Upper gastrointestinal surgery, commonly referred to as “upper GI surgery,” is surgery on the upper parts of the gastrointestinal tract. Upper GI surgery can be open or laparoscopic.

Open surgery requires a large incision, generally enough to accommodate the surgeon’s hands. Laparoscopic, sometimes referred to as keyhole surgery, involves only small incisions in the abdomen, through which instruments can be inserted to view and treat affected areas.

What is it used for?

Upper GI surgery is used to treat a number of conditions affecting the oesophagus, stomach, duodenum area of the small intestine, diaphragm, gall bladder, liver, spleen and pancreas.

Conditions that can benefit from upper GI surgery include abdominal wall hernias, gallstones, diseases of the pancreas and liver, gastroesophageal reflux disease, dysphagia, oesophageal diseases and disorders, and post-hepatic (also called obstructive) jaundice.

Who performs it?

To perform upper GI surgery, a physician must be qualified as a surgeon with a specialisation in the upper gastrointestinal tract. Some upper gastrointestinal surgeons may specialise further, focusing specifically on oesophago-gastric or hepato-pancreatico-biliary disorders.

Oesophago-gastric disorders involve the oesophagus and stomach, and hepato-pancreatico-biliary disorders involve the liver, pancreas and billiary tract. Hepato-pancreatico-biliary specialization can be even further narrowed to allow a surgeon to specialize in liver disorders, including hepatic resection and transplantation.

How to become qualified

Training to become qualified to perform upper GI surgery is the same as training for any other surgical speciality. Physicians complete five years of general medical training then undertake a two-year foundation programme. Upon completing the foundation programme, which includes general surgical training, trainees take the MRCS (Membership of the Royal College of Surgeons) Examination.

After passing the MRCS, the trainee can apply for specialist training in upper gastrointestinal surgery.

When specialist training has been successfully completed, a surgeon may apply for a Certificate of Completion of Training, or CCT, and apply to join the General Medical Council (GMC) Specialist Register. Doctors must be registered with the GMC to practice in the U.K.