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Background: Hiatal Hernia is where the opening in the diaphragm enlarges and abdominal contents can push up into the chest. This is most commonly seen with partial  stomach migration. Hiatal Hernias often cause GERD symptoms which can be controlled, but not corrected by medication. Hiatal Hernias can also present with regurgitation, pain, intestinal bleeding, and difficulty eating.

Procedure: Operations for Hiatal Hernia include delivering the stomach back into the abdominal cavity to its normal position and resizing the diaphragm opening to the correct size. Your doctor may refer you for surgical correction if your hernia is very large or if you are developing severe symptoms. The operation is done robotic assisted and usually is an outpatient procedure. Risks of the surgery include rare bowel injury and chance of recurrence.

Background: Gastroesophageal Reflux Disease (GERD) is associated with an incompetent lower esophageal sphincter and abnormal hiatus, which allows reflux of gastric contents into the esophagus. Symptoms can include indigestion, burning chest pain, regurgitation, chronic cough, and even voice changes. GERD is a progressive disease- as symptoms become severe, patients typically progress from single to double dose PPI medication. Medication does not fix the reflux problem, it only reduces the acid. Chronic GERD can lead to strictures, bleeding, and cancer. 

Procedure: Surgical interventions for GERD have focused on repairing the hiatus and performing a fundoplication (stomach wrap) to augment the lower esophageal sphincter. Different types of fundoplication include the Nissen, Dor, and Toupet. The Toupet Fundoplication has gained favor for its effectiveness (90% improvement in symptoms and 75% chance of discontinuing all PPI medication) while minimizing side effects of dysphagia and gas bloat.

Background:  Gastroesophageal Reflux Disease (GERD) is associated with an incompetent lower esophageal sphincter and abnormal hiatus, which allows reflux of gastric contents into the esophagus. Symptoms can include indigestion, burning chest pain, regurgitation, chronic cough, and even voice changes. GERD is a progressive disease- as symptoms become severe, patients typically progress from single to double dose PPI medication. Medication does not fix the reflux problem, it only reduces the acid. Chronic GERD can lead to strictures, bleeding, and cancer. Surgical interventions of Laparoscopic Gastric Fundoplication are effective in treating GERD, but notable rates of failure (20-40%), complications (1%), and side effects (dysphagia, bloating) have limited its use.

Technology: LINX is a first line, fundic-sparing surgical treatment option for GERD. It consists of small, flexible band of titanium beads, with magnetic cores that augment the lower esophageal sphincter ability to close while allowing food and liquid to pass through to the stomach. LINX is implanted via a laparoscopic outpatient procedure. LINX is efficacious and reversible. It has similar success rates to fundoplication with higher rates of dysphagia.

Who is a candidate?

Individuals with diagnosed GERD who are on maximal dose PPI medication and continue to suffer from symptoms.

Research shows a 90% improvement in symptoms and a 75% chance of discontinuing all PPI medication. The chance for device removal is 3%.

Your belly button is one of the more common locations a hernia can develop. A hernia is simply a condition where there is a defect in the abdominal wall and tissue can protrude through this defect. When umbilical hernias become uncomfortable, or bowel is trapped, recommendation is for repair of the defect. We often close the defect and augment the repair with placement of a mesh to decrease the chance of recurrence.

Sometimes after an operation, the abdominal wall can fail to heal correctly and a hernia can develop over the prior incision. A hernia is simply a condition where there is a defect in the abdominal wall and tissue can protrude through this defect. When ventral hernias become uncomfortable, or bowel is trapped, recommendation is for repair of the defect. We often close the defect and augment the repair with placement of a mesh to decrease the chance of recurrence.

Inguinal hernias are the most common types of hernias. A hernia is simply a condition where there is a defect in the abdominal wall and tissue can protrude through this defect. The inguinal canal is a passageway into the abdominal cavity. When inguinal hernias become uncomfortable, or bowel is trapped, recommendation is for repair of the defect. We often close the defect and augment the repair with placement of a mesh to decrease the chance of recurrence. The robotic assisted technique provides advantages of quick recovery and possibly improved outcomes.

Your gallbladder is considered a reservoir for the bile that your liver makes to digest fat. Sometimes bile can form stones or sludge which adversely affect normal physiology. Biliary pathology can cause pain and liver dysfunction. One of the more commonly performed general surgery operations is to remove the gallbladder and associated stones to relieve and prevent future pain. Robotic assisted cholecystectomy provides advantages over traditional laparoscopic cholecystectomy in terms of improved visualization and magnification which can make the operations safer.

Small intestines can develop a problem that may require partial removal of the affected segment. Various reasons for removal include tumors, adhesive obstructions, bleeding, intussusception, diverticula, ischemia. The operation can often be done via a minimally invasive laparoscopic approach.

Large intestine can develop a problem that may require partial removal of the affected segment. Various reasons for removal include tumors, bleeding, complicated diverticulitis, ischemia. Patients undergo a bowel prep prior to surgery and typically require an inpatient hospital stay.

Sometimes after abdominal surgery or severe inflammation, scar tissue can form in the abdominal cavity creating adhesions. Adhesions can possibly cause severe pain and/or obstructive symptoms. Robotic assisted adhesiolysis is a operation where the scar tissue is taken down with sharp dissection to hopefully relieve any pain or obstructive symptoms.

In addition to the mentioned operations, we also provide a variety of general surgery interventions such as: Port Placement, Fatty Tumor Removal, Panniculectomy.