric acid and other gastric juices can pass back up into the oesophagus causing irritation, at times leading symptoms such as a burning sensation behind the sternum, difficulty swallowing, regurgitation, hoarse voice, cough, dental enamel changes and aspiration causing chest infections. This is a common condition that can often be managed effectively with lifestyle modifications and acid suppressing medications. Reflux can less commonly lead to more more serious problems such as erosive oesophagitis, Barrett’s oesophagus and narrowing of the oesophagus (stricture). Reflux is a recognised risk factor for developing oesophageal cancer.
Some people, typically younger people, may be trialled with acid suppression medication to treat reflux without further investigation. In general older people with new onset reflux symptoms, or people with concerning symptoms such as food sticking, regurgitation, weightloss or anaemia should be further investigated prior to treatment. This will usually involve an endoscopy to visualise the oesophagus and biopsies can be taken if needed. This is a day stay procedure usually performed with sedation. More objective tests such as an oesophageal 24Hr acid study, manometry (pressure) study and barium swallow may be needed to further investigate severe reflux symptoms not being controlled with medication.
For people with more severe reflux, or potentially life threatening symptoms such as aspiration pneumonia, there may be a role for antireflux surgery but this should be discussed with a specialist Upper GI surgeon. Dr Links performs laparoscopic (keyhole) fundoplication surgery for reflux and can discuss the decision around medical and surgical management of reflux with you.
Hiatus hernia is a condition where part of the stomach slides up through the diaphragm into the chest. Quite commonly people may be diagnosed with a small sliding hiatus hernia on endoscopy. This does not typically require surgical repair unless contributing to significant reflux symptoms. Giant hiatus hernia however can cause symptoms such as chest pain after meals, regurgitation, reflux and anaemia and bleeding. Giant hiatus hernia can cause shortness of breath as the hernia pushes on the heart and impairs blood flow. There may be a risk of the stomach twisting (gastric volvulus) in the chest and requiring emergency surgery. A surgeon may recommended to repair a giant hiatus hernia to avoid some of these risks, once investigations such as a CT scan, barium swallow and endoscopy have demonstrated the size and nature of the hernia. Dr Links is experienced in laparoscopic and revision hiatus hernia repair.
Dr Links performs both laparoscopic (keyhole) and open hernia repair for
- Groin or inguinal hernia
- Umbilical Hernia
- Incisional hernia
- Complex abdominal wall hernia and component separation
There are many factors that impact on the decision to perform hernia surgery open or keyhole and every person’s situation is different. Dr Links will discuss with you what options may best suit your needs so you can make an informed choice.
Dr Links performs cholecystectomy (removal of the gallbladder) and bile duct exploration for symptomatic gallstones.
Endoscopy and Colonoscopy
For investigation of heartburn, bleeding, positive stool screening samples and other GI symptoms. Dr Links performs interventional endoscopy including stenting and dilation of the oesophagus and stomach, and endoscopic mucosal resection (EMR).
General surgical operations
Excision of skin lesions, cysts and lumps.