General Surgery
General surgery is the surgical specialty often called "the Jack of all trades". It involves the skill and ability to care for many different surgical problems. A general surgeon has done four years of medical school and five to six years of general surgical residency training. This extensive training and experience allows Northwest Surgical Specialists to give their patients the best surgical care.
Common surgeries done by a general surgeon include gallbladder surgery, surgery for appendicitis and hernia repair.
Gallbladder
The gallbladder is a storage sac for bile that sits under the liver in the right upper quadrant of the abdomen. Bile is what is needed for digestion of fat. When your stomach receives food high in fat, a message is sent to the gallbladder to contract and release more bile for digestion.
Gallstones can form in the gallbladder. Most gallstones are made of cholesterol. Estrogens promote gallstone formation. Therefore, being female, pregnancy and birth control pills are factors in developing gallstones. Genetics does have some influence. American Indians have a high incidence of forming gallstones. Diet has not been scientifically proven to cause stones. More than 25% of Americans have gallstones. 800,000 gallbladder surgeries are performed annually. 30% of people with gallstones are asymptomatic. 60% of people with stones have pain. Typical symptoms of gallstones are epigastric (upper abdomen) pain or pressure that is constant. Nausea and vomiting sometimes occur. Symptoms may be associated with meals. The attacks can last for minutes to many hours. Gallbladder pain can be confused with heart pain. Therefore, always call your doctor or seek medical help when you develop upper abdominal or lower chest pain.
Ultrasound will be ordered to diagnose gallstones. The best treatment for gallstones is surgical removal of the gallbladder. Today this is done with the laparoscope. This procedure is called laparoscopic Cholecystectomy. Typically this requires general anesthesia and the gallbladder is removed via tiny incisions in the abdomen (see laparoscopy). The surgery takes 1-2 hours. Most people stay in the hospital less than 24 hours and often return to work in about a week.
Appendicitis
The appendix is a diverticulum (pouch) located at the end of the cecum (colon). It is located in the right lower quadrant of the abdomen. The normal appendix is soft and narrow (like a worm). Its' function is still unclear. When the appendix becomes inflamed (appendicitis) the appendix swells and becomes thick like a sausage. Appendicitis is a word well known to most people, however, only 4% - 7% of the population develop appendicitis. Peak occurrence of appendicitis is commonly seen between ages 5-10 years and early twenties. At Northwest Surgical Specialists we have seen appendicitis in very young children and as old as 89 years old.
Typical symptoms of appendicitis are vague abdominal pain with some nausea and occasional vomiting. Within a few hours pain localizes to the right lower quadrant. Increasing tenderness, restless sleep, lack of appetite and low-grade fever also could be present. Blood tests may show you have an elevated white blood cell count and ultrasound or CT scan may verify appendicitis. Often patients have only a few of these symptoms and lab tests could be normal. This makes the diagnosis of appendicitis difficult at times.
Surgery and antibiotics are the best treatments for appendicitis. The operation can be performed through a small incision in the right lower quadrant or via the laparoscope. Surgery takes about 1 hour. Your surgeon will discuss which method is best for you. Most people can go home within 24 hours unless the appendix is ruptured which often requires intravenous antibiotics for several days.
Hernia
A hernia is a protrusion of abdominal tissue through a defect in the abdominal wall. 75% of all hernias appear in the groin (inguinal). 10% are a result of previous surgery (old incisions) and are called incisional hernias. 3% are umbilical hernias (belly button).
Most hernias produce no symptoms. They are noticed as a protrusion (lump) which goes away when you lay down. Often patients experience a sense of discomfort or pain when the hernia protrudes. The discomfort resolves when the hernia reduces back in to the abdomen.
The concern with hernias is incarceration. Tissue from the abdomen (often intestine) becomes stuck in the hernia. The blood supply to the tissue is compromised and the tissue could die. Repair of the hernia resolves this devastating problem.
Most hernias are repaired through an incision over the hernia. The defect is closed with sutures or repaired with mesh. This can easily be accomplished with day surgery. Laparoscopic repair of hernias began in the early 90's. The success has been good. The beauty of laparoscopic repair is that it provides the opportunity to fix bilateral groin hernias at the same time using the same small incisions. Unfortunately general anesthesia is needed for laparoscopic hernia repair. Long term results and complications are being studied. Your surgeon will help you decide which approach is best for you.
Cancer
Over one million new cases of cancer are detected in the United States yearly. General surgery is the specialty which deals with skin, breast, colon and lung cancer as well as many other abdominal or soft tissue cancers.
Skin cancer is on the rise, probably as a result of excessive sun exposure. Any skin lesion with abnormal growth or irregularity, bleeds easily, changes color or is concerning to you should be examined by a physician. Your general surgeon will often remove these lesions in the office. If the skin growth is malignant further treatment may be needed. Coordination of care with an oncologist may occur.
Breast problems are one of the most common conditions seen by a general surgeon. The general surgeon often sees a woman for an abnormal mammogram or palpable breast lump. Fortunately 80% of breast lumps are benign.
Currently many abnormal mammograms or breast lumps are biopsied in the office or at a breast center using a needle core biopsy. Under local anesthesia a biopsy is taken of the abnormality and is examined by the pathologist. If the biopsy is benign the lesion can be watched for a period of time. If the biopsy is malignant further surgical care is needed.
At Northwest Surgical Specialists our continued, advanced evaluation has given our patients the opportunity of breast preservation (lumpectomy) and still have a long disease free survival. Sentinel node evaluation for breast cancer is done by surgeons at Northwest Surgical Specialists. Our approach is a multidisciplinary one, of working with oncologists, radiation-oncologists, radiologists, pathologists, psychologists and nursing support in the excellent care of our patients. (See Breast for more detail) Colon cancer 160,000 Americans get colon-rectal cancer per year. Surgery is the primary treatment. At Northwest Surgical Specialists we have a long extensive experience with colon cancer. We work together with gastroenterologists and oncologists in total care of the patient.
As you can see General surgery is a broad field of medicine. Many general surgeons also practice vascular and thoracic surgery. (See vascular, and Chest ((thoracic)) surgery buttons).
See our procedure list of all the procedures we perform at Northwest Surgical Specialists. If you have a surgical problem Northwest Surgical Specialists can give you the expert, experienced care needed to return to good health.
Our phone number is 206-363-2882, click here for more information.