Digestive system surgery, or gastrointestinal surgery, can be divided into upper GI surgery and lower GI surgery.

Subtypes

Upper gastrointestinal

Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

that focuses on the upper parts of the

gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...

. There are many operations relevant to the upper gastrointestinal tract that are best done only by those who keep constant practise, owing to their complexity. Consequently, a

general surgeon In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...

may specialise in 'upper GI' by attempting to maintain currency in those skills. Upper GI surgeons would have an interest in, and may exclusively perform, the following operations: *

Pancreaticoduodenectomy A pancreaticoduodenectomy, also known as a Whipple procedure, is a major surgical operation most often performed to remove cancerous tumours from the head of the pancreas. It is also used for the treatment of pancreatic or duodenal trauma, or ch ...

Esophagectomy Esophagectomy or oesophagectomy is the surgical removal of all or parts of the esophagus. Medical uses The principal objective is to remove the esophagus, a part of the gastrointestinal tract. This procedure is usually done for patients with es ...

* Liver resection

Lower gastrointestinal

Lower gastrointestinal surgery includes

colorectal surgery Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices rela ...

as well as surgery of the

small intestine The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...

. Academically, it refers to a sub-specialisation of medical practise whereby a

focuses on the lower

. In the U.S., a student wanting to specialize and practice in adult lower GI surgery would generally have to go through four years of undergraduate college pre-medical education and get a bachelor's degree, then finish the four years of medical school, then finish a typically five-year-long residency in general surgery, and then perform a subsequent one-year-long (minimum) residency in surgery of the small intestine or large intestine (the colon- specifically, the

cecum The cecum ( caecum, ; plural ceca or caeca, ) is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix (a ...

, the

vermiform appendix The appendix (: appendices or appendixes; also vermiform appendix; cecal (or caecal, cæcal) appendix; vermix; or vermiform process) is a finger-like, blind-ended tube connected to the cecum, from which it develops in the embryo. The cecum ...

, the

ascending colon In the anatomy of humans and homologous primates, the ascending colon is the part of the colon located between the cecum and the transverse colon. Characteristics and structure The ascending colon is smaller in calibre than the cecum from wh ...

, the

transverse colon In human anatomy, the transverse colon is the longest and most movable part of the Large intestine#Structure, colon. Anatomical position It crosses the abdomen from the ascending colon at the right colic flexure (hepatic flexure) with a downward ...

, the

hepatic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. S ...

and the

splenic flexure In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. St ...

, the

descending colon In the anatomy of humans and homologous primates, the descending colon is the part of the colon extending from the left colic flexure to the level of the iliac crest (whereupon it transitions into the sigmoid colon). The function of the descen ...

, and the

sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...

; and also the

rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...

and the

anus In mammals, invertebrates and most fish, the anus (: anuses or ani; from Latin, 'ring' or 'circle') is the external body orifice at the ''exit'' end of the digestive tract (bowel), i.e. the opposite end from the mouth. Its function is to facil ...

). A fellowship (in surgery of the small intestine or of the large bowel, or in pediatric/neonatal lower GI surgery, or in surgery of congenital abnormalities or rare disorders of the lower GI tract, or in emergency/trauma surgery or in cancer surgery of the area), would add on approximately one to three more years. A lower GI surgeon might specialise in the following operations: *

Colectomy Colectomy (''wikt:colo-#Prefix, col-'' + ''wikt:-ectomy#Suffix, -ectomy'') is the surgical removal of any extent of the Large intestine#Structure, colon, the longest portion of the large bowel. Colectomy may be performed for prophylactic, curativ ...

* Low (anterior) (LAR) or ultra-low (anterior) resections (ULAR) for rectal cancer, etc. *

Pelvic exenteration Pelvic exenteration (or pelvic evisceration) is a radical surgical treatment that removes all organs from a person's pelvic cavity. It is used to treat certain advanced or recurrent cancers. The urinary bladder, urethra, rectum, and anus are rem ...

for advanced or recurrent cancer; usually performed in conjunction with other surgeons (e.g., urologists, obstetricians and gynecologists)

References

General surgery {{Surgery-stub