Services

Below are a variety of general and vascular services our physicians provide:

  • Carotid Endarterectomy
  • Abdominal Aortic Aneurysm
  • EVAR (EndoVascular Aneurysm Repair)
  • Varicose Vein Treatment
  • Arteriograms
  • Atherectomy
  • Arterial Stenting
  • IVC Filter Placements & Removal
  • PICC Line Insertion
  • Venography (Venogram)
  • Venous Stenting
  • Varithena
  • Temporal Artery Biopsy
  • Port Placements & Removal

Hernia Repairs
This is 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, including herniorrhaphy, hernioplasty, and herniotomy. They can be performed laparoscopically or open. Hernia repair is often performed as an ambulatory procedure.

Colon Surgery
Colon surgery is the most common treatment for colon cancer. In ideal situations, where the cancer is found at a very early stage, a doctor can remove the tumor with a colonoscope. Most of the time however, colon surgery is required.

Surgical Resection
When cancer is identified at a later stage, treatment usually requires the kind of colon surgery you tend to think of when you hear the word "surgery."" The standard procedure is called a surgical resection. In a resection, a surgeon makes an incision in the abdomen, removes the tumor, and then reconnects the colon so it's one long, healthy piece again.

Ostomy Related Surgeries
An ostomy is another type of colon surgery and is basically a detour for your intestines. Waste normally travels through the colon into the rectum, and then is released through the anus during defecation. An ostomy bypasses the rectum altogether and instead waste material leaves the intestine through a port in the abdomen, and moves into a colostomy bag on the outside of the body. Some ostomies are permanent. Others are temporary detours that give part of your body a chance to heal before you use it again.

Breast Surgery
Breast Surgery is a form of surgery performed on the breast. There are many types and reasons to perform these surgeries. Some non-cosmetic types include:  Mastectomy  Lumpectomy  Breast-conserving surgery, a less radical cancer surgery than a mastectomy.

Mastectomy
This is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. It is also the medical procedure carried out to remove breast cancer tissue in males. Alternatively, certain patients can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are what are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

Traditionally, in the case of breast cancer, the whole breast was removed. Currently the decision to do the mastectomy is based on various factors including breast size, number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of tumor recurrences after lumpectomy and radiation. Outcome studies comparing mastectomy to lumpectomy with radiation have suggested that routine radical mastectomy surgeries will not always prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis, and operation.

Lumpectomy
This is a common surgical procedure designed to remove a discrete lump, usually a benign tumor or breast cancer, from an affected man's or woman's breast. As the tissue removed is generally quite limited and the procedure relatively non-invasive, compared to a mastectomy, a lumpectomy is considered a viable means of "breast conservation" or "breast preservation" surgery with all the attendant physical and emotional advantages of such an approach. According to the National Comprehensive Cancer Network guidelines, lumpectomy may be performed for ductal carcinoma in situ (DCIS), for invasive ductal carcinoma, or for other conditions.

Cholecystectomy (Gallbladder Removal)
Cholecystectomy is the surgical removal of the gallbladder. It is a common treatment of symptomatic gallstones and other gallbladder conditions. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.

Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallstones and inflammation of the gallbladder unless there are contraindications to the laparoscopic approach. This is because open surgery leaves the patient more prone to infection. Sometimes, a laparoscopic cholecystectomy will be converted to an open cholecystectomy for technical reasons or safety.

Laparoscopic cholecystectomy requires several small incisions in the abdomen to allow the insertion of operating ports, small cylindrical tubes approximately 5 to 10 mm in diameter, through which surgical instruments and a video camera are placed into the abdominal cavity. The camera illuminates the surgical field and sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through the operating ports.

To begin the operation, the patient is placed in the supine position on the operating table and anesthetized. A scalpel is used to make a small incision at the umbilicus. Using either a Veress needle or Hasson technique the abdominal cavity is entered. The surgeon inflates the abdominal cavity with carbon dioxide to create a working space. The camera is placed through the umbilical port and the abdominal cavity is inspected. Additional ports are opened inferior to the ribs at the epigastric, midclavicular, and anterior axillary positions. The gallbladder fundus is identified, grasped, and retracted superiorly. With a second grasper, the gallbladder infundibulum is retracted laterally to expose and open Calot's Triangle (the area bound by the inferior border of the liver, cystic duct, and common hepatic duct). The triangle is gently dissected to clear the peritoneal covering and obtain a view of the underlying structures. The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut. Then the gallbladder is dissected away from the liver bed and removed through one of the ports. This type of surgery requires meticulous surgical skill, but in straightforward cases can be done in about an hour.

Recently, this procedure is performed through a single incision in the patient's umbilicus. This advanced technique is called Laparoendoscopic Single Site Surgery or "LESS".