Procdedure Descriptions

Abdominoplasty (Tummy Tuck)
For those patients who require the most correction, the abdomen is cut from hipbone to hipbone. The incision will be made low, at about the same level as your pubic hair. Your surgeon will then manipulate and contour the skin, tissue and muscle as needed. Your belly button will have a new opening if you undergo this procedure, because it's necessary to free your navel from surrounding tissue. Drainage tubes may be placed under your skin, and these will be removed in a few days as your surgeon sees fit.

For patients whose fat deposits are located below the navel and require shorter incisions, the belly button most likely will not be moved. Your skin will be separated between the line of incision and your belly button. This type of surgery may also be performed with an endoscope, a small camera on the end of a tube.

Anterior Cruciate Ligament (ACL) Reconstruction
ACL Reconstruction is surgery to replace the torn ligament with an autograft (tissue from the patient's own body) or an allograft (tissue from a cadaver). The most common autografts use part of the patellar tendon (the tendon in the front of the knee) or use the hamstring tendons. Each type of graft has small advantages and disadvantages, and work well for many people.

The procedure is usually performed by knee arthroscopy. The surgeon will replace the ACL. Additional small incisions are made around the knee to place the new ligament. The old ligament will be removed using a shaver or other instruments. Bone tunnels will be made to place the new ligament in the knee at the site of the old ACL. If the patient's own tissue is to be used for the new ligament, a larger, "open" incision will be made to take the tissue. The new ligament is then fixed to the bone using screws or other devices to hold the ligament in place.

Arthroscopic Surgery
Arthroscopic Surgery is used to diagnose and treat many joint problems. This significant advance in joint care allows for rapid return to improved activity. Most commonly used in knees, shoulders and ankles, the arthroscope can also be sued for spine, hip, wrists and elbows.
Step 1 - Two small incisions are made around the join area. Surgical instruments will be positioned in these incisions.
Step 2 - A tube-like needle is inserted in one incision. Fluid is pumped through the tube and into the joint. This expands the joint, giving the surgeon a clear view and room to work. The tube will also be used as drainage needle to regulate the amount of fluid in the joint during the procedure.
Step 3 - Through another incision, the surgeon insets the arthroscope. This instrument has a light and a small video camera that send images to a TV monitor in the operating room.
Step 4 - With the video images from the arthroscope as a guide, the surgeon can look for damaged tissue. If the surgeon sees an opportunity to treat a problem, a variety of small surgical instruments can be inserted through the third small incision.
Step 5 - The surgeon may close the incisions with stitches or tape. Recovery from arthroscopy is faster than recovery from traditional open joint surgery.

Bone Spur Surgery
Bone Spur Surgery involves the surgical removal or fusion of a piece of bone at a joint, most commonly from the spine, shoulders, hands, hips, knees, and feet. The two most common surgical procedures are called a Chilectomy (pronounced "K-eye-leck-toe-me") or an Arthrodesis (fusion). The Chilectomy is a procedure done to remove the bone spurs. This often helps if the spurs are causing a block to the joint motion. However, if the joint cartilage is all worn off, a Chilectomy may not help the pain. The Arthrodesis, or fusion, is an excellent procedure at eliminating much of the pain, but it will cause the toe to be stiff at its base.

Breast Reduction
Breast reduction surgery, also called Reduction Mammaplasty, removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used for breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon's advice.

Bunionectomy
A bunion is a painful deformity of the bones and joint between the foot and the big toe. Long-term irritation caused by poorly fitting and/or high-heeled shoes, arthritis, or heredity causes the joint to thicken and enlarge. This causes the big toe to angle in toward and over the second toe, the foot bone (metatarsal) to angle out toward the other foot, and the skin to thicken.

Surgical removal of a bunion is usually done while the patient is under general anesthesia and rarely requires a hospital stay. An incision is made along the bones of the big toe into the foot. The deformed joint and bones are repaired, and the bones are stabilized with a pin and/or cast.

Colonoscopy
A Colonoscopy enables the physician to look inside a patient's entire large intestine. This procedure is used to look for early signs of cancer in the colon and rectum, as well, as diagnose the causes of unexplained bowel habits.

Before the procedure, the patient is usually given a mild sedative. While the patient lies on their left side, the physician will inset a long, flexible, lighted tube into the patient's rectum and slowly guide it into the colon. The tube, called a colonoscope, transmits an image of inside the colon and can inflate the colon with air to help the physician see clearly.

The physician can remove all or part of an abnormality using tiny instruments passed through the scope. If there is bleeding, the physician can pass an instrument through the scope to stop the bleeding or inject medicine.

EGD
Esophagogastroduodenoscopy (EGD) or Upper Endoscopy is an examination of the esophagus, stomach, and duodenum. During this procedure, a thin flexible tube, containing a light source and camera, is placed down the patient's throat. The physician is able to examine the patient's upper GI tract from the video output of the camera. Before the EGD procedure, an anesthetic spray is used to numb the back of the throat, and sedation is given for the 15-minute exam.

Endoscopic Carpal Tunnel Surgery
Endoscopic Carpal Tunnel Surgery involves a small incision over the palm of the hand through which a surgeon will insert a small tube with a light and camera. Using that tool they will cut the transverse carpal ligament to releases pressure on the median nerve.
Some surgeons will remove tissue surrounding the nerve, especially if the tissue is swollen or irritated (as is often found in arthritis patients). The surgeon will then usually close the skin and subcutaneous tissues over only the carpal ligament, leaving the carpal tunnel uncovered. Other surgeons reattach the carpal ligament after lengthening it.

Hammertoe Repair
Hammertoe is a bending of one or both joints of a toe. This deformity can put excessive pressure on the toe resulting in pain and discomfort.
Arthroplasty is the most common surgical procedure to correct hammertoe. In this procedure, the surgeon straightens the toe by removing a small section of the bone from the affected joint.
Arthrodesis is another surgical procedure to correct hammertoe and is usually reserved for the more advanced cases. In this procedure, the surgeon fuses a small joint in the toe to straighten it. A pin is typically used to hold the toe in position while the bone is healing.
Other procedures may be necessary in more severe cases, including skin wedging (the removal of wedges of skin), tendon/muscle rebalancing or lengthening, small tendon transfers, or relocation of surrounding joints.

Hernia Repair
A hernia develops when the outer layers of the abdominal wall weaken (or have a defect), bulge, and tear. The hole in this outer layer allows the inner lining of the abdomen to protrude and form a sac.

Laparoscopic Hernia Surgery is usually performed under general anesthesia. A telescope is attached to a camera is placed through a small opening under the belly button. Two more small cuts are made in the lower abdomen. The hernia defect is covered with a mesh and secured with stitches, staples, titanium tacks, or tissue glue.

Open Repair Surgery is the more traditional approach to Hernia treatment. Although there are many approaches, in a typical surgery, the protruding tissue is returned to the abdominal cavity and the sac that has been formed is removed. The surgeon repairs the hole in the abdominal wall by sewing strong surrounding muscle over the defect. Mesh may be used in place of sewing.

Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy is the surgical removal of the gallbladder, a small, pear-shaped organ that lies on the underside of the liver, in the upper right portion of the abdomen.

The surgeon creates four very small incisions and will insert a special instrument called the laparoscope through one of the incisions. A laparoscope is a long, rigid tube that is attached to a tiny video camera and a light. Once the laparoscope has been inserted, the surgeon then guides the laparoscope while watching the view it provides on a video monitor.

The surgeon will use an electrocautery device to cut free the gallbladder. Once the gallbladder has been cut free, the surgeon collapses the organ and removes it through the incision at the navel.

Pain Management Injection
The most common type of pain management procedure is an Epidural Steroid Injection or Spinal Epidural Injection. Prior to an epidural steroid injection, the patient's skin is cleaned with a sterilizing solution and a sterile drape is placed over the skin. Local anesthesia is injected into the skin to provide numbness at the injection site. The steroid injection consists of a local anesthetic and/or steroid. A small bandage may be placed over the injection site.

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