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General & Specialist Surgery

Other
Abdominal
Diseases

Beyond his core specialties, Dr Cha manages a broad range of abdominal conditions — from common gallbladder and reflux disease to complex adrenal, splenic, and soft tissue tumour surgery.

5
Surgical
Specialties
Jump to
01

Gallbladder Surgery

Gallbladder disease is one of the most common surgical conditions in Malaysia. Dr Cha performs laparoscopic cholecystectomy — keyhole removal of the gallbladder — as a day surgery or overnight procedure with excellent outcomes.

The gallbladder is a small organ beneath the liver that stores bile — a digestive fluid made by the liver. Problems arise when gallstones form inside the gallbladder, causing pain, inflammation, or blockage of the bile ducts.

Laparoscopic cholecystectomy (keyhole removal of the gallbladder) is the definitive treatment for symptomatic gallstones and gallbladder disease. Performed through 3–4 tiny incisions under general anaesthesia, most patients go home the same day or the following morning and return to normal activity within a week.

Conditions Treated

  • Gallstones (cholelithiasis) — symptomatic or complicated
  • Acute and chronic cholecystitis (gallbladder inflammation)
  • Gallstone pancreatitis
  • Common bile duct stones (choledocholithiasis)
  • Gallbladder polyps requiring removal
  • Acalculous cholecystitis
Laparoscopic Cholecystectomy ERCP for bile duct stones Day Surgery
Gallbladder Surgery
Procedure Time
45–90 minutes
Hospital Stay
Day surgery or 1 night
Return to Work
5–7 days
Approach
Laparoscopic (keyhole)
⚠️ When to Seek Urgent Care

Seek immediate attention if you experience severe upper right abdominal pain, fever, yellowing of the skin or eyes (jaundice), or dark urine — these may indicate acute cholecystitis or bile duct obstruction.

02

Antireflux Surgery

For patients with severe gastro-oesophageal reflux disease (GERD) that does not respond adequately to medication, antireflux surgery offers a durable and effective long-term solution.

Gastro-oesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the oesophagus, causing heartburn, regurgitation, chest pain, and over time, damage to the oesophageal lining. While most cases are managed with proton pump inhibitors (PPIs), some patients experience persistent symptoms, medication side effects, or wish to avoid lifelong tablet dependency.

Laparoscopic Nissen fundoplication — the gold standard antireflux operation — wraps the upper part of the stomach around the lower oesophagus to reinforce the natural valve mechanism and prevent acid reflux. When performed laparoscopically, recovery is fast and the long-term results are excellent, with most patients achieving complete or near-complete relief from reflux symptoms.

Indications for Surgery

  • Persistent GERD symptoms despite optimal medical therapy
  • Patient preference to stop long-term medication
  • Large or symptomatic hiatal hernia
  • Barrett's oesophagus requiring reflux control
  • Medication intolerance or side effects
  • Volume regurgitation not controlled by PPIs
Laparoscopic Nissen Fundoplication Hiatal Hernia Repair Partial Fundoplication
Antireflux Surgery
Procedure Time
60–90 minutes
Hospital Stay
1–2 nights
Return to Work
1–2 weeks
Approach
Laparoscopic
Surgery vs Lifelong Medication

Studies show that laparoscopic antireflux surgery provides durable symptom control in over 90% of patients at 10 years — often superior to long-term PPI therapy for the right patient.

03

Adrenal Surgery

The adrenal glands sit above the kidneys and produce hormones critical to life. Surgery on the adrenal gland — adrenalectomy — is a technically demanding operation that Dr Cha performs laparoscopically through keyhole incisions.

Adrenal surgery is indicated for a range of conditions, from hormonally active tumours that cause hypertension or metabolic disturbance, to adrenal incidentalomas with features suspicious for malignancy, to metastatic deposits in the adrenal gland.

Laparoscopic adrenalectomy is the preferred approach for most adrenal tumours, offering the same oncological result as open surgery through small keyhole incisions. Dr Cha performs both transperitoneal and retroperitoneal laparoscopic adrenalectomy depending on the tumour characteristics and patient anatomy.

Conditions Requiring Adrenal Surgery

  • Phaeochromocytoma — adrenaline-secreting tumour causing hypertension
  • Conn's syndrome (primary hyperaldosteronism) — adrenal adenoma causing high blood pressure
  • Cushing's syndrome — cortisol-producing adrenal adenoma
  • Adrenal incidentaloma — enlarging or suspicious lesion found incidentally
  • Adrenocortical carcinoma — primary adrenal malignancy
  • Adrenal metastasis from other primary cancers
Laparoscopic Adrenalectomy Transperitoneal Approach Retroperitoneal Approach
Adrenal Surgery
Procedure Time
90–150 minutes
Hospital Stay
2–3 nights
Return to Work
2–3 weeks
Approach
Laparoscopic
🩺 Important Pre-op Workup

All adrenal tumours require thorough hormonal assessment before surgery. Phaeochromocytomas in particular require careful medical preparation with alpha-blockade to prevent dangerous blood pressure swings during the operation.

  • Endocrine workup required
  • Cross-sectional imaging (CT / MRI)
  • Multidisciplinary planning
04

Splenic Surgery

The spleen plays an important role in immunity and blood filtration. When disease, injury, or haematological conditions require its removal, Dr Cha performs laparoscopic splenectomy — minimising recovery time and surgical risk.

Splenectomy — removal of the spleen — may be required for a range of conditions including blood disorders, splenic tumours, trauma, or as part of a larger cancer operation. Laparoscopic splenectomy is well established as the preferred approach for most elective cases, offering significantly less post-operative pain and a shorter hospital stay compared to open surgery.

Dr Cha performs laparoscopic splenectomy for both benign and malignant splenic conditions. For very large spleens (massive splenomegaly), a hand-assisted or open approach may be necessary to ensure safe removal. All patients undergoing splenectomy receive appropriate vaccinations before or after surgery to protect against infection.

Indications for Splenectomy

  • Immune thrombocytopaenic purpura (ITP) refractory to medical treatment
  • Hereditary spherocytosis and haemolytic anaemia
  • Splenic cysts, abscesses, or pseudocysts
  • Primary splenic tumours or lymphoma
  • Splenic artery aneurysm
  • Trauma with splenic injury not amenable to conservative management
Laparoscopic Splenectomy Hand-assisted Splenectomy Pre-op Vaccination
Splenic Surgery
Procedure Time
60–120 minutes
Hospital Stay
2–3 nights
Return to Work
2–3 weeks
Approach
Laparoscopic / Open
Post-splenectomy Care

After splenectomy, patients are at increased risk of overwhelming bacterial infections. Vaccination against pneumococcus, meningococcus, and Haemophilus influenzae is essential, along with long-term awareness of infection risk.

05

Rare & Complex

Intra-abdominal
Sarcoma

Intra-abdominal sarcomas are rare and complex soft tissue tumours arising within the abdominal cavity. Their management demands specialist surgical expertise, careful oncological planning, and a multidisciplinary team approach.

Soft tissue sarcomas of the abdomen and retroperitoneum are uncommon malignancies that arise from connective tissue — fat, muscle, fibrous tissue, or blood vessels — within or behind the abdominal cavity. The most common types include retroperitoneal liposarcoma, leiomyosarcoma, and gastrointestinal stromal tumours (GIST).

These tumours often grow to a large size before causing symptoms, making early detection difficult. When symptomatic, patients may notice a palpable abdominal mass, vague abdominal discomfort, early satiety, or symptoms related to compression of adjacent organs.

Surgery is the cornerstone of treatment for localised intra-abdominal sarcoma. The goal is complete resection with clear margins (R0 resection) — the single most important factor in determining long-term outcome. This often requires en-bloc removal of adjacent organs to achieve adequate clearance, which demands careful pre-operative planning and experienced surgical judgment.

Surgical Principles

  • Complete resection with clear margins (R0) is the primary goal
  • En-bloc resection of involved adjacent structures when necessary
  • Pre-operative imaging to plan resection extent
  • Multidisciplinary team discussion before every case
  • Pathological confirmation of diagnosis guides further treatment
🔬 Retroperitoneal Liposarcoma

The most common retroperitoneal sarcoma, arising from fat cells behind the abdominal cavity. Often very large at presentation. Requires wide surgical resection, frequently involving adjacent kidney, colon, or other organs to achieve clear margins.

💪 Leiomyosarcoma

Arises from smooth muscle tissue, commonly from the inferior vena cava or retroperitoneal soft tissues. Complex vascular involvement may require specialised reconstruction. Multidisciplinary surgical planning is essential.

🎯 Gastrointestinal Stromal Tumour (GIST)

While covered under Gastric Cancer Surgery for stomach GISTs, these tumours can arise anywhere in the GI tract or abdominal cavity. Laparoscopic or open resection depending on size and location, with targeted therapy (imatinib) for high-risk cases.

👥 Multidisciplinary Approach

All intra-abdominal sarcoma cases are discussed in a multidisciplinary tumour board before surgery. Dr Cha works closely with medical oncologists, radiation oncologists, and radiologists to optimise treatment planning and post-operative care.

Not sure which condition
applies to you?

Book a consultation with Dr Cha — he will assess your condition and recommend the most appropriate treatment plan.

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