GENERAL SURGERY

At AGVS we treat many problems but the most common include gallbladder, hernias, breast disease, and several types of cancers including: breast, colon, stomach, and intestinal. Your primary care doctor may also refer you to us for other general problems that can be treated with surgery.

Gallbladder
Most common problems that cause pain in the gallbladder are from stones, but occasionally symptoms can arise because the gallbladder is not contracting normally. Gallstones create blockage in the gallbladder and prevent it from functioning normally.

Symptoms and Risk Factors: Severe pain and aching in the upper abdomen, dull aches beneath the ribs, back and right shoulder blade pain, nausea, upset stomach, heartburn, and vomiting are all symptoms of gallbladder problems. Anyone can develop these difficulties.

Diagnosis: A variety of test can be performed to determine if the gallbladder needs to be removed. An ultrasound, a CT scan, or a hepatobiliary scan (HIDA) can all be used.

Treatments: If it is determined that the gallbladder needs to be removed, there are a few options. Laparoscopic surgery is more common and less invasive than open surgery. In some cases, however, open surgery may be needed.

Laparoscopic Surgery: Small incisions are made in the abdomen and a small camera and light are used to guide the instruments into the body and remove the gallbladder. Patients usually go home the same day.

Open Surgery: A larger incision is made in the abdomen and the doctor is able to remove the gallbladder. This type of surgery has a hospital stay of 3-5 days, but in some cases is the only way to remove the gallbladder.

Hernias
A hernia is a weakness or defect in the wall of the abdomen. There are several types and each is treated slightly different. The most common are inguinal and incisional. Inguinal hernias are found in the groin and may need to be repaired. Incisional hernias are found the abdomen wall, the navel, or at prior incision sites and only need to be repaired if they are painful or become large.

Symptoms and Risk Factors: A bulge in the groin, abdomen, or thigh, pain when lifting, pain during physical activity, coughing, sneezing, feelings of weakness or pressure in the groin and discomfort when urinating are all signs of a possible hernia. Anyone can develop a hernia.

Diagnosis: A physical examination can diagnose a hernia.

Treatments: Either laparoscopic or open surgery is required to repair a hernia.

Inguinal: The contents of the hernia are pushed back into the abdomen and the defect in the abdomen wall, or weakness, is sewn closed. Sometimes a mesh is used to reinforce the repair. This type of surgery is done as an outpatient procedure and the patient may return home shortly after the surgery.

Incisional: The contents of the hernia are returned to the abdomen and the hole or weakness is sewn closed. If adjacent tissue is also weak, a synthetic mesh can be sewn in to reinforce the repair. Most of these procedures are outpatient, but in some cases a short hospital stay may be required.

Breast Disease
Many women develop lumps in their breasts that can be benign or cancerous. Often benign lumps are caused by fibrocystic changes, cysts, discharge, or microcalcifications. Some changes need no treatment at all, but if they do there are a variety of procedures that can determine if a breast lump is benign or cancerous.

If you feel a change in your breast, it is best to see a doctor and have a mammogram. An ultrasound of the breast may also be used to determine if a lump is solid or filled with fluid. If needed a biopsy of the lump is performed.

Non Surgical Biopsy: Fine needle aspiration, ultrasound guided, and stereotactic biopsies are all performed without anesthesia. A sample of the lump is removed and tested to determine if the lump is benign or cancerous.

Surgical Biopsy: A surgical biopsy allows a larger sample to be obtained. This may require wire localization. A small, thin wire is placed in the breast to mark the tissue that is to be removed. In the operating room the wire and the lump is removed and the mass is tested.

There are several treatment options if a biopsy has determined that the breast lump is cancerous.

Surgery: A lumpectomy or mastectomy may be used to remove the cancer, depending on the size of the lump and how far the cancer has spread. A lumpectomy only removes the lump while a mastectomy removes the entire breast.

Chemotherapy: This technique uses drugs to destroy the cancer cells.

Radiation Therapy: This type of therapy uses x-rays to help destroy remaining cancers cells after a lumpectomy.

Hormonal Therapy: Hormones are used to combat cancerous cells and are used after surgery for approximately five years. They can help prevent cancer from returning after surgery.

The American Cancer Society and the National Cancer Institute can offer more information and support for breast cancer.

Colon Cancer
Colon cancer and repeated or severe infections in the colon can require removal of all (colectomy) or part (hemi-colectomy) of the colon.

Treatments: The colon is removed during surgery and the intestine is sewn back together. The procedure generally requires a short hospital stay of about five days.

Thyroid and Parathyroid Disease
Patients may have difficulty with thyroid function. Lumps or calcium disorders may require surgery. Their conditions are carefully evaluated with our medical colleagues.