INDICATIONS: Most gallbladder surgery is done for people who have symptomatic gallstones. Symptoms typically involve right-sided abdominal pain, commonly occurring after eating fatty or greasy foods. The pain can be associated with nausea and vomiting, and a bloating sensation. The pain can also radiate into the back. A small percentage of people has these same symptoms without gallstones, but can be shown to have gallbladder dysfunction.

PROCEDURE: Laparoscopic surgery involves four small incisions, less than one-half inch in length. A camera is inserted into the abdomen through one of these holes. The other holes are used for the insertion of instruments that the surgeon uses to remove the gallbladder, instead of making a large incision as was commonly done in the past.

PRE-OP PREP: Little preoperative preparation is needed. Routine studies are ordered prior to surgery based on the patient’s age and the presence of any existing medical problems. An empty stomach is required and instructions are given to every patient concerning this and the appropriate medications to take on the day of surgery. For example, blood thinners are commonly discontinued, heart medicines are continued and adjustments are made in insulin dosing.

INPATIENT VS. OUTPATIENT: In healthy patients, most of this surgery can be done as an outpatient. Some will require extended observation, with discharge later in the day or the next morning. This occasionally is required in elderly patients, those with many other medical problems, or in patients who may be nauseated or uncomfortable postoperatively.

RECOVERY: This seems to vary from patient to patient. Some return to work shortly after surgery, others require several weeks until full recovery. On the average, one to two weeks after surgery patients are ready to resume all normal activities.

Indications:  For benign colon disease only.  Colon strictures from old diverticular disease, benign polypoid disease are examples of the types of colon lesions amenable to this technique.   Clinical trail are now underway in the use of this technique in malignant disease.  These trials are still underway, and to date this technique is used only in benign colon disease.

PROCEDURE: Laparoscopic surgery involves two small incisions, less than one-half inch in length. A "hand-assist" port is often added to facilitate resection, using the surgeons own hand and full laparoscopic technique.  A camera is inserted into the abdomen through one of these holes. The other holes are used for the insertion of instruments that the surgeon uses to remove the colon, instead of making a large incision as was commonly done in the past.

PRE-OP PREP: Routine bowel preparation is needed. Routine studies are ordered prior to surgery based on the patient’s age and the presence of any existing medical problems. An empty stomach is required and instructions are given to every patient concerning this and the appropriate medications to take on the day of surgery. For example, blood thinners are commonly discontinued, heart medicines are continued and adjustments are made in insulin dosing.

INPATIENT VS. OUTPATIENT:  Most patients will require extended observation, with discharge when bowel function returns.

RECOVERY: This seems to vary from patient to patient.  On the average, one to two weeks after surgery patients are ready to resume all normal activities.

INDICATIONS:  Ventral or incisional Hernias can be treated laparoscopically.  Laparoscopic treatment is usually reserved for large and complex ventral hernias.

Procedure:  The defect(s) are repaired using prosthetic mesh that covers all of the defects from the inside of the abdominal cavity.  The mesh material is sewn to the body wall in a way that eliminates the defects.

PRE-OP PREP:  Routine studies are ordered and the patient requires an empty stomach for about eight hours prior to surgery.

INPATIENT VS. OUTPATIENT: This procedure can be done as an outpatient, with overnight stay in the hospital occasionally necessary.

PRE-OP PREP:  Routine studies are ordered and the elective patient requires an empty stomach for about eight hours prior to surgery.  Trauma patients are treated as dictated by their condition.

RECOVERY: Patients usually recover within a day.

INDICATIONS:  Malignancies, hypersplenism and ITP are common indications for this procedure.

PRE-OP PREP:  Routine studies are ordered and the elective patient requires an empty stomach for about eight hours prior to surgery. 

RECOVERY: Patients usually recover within a day or two.  Time in the hospital is often determined by the patients underlying condition.

INDICATIONS: There are two general forms or dialysis: hemodialysis, using the bloodstream, and peritoneal dialysis, using the lining of the abdominal cavity. To facilitate the latter, a tube is inserted into the abdominal cavity to allow for the infusion of fluids to help cleanse the body of waste products that accumulate in the face of kidney failure. Candidates for peritoneal dialysis must be relatively independent and be able to perform their own dialysis. Catheters are also sometimes inserted for excessive fluid (ascites) and for some unusual malignancies.

PROCEDURE: Similar to other laparoscopic procedures, a camera is used to visualize the abdominal contents, avoiding the larger incisions associated with more traditional methods. The catheter can be placed in a dependent portion of the abdominal cavity to maximize its function.

PRE-OP PREP: Routine studies are ordered and the patient requires an empty stomach for about eight hours prior to surgery.

INPATIENT VS. OUTPATIENT: This procedure can be done as an outpatient, with overnight stay in the hospital occasionally necessary.

RECOVERY: Patients recover much faster when compared to the open procedure. Since the surgery is usually done on patients with renal failure, the disease process tends to be more of a limiting factor than the procedure itself.

INDICATIONS: In addition those listed under LUNG BIOPSY, other indications include recurrent pneumothorax (lungs that spontaneously perforate) and empyema, or chest infection. In addition sometimes information is needed to determine the resectability (removability) of a malignant process, or even to distinguish a benign from a malignant process.

SEE LUNG BIOPSY SECTION FOR ADDITIONAL INFORMATION

INDICATIONS: Some patients have diffuse disease in their lungs associated with signs or symptoms of infection or inflammation. In these settings removal of a portion of lung tissue may be required to aid in identifying a disease process and initiating correct therapy. Additionally sometimes a lesion in the lung may be localized but all other attempts at biopsy are ineffective, thereby requiring direct visualization.

PROCEDURE: Two to three small incisions are made between the ribs. Inserted through these are a camera and instruments used to staple and remove a piece of lung tissue for biopsy. Care is taken to allow for re-expansion of the lung at the completion of the procedure.

PRE-OP PREP: Routine studies are ordered, sometimes including chest x-ray, pulmonary function studies and arterial blood gas measurements.

INPATIENT VS. OUTPATIENT: Observation is required postoperatively, the length of which depends on the condition of the patient and the reason for biopsy. A chest tube is usually required for one to two days to allow for lung re-expansion.

RECOVERY: Significant improvement is noted in the recovery of patients having thoracoscopic surgery as opposed to an open thoracotomy. Hospital stays are significantly shorter, with faster functional recovery and much less discomfort.