General Surgery

No one ever really feels prepared to face surgery. But at PSG, we want to do what we can to reduce your anxiety. Learn more about our surgeons, staff, experience and procedures right here on our website. Then get to know us in person, as we care for you from start to finish.

Appendectomy

Definition/Overview

An appendectomy is the surgical removal of the appendix. The procedure is normally performed in an emergency situation, when a patient is suffering from acute appendicitis. Appendicitis is an inflammation of the appendix. If left untreated, an inflamed appendix could eventually burst, or perforate, leaking infectious material into the abdominal cavity, eventually causing sepsis.

Procedure

Once the diagnosis of appendicitis has been made (usually based upon a physical exam, blood and urine tests, and possibly an X-ray, ultrasound or CT scan), antibiotics are administered prior to surgery. Appendectomies can be performed using an open method, or laparoscopically.

In an open appendectomy, a two to three inch incision is made through the layers of the abdominal wall near the appendix. After examining the surrounding area, the appendix is removed by cutting it from the colon and sewing over the hole. The incision is then closed. This procedure is performed while the patient is under general anesthesia, and the hospital stay is usually one or two days. If the appendix has been perforated, the surgeon may insert a drain to release fluid from the abscess before removing the appendix. In this case, antibiotics must be administered after the surgery and the patient may remain in the hospital for a longer period of time.

The laparoscopic technique involves making a series of small incisions in the abdomen. One incision is for insertion of a laparoscope, a thin telescopic instrument attached to a video camera that allows the surgeon to inspect the abdomen and appendix. Special instruments are inserted in the other incisions, and the appendix can be removed through one of the small incisions. This approach generally results in less post-operative pain for the patient and a quicker recovery time. Laparoscopic surgery also enables the surgeon to make a clear diagnosis in case appendicitis is in doubt.

General surgery, despite its name, is a surgical subspecialty that primarily focuses on abdominal organs and the intestines including esophagus, stomach, colon, liver, gallbladder and bile ducts, and often the thyroid gland (depending on the availability of head and neck surgery specialists). This encompasses a wide range of procedures including appendectomies and hernia repair to lung volume reduction surgery and thyroidectomy.

This website includes a basic explanation of many commonly-performed general surgeries. These procedure overviews describe the typical situation; however, every patient and each surgery is unique. Your physician or nurse can provide additional details on your individual circumstances

Gallbladder Removal (Cholecystectomy)

Definition/Overview

A cholecystectomy is the surgical removal of the gallbladder. Although it is occasionally performed for gallbladder cancer (which is very rare), it is most often used to treat symptomatic gallstones.

Procedure

In an open cholecystectomy, the patient is given general anesthesia and the gallbladder is removed through a 4 to 7 inch incision. Patients usually remain in the hospital overnight and recovery may take several weeks at home.

A laparoscopic cholecystectomy involves making several smaller incisions in the abdomen and inserting a laparoscope — a thin, lighted instrument with a camera on the end — into the abdominal cavity. The surgeon is able to view images on a video monitor, and performs the operation by manipulating the surgical instruments through the other incisions. The gallbladder is removed through one of the incisions.

This procedure is also done under general anesthesia. However, it generally involves less pain, quicker healing time and fewer complications. Most patients are discharged the same day, and can return to a normal routine in about a week. Your surgeon will determine if you are best suited for the open or laparoscopic technique.

Hernia Surgery

Hernia repair refers to a surgical operation for the correction of a hernia (a bulging of internal organs or tissues through a defect in the wall of a body cavity). Hernias can occur in many places, including the abdomen, groin, diaphragm, brain, and at the site of a previous operation. There are many different approaches to the surgical repair of hernias.

da Vinci® Surgery System

Thanks to a breakthrough surgical technology, there is a new category of minimally invasive surgery for which you may be a candidate. It is an effective, minimally invasive alternative to both open surgery and laparoscopy. Through the use of the da Vinci® Surgical System, surgeons are now able to offer a minimally invasive option for complex surgical procedures. Find out
more at: http://www.davincisurgery.com

Liver Resection

Definition/Overview

A liver resection is the surgical removal of a portion of the liver, and is usually performed in order to extract various types of liver tumors. The liver is the only organ with the ability to regenerate itself. Up to 75% of the liver can be removed as long as the remaining tissue is healthy.

Procedure

A liver resection is performed under general anesthesia. An incision is made in your abdomen below the rib cage. The surgeon will cut the section of the liver to be removed from the supporting veins, arteries and bile ducts. The incision is then closed using staples or stitches.

The hospital recovery time for a liver resection can be up to a week or more. You will experience some discomfort during recovery, and your physician will prescribe pain medication during your recovery.

Pancreatic Surgery

Definition/Overview

A pancreatectomy is the surgical removal of the pancreas. It is the most effective treatment for cancer of the pancreas, and can also be performed due to injury or trauma to the pancreas, or chronic pancreatitis (continued inflammation of the pancreas that can result in permanent damage to the organ).

Procedure

The surgical procedure you are having will determine the length of your hospital stay as well as your recovery period. All of the following procedures require general anesthesia.

Central Pancreatectomy

This procedure is performed if there is a benign tumor in the neck of the pancreas. Since this is a difficult area of the pancreas to reach, the goal is to remove any tumors in the area while preserving as much of the pancreas as possible, as well as avoiding complications such as diabetes and malabsorption of nutrients.

Distal Pancreatectomy

This procedure is performed if there is a tumor present in the body or tail of the pancreas. The bottom half of the pancreas is removed and the cut edge is sutured to prevent leakage of pancreatic juice.

In some cases, distal pancreatectomy is performed in conjunction with a splenectomy. The spleen is removed with the pancreas since the blood supply to the spleen is associated directly with that of the pancreas.

Subtotal and Total Pancreatectomy

Pancreatectomy is a procedure to remove part or the entire pancreas. A partial removal is called a subtotal pancreatectomy; a removal of the entire organ is called a total pancreatectomy.

Pancreatic Resections

Definition/Overview

A pancreatic resection is performed on patients who have pancreatic cancer in which the tumor is localized and only if they meet a certain criteria, such as the stage and classification of the cancer.

Procedure

The surgical procedure you are having will determine the length of your hospital stay as well as your recovery period. All of the following procedures require general anesthesia.

Pancreatectomy

Central Pancreatectomy

This procedure is performed if there is a benign tumor in the neck of the pancreas. Since this is a difficult area of the pancreas to reach, the goal is to remove any tumors in the area while preserving as much of the pancreas as possible, as well as avoiding complications such as diabetes and malabsorption of nutrients.

Distal Pancreatectomy

This procedure is performed if there is a tumor present in the body or tail of the pancreas. The bottom half of the pancreas is removed and the cut edge is sutured to prevent leakage of pancreatic juice.

In some cases, distal pancreatectomy is performed in conjunction with a splenectomy. The spleen is removed with the pancreas since the blood supply to the spleen is associated directly with that of the pancreas.

Whipple Procedure

Also known as a pancreatoduodenectomy, this procedure involves removing the head of the pancreas, most of the duodenum (part of the small intestine); a portion of the bile duct and in some cases a portion of the stomach.

Cysts

Cyst Gastrostomy

This procedure involves the internal drainage of the non-cancerous growth’s contents into the stomach.

Cyst Entrostomy

This procedure involves the internal drainage of the non-cancerous growth’s contents into the intestines.

Panendoscopy

Definition/Overview

A panendoscopy is a procedure that a physician uses to examine the lining of the esophagus, stomach and duodenum (the first part of the small intestine). A panendoscope is a long, flexible tube that is passed through the mouth and back of the throat into the upper digestive tract. This procedure is commonly performed since many problems of the upper digestive tract can’t be diagnosed with an X-ray.

Procedure

You will be given medication to make you relaxed and sleepy, and the back of your throat may be sprayed with a local anesthetic. The panendoscope will be inserted through your mouth and each part of the esophagus, stomach and duodenum.

This procedure is performed on an outpatient basis. Your throat may be sore for a few hours, and you may feel fullness in your abdomen because of the air that was introduced to examine your stomach.

Splenectomy

Definition/Overview

The spleen is an organ located in the upper left part of the abdomen near the stomach, and is the largest lymphatic organ in the body. The spleen filters and serves as a reservoir for blood and destroys aged blood cells.

Procedure

Splenectomies can be performed using an open method, or laparoscopically. Splenectomies can also be complete or partial.

A complete splenectomy is the removal of an enlarged or ruptured spleen. This procedure is performed under general anesthesia. If the spleen is enlarged or ruptured, the surgeon makes a cut in the abdomen and ties the splenic artery off to prevent blood loss and reduce the spleen’s size. He then detaches the ligaments holding the spleen and removes, and sends tissue samples for analysis.

In a partial splenectomy, the surgeon removes only a portion of the spleen. In some cases, this can reduce the pain of an enlarged spleen and reduce the incidence of infection.

Laparoscopic splenectomy is the removal of the spleen using several small incisions. The surgeon inserts a thin, lighted scope with a camera on the end into one of the incisions, and the surgical instruments in another. Laparoscopic splenectomy reduces pain, scarring and length of hospital stay. Your physician can evaluate your particular case and determine if you are a candidate for laparoscopic surgery.

Hospitalization time for a splenectomy is about a week if the procedure is done through an abdominal incision. If it is done laparoscopically, hospital time may be reduced.

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