Laparoscopic Inguinal Hernia Repair

Laparoscopic hernia repair is similar to other laparoscopic procedures. General anesthesia is given, and a small incision is made in or just below the navel. The abdomen is inflated with air so that the surgeon can see the abdominal organs.

A thin, lighted scope called a laparoscope is inserted through the incision. The instruments to repair the hernia are inserted through other small incisions in the lower abdomen. Mesh is then placed over the defect to reinforce the abdominal wall.

Laparoscopic Anti-Reflux (GERD) Surgery

Laparoscopic anti-reflux surgery (commonly referred to as Laparoscopic Nissen Fundoplication) involves reinforcing the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus - much the way a bun wraps around a hot dog.

In a laparoscopic procedure, surgeons use small incisions (1/4 to 1/2 inch) to enter the abdomen through cannulas (narrow tube-like instruments). The laparoscope, which is connected to a tiny video camera, is inserted through the small incision, giving the surgeon a magnified view of the patient's internal organs on a television screen. The entire operation is performed “inside” after the abdomen is expanded by inflating gas into it.

Laparoscopic Colon Resection

Using a cannula (a narrow tube-like instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a video camera) is inserted through the cannula, giving the surgeon a magnified view of the patient's internal organs on a television monitor. Several other cannulas are inserted to allow the surgeon to work inside and remove part of the colon. The entire procedure may be completed through the cannulas or by lengthening one of the small cannula incisions.

Laparoscopic Biliary Surgery (e.g. Gallbladder)

Using a cannula (a narrow tube-like instrument), the surgeon enters the abdomen in the area of the belly-button. A laparoscope (a tiny telescope) connected to a special camera is inserted through the cannula, giving the surgeon a magnified view of the patient's internal organs on a television screen. Other cannulas are inserted which allow the surgeon to delicately separate the gallbladder from its attachments and then remove it through one of the openings. Many surgeons perform an X-ray, called a cholangiogram, to identify stones, which may be located in the bile channels, or to ensure that structures have been identified. If the surgeon finds one or more stones in the common bile duct, (s)he may remove them with a special scope, may choose to have them removed later through a second minimally invasive procedure, or may convert to an open operation in order to remove all the stones during the operation. After the surgeon removes the gallbladder, the small incisions are closed with a stitch or two or with surgical tape.

All types of Breast Cancer evaluation including the following as well as in-office ultrasound

Stereotactic Needle Core Biopsy

Stereotactic breast needle biopsy refers to the sampling of nonpalpable or indistinct breast lesions by using techniques that enable the spatial localization of the lesion within the breast. The word stereotactic is derived from Greek and Latin roots meaning “touching in space.” Stereotactic techniques have evolved in parallel with the current trend in breast conservation and minimally invasive surgery.

Sentinel Lymph Node Biopsy

Examination of the sentinel node (“gland”) is performed to learn whether that node does or does not have tumor cells within it. Which lymph node is the sentinel node for a given tumor is determined by injecting around the tumor a tracer substance that will travel through the lymphatic system to the first draining (sentinel) node and identify it. The tracer substance may be blue dye that can be visually tracked or a radioactive colloid that can be radiologically followed.