- LAPAROSCOPIC SURGERY
- DIGESTIVE SURGERY
- ENDOCRINE SURGERY
- VASCULAR SURGERY
- TRAUMA SURGERY
- Note: we do not do Lap Band as we primarily focus on gastric bypass and gastric sleeve procedures which has been proven to be the most effective procedures.
- LAPAROSCOPIC SURGERY:
Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5–1.5 cm) as compared to the larger incisions needed in laparotomy.
Keyhole surgery uses images displayed on TV monitors for magnification of the surgical elements.
Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy.
There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time.
The key element in laparoscopic surgery is the use of a laparoscope. There are two types: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where the charge-coupled device is placed at the end of the laparoscope, eliminating the rod lens system. Also attached is a fiber optic cable system connected to a ‘cold’ light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or trocar to view the operative field. The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.
Digestive system surgery can be divided into upper GI surgery and lower GI surgery.
Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of surgery that focuses on the upper parts of the gastrointestinal tract. There are many operations relevant to the upper gastrointestinal tract that are best done only by those who keep constant practise, owing to their complexity. Consequently, a general surgeon may specialise in ‘upper GI’ by attempting to maintain currency in those skills.
Upper GI surgeons would have an interest in, and may exclusively perform, the following operations:
A lower GI surgeon might specialise in the following operations:
- Low or ultralow resections for rectal cancer, etc.
Endocrine surgery is a specialized surgical field where procedures are performed on endocrine glands to achieve a hormonal or anti-hormonal effect in the body. Almost always, this entails operating to remove a tumor which has grown on or within an endocrine gland.
Thyroid, parathyroid, and adrenal
The most common endocrine surgery operation is removal of the thyroid (thyroidectomy), followed by parathyroid surgery (parathyroidectomy), followed by the rare operation on the adrenal gland (adrenalectomy).
Pituitary, testicles/ovaries, and pancreas
Although not typically referred to as endocrine surgery, it could be argured that surgery of the pituitary gland, testicles, ovaries, and pancreas are also forms of endocrine surgery since these glands are hormone producing glands as well. More classically, however, only thyroid, parathyroid and adrenal surgery are thought of as “endocrine surgery” with pituitary surgery typically thought of as a form of neurosurgery; testicle surgery typically thought of as urologic surgery; ovary surgery typically thought of as a form of gynecologic surgery; and pancreatic surgery typically thought of as oncology surgery.
Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery. Early pioneers of the field include Russian surgeon Nikolai Korotkov, noted for developing early surgical techniques, and the Australian Robert Paton, often credited with helping the field achieve recognition as a speciality. Edwin Wylie of San Francisco was one of the early American pioneers who developed and fostered advanced training in vascular surgery and pushed for its recognition as a specialty in the United States in the 1970s. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system except that of the heart and brain. Cardiothoracic surgeons manage surgical disease of the heart and its vessels. Neurosurgeons and interventional neuroradiologists manage surgical disease of the vessels in the brain (e.g. intracranial aneurysms).
Trauma surgery is a surgical specialty involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for the initial resuscitation and stabilization of the patient, as well as ongoing evaluation and management. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff as well as resident physicians in teaching hospitals.