Surgical procedures performed on the stomach or intestines to induce weight loss.
Gastric Balloon
The Intragastric Balloon System is a weight-loss system that uses a gastric balloon that occupies space in the stomach. The balloon is placed into the stomach through the mouth, using a minimally invasive endoscopic procedure, while the patient is under mild sedation.
Gastric Sleeve
Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature.
Duodenal Switch
The duodenal switch procedure, also known as biliopancreatic diversion with duodenal switch or gastric reduction duodenal switch, is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect.
Revision Bariatric Surgery
Revision weight loss surgery is a surgical procedure that is performed on patients who have already undergone a form of bariatric surgery, and have either had complications from such surgery or have not successfully achieved significant weight loss results from the initial surgery. Procedures are usually performed laparoscopically, though open surgery may be required if prior bariatric surgery has resulted in extensive scarring.
Lap Band
A laparoscopic adjustable gastric band, commonly called a lap-band, A band, or LAGB, is an inflatable silicone device placed around the top portion of the stomach to treat obesity, intended to slow consumption of food and thus reduce the amount of food consumed.
Gastric Bypass
Gastric bypass surgery refers to a surgical procedure in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both.
Colorectal
Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon.
Colectomy
Colectomy is bowel resection of the large bowel. It consists of the surgical removal of any extent of the colon, usually segmental resection.
Colostomy
A colostomy is a surgical procedure in which an opening is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place.
Endoscopic Surgery
Endoscopic surgery uses scopes going through small incisions or natural body openings in order to diagnose and treat disease.
Hemorrhoidectomy
Hemorrhoidectomy is surgery to remove hemorrhoids. You will be given general anesthesia or spinal anesthesia so that you will not feel pain. Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed.
Ileal Pouch Anal Anastomosis (J-Pouch)
Ileoanal anastomosis (il-e-o-A-nul uh-nas-tuh-MOE-sis) surgery (commonly called J-pouch surgery) allows you to eliminate waste normally after removal of the upper and lowest parts of the large intestine (colon and rectum). J-pouch surgery is also known as ileal-pouch anal anastomosis (IPAA) surgery. The procedure avoids the need for a permanent opening in the abdomen (stoma) for passing bowel movements.
Inflammatory Bowel Disease (IBD) Surgery
In general, surgery for IBD removes part the part of the bowel (large or small intestine) which is damaged and/or inflamed or treats strictures (narrowing) or abscesses or fistulas. In some cases surgery can mean a stoma is created on the surface on your stomach and your bowel waste goes into a bag, in others the bowel is reconnected. The type of surgery, though, varies from person to person depending on the type of IBD you have and the severity of any damage to your bowel.
Internal Sphincterotomy
Lateral internal sphincterotomy is an operation performed on the internal anal sphincter muscle for the treatment of chronic anal fissure.
Rectopexy
Laparoscopic rectopexy is one of the surgeries used to repair a rectal prolapse. In this surgery, the rectum is restored to its normal position in the pelvis, so that it no longer prolapses (protrudes) through the anus. Usually, stitches are used to secure the rectum, often along with mesh.
Resection
Resection is a surgical procedure to remove part of an organ or gland, as a sub-type of a resection, which might involve removing the whole body part. It may also be used to remove a tumor and normal tissue around it.
ENT
Otorhinolaryngology is a surgical subspecialty within medicine that deals with conditions of the ear, nose, and throat and related structures of the head and neck.
Tonsillectomy/Adenoidectomy
Excision of the adenoids is an adenoidectomy. Both procedures are often performed at the same time; hence the surgery is known as a tonsillectomy and adenoidectomy, or T&A.
PE Tubes (Myringotomy)
This procedure involves a small surgical incision into the eardrum to promote drainage of the fluid and to relieve pain. A ventilation tube (PE tube) can be placed in the incision to prevent further fluid accumulation and to improve hearing.
Nasal Septum Surgery (Septoplasty)
Septoplasty is an operation to correct a deviated septum. This procedure is usually done to improve the nasal breathing function but can also be done to provide adequate examination of the inside of the nose for the treatment and/or removal of nasal polyps, inflammation, tumors, or bleeding.
Sinus Surgery
Endoscopic sinus surgery (ESS) involves the insertion of a very thin fiber-optic tube (an endoscope), into the nose for a visual examination of the sinus openings. With state of the art micro-telescopes and instruments, abnormal and obstructive tissues are then removed. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. The basic endoscopic surgical procedure is performed under local or general anesthesia.
Tympanoplasty
This procedure involves grafting tissue across the perforated eardrum that will allow it to heal. This usually requires an incision behind the ear to obtain the tissue for the “patch”. For smaller perforations, sometimes a piece of fat tissue can be used, which is obtained by making a small incision behind the patient’s earlobe. Most of the time the surgeon will place a dissolvable packing behind the eardrum and in the ear canal. Drops may be used postoperatively to help the packing dissolve quicker, which will often stay in for upwards of six to eight weeks. This is an outpatient procedure and generally, the patient can return home within two to three hours following surgery.
General Surgery
General surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland (depending on local referral patterns).
Ambulatory Phlebectomy
Veins can commonly be treated with ambulatory phlebectomy. This is simply the removal of varicose veins through tiny incisions in the leg. This can be performed in the office, or in an outpatient facility under sedation. The procedure usually lasts 15-60 minutes, depending on the number of veins to be removed.
Breast Biopsy, Core
The core breast biopsy helps doctors accurately diagnose breast abnormalities. It is performed in less than 1 hour, requires only a single ¼ inch incision, and requires no stitches. It is done in the office under local anesthesia.
Breast Biopsy, Open/Lumpetomy
Open breast biopsy is a procedure used when your doctor feels a lump. A needle-directed biopsy is used when the doctor cannot feel a lump, but there is an abnormality in the mammogram that warrants biopsy. Though the anesthesia is usually local (numbing medicine injected at the site of incision) with intravenous sedation, a general anesthesia can also be used.
Colon Cancer Surgery
Many colon and rectal cancers can be cured by surgical removal of the tumor. Other cancers may require the addition of radiation and/or chemotherapy to cure the cancer. Colon cancer can grow very large without any warning. It can be picked up earlier with routine screening colonoscopy. This allows for a higher cure rate of colon cancer. We recommend routine screening starting at age 50 for people with average risk.
Hemorrhoids
Often lifestyle changes, topical medications, and good hygiene are all that is needed to reduce the symptoms of hemorrhoids. Most painful hemorrhoids stop hurting on their own in one to two weeks. If the pain persists, it is time to talk to a physician about other treatment options. In a certain percentage of cases, surgical procedures are necessary to provide satisfactory, long-term relief. The newest procedure for advanced hemorrhoids is called the Procedure for Prolapse and Hemorrhoids (PPH). PPH is a technique that reduces the prolapse (enlargement) of hemorrhoidal tissue. With the PPH procedure, patients experience less pain and recover faster than patients who undergo the conventional hemorrhoidectomy procedure.
Hemorrhoids (Advanced)
The Procedure for Prolapse and Hemorrhoids (PPH) eliminates the need for traditional hemorrhoidectomy for many patients. PPH is a technique that reduces the prolapse (enlargement) of hemorrhoidal tissue. With the PPH procedure, patients experience significantly less pain and recover faster than patients who undergo conventional hemorrhoidectomy procedures.
Laparoscopic Cholecystectomy
Removal of the gallbladder is a very common procedure as about 600,000 gallbladders are removed in the United States every year! The gallbladder is responsible for storage of a small amount of bile for use after a fatty meal. However, when the gallbladder gets stones that have formed, it will often get symptoms of pain and bloating. These are signs that more serious complications such as infection and bile duct blockage may also occur. The vast majority of gallbladders are removed with the laparoscope.
Laparoscopic Colon Resection
The advantage to laparoscopic or hand-assisted laparoscopic surgery is quicker recovery time and shorter hospital stay. We have found that the length of hospital stay has shortened to 1-3 days for laparoscopic colon resection as compared to 3-5 days for the traditional open operation. This is primarily because the post-operative pain is much less and fewer narcotics are used for pain control in the post-operative period.
Laparoscopic Nissen Fundoplication
Nissen Fundoplication is used in patients with gastroesophageal reflux disease (GERD). During the operation the top part of the stomach, called the fundus, is wrapped around the area where the esophagus meets the stomach. This will tighten the sphincter muscle that is between the esophagus and stomach and allow this sphincter to function properly again. The entire operation can be done with the laparoscope. Nearly every patient can go home the day after the operation.
Laparoscopic Ventral Hernia Repair
Ventral hernias are repaired on an elective basis to avoid internal organs getting stuck in the hernia. This can result in strangulation, or death of the internal organ. Every hernia is repaired with mesh when we use the laparoscope. This mesh is made of PTFE which is the material used in Gore-Tex™. The advantage of mesh is a more durable repair and less post-operative pain than the older type of hernia repair without mesh. Recurrence rates for a mesh repair are around 1% compared to around 10% with the older technique. This procedure is done under general anesthesia.
Lung Surgery
We perform surgery for both malignant and benign lung disease. We also utilize a minimally invasive procedure called thoracoscopy for treatment of some lung diseases.
Sclerotherapy and Ultrasound-Guided Sclerotherapy
Sclerotherapy is simply injection of a compound into the vein to cause that vein to shut down completely.Once that vein shuts down, the blood supply to the vein is gone and the body will eventually absorb it. Because all of these veins are superficial veins they can be spared and usually do not play a significant part in the blood supply from your leg. Our surgeons now offer state-of-the-art ultrasound guided sclerotherapy. This injects deeper veins that may not be visible on the surface but are contributing to varicose or spider veins. The vascular ultrasound locates the vessel and guides the surgeon for precise injections.
Thyroid Surgery
We perform partial and total thyroid removals for thyroid cancer and for suspicious thyroid lumps or nodules.
Ultrasound
Our surgeons have had additional training in ultrasound techniques. We have two ultrasound machines available for immediate exams. We now have the capability to perform ultrasound for breast disease, vascular disease, varicose veins, thyroid evaluations, lymph node evaluations and examination for possible fluid collections under the skin. We also use ultrasound to help in the accurate placement of needles during biopsy procedures.
Varicose Veins
Treatment involves compression stockings, exercise, or procedures to close or remove the veins.
VINUS Closure
Using
a catheter based approach and VNUS’ patented radiofrequency technology, the
Closure system occludes the saphenous vein thereby eliminating reflux. This prevents blood from flowing downstream
back into the leg and prevents blood from filling varicose veins. The Closure
procedure is an outpatient or day-surgery treatment which can be performed
under local anesthesia. After the
Closure procedure, over 90 percent of veins are reflux free and 87 percent of
limbs are absent of varicose veins; 94-100 percent of varicose veins are
invisible after the procedure by ultrasound.
Gastroenterology
Gastroenterology is the branch of medicine focused on the digestive system and its disorders. Diseases affecting the gastrointestinal tract, which include the organs from mouth to anus, along the alimentary canal, are the focus of this specialty.
Colonoscopy
The doctor uses a lighted tube to look inside all or your colon. The doctor will be looking for a growth that could be cancer or a polyp that could turn into cancer. If he sees something that concerns him, he can take a piece of the growth and test it for cancer.
Upper Endoscopy/Esophagogastroduodenoscopy (EGD)
Upper GI endoscopy, sometimes called EGD (esophagogastroduodenoscopy), is a visual examination of the upper intestinal tract using a lighted, flexible fiber optic or video endoscope, which is usually performed on an outpatient basis.
Capsule Endoscopy - Pill Cam
Capsule Endoscopy enables your doctor to examine your entire small intestine by swallowing a small camera contained within a capsule.
BravoTM pH Test
The Bravo pH capsule (about the size of a gelcap) is used to measure the pH levels in the esophagus over a 48 hour period, which helps in diagnosing gastro-esophageal reflux (GERD). The capsule is temporarily attached to the wall of the esophagus where it can take pH measurements and send the readings to a receiver worn on the patients’ belt.
Gynecology
Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive systems and the breasts. Outside medicine, the term means "the science of women".
Colposcopy
Office
examination of the cervix, following an abnormal pap smear, with a microscope
to detect any abnormalities.
Diagnostic Laparoscopy
Hospital
procedure where a laparoscope, a thin viewing tube similar to a telescope, is
passed through a small incision in the abdomen. This helps the doctor look
directly at the outside of the uterus, ovaries, fallopian tubes, and nearby
organs.
Dilation and Curettage (D&C)
Hospital
procedure in which the cervix is stretched with a special instrument to make it
wider (Dilation). Once the opening of the cervix is enlarged, another
instrument is inserted into the uterus to loosen and remove the lining of the
uterus (Curettage).
Endometrial Biopsy
Office procedure in which the endo metrial lining is sampled.
Endometrial Ablation
A
minimally invasive office or hospital procedure to remove the lining of the
uterus. Performed on women who have excessive menstrual bleeding or
dysfunctional uterine bleeding.
Hysteroscopy
A
minimally invasive office or hospital procedure in which the uterine cavity is
evaluated with a small camera and surgery performed if necessary
Hysterectomy
Hospital
procedure to surgically remove the uterus, this can be performed in a variety
of ways depending on several factors.
Minimally
invasive hospital surgery in which the pelvis is evaluated laparoscopically and
the uterus and cervix are removed through the vagina.
Laparoscopic Supracervical Hysterectomy (LSH)
Minimally
invasive hospital surgery in which the uterus and cervix are removed
laparoscopically.
LEEP (Loop Electrosurgical Excision Procedure)
Office
procedure which removes part of the cervix that has been affected by
precancerous cells.
Myomectomy
Hospital procedure where uterine fibro ids are surgically removed from the uterus through an abdominal incision.
Oophorectomy
Hospital
procedure used to surgically remove an ovary or ovaries.
Ovarian Cystectomy
Hospital
procedure to surgically remove a cyst from one or both ovaries, leaving the
ovaries intact if still functional
Total Abdominal Hysterectomy (TAH)
Hospital
procedure to remove the uterus and cervix through an abdominal incision.
Total Laparoscopic Hysterectomy (TLH)
Minimally invasive hospital surgery in which the uterus and cervix are removed laparoscopically.
Total Vaginal Hysterectomy (TVH)
Hospital procedure to remove the uterus and cervix through the vagina.
Transvaginal or Transobturator Taping (TVT, TOT)
Hospital outpatient procedure to treat stress urinary incontinence by placing a sling to support the bladder neck.
Tubal Ligation: Laparoscopic, Hysteroscopic
Office or hospital procedure for permanent sterilization by surgical occlusion of the fallopian tube.
Urodynamics
Office procedure used to test the functions and behaviors of the bladder and urethra (the tubes that lead from your bladder to the outside). This test involves the placement of a very small catheter, or tube, in the bladder, and another small tube in the vagina. Sterile fluid is then used to fill the bladder, so that your doctor can tell how the bladder behaves as it is getting full.
Minimally Invasive Spine
Minimally invasive spine surgery, also known as MISS, is any minimally invasive procedure that targets conditions specifically within the spine through the use of small incisions as opposed to traditional open-spine surgery which typically requires a 5-6 inch incision.
Herniated disc
During
a minimally-invasive microdiscectomy procedure, the herniated portion of the
disc under the nerve root is removed.
Bulging disc
Bulging
disc surgery is usually a last resort for patients who have not found pain
relief from non-invasive treatments. However, anyone who has considered a traditional
open back surgery also knows that it can be a scary prospect because of the
associated risks and lengthy recovery times. What you might not know is there
is an alternative: state-of-the-art technology now allows bulging discs and
other spine conditions to be treated on an outpatient basis with minimally
invasive spine surgery.
Bone
spurs
Bone
spurs are bony projections that develop along the edges of bones. Bone spurs
(osteophytes) often form where bones meet each other — in your joints. They can
also form on the bones of your spine. The main cause of bone spurs is the joint
damage associated with osteoarthritis.
Spinal stenosis
Stenosis means the abnormal narrowing of a body channel. When combined
with the word spinal, it defines a narrowing of the bone channel
occupied by the spinal nerves or the spinal cord.
Ligament hypertrophy
Ligamentum Flavum Hypertrophy which is also known by the
name of Ligamentum Flavum Thickening is a pathological condition of the spine
in which there is degeneration or swelling of the Ligamentum Flavum. This condition
is quite common for people who have chronic back pain.
Osteoarthriti
Sometimes called degenerative joint disease or “wear and tear”
arthritis, osteoarthritis (OA) is the most common chronic condition of
the joints. It occurs when the cartilage or cushion between joints
breaks down leading to pain, stiffness and swelling. pain.
Degenerative disc disease
Degenerative disc disease is one of the most common causes of low back and neck pain, and also one of the most misunderstood. Simply put, degenerative disc disease refers to symptoms of back or neck
pain caused by wear-and-tear on a spinal disc. In some cases,
degenerative disc disease also causes weakness, numbness, and hot,
shooting pains in the arms or legs (radicular pain). Degenerative disc
disease typically consists of a low-level chronic pain with intermittent
episodes of more severe pain.
Orthopedics
Orthopedic surgery or orthopedics, also spelled orthopaedic[s], is
the branch of surgery concerned with conditions involving the
musculoskeletal system.
Arthroscopy
Arthroscopy is a minimally invasive surgical procedure on a joint
in which an examination and sometimes treatment of damage is performed
using an arthroscope, an endoscope that is inserted into the joint
through a small incision.
Soft tissue repair
Soft tissue repair, for torn ligaments and tendons.
Joint replacement
Replacement arthroplasty, or joint replacement surgery, is a
procedure of orthopedic surgery in which an arthritic or dysfunctional
joint surface is replaced with an orthopedic prosthesis.
Revision joint surgery
Joint replacement surgeries for hips and knees affected by arthritis are almost always successful, restoring joint function and easing pain for nearly all patients who have them. But as more and more people undergo a joint replacement—including younger patients—it brings an interesting dilemma: More patients now need a second joint replacement, called a joint revision surgery, as they outlive their original joint implant.
Bone fracture repair
When you experience a bone break (also known as a fracture), it’s important that the bone can heal properly in its original position. There are several treatments for a broken bone, and the one a doctor recommends is based upon several factors. These include how severe the break is and where it is. While some bones can heal by wearing a cast, others may require more invasive treatments, such as bone fracture repair.
Bone fracture repair is a surgery to fix a broken bone using metal screws, pins, rods, or plates to hold the bone in place. It’s also known as open reduction and internal fixation (ORIF) surgery.
Debridement
Debridement is the medical removal of dead, damaged, or infected
tissue to improve the healing potential of the remaining healthy tissue.
Removal may be surgical, mechanical, chemical, autolytic, and by maggot
therapy.
Fusion of bones
Spinal fusion, also called spondylodesis or spondylosyndesis, is a
neurosurgical or orthopedic surgical technique that joins two or more
vertebrae.
Spine fusion
Spinal fusion, also called spondylodesis or spondylosyndesis, is a
neurosurgical or orthopedic surgical technique that joins two or more
vertebrae.
Osteotomy
An osteotomy is a surgical operation whereby a bone is cut to
shorten or lengthen it or to change its alignment. It is sometimes
performed to correct a hallux valgus, or to straighten a bone that has
healed crookedly following a fracture.
Pain
Management
Pain is complex, so there are many treatment options -- medications, therapies, and mind-body techniques.
Interventional procedures
An interventional procedure is used for diagnosis or for treatment. It involves: making a cut or a hole to gain access to the inside of a patient's body. For example, carrying out an operation or inserting a tube into a blood vessel.During a minimally-invasive microdiscectomy procedure, the herniated portion of the disc under the nerve root is removed.
Medication management
Medication management therapy – or MTM – is a treatment system used by doctors and pharmacists to ensure that patients are receiving optimal therapeutic outcomes for the prescription medications that they may be taking.
Physical therapy or chiropractic therapy
Physical therapy is used to diagnose and treat movement impairments and disorders of call kind. Treatments prescribed may be both active and passive stretching, hot/cold therapy, or specific exercises. The goal of physical therapy is to help patients regain lost mobility, maintenance care, or to prevent future injury. Treatments are generally administered in hospitals, nursing homes, or other locations and generally require a referral from a physician.Chiropractic is different in that its goal is to realign any spinal vertebrae that may be out of place, which can relieve pain and pressure on nerves. While the goals are the same as in physical therapy, the focus is shifted more towards correcting subluxations. Chiropractors will usually adjust a patient’s spine using their hands or adjusting devices in addition to using other potential treatments. Some are the same as what is used in physical therapy, including hot/cold therapy and stretching, but can also include electric muscle stimulation and ultrasound.
Psychological counseling and support
Psychologists are experts in helping people cope with the thoughts, feelings and behaviors that accompany chronic pain. They may work with individuals and families through an independent private practice or as part of a health care team in a clinical setting. Patients with chronic pain may be referred to psychologists by other health care providers. Psychologists may collaborate with other health care professionals to address both the physical and emotional aspects of the patient's pain.When working with a psychologist, you can expect to discuss your physical and emotional health. The psychologist will ask about the pain you experience, where and when it occurs, and what factors may affect it. In addition, he or she will likely ask you to discuss any worries or stresses, including those related to your pain. You also may be asked to complete a questionnaire that allows you to record your own thoughts and feelings about your pain.
Acupuncture and other alternative therapies
Acupuncture is indeed an effective and safe way to help relieve your back pain—when the treatment is administered by a trained and licensed acupuncturist. It is worth talking to your doctor about trying it for your particular back pain-related symptoms.
Podiatry
Your feet take the whole weight of your body, so it's important to take good care of them. Our list of Common Foot Problems helps highlight the issues and the way in which you can take care of your feet.
Ageing Feet
As we age, we naturally develop more problems with our feet due to normal daily wear and tear of joints, but also because the skin starts to become thin and loses its elasticity, as well as being dry and much more fragile.
Athletes Foot
Athlete’s foot is a skin fungal infection. It can lead to intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin usually between the fourth and fifth toes initially, or on dry, flaky skin around the heels or elsewhere on the foot. Large painful fissures can also develop and the condition can also spread along all five toes and sometimes to the soles of the feet if left untreated.
Blisters
Blisters are painful, fluid-filled lesions produced by friction and pressure. They can be caused by the following:
Ill-fitting footwear
Stiff shoes
Wrinkled socks against the skin
Excessive moisture
Foot deformities
Bunions
More than 15% of women in the UK suffer from bunions, but what is a bunion? A bunion, also known as ‘hallux valgus’ is a deformity of the big toe in which the big toe excessively angles towards the second toe and leads to a bony lump on the side of the foot. This can also form a large sac of fluid, known as a bursa, which can then become inflamed and sore.
Chilblains
Chilblains (also called pernio) are small itchy, red (and sometimes purple) swellings on the skin, which can become increasingly painful, can swell and then dry out leaving cracks in the skin which expose the foot to the risk of infection. They occur on the toes (particularly the smaller ones), fingers, the face (especially the nose) and the lobes of the ears. They can also occur on areas of the feet exposed to pressure, for instance, on a bunion or where the second toe is squeezed by tight shoes. They can also lead to blisters and break down to become a small ulcer prone to infection.
Corns & Callus
When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker to withstand the pressure. When this pressure becomes excessive, some areas of skin thicken in the form of corns and callus, as a protective response to the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground. Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type. Elderly people have less fatty tissue in their skin and this can lead to callus forming on the ball of the foot. Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core which may cause pain if it presses on a nerve. There are five different types of corns, the most common of which are ‘hard’ and ‘soft’ corns:
Hard corns – these are the most common and appear as a small area of concentrated hard skin up to the size of a small pea usually within a wider area of thickened skin or callus. This may be a symptom of the feet or toes not functioning properly.
Soft corns – these develop in a similar way to hard corns but they are whitish and rubbery in texture and appear between toes where the skin is moist from sweat or from inadequate drying.
Seed corns – these are tiny corns that tend to occur either singly or in clusters on the bottom of the foot and are usually painless.
Vascular corns – these can be very painful and can bleed profusely if cut.
Fibrous corns – these arise when corns have been present for a long time and are more firmly attached to the deeper tissues than any other type of corn. They may also be painful.
Gout
Arthritis is a disease of the joints which causes them to become inflamed and stiffen. There are three types of arthritis – Rheumatoid arthritis, Osteo-arthritis and the less common form, Gout.
Heel Pain
The heel is a specialised part of the body designed to absorb the impact of your body weight when walking, running or undertaking any other form of physical exertion or weight bearing exercise. When pain does develop, it can be very disabling, making every step a problem which in turn affects your overall posture There are various types of heel pain and the more common ones include:
Heel spurs (plantar fasciitis)
Heel bursitis (subcalcaneal bursitis)
Heel bumps
Ingrowing Toenail
An ingrowing toenail is one that pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too. Whereas a nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn't an ingrowing toenail but can feel very painful and also appear red and inflamed as well.
Osteoarthritis
Osteo-arthritis (OA) is often called the ‘wear and tear’ arthritis. It occurs when the cartilage of a joint (a thin layer of gristle that covers the end of the bones and allows them to glide over each other) becomes damaged. When the cartilage deteriorates, the bone underneath can thicken, causing pain, stiffness and swelling. The joints most affected are the knees, hips, hands and big toes. In severe cases, the cartilage can deteriorate to the extent that the bones rub together making it difficult to move the affected joint at all. Symptoms vary from person to person and some people may have OA without experiencing many symptoms at all.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a condition that causes inflammation in many joints of the body which particularly affects the hands, feet, wrists, ankles and knees – and tends to occur symmetrically. For example, if your right big toe is swollen and painful, chances are your left big toe will be too. In addition, as well as joint pain and stiffness, symptoms include muscle aches, anaemia (a low blood count leaving you feeling tired), and fever. The stiffness tends to be worse in the morning and after rest.
Sweaty Feet
Most of us have suffered from foot perspiration and odour from time to time, yet for some people, sweaty feet (along with sweaty palms and armpits) are a persistent problem which can be embarrassing and uncomfortable. For some people, this can affect their day-to-day life considerably resulting in decreased social contact with others but the condition is treatable. Sweaty feet is a complaint known as Hyperhidrosis (or excessive sweating) and has a lot to do with how the sweat glands in this part of the body work. With 250,000 sweat glands, feet do tend to sweat more than other parts of the body but with a daily hygiene routine, few people should suffer from the embarrassment that it may cause. There are more sweat glands per inch in our feet than anywhere else in the body and their function is to keep the skin moist and therefore supple and regulate temperature when the weather is hot, if you have an unnaturally high temperature or while exercising. They secrete all the time, not just in response to heat or exercise, like elsewhere in the body.
Verrucae
Verrucae are plantar warts that commonly occur on the soles of the feet or around the toe area. They are caused by the Human Papilloma Virus (HPV) which is highly contagious through direct person to person contact. There are various forms of HPV which all relate to various parts of the human body.
Urology
Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs.
Bladder Cancer
The wall of the bladder is lined with cells called transitional cells and squamous cells. More than 90 percent of bladder cancers begin in the transitional cells. This type of bladder cancer is called transitional cell carcinoma. About 8 percent of bladder cancer patients have squamous cell carcinomas. Cancer only in cells in the lining of the bladder is called superficial bladder cancer. This type of bladder cancer often comes back after treatment, but it does not tend to progress. If the tumor recurs, the disease often recurs as another superficial cancer in the bladder. Cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall. It may grow into a nearby organ such as the uterus or vagina in women or the prostate gland in men. It also may spread to other parts of the body.
Erectile Dysfunction
Erectile dysfunction (ED), also known as impotence, is a common condition affecting an estimated 20 to 30 million men in the United States and over 150 million men worldwide. ED is defined as a man's inability to achieve and maintain an erection that is sufficient for satisfactory sexual intercourse. The ability to have an erection requires the normal, integrative functions of the nerves, blood vessels, muscles and brain. ED may result from a variety of factors or a combination of factors. These may include psychological, neurological, hormonal and vascular disorders. Certain drugs and chronic diseases, as well as the natural aging process, also may contribute to ED.
Genitourinary Tract Injuries
About 10 percent of all injuries seen in the emergency room involve the genitourinary tract, including the kidneys, bladder, genitals, ureters and urethra.
Infertility in Men
As with female reproduction, male reproduction is hormonally driven, requiring a normally functioning hypothalamus and pituitary gland. As in women, gonadotropin releasing hormone, or GnRH, is released in a pulsatile fashion, stimulating the release of follicle stimulating hormone (FSH) and leutinizing hormone (LH). In men, LH primarily stimulates testosterone production, while FSH stimulates the production of sperm. The testes must be capable of response to this hormonal stimulus. In addition, there must be an intact ductal system to transport sperm to the urethra. The male external genitals consist of the scrotum, which houses the testes and associated ductal systems (the epididymis and vas deferens), and the penis. The testes are covered by a tough fibrous layer called the tunica albuginea, which divides the testes into lobules. Each of the 200 to 300 lobules contains one to three long and tightly coiled seminiferous tubules, within which sperm production occurs. In contrast to female eggs, sperm are continually produced throughout a man's lifetime. During spermatogenesis and transport through the male reproductive tract, the male spermatozoa are transformed into a highly specialized cell with its own motility and enzymatic capacity to penetrate the egg. Epididymal function must be normal and the accessory glands must be functional to produce normal seminal plasma. An intact nervous system is also required to permit penile erection and normal ejaculation.
Kidney Cancer
About 50,000 people in the United States are diagnosed with kidney cancer every year. The kidneys are a pair of kidney bean-shaped organs, located above the waist on either side of the spine, that filter and clean blood and produce urine.
The most common adult kidney cancer is renal cell carcinoma, which forms in the lining of small tubes in the kidney. Children usually develop a different form of kidney cancer called Wilms' tumor.
Peyronie's Disease
Peyronie's disease is a disorder affecting about three percent of men middle-age and older. The condition is caused by the formation of dense, fibrous scar tissue, or plaque, in the penis' tunica albuginea, the sheath that surrounds the erectile tissue.
The cause of Peyronie's disease is not completely known. However, factors such as genetics and trauma to the penis, which can occur due to injury or invasive penile procedures, may contribute to the disease.
Priapism
Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation. In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including sickle cell disease, pelvic tumors, pelvic infections, leukemia, genital trauma or spinal cord trauma, and medications or recreational drugs.
Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).
Ischemic Priapism — This is the most common form of priapism and usually occurs with several hours or days of a painful erection. It is caused by an obstruction in the penis' venous drainage, which results in a buildup of poorly oxygenated blood in the corpora cavernosa, the tissue that forms the bulk of the erectile body of the penis. Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function, by causing extensive scar tissue build-up and impotence.
Non-ischemic Priapism — This type of priapism is not as common or painful. It is usually caused by an injury to the penis or perineum, the area between the scrotum and anus. The injury causes the artery within the erectile body to rupture, and thus pump large amount of blood to the penis continuously.
Arthritis is a disease of the joints which causes them to become inflamed and stiffen. There are three types of arthritis – Rheumatoid arthritis, Osteo-arthritis and the less common form, Gout.
Testicular Cancer
When detected early, testicular cancer is highly treatable and usually curable, which is why early diagnosis and treatment are so important for men of all ages. Adolescent boys and young men should be particularly aware of the signs and symptoms of the disease and perform regular testicular self-exams.
Testicular cancer is a disease in which cells become malignant, meaning cancerous, in one or both of the testicles. Testicular cancer can be broadly classified into two types: seminoma and nonseminoma. Seminomas make up about 40 percent of all testicular cancers. Nonseminomas are a group of cancers that include choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumors. A testicular cancer may have a combination of both types.
Urethral Injuries
If the urethra is injured, a person may develop urethra obstructions or strictures. Urethral strictures occur when the urethra is injured or scarred by an infection and then narrows. As a result, problems with the normal passage of urine and semen can develop.
Urethral injuries can have devastating long-term consequences, such as potential complications of impotence, stricture and incontinence.
Injuries may affect either the anterior or posterior part of the urethra. In most cases, anterior urethral trauma is characterized as a blunt injury to the perineum — the area between the genitals and anus — since the urethra is located near the skin in this area. This type of trauma is often the result of straddle-like injuries, such as when a child forcefully straddles a bicycle or fence. Penetrating injuries to the anterior urethra, such as those from a gunshot wound, also may cause strictures or obstructions. Posterior urethral trauma affects the part of the urethra that travels inside the body. This type of trauma almost always occurs as a result of pelvic fractures following automobile accidents, serious falls or industrial crash injuries.
Vascular
Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction.
Amputation
Amputation is the removal of a limb (arm or leg) or part of an extremity (foot, toe, hand or finger/s) when an alternate treatment is not available or has failed, to remove bone and tissue due to:
Extensive infection.
Lack of blood supply.
Significant trauma.
Frostbite.
Severe burns.
Wounds.
Carotid Endarterectomy
A carotid endarterectomy is a surgical procedure to open or clean the carotid artery with the goal of stroke prevention. It is a durable procedure but not a cure; though rare, blockage can accumulate again.
Catheter-Directed Thrombolytic Therapy
Catheter directed thrombolytic therapy is a nonsurgical treatment for acute deep vein thrombosis (DVT) that dissolves blood clots. These clots typically occur in your leg, thigh or pelvis but can travel. If a DVT travels to your lungs (referred to as a pulmonary embolism or PE), it can cause shortness of breath, chest pain and lead to death.
Diabetic Foot Care
If you have diabetes, complications from the disease can put you at significant risk for amputation of a foot or leg. Diabetic foot care is a simple list of things you can do daily—at home, guided by your doctor—to protect your feet against wounds and avoid amputation.
Dialysis Access
If your kidneys fail, unless and until you have a successful kidney transplant, you will need dialysis therapy to clean and filter your blood. The first step is establishing dialysis access one of four ways:
A tunneled catheter in your neck—temporary, because the possibility of infection is high.
An AV fistula—taking a piece of a vein from your arm or leg and sewing it into a nearby artery, and allowing the sewn-in vein to enlarge and become thicker, like an artery. Considered the best option because it has the lowest risk of infection.
An AV graft—the sewing of a prosthetic graft between an artery and vein in your arm or leg. The preferred option if your veins are too small for an AV fistula. AV grafts tend to close more quickly and are more prone to infection because they are not formed from natural tissue.
Peritoneal dialysis—placement of a small tube, called a cannula, in your abdomen to allow the use of the lining of the abdomen (peritoneum) to filter your blood. It requires several “exchanges” every day: you introduce and remove fluid through the tube. A convenient option because you perform the dialysis therapy at home, but infections sometimes occur and the tube can become clogged.
Endovascular Repair of Abdominal Aortic Aneurysms
An aortic dissection is a tear in the lining of the aorta that creates two blood flow channels. One channel, called the true lumen, feeds blood to most of the important branches of the aorta and is surrounded by the normal aortic lining. The second channel, called the false lumen, may only feed a few (if any) important branches. Aortic dissection is a very complicated condition. Untreated, an aortic dissection can lead to death. A dissection that involves the ascending aorta almost always requires emergency open-heart surgery to repair the vessel and prevent death. ONLY ENDOVASCULAR TREATMENTS for distal dissections occurring beyond the left subclavian artery (feeds the left arm) are described here.
Endovascular Treatment of an Aortic Dissection
Priapism is an uncommon condition that causes a prolonged and often painful erection, which occurs without sexual stimulation. In a third of the cases, the cause is unknown. The remaining cases are caused by an associated condition, including sickle cell disease, pelvic tumors, pelvic infections, leukemia, genital trauma or spinal cord trauma, and medications or recreational drugs.
Priapism is classified into two types — ischemic (no-flow) or non-ischemic (high-flow).
Ischemic Priapism — This is the most common form of priapism and usually occurs with several hours or days of a painful erection. It is caused by an obstruction in the penis' venous drainage, which results in a buildup of poorly oxygenated blood in the corpora cavernosa, the tissue that forms the bulk of the erectile body of the penis. Ischemic priapism is considered a medical emergency and requires immediate treatment. If left untreated, the condition can significantly damage erectile function, by causing extensive scar tissue build-up and impotence.
Non-ischemic Priapism — This type of priapism is not as common or painful. It is usually caused by an injury to the penis or perineum, the area between the scrotum and anus. The injury causes the artery within the erectile body to rupture, and thus pump large amount of blood to the penis continuously.
Arthritis is a disease of the joints which causes them to become inflamed and stiffen. There are three types of arthritis – Rheumatoid arthritis, Osteo-arthritis and the less common form, Gout.
Open Surgery Treatment of an Aortic Dissection
When detected early, testicular cancer is highly treatable and usually curable, which is why early diagnosis and treatment are so important for men of all ages. Adolescent boys and young men should be particularly aware of the signs and symptoms of the disease and perform regular testicular self-exams.
Testicular cancer is a disease in which cells become malignant, meaning cancerous, in one or both of the testicles. Testicular cancer can be broadly classified into two types: seminoma and nonseminoma. Seminomas make up about 40 percent of all testicular cancers. Nonseminomas are a group of cancers that include choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumors. A testicular cancer may have a combination of both types.
Peripherally Inserted Central Catheter Line
PICC lines and central lines allow patients to receive medication or nutrition without staying in a hospital. Some of these lines can be left in place for several months.
A tunneled dialysis catheter (TDC) is a dialysis access option for people who need dialysis therapy and may not be able to have a fistula or graft placed. The TDC can be used as soon as correct placement is confirmed. Sometimes people use a TDC temporarily while they wait for a fistula or graft to mature.
Repair of a Thoracic Aortic Aneurysm
A thoracic aortic aneurysm or TAA is a bulging of the wall of the aorta, the main vessel that feeds blood from your heart to tissues and organs throughout your body. The aorta is normally about the size of a large garden hose. When the aorta expands to more than twice its normal diameter, it is called an aneurysm. When an aneurysm occurs in a portion of the aorta within your chest, it is called a thoracic (chest) aortic aneurysm or TAA. Usually affects elders, but not always About 15,000 people in the United States are diagnosed with this condition every year, usually people their 70s and 80s. Still, younger people can develop a TAA, particularly if they have certain genetic inherited diseases. You are more likely to develop a TAA if you are a smoker and if you have uncontrolled hypertension.
Thoracic aortic aneurysms are classified by their specific location, by their shape and by how they formed.
LOCATION: Aneurysms can occur in any of the three regions of the thoracic aorta:
THE ASCENDING AORTA comes directly out of the heart.
THE AORTIC ARCH is the next region; it has branches to provide blood to the upper body and to the head.
THE DESCENDING AORTA travels through the left chest and passes through the diaphragm where it becomes the abdominal aorta.
SHAPE: Aneurysms can be:
SACCULAR, affecting only a portion of the circumference of the aorta wall and bulging only on one side.
FUSIFORM, involving the entire circumference of the wall and shaped like a fat sausage.
Surgical Bypass
IN THE LEG, also called lower extremity bypass, leg bypass, fem-pop bypass, fem-tib bypass, fem-distal bypass. IN THE ABDOMEN, also called aortic bypass, aorto-iliac bypass, aorto-femoral bypass, fem-fem bypass, aorto-mesenteric, and ax-fem bypass, depending on which blood vessel is being bypassed. With the help of a natural or synthetic graft, a surgical bypass routes blood flow around an area of blockage caused by peripheral arterial disease (PAD). The surgery does not cure the disease or remove the blockage. Think of a surgical bypass as a road detour. How long it lasts varies The lifespan of a surgical bypass depends on the health of your arteries, the type of graft used (natural vein grafts last longer than synthetic ones) and other health factors, such as whether you smoke, or have diabetes or kidney failure.
Surgical Bypass for Aortoiliac Occlusive Disease
A surgical bypass reroutes blood flow around a diseased artery to increase blood flow to your legs. Surgical bypass is not a cure for aortoiliac occlusive disease. It is a treatment given to resolve the symptoms when medical management or minimally invasive therapies, such as balloon angioplasty and stenting, have not worked or are not suitable for you.
Thoracic Endovascular Aortic Repair
Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive procedure to repair the major blood vessel in the body, called the aorta. The aorta exits the heart and carries blood to all the organs and the rest of the body. After leaving the heart, the aorta branches to the arms and the brain before running down the back of the chest (thorax) into the belly (abdomen). The aorta forks at the level of the belly button (umbilicus) into branches that go down each leg. To fix or "re-line" the aorta, doctors place a device through a small hole in your groin, known as a stent graft. This device is made of a fabric-covered metal mesh which is fully opened under X-ray. The device repairs the diseased aorta and helps to keep it open and allow blood to flow properly to the rest of the body. The aorta can be affected by a number of different diseases including aneurysm, dissection, transection and stenosis.
Depending on the type of disease, the TEVAR procedure usually provides a cure. The procedure usually takes around 2 hours to complete.
The alternative to TEVAR is what doctors refer to as "open repair". This procedure requires a large incision through the breastbone or side of the chest, much more invasive compared to the small groin incision made with TEVAR.
Current devices (stent grafts) have a lifespan of at least 10 years.
Thrombolytic Therapy
Thrombolytic therapy is the administration of drugs called lytics or “clot busters” to dissolve blood clots that have acutely (suddenly) blocked your major arteries or veins and pose potentially serious or life-threatening implications. To be effective, the therapy needs to be initiated as soon as possible, before permanent damage has occurred. The length of a treatment session varies depending on the underlying cause. A session can take from 60 minutes (typical for a heart attack) to 48 hours (often the case for deep vein thrombosis, or DVT).