Vikneswaran V Paranjothy
General Practitioner
Source: Getty Images
General Practitioner
If your perception of surgery only involves a doctor operating on a patient’s body in a hospital’s operating theatre, think again. Though it’s less commonly known, minor surgical procedures can also be performed in clinics.
Woodlands Parkway Shenton Medical Clinic, helmed by General Practitioner Dr Vikneswaran V Paranjothy, is one such clinic providing more than the usual gamut of medical services. Besides consulting patients who are unwell, conducting medical examinations, and administering vaccinations, Dr Vikneswaran is skilled in the field of general surgery and trained to perform a wide variety of minor surgical procedures as well as wound care.
Read on as he shares his responses to 6 common questions about minor surgical procedures, the conditions that may necessitate a minor surgical procedure and the minor surgeries he performs for patients.
Minor surgical procedures refer to surgery performed on superficial tissue, usually under local anaesthesia and using minimal equipment. These procedures can be performed safely and quickly with few or no complications, and while the patient is conscious throughout the procedure.
Minor surgeries can be performed to treat a wide range of conditions, including ingrown toenails and sebaceous cysts. Some of the more commonly performed procedures include removal of ingrown toenails, removal of lumps and bumps such as lipoma, sebaceous cysts, and stitches for open wounds and nasty cuts.
Ingrown toenails occur when the corner or side of a toenail grows into the flesh, which can cause pain and discomfort, and may also cause the skin of the toe to be inflamed, swollen or infected.
The condition could be a result of wearing footwear that is too tight around the toes, cutting your nails too short or injuring the toe or toenail. If at-home care does not work or the ingrown toenail is recurring or severe, minor surgery to partially remove or totally remove the nail along with the nail bed can help address the problem.
Due to various causes such as a scratch or surgery, the sebaceous gland which coats our hair and skin with oil may experience trauma. As a result, a sebaceous cyst may develop from the sebaceous (oil) glands, appearing as a lump on the body.
If a sebaceous cyst grows large and causes discomfort, it can be treated by surgical removal. This also reduces the chances of the cyst returning.
The full list of minor surgical procedures performed at the clinic can be found below. To find out more about the costs of these procedures, you may reach out to the clinic through the contact details listed here.
Nail
These are the procedures that can be carried out for nail-specific conditions:
Excision of Cutaneous lumps
This refers to the removal of a skin lump, such as:
Excision biopsies
This refers to the removal of a skin lesion, such as a:
Incision and curettage of chalazion
This refers to a surgical removal of a cyst or lump which develops on the eyelid as a result of a blocked gland.
Abscess incision and drainage
This involves a surgical cut and drainage of a tender mass filled with pus, bacteria, and debris as a result of infection
Cauterisation
This involves the use of heat, electricity or chemicals to destroy:
Toilet and suturing (T&S)
This refers to the closing of a wound with stitches.
Removal of a foreign body
These non-surgical procedures are also performed at the clinic:
Aspiration
This refers to removing fluid from a cavity of the body for these conditions:
Cortisone H & L Injections
These injections relieve pain and inflammation in your body for conditions including:
Hyaluronic Acid Injection
This refers to the administering of the Monovisc injection, which acts as a lubricant and shock absorber of the joints used to treat knee pain caused by osteoarthritis of the knee.
In all cases, the attending doctor will assess the patient’s condition and medical history before any surgical procedure, however minor. Some instances where minor surgery may not be possible include:
Should your doctor advise that your condition warrants a minor surgical procedure, it can be performed as soon as the same day at the clinic or at the patient’s or clinic’s next availability.
Your consent will be taken and all precautions and likely complications will be discussed.
During most procedures, local anaesthesia would be administered.
You would be provided information on after-care and the clinic’s contact number should there be a need for urgent medical attention. Additionally, a follow-up medical appointment would be recommended so the doctor can assess your recovery and whether any next steps are required.
Minor surgical procedures are conducted in a dedicated surgical procedure room that is well-ventilated, air-conditioned, and cleaned and mopped after every surgical procedure. Before any procedure, the doctor will don single-use disposable surgical gowns, gloves and a pair of goggles.
These are the equipment and surgical tools that you would find in the surgical room:
Operating table
The surgical room is equipped with an operating bed that is height-adjustable, hence giving the operator access from all sides and the ability to operate comfortably while sitting or standing
Doctor’s stool
This is a height-adjustable stool with wheels
Surgical lamp
Mounted from the ceiling, the surgical lamp illuminates bright light. It can be focused to facilitate precision in the surgical field
Showcase, containers and cupboard
Allows surgical equipment and consumables to be stored neatly
Autoclave
The autoclave machine in the room sterilises all surgical equipment after use. Subsequently, the surgical equipment is individually packed and sealed to maintain sterility.
Surgical instruments
As with most surgical procedures, the basic tools such as scalpel blade, needle holder, mosquito or artery forceps, Adson forceps with teeth and mayo scissors are used.
Electrocautery
This machine is able to coagulate and cut through different tissues with the help of a current, enabling the operating doctor to operate safely without worrying about needing to control bleeding.
Tissue adhesives or glue
These are known as cyanoacrylates which bind the superficial layer of the skin called the epidermis together, holding the two wound edges for 7 – 14 days. This process enables rapid healing time for the patient, is pain-free, and does not require suture removal. Additionally, it is safer than sutures as it avoids needle stick injuries.
Resuscitation equipment
This is an emergency kit that has vascular access – allowing the chemicals or devices to be inserted or removed from the bloodstream. It also consists of resuscitation drugs like atropine and adrenaline, normal saline drips with airway equipment and a nearby defibrillator.
While less common, minor surgical procedures can address a wide range of conditions that range from ingrown toenails to sebaceous cysts. If any of these conditions are experienced with worrying symptoms, consulting a doctor promptly will allow you to receive the appropriate treatment and prevent the condition from worsening.