General & Gastrointestinal Surgery

General surgery refers to the more common procedures that patients undergo. Some of these procedures can be performed with just local anesthesia and most with local plus light sedation. Most of these procedures are done as same day surgery and the patient goes home after a brief recovery period. General Surgery procedures can include:

• Hernias (a protrusion of the abdominal contents through a muscle layer into the fatty outer layer or into another body space).  There is a laparoscopic (through small incisions - minimally invasive) option for most hernia repairs – but your surgeon will advise which method is best for you personally.

  • Groin hernias (indirect, direct and femoral – these are different spaces through which the bowel can protrude)

  • Umbilical (If an umbilical hernia has not spontaneously closed by age 4 – it should be repaired.)

  • Epigastric (2-3 inches above the umbilicus)

  • Ventral/Incisional (occurs after the abdomen has been opened previously for surgery. There is a higher chance of later hernia development if there was a wound infection at the time of that surgery)

  • Rare hernias – Spigelian, lumbar, obturator, Richter's

• Removal of skin lesions (moles, infections)

• Drainage of abscesses

• Removal of fatty growths – lipomas

• Placement of ports for the administration of intravenous medicines such as chemotherapy for cancer treatment or nutrition when the patient cannot be fed through their gut.

• Breast biopsy

• Hemorrhoids

• Pilonidal cysts

Gastrointestinal surgery usually refers to procedures that almost always require a general anesthetic and are  conducted on organs that are within your abdominal cavity. Many of these procedures have a laparoscopic (through small incisions - minimally invasive) option as well. These may include:

• Cholecystectomy – gallbladder removal – usually can be done laparoscopically.  When the gallbladder is acutely inflamed the chance of the procedure being converted to an open (old fashion) cholecystectomy is about 50%.

• Appendectomy

• Repair of bowel obstruction (usually caused by scarring or adhesions from past surgery, less commonly by internal congenital bands or internal hernias). Sometimes the bowel has been so damaged by the process that a portion of it might have to be removed. Rarely an ostomy (bag on the abdominal wall into which the feces pass) has to be done with this type of problem when it involves the small intestine. However when the obstruction involves the large intestine (colon) in this emergency type of surgery, a colostomy may have to be performed.

• Stomach and duodenal surgery for ulcers or bleeding

• Liver biopsy

• Intestinal surgery for treatment of inflammatory bowel disease, ischemic bowel, diverticulitis and colitis

• Feeding tubes in the stomach or jejunum for people who cannot eat by mouth (stroke patients with aspiration of food into their wind pipe, coma, elderly, oropharyngeal and upper intestinal cancer patients who cannot nourish themselves during their surgery and treatment period)

• Hiatal hernia (the defect is in the diaphragm – the breathing muscle. The stomach and occasionally other organs go through this hole from the abdomen into the chest cavity)

  • Sliding hiatal hernia – this is the one associated with reflux and heartburn

  • Paraesophageal hernia – the defect in the diaphragm allows portions or the entire stomach to pass alongside the esophagus and migrate into the chest. Other organs such the colon, small bowel and the spleen can also herniate into the chest. This type of hernia causes obstruction and vomiting. This type of herniate can strangulate.