Practice No 4208293
Practice No 4208293
Practice No 4208293
Practice No 4208293
Meet Your Surgeons
General surgery covers a wide range of problems that affect skin, soft tissue, tummy organs and the thyroid. On one page you will find help for ingrown toenails, pilonidal sinus, perianal abscess, gallbladder pain, bowel fistulas, hernias and more. We also perform day-case scopes such as colonoscopy and gastroscopy to spot issues early and remove polyps before they cause trouble. For breast or thyroid lumps we use careful techniques that spare healthy tissue and give clear lab results fast. Every operation is planned around your safety, comfort and a quick return to normal life.
From abscess drainage and hernia repair to thyroid and bowel surgery, we outline each option in clear language so you know what to expect, why it helps and how quickly you can get back to everyday life.
What is the problem?
An abscess is a pool of liquid pus that forms deep inside the tummy (abdomen) due to infection. This condition can make a person feel ill and feverish, and if left untreated, it can worsen and cause serious problems. These abscesses commonly appear two or more weeks after the initial infection and often need to be left even longer to become “ripe” enough for safe drainage. Abscesses can form under the ribs, deep in the pelvis, or anywhere in between, and sometimes multiple abscesses may be present.
What does the operation consist of?
A cut is made in the skin of the tummy as close as possible to the abscess. The cut is then deepened until the abscess is reached, allowing the pus to drain out to the skin. A drainage tube is inserted into the abscess space to continue draining any further pus. This tube remains in place until X-ray tests confirm that the abscess space is getting smaller. The tube is then shortened gradually, inch by inch, over several days. Finally, the wound dries up and heals over
What is a bowel fistula?
A bowel fistula occurs when a diseased part of the bowel tube in the tummy (abdomen) leaks food waste along an abnormal path to the outside. If left untreated, the fistula is harmful and unpleasant. While most fistulas close on their own, surgery is required when they do not. The primary goal of the operation is to remove the diseased bowel and the fistula. The underlying cause of the fistula might sometimes be in a nearby organ, necessitating its removal alongside the bowel and fistula. Some fistulas are very complex and may require more than one operation.
What does the operation consist of?
An incision, approximately 10 inches (25 cm) long, is made in the tummy at the optimal location for the specific fistula, depending on its type and other factors. The diseased bowel, the fistula, and any other affected organs are removed. The remaining healthy ends of the bowel are then joined together, and the wound is closed. In some cases, an existing colostomy or ileostomy might be closed during the same operation, though it is usually deferred to a later date. Alternatively, it might be safer to create a colostomy or ileostomy when the fistula is removed to protect the newly joined bowel for a month or two; this is then closed later. Occasionally, if there is a significant infection around the diseased bowel, it may be safer to bypass the bowel for a period of one or two months before tackling the fistula area. This involves bringing the upstream bowel out onto the front of the tummy to create a colostomy or ileostomy, requiring the patient to wear a bag to collect waste, which would later be closed.
What is an inguinal hernia?
A hernia is a weakness in the muscles which form the lower front of the stomach in the groin region and results in a bulge.
What does the operation consist of?
This method of hernia repair uses a small telescope under the muscles of the abdomen to examine the weak area. Two other instruments are inserted through the skin and abdomen to dissect away the tissues and display the weakened hernial site. A patch of teflon material is then used to reinforce the weakened area. Using this method a large cut through the muscles of the groin is avoided and the postoperative pain is less and the recovery time quicker. The results appear to be as good as the open repair technique and gradually this operation is being done more and more. However about 5% of hernias will recur after open or laparoscopic repairs. About 2% of laparoscopic hernia repairs have to be converted to open operations because of technical difficulties
What is a Hernia?
A hernia is a bulge or weakness in the muscles which form the lower front of the stomach in the groin region.
What does the operation consist of?
A cut is made into the skin overlying the hernia. The bulge is pushed back and the sac is cut off. The weak part is mended and strengthened, usually with nylon stitches or a mesh patch which is used to strengthen the defect. The cut in the skin is then closed up.
What is a Lumpectomy and axillary clearance?
This operation is performed to remove cancer of the breast. It involves the removal of a lump in the breast, along with the surrounding normal breast tissue, and the lymph nodes (glands) in the axilla (armpit). No muscles are removed during this procedure. The removal of the glands allows for careful staging of the cancer, which helps in deciding whether further treatment after the operation is necessary.
What does the operation consist of?
The entire lump and the lymph nodes in the armpit are removed. The expected outcome is smooth skin across half the chest with a barely visible scar. After the operation, patients will have a drip tube in an arm vein and two fine plastic drainage tubes near the wound, connected to plastic vacuum containers to collect drainage. The drainage tubes are typically removed after 4 to 5 days, or longer if drainage continues.
What is the problem?
You have a lump or a mark or a blemish which is causing trouble or worry. There are three good reasons for having the piece taken out. First you will be freed from the symptoms. Second, it will no longer be there to worry you. Third, we can examine the piece under a microscope to find out exactly what it is.
What does the operation consist of?
The problematic piece of tissue is cut out using an incision designed to leave the best possible scar, often by following natural skin lines and creases. The wound is usually closed with stitches. This operation can be performed under either a local or general anaesthetic. If a local anaesthetic is used, the patient will feel a sting from the injection, but no pain during the operation, though some pulling sensation may be felt.
What is the Oesophagus or Gullet?
The oesophagus, or gullet, is a tube about 10 inches (25 cm) long that carries food and drink to the stomach. Sometimes, this tube narrows, making swallowing difficult or painful. Oesophageal dilatation is a procedure to stretch the narrow part of the oesophagus to restore proper swallowing.
What does the operation consist of?
After the throat is numbed with a local anaesthetic and the patient is given sedatives for comfort, a flexible telescope (gastroscope) is passed down the back of the throat to the narrowed area in the oesophagus. A small piece of the narrowed part is typically taken for laboratory examination. Special instruments are then pushed through to stretch the constricted area until a proper channel is achieved. Afterwards, the oesophagus lining is checked to ensure there has been no serious damage. The procedure also involves monitoring breathing with a probe attached to a finger and the patient lying on their left side with a plastic tooth guard. The patient may feel a tickling sensation and hear fizzing noises as the gastroscope is inserted
What is an Oesophago-gastrectomy?
An oesophago-gastrectomy is a major operation performed when a narrowing, growth, or other problem affects the junction between the oesophagus (gullet) and the stomach. This condition necessitates the removal of the lower part of the oesophagus and either a portion or the entirety of the stomach.
What does the operation consist of?
The main part of the operation is carried out through an incision in the upper abdomen, although the chest may also need to be opened in some cases. The surgeon will explain the specific incision plans. The diseased section of the oesophagus and stomach is removed, and the remaining healthy ends are joined together, typically by bringing the stomach into the chest cavity. The wound is then closed. Patients usually have a fine rubber tube (catheter) inserted into the bladder to keep it empty and small during the operation and to help control body fluids afterwards. After the operation, patients are usually taken to the Intensive Care Unit, may be connected to an anaesthetic ventilator if they have chest problems, and will have various tubes for draining the stomach, collecting urine, and monitoring heart action and blood pressure. The wound pain is often controlled by an epidural injection, in addition to injections and tablets. Drinking and eating are delayed for about 5-6 days to allow the oesophageal join to heal, with an X-ray taken to confirm healing before fluids are started.
What is an appendicectomy?
An appendicectomy is an operation to remove the appendix, which is a finger-sized outpouching of the bowel located in the lower right side of the tummy. The appendix has no practical use in humans but can become swollen and painful. If left untreated, a diseased appendix can burst, leading to serious infection and illness inside the abdomen. Sometimes, the appendix is removed even if healthy, especially when diagnosis is uncertain, to avoid the risk of leaving a diseased appendix.
What does the operation consist of?
A cut is made in the skin and muscle over the appendix. The appendix is then cut off, the hole in the bowel is closed, and the wound is stitched up. If there is uncertainty about the diagnosis, the surgeon may first examine the appendix using a small telescope placed into the abdomen, a procedure known as a ‘laparoscopy,’ which is more common in females to rule out ovarian problems that can mimic appendicitis. After the operation, the wound is covered with a dressing that may show blood staining in the first 24 hours. Stitches are either removed after 8-10 days or are absorbable sutures under the skin. A plastic drain may be used to remove excessive secretions from the wound or abdominal cavity for a few days.
What is a Perianal Abscess?
A perianal abscess is an infection in the wall of the lowest part of the back passage, where pus accumulates under the skin, causing swelling and pain. There may sometimes be a connection between the abscess and the back passage itself.
What does the operation consist of?
The pus is released through a cut made in the skin. The wound is then plugged with an antiseptic material. Antibiotics may also be administered to aid in the healing process. After the operation, the wound has a dressing held on by elastic netting pants, which may show some staining in the first 12 hours. This dressing is replaced with a lighter one after cleansing with an antiseptic solution the day after the operation. Patients are usually able to go home the same day or the day after for small abscesses; larger ones may require a longer hospital stay.
What is Pilonidal Sinus?
A pilonidal sinus is a condition characterised by small hairs collecting under the skin between the buttocks. This operation is performed to treat this condition.
What does the operation consist of?
The affected skin and involved tissue are removed. The resulting defect is then closed with stitches. However, if there is an associated infection or an abscess, it may be unsafe to close the wound; in such cases, it is left open and allowed to heal over a period of 4 to 10 weeks, depending on the wound’s size. Wounds left open may require daily dressings initially. For stitched wounds, a dressing is applied, and stitches are removed after 8-10 days. If the wound is not stitched, dressings are soaked off daily in a warm bath, and a new dressing is applied. A plastic drain may be used for a few days if excessive secretions are present.
What is a thyroid?
The thyroid is an H-shaped gland that lies just in front of the windpipe in the neck. It is about 8 cms across. It makes a hormone using iodine, which passes into the blood stream and keeps the body active. Sometimes the gland produces too much hormone making the body overactive. Sometimes the gland swells, pressing on the windpipe and other parts of the neck. Sometime a lump grows in the thyroid, which needs to be removed.
What does the operation consist of?
A cut is made across the front of the neck, typically in a skin crease. A portion of the thyroid gland is removed, and then the skin incision is closed. After the operation, a drip tube is placed in an arm vein, and a fine plastic tube connected to a suction container comes out near the skin wound to drain secretions. A dressing is applied to the wound. The thin plastic drain tube is usually removed after 24 hours when it stops draining. Stitches (self-dissolving) or staples are used to close the skin and are removed about 3 days after the operation.
What is the problem?
Your toenail, as it grows from the quick, can cause trouble in two main ways. First, it can make the skin fold at the side very swollen and red (ingrowing toenail). Second, it can become very thick, curved and painful. Both these conditions can be treated by an operation.
What does the operation consist of?
The toe is numbed with an injection of local anaesthetic at its base; occasionally, a general anaesthetic may be used. For an ingrowing toenail, a sliver of the nail and its “quick” (the part that produces the nail) is cut out from each tender and swollen side, which narrows the nail and allows the skin fold to settle. For a thick, curved nail, the entire nail and all of its “quick” are removed, so that only skin remains where the nail used to be. The toe is cleaned with antiseptic, sterile towels are draped, and a tight band is clipped around the toe to prevent bleeding during the 10-minute operation per toe. The toe is then covered with a dressing and a bandage, and the tight band is removed. There are usually no stitches in the skin, as the wound is held together underneath.
What is an Umbilical Hernia?
This is a weakness or swelling of the navel (belly button). It will get bigger and become unsightly. Sometimes fat or bowel gets stuck in the hernia causing severe pain and illness.
What does the operation consist of?
An incision is made around the navel. Any fat or bowel that has protruded into the hernia is either pushed back into place or removed. The weakened area is then repaired with strong stitches, and the skin incision is closed. A dressing, often waterproof for showering, covers the wound until the stitches are removed after 7-10 days. Sometimes, a plastic suction drain is used for a day or two to remove excessive secretions from the wound.
What is an Umbilical Hernia?
An umbilical hernia in a child is a weakness in the navel that typically closes naturally at birth or within the first two years of life. If this weakness persists, it causes a swelling that will not resolve on its own and may enlarge or cause pain.
What does the operation consist of?
A cut is made into the skin of the navel. The swelling located under the skin is then tied off. Finally, the cut in the skin is closed, aiming for a normal appearance of the navel. The wound is closed with absorbable stitches and covered with a waterproof dressing, allowing the child to bathe. Minor crusts may fall off after 7-10 days, and occasional matchhead-sized blebs may form, discharging yellow fluid before settling down.
Splenectomy means an operation to remove your spleen.
A spleen is about the size and shape of a person’s fist. It is tucked under the ribs on the left. It filters the blood of impurities and helps the body fight infections.
A cut is made in the skin between your breastbone and your navel (belly button). The spleen is
taken out. The cut in the skin is then closed up.
Dr. Mark grew up in Durban and matriculated in the top 30 in Natal. He completed his medical undergraduate training at UCT in 1998, where he was the elected class rep. for five years. He won the Family Medicine class medal, and Frank Foreman prize for the greatest contribution to student affairs. Internship at Edendale Hospital in Pietermaritzburg was followed by a year at various secondary hospitals in Cape Town for his community service, and then a year getting some GP experience in Manitoba, Canada. In 2002 Mark returned to Cape Town to specialise in general surgery at UCT. He completed this training in 2006, being awarded the ASSA prize for surgical research, and the Swann-Morton prize for the best surgical registrar.
Super-specialist training in HPB (Hepato-Pancreatico-Biliary) surgery started with the 2-year Certificate in Surgical Gastroenterology at Groote Schuur Hospital, with the CMSA exams completed at the end of 2008. In 2009 Mark further expanded his HPB experience and training with a Fellowship in HPB surgery at the HPB/Transplant unit in Newcastle-upon-Tyne, UK.
Super-specialist training in HPB (Hepato-Pancreatico-Biliary) surgery started with the 2-year Certificate in Surgical Gastroenterology at Groote Schuur Hospital, with the CMSA exams completed at the end of 2008. In 2009 Mark further expanded his HPB experience and training with a Fellowship in HPB surgery at the HPB/Transplant unit in Newcastle-upon-Tyne, UK.
Mark joined the Matley and Partners team in 2010. His primary interest is in HPB surgery, and he is accomplished in all aspects of this discipline, ranging from the management of gallstone disease, to complex liver and pancreatic resections. He is a keen endoscopist, including gastroscopy, colonoscopy and ERCP. Mark was the first surgeon in South Africa to perform the ALPPS liver resection procedure. In addition to the HPB surgery, Mark enjoys all aspects of general and laparoscopic surgery, including laparoscopic hernia repairs. He is a believer in team work, and tries to blend the best of modern techniques and technology with some old-fashioned “good bed-side manner”, in addition to careful decision-making and surgical technical expertise.
Mark is married to Tanya and they have two children. Mark’s hobbies include golf, fly-fishing, and scuba diving. Despite more than 25 years in the Cape, he remains a Sharks fan.
Ebrahim joined the Matley Partnership as a specialist colorectal surgeon with international training in laparoscopy from both Amsterdam and Nottingham. He is a Capetonian who matriculated from Livingstone High School, and completed his MBChB at UCT in 2002.
He completed his internship in Durban, where he met his wife Khatija, and completed his community service in Khayelitsha, including an additional year there with Medicin Sans Frontier, rolling out their antiretroviral program.
After two years of surgery in the UK, he completed his specialist training in Cape Town, obtaining his FCS in 2013. During this time he was awarded the MMed degree from UCT for his dissertation “Systems delays in Breast Cancer”. He gained a broad experience in general surgery before two years of sub-speciality training in the colorectal unit at Groote Schuur. In 2016 he was awarded the Specialist Certificate in Surgical Gastroenterology.
In 2017, he was awarded the SASES travelling fellowship to work with internationally renowned colorectal and laparoscopic surgeon, Professor Willem Bemelman, at the Amsterdam Medical Centre. Thereafter he completed his year abroad as a colorectal fellow, in Nottingham, UK. This is a busy unit with 10 colorectal surgeons providing the full range of colorectal specialist services. During this time he gained invaluable experience in advanced laparoscopy for inflammatory bowel disease and cancer surgery, which are his specific interests, and he is currently accruing UK robotic credentialing. Ebrahim is one of a handful of accredited specialist colorectal surgeons in the Western Cape, adding this expertise to the GIT team at Matley and Partners.
He is married to Khatija, a full time Obstetrician & Gynaecologist consultant at Groote Schuur Hospital, and they have two children. He is a golfer, family man and enjoys travelling at home and abroad.
Dr. Henri Pickard is a specialist Vascular Surgeon who proudly continues a rich family tradition of surgical practice, following in the footsteps of both his grandfather and father. He studied Medicine at the University of Cape Town (UCT), beginning a journey deeply rooted in heritage and excellence.
After completing his internship in Pietermaritzburg and community service in East London, Henri developed a strong interest in surgery. In 2012, he returned to Cape Town to work at the Trauma Centre at Groote Schuur Hospital, followed by a period at Victoria Hospital where he gained a wide range of surgical experience.
In 2014, Henri began his MMed degree and specialist training in General Surgery at Groote Schuur Hospital through UCT. In 2020, driven by a passion for the precision and complexity of the field, he pursued sub-specialist training in Vascular Surgery.
Henri is known for his collaborative work in multidisciplinary teams, his commitment to achieving the best outcomes for his patients, and his compassionate, patient-centred approach.
He grew up in Pietermaritzburg, George, and Cape Town, and matriculated from Rondebosch Boys’ High School. A proud South African, Henri is an enthusiastic Two Oceans runner, avid cricket follower, passionate Springbok supporter, and a devoted follower of Jesus. He is also a committed family man, deeply devoted to his wife Tricia and their three young children.
Neil grew up in Worcester and matriculated from Esselen Park High School in 1985. He completed his medical training at the University of Cape Town in 1991 and did his internship at Livingstone Hospital in Port Elizabeth. Following internship Neil worked at Red Cross Children’s Hospital as a medical officer in paediatrics before joining Mitchells Plain community health centre, where he gained extensive experience in general medical practice. His surgical experience started in 1996 at Worcester Regional Hospital where he worked as a medical officer in General Surgery for 3 years, prior to starting his specialist surgical training at Groote Schuur hospital in 1999.
On completion of his training in general surgery he was appointed as a consultant general surgeon at New Somerset hospital in 2005, where he was responsible for all clinical services until 2007 when he started his sub-specialist training in vascular surgery at St James’s hospital, the academic hospital of Trinity College Dublin in the Republic of Ireland. During his 3 year training period in vascular surgery, Neil received expert training in all aspects of open, endovascular and venous surgery at this prestigious high case volume unit. Neil returned to Cape Town in 2010 and was appointed as a consultant vascular surgeon at Groote Schuur hospital. In 2014 he was appointed as head of the vascular unit at University of South Africa (Medunsa) in Pretoria.
During the past 7 years, he was responsible for undergraduate, postgraduate and fellowship vascular teaching and training at the university as well as doing private practice at Netcare Unitas hospital in Centurion. Neil has served on the EXCO of the Vascular Society of South Africa since 2014.
Neil is an accomplished and experienced vascular surgeon, with special interests in endovascular surgery, dialysis access and venous surgery. He believes that good clinical practice is built on the foundation of empathetic bedside manner and teamwork.
Neil is married to Tracy, and they have 3 children. Neil enjoys an active outdoor lifestyle with hobbies including running, cycling, and golf. He also has a keen interest in history and philosophy.
Philip Matley has been a vascular surgeon in the practice that now bears his name since 1990. He is past-President of the Vascular Surgery Society of South Africa and a past moderator and chief examiner for the vascular surgery specialist examinations in South Africa. He has served on various national and international regulatory bodies and educational foundations.
During his training in Cape Town, he was the recipient of numerous awards including the Douglas Medal for the best candidate in the examination for the Fellowship of the College of Surgeons of South Africa as well as the Phyllis Knocker-Bradlow Award.
He has a special interest in the minimally invasive treatment of varicose veins, improving the circulation in the legs and brain through stents or surgery and the treatment of aneurysms.
In addition to his surgical practice, he is the chairman of Surgicom, the management body for private surgery practice in South Africa and serves on the board of South African Private Practitioners Forum (SAPPF).
Philip Matley grew up in KZN and is a keen golfer, mountain biker, walker and traveller
