In addition to performing a wide variety of surgical procedures, many patients are seen for long term disease monitoring via routine office visits. Minor surgical procedures can be performed in the office under local anesthesia at the discretion of the surgeon. This may include minor lump removal, small biopsies and medical device removal. Wound care is also performed in the office. More complex procedures are done in the hospital or an ambulatory surgical center setting. We have a fully accredited peripheral vascular lab to test vascular conditions. Common surgical procedures are briefly discussed below.
The surgeons at Virginia Beach Surgery are skilled at treating benign and malignant conditions of the esophagus, stomach, small intestine, large intestine, rectum, anus, liver, pancreas, and biliary system. They are well-trained in surgical endoscopy.
Minimally Invasive Techniques strive to avoid the large incisions that were common in the past.
Laparoscopy( often mistakenly called laser surgery) is a way to perform surgery using cameras and miniaturized instruments passing through small ports inserted into the abdominal cavity. Often these surgeries are performed on an outpatient basis and are associated with significantly reduced postoperative recovery time and less post-operative pain. The most common laparoscopic surgeries include laparoscopic gallbladder removal, reflux or hiatal hernia surgery, groin hernia surgery, abdominal exploration and biopsy, and colon surgery.
Cholecystectomy is the removal of the gallbladder. This is usually performed for symptomatic gallstones, however dysfunctional gallbladders may also need removal. This is one of the most common surgeries performed and is usually performed in a minimally invasive fashion with minimal risk.
Gastroesophageal Reflux Disease, GERD
GERD is controlled medically in most people. However, for some patients, symptoms persist despite our strongest medical therapies. Others have symptoms relieved by medicine but face a lifetime of medication for a disorder that can be eliminated by surgery. Chronic reflux can not only cause severe heartburn, but also chronic lung problems and contribute to pre-cancerous conditions of the esophagus.
At Virginia Beach Surgery, physicians perform laparoscopic surgeries to eliminate reflux. The laparoscopic technique dramatically shortens hospital stay as compared to standard surgery and speeds return to work. Often the patient is discharged within 24 to 48 hours and returns to work within a week.
Hernias are defects in a muscle layer through which internal structures are pushed outward. They come in a variety of locations and sizes. Hernias are repaired to eliminate symptoms and to prevent hernia-related bowel obstruction. Although the types of hernias have not changed, there are an increasing variety of laparoscopic techniques available to repair hernias. At Virginia Beach surgery the choice of hernia repair is matched to best suite the patient. Mesh is a permanent artificial material that is used extensively to re-enforces the strength of native tissue and, despite recent bad press, has significantly improved the outcomes of hernia repair.
The finding of a breast mass is a very stressful event with risk of breast cancer for all women being close to one in eight. However there are many other non cancerous breast conditions that may require medical attention and we at Virginia Beach Surgery evaluate and treat all abnormalities of the breast. We emphasize patient education self examination and surveillance in routine breast for women.
We employ all current technologies including mammography, ultrasound, CT, MRI and nuclear scanning to evaluate breast tissue. A biopsy may be required for a complete diagnosis and can be performed with minimal incisions utilizing ultrasound guided biopsies or computer assisted biopsies with mammography or MRI imaging. Breast cancer surgery can be minimized with lumpectomy and radiation, preserving the breast rather than mastectomy. However mastectomy is still required on occasion and can be combined with immediate plastic surgery reconstruction. Sentinel node biopsy selectively removes the key lymph nodes from under the arm to determine if the cancer has spread. This methodology significantly reduces postoperative pain and arm swelling.
The fight against cancer requires specialized care. The surgeons at Virginia Beach Surgery perform appropriate surgical tumor excisions. In addition we coordinate surgery with other cancer specialist including oncologists and radiation oncologist to provide chemotherapy and radiation therapy to maximize the patients prognosis.
Complex cases are discussed at the hospitals Tumor Board which is a weekly conference consisting of surgeons, oncologists, radiation oncologists, pathologists, and radiologists. Additional information on specific cancers is located in the links page.
Breast and colonoscopic screenings are available through our office.
Melanoma and other Skin Cancers
The incidence of melanoma and other skin cancers is growing at an alarming rate in a large part because of the population’s increasing sun exposure. At Virginia Beach Surgery, suspicious lesions are removed for diagnostic and therapeutic purposes. We work together with your dermatologist to maximize overall patient outcomes. When necessary, skin grafts are used to replace removed skin. Melanoma is especially dangerous and often requires the removal of adjacent lymph nodes. Sentinel node biopsies are employed to minimize the amount of required surgical dissection when melanoma is at risk of spreading to other parts of the body.
Endocrine glands secrete hormones that regulate body chemistry and function.
Tumors of endocrine glands can abnormally increase hormone levels and cause symptoms such as altered metabolism, weight loss or weight gain, digestive problems, anxiety, hyperglycemia or hypoglycemia, high blood pressure, kidney stones, and osteoporosis among others. Expertise at Virginia Beach Surgery allows identification of such tumors and the correct surgical management. The newest methods of tumor localization using CAT scans, MRI, selective venous sampling, and the use of radioactive tracers are employed.
Vascular (Arteries and Veins) Surgery
Vascular surgery involves the correction of abnormalities in the arteries and veins. At Virginia Beach Surgery, physicians treat a variety of vascular problems with non-invasive, minimally invasive, or traditional surgical methodologies. Only the most common are discussed below.
The carotid arteries supply blood to the brain. Blockages in the carotid arteries may cause stroke and can be reopened by carotid endarterectomy. The success rate of this surgery has been studied in great detail in national multicenter randomized trials. The success rate of the surgeons at Virginia Beach Surgery with carotid endarterectomy matches the reported national average.
Aneurysms are dilations of the arterial wall, which thins as it enlarges. The risk of rupture increases as an aneurysm increases in diameter. Aneurysm ruptures can be life threatening. Virginia Beach Surgery physicians monitor the growth of an aneurysm and pursue correction of the aneurysm at the appropriate size. For endovascular ( minimally invasive) approaches, we work closely with our expert interventional radiology colleagues.
Blockages in the aorta and the arteries of the legs can result in pain or cramping with ambulation (claudication), pain at rest, or gangrene. Blockages may be addressed with exercise, medication, angioplasty, stenting, or bypass surgery. Blockages in the arteries of the arms, intestines, and kidneys result in different symptoms but have a similar range of therapies.
Our surgeons are also responsible for the insertion and management of acute and chronic access for dialysis needs. Acute hemodialysis requires the placement of a large catheter into a vein, while chronic access involves the use of a surgically placed connection between an artery and vein usually in the arm. Peritoneal dialysis catheters are placed into the abdominal cavity
Blockages of the veins of the extremities are usually from blood clots that require treatment with blood thinners. In some cases clot dissolving medications(clot busters) are utilized. If a patient’s blood clot progresses on a blood thinner or the patient cannot tolerate blood thinners, insertion of a surgical filter to block the clot from extending into the heart and lungs is indicated.
Improper functioning of the valves of the deep veins of the leg causes varicose veins, which may or may not need surgical treatment. Varicose veins are treated with compression stockings, sclerotherapy (vein injections). Radiofrequency ablation (RFA) to obliterate varicose veins is performed in our office but extreme cases may require surgical vein stripping.
We have a fully accredited vascular lab at Virginia Beach Surgery. Our vascular technician can perform a variety of non-invasive and pain free vascular tests that utilize blood pressure, sound waves (Doppler), and electrical impulses to asssess the adequacy of blood flow in arteries and veins. These results are then analyzed and interpreted by our vascular surgeons who are accredited and registered vascular test interpreters. Areas of study include cerebral vascular flow, extremity venous and arterial studies, main aortic, renal, and mesenteric arterial evaluations. We also offer vascular screening testing!
Our physicians are trauma surgeons and take trauma call at Sentara Virginia Beach General Hospital. This is an accredited level III trauma facility and is the busiest level III center in the state. In fact we treat more injured patients than the majority of the state's level II centers. We have developed trauma initiatives that are being copied by other centers in the state and utilize the most current trauma protocols. We in turn work closely with our level I center at Sentara Norfolk General Hospital.