Services

Surgical Services

We offer a full range of surgical services from minor procedures to advanced cancer care. If you have any questions about a service that is not listed here, please contact our office to discuss your specific needs.

  1. Aortic Aneurysms

    What Are Abdominal Aortic Aneurysms?

    An aortic aneurysm is an abnormal bulge in the wall of the aorta, the body’s largest. Although an aneurysm can develop anywhere along your aorta, most occur in the section running through your abdomen. The rest occur in the section that runs through your chest. The weakened artery wall may stretch as blood is pumped through it from the heart. The bulge or ballooning may be symmetrical . An aneurysm may occur because of a localized weakness of the artery wall. If the diameter of the aneurysm is more than 1.5 times the size of the normal aorta, it is called an aneurysm. An aortic aneurysm may rupture, causing life-threatening internal bleeding. The risk of an aneurysm rupturing increases as the aneurysm gets larger. The risk of rupture also depends on the location of the aneurysm.
    Shape
    Fusiform aneurysms
    -Most fusiform aneurysms are true aneurysms. The weakness is often along an extended section of the aorta and involves the entire circumference of the aorta.
    Saccular aneurysms
    -Saccular aneurysms appear like a small blister or bleb on the side of the aorta and are asymmetrical.
    Cause
    Degenerative aneurysms
    -Degenerative aneurysms are the most common types of aneurysms. They occur as the result of breakdown of the connective tissue and muscular layer. The cause could be cigarette smoking, high blood pressure and/or genetic conditions.
    Dissecting aneurysms
    -Dissecting aneurysms occur when a tear begins within the wall of the aorta, causing the three layers to separate. The dissection causes the wall of the aorta to weaken, and the aorta enlarges. Dissections may occur any place along the aorta and treatment depends upon the location. Frequently, those involving the ascending aorta are treated with emergency surgery while those involving the descending thoracic aorta are treated with medication
    Location
    Thoracic aortic aneurysms
    -The aorta is shaped like an old-fashioned walking cane with the short stem of the curved handle coming out of the heart and curling through the aortic arch which gives off branches to the head and arms. Then the aorta descends through the chest cavity into the abdomen and separates off to provide blood to the abdominal organs and both legs. Thoracic aneurysms can occur anywhere along the aorta above the diaphragm, including the ascending aorta, the aortic arch, and the descending thoracic aorta.
    Abdominal aortic aneurysms
    -Abdominal aortic aneurysms are located along the portion of the aorta that passes through the abdomen. Continuing from the thoracic aorta, the abdominal aorta carries blood down through the abdomen until it eventually splits off into two smaller arteries that provide blood to the pelvis and legs.

  2. Appendectomy

    Appendectomy

    Related Diseases
    Appendicitis What is an appendectomy and why is it necessary? An appendectomy is the surgical removal of the appendix. It is the routine treatment for appendicitis, the swelling of the appendix due to inflammation. An appendectomy may be performed with an open incision or with laparoscopic instruments. During the procedure, the finger-like appendix is tied off, cut, and removed. If the appendectomy is performed laparoscopically, the surgeon will use slender instruments inserted through several small incisions.

  3. Dialysis Access

    Dialysis Access

    Basic Facts
    ¬ Dialysis access refers to the creation of a portal into the bloodstream so blood can be cleansed by dialysis.
    ¬ The portal is commonly located in the arm, the leg, or the neck.
    ¬ The best access is provided by a fistula, in which an artery and vein are joined under the skin in a minor surgical procedure.
    Hemodialysis, also called dialysis, is a procedure in which blood is circulated through a machine that cleans it of impurities and regulates fluid and chemical balances. To prepare for long-term dialysis, a surgeon crafts an easy-to-access portal, called the dialysis access, into the bloodstream under the skin. This portal allows blood to be removed and returned speedily and efficiently during the dialysis.
    Individuals who suffer from sudden kidney failure begin dialysis using a catheter, a soft, thin, flexible tube that is inserted into a large vein in the neck, the chest, or the leg near the groin. Catheters rarely are a permanent solution. They can clog, become infected, or dislodge. As a result, the physician will recommend the creation of a permanent portal under the skin. Creating the portal is considered minor surgery.

  4. Breast Procedures

    Breast Mass

    Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign (not cancer) or malignant (cancerous).
    A breast biopsy is performed to remove some cellseither surgically or through a less invasive procedure involving a vacuum assisted hollow needlefrom a suspicious area in the breast and sent to pathology to be examined them under a microscope to determine a diagnosis. Image-guided needle biopsy is not designed to remove the entire lesion, all though we try to remove as much as possible, most of the small lesions may be removed in the process of biopsy.
    Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation).
    In ultrasound-guided breast biopsy, offered at our office, ultrasound imaging is used to help guide the vacuum assisted instruments to the site of the abnormal growth. A titanium marker, the size of a needle head is placed in the biopsy site for further reference.
    In stereotactic breast biopsy, x-ray imaging is used to find the lesion; this procedure is performed under local anesthesia at the hospital.
    Pathology results are usually ready within 3 to 5 days after the surgery date, It is very important to follow up at the office to find out what the diagnosis and treatment will be recommended by the physician.

    Fibroadenomas

    Fibroadenomas are one of the findings that can be seen on your mammogram. They are benign (not cancerous) breast tumors that are made of glandular and fibrous breast tissue. Fibroadenomas can occur alone, in groups or as a complex. If you have multiple or complex fibroadenomas, this may raise your risk of breast cancer slightly.
    While doing your regular breast self-exam, you may feel a breast fibroadenoma. These feel firm, round, smooth, rubbery, and are movable. They are so mobile that women sometimes refer to them as breast mice because they tend to run away from your fingers. A fibroadenoma may feel tender, especially right before your period, when it may swell due to hormonal changes.
    Fibroadenomas range in size from one to five cm, (0.39 inches to nearly two inches). Giant fibroadenomas can be the size of a small lemon, about 15 cm (5.9 inches).
    Fibroadenomas appear as round or oval smooth-edged masses. The outline of the mass will be clearly defined, not blurry. Sometimes they are accompanied by coarse calcifications. Fibroadenomas can look like cysts or a well-contained tumor.
    Your doctor or radiologist may send you to have an ultrasound study done. This is because a fibroadenoma will be easier to distinguish from other tissue, because of the way it responds to sound waves. It will appear as a dark area, with a definite outline, homogeneous, round or oval, and may have smooth-edged bumps. If the ultrasound doesnt give a definite result, the next study may be an MRI (magnetic resonance image). The most conclusive test is a fine needle biopsy or a core needle biopsy, to get a sample of the cells for a pathologist to examine.

    Breast Cancer

    Breast cancer starts in the ducts or lobules of the breast. Cells lining the ducts or lobules can grow out of control and develop into cancer. Some breast cancers are found when they’re still confined to the ducts or lobules of the breast. This is called pre-invasive breast cancer. The most common types are ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).
    Most breast cancers are found when they’re invasive. This means the cancer has spread outside the ducts or lobules of the breast into surrounding tissue. The most common types are invasive ductal cancer (IDC) and invasive lobular cancer (ILC). The exact cause of breast cancer is not known.
    Some factors increase the risk:
    -Getting older
    -Having several close relatives, like a mother, sister or daughter, diagnosed with breast cancer
    -If you’ve had breast cancer before
    -If you’ve had certain breast conditions such as atypical ductal hyperplasia or lobular carcinoma in situ.
    *Having some of these risk factors doesn’t mean that you’ll develop breast cancer. Most women with breast cancer have no known risk factors, aside from getting older.

    Mastectomy

    Mastectomy is the partial or total removal of the breast for treatment of breast cancer. There are different types or degrees of mastectomy. Your surgeon will help you determine the best course of treatment for you. McAllen Surgeons, LLP practice “breast conservation” whenever possible.
    ¬ A lumpectomy is a type of mastectomy in which the surgeon removes the tumor and part of the breast tissue surrounding the tumor.
    ¬ Axillary node dissection is the removal of axillary lymph nodes located beneath the armpit. These lymph nodes are responsible for filtering fluid from surrounding tissue including the breast.
    ¬ A subcutaneous mastectomy is where the subcutaneous breast tissue is removed and the overlying skin and nipple are left intact.
    ¬ A modified radical mastectomy includes the removal of the breast as well as all of the lymph nodes.

    Cryotherapy for Breast Fibroadenoma

    There is a growing interest in minimally invasive treatments for benign breast tumors, initiated by both patients and healthcare professionals. As an alternative to conventional surgical removal for benign breast fibroadenomas, cryotherapy ablation offers a minimally invasive, short 30 minute procedure with minimal to no scarring. Furthermore, cryotherapy requires only local anesthesia whereas conventional surgical excisions involve conscious sedation.
    U.S. Food & Drug Administration (FDA) approved cryoablation as a treatment for biopsy-proven breast fibroadenomas. Recommendations by the American Society of Breast Surgeons specify that the tumor must be sonographically visible, should be less than 5 cm in diameter, and that diagnosis has to be histologically confirmed for cryosurgical treatment.
    Minimally invasive techniques as alternative to surgical removal of benign breast tumors include vacuum assisted biopsy and various ablation technologies, including FDA-cleared cryoablation as well as investigational technologies such as Radiofrequency (RF) ablation and high-intensity focused ultrasound (HIFU).
    Breast fibroadenoma cryoablation, an image-guided and minimally invasive procedure, is performed with ultra-thin needles inserted percutaneously in the breast directly to the benign tumor. The tip of the cryoablation needle is cooled to sub-zero temperatures to create an ice ball. The Cryosurgical ablation of breast fibroadenoma can be performed as an office or outpatient procedure with standard ultrasound for direct observation and monitoring of the procedure.
    The cryosurgery (freezing) itself acts as an anesthetic, so patients remain awake and are given only local anesthesia to numb the breast. As compared to other ablation treatments, the cryo procedure results in minimal pain.

  5. Carotld Endarterectomy

    Carotid Endarterectomy

    Basics Facts
    ¬ Atherosclerotic plaque buildup in the carotid arteries can cause complete blood flow blockage or can break off into small floating particles that can result in transient ischemic attacks or stroke.
    ¬ The surgical removal of the inner lining of a carotid artery that contains plaque deposits is called carotid endarterectomy.
    ¬ Carotid endarterectomy is a safe and durable treatment that has been shown to prevent stroke.
    The two common carotid arteries bring oxygenated blood from the heart through the neck to each side of the head. Each main artery branches off into the external carotid and internal carotid arteries. The internal carotid artery is the important branch because it continues into the brain. The external carotid artery is one of many arteries that supply blood to the face and scalp. As people age, plaque can build up inside their arteries. Over time, these plaques collect on arterial walls as cholesterol circulates in the blood. As the plaques enlarge, the arteries become narrow and stiff, a process called atherosclerosis or hardening of the arteries. Plaque buildup is typically seen in the carotid artery at the point where it branches into the internal and external carotid arteries and in the origin, or lower part, of the internal carotid artery. Endarterectomy is a treatment for carotid arteries that are partially blocked by atherosclerotic plaque, and is usually only done when the amount of partial blockage is severe enough to threaten a stroke. Endarterectomy is performed vascular surgery procedure.

  6. Colon Resection

    Colon Resection

    What is a colon resection and why is it necessary?
    A colon resection is the surgical procedure to remove a part or the entire colon (large intestine). A colon resection may be performed to treat the following colon problems:
    ¬Bowel obstruction
    ¬ Strictures
    ¬ Fistulas
    ¬ Abscesses
    ¬ Diverticulitis
    ¬ Crohns Disease
    ¬ Colon cancer
    ¬ Inflammatory bowel disease
    ¬ Bleeding arteriovenous malformations
    ¬Volvulus or twist

  7. Gall Bladder Removal

    Gall Bladder Removal

    Related Diseases
    -Cholangitis
    -Cholecystitis
    What is a cholecystectomy and why is it necessary?
    Cholecystectomy is the surgical removal of the gallbladder, which is located in the abdomen beneath the right side of the liver. Gallbladder problems are usually the result of gallstones, usually related to right upper abdomen pain, radiating to the back. These stones may block the flow of bile from your gallbladder, causing the organ to swell. Other causes include cholecystitis (inflammation of the gallbladder) and cholangitis (inflammation of the bile duct).

  8. Ventral Hernia

    Ventral Hernia

    You have an abdominal wall hernia. Because of your current symptoms and/or findings, and the potential for complications arising from the presence of this hernia, surgical repair has been
    recommended. Hernias are a very common problem. They can occur in men or women of all ages, but are more common in men. A hernia occurs due to a weakness, gap or opening in the muscles or tendons of the abdominal wall, resulting in a bulge of intra-abdominal contents and/or pain or discomfort. This pain and discomfort is the result of tissue nerves in this area being irritated or stretched as the surrounding abdominal wall is also stretched. Hernias are most common in the groin, but can occur anywhere in the abdominal wall, including around the umbilicus (bellybutton) or at the site of a prior incision.

  9. Hiatal Hernia

    Hiatal Hernia/ Lap Nissen Fundoplication

    Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing. The cause is unknown, but hiatal hernias may be the result of a weakening of the supporting tissue. Increasing age, obesity, and smoking are known risk factors in adults. Children with this condition are usually born with it (congenital). It is often associated with gastroesophageal reflux (GERD) in infants.
    Hiatal hernias are very common, especially in people over 50 years old. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.
    Most usual symptom is burning sensation behind the breastbone. Sometimes it can be very mild, sometime it can become so painful that it could be hard to concentrate on anything else but the pain.
    Another one is burping, belching and other unpleasant things. There are certain kinds of foods which guaranteed to give you this (like soft drinks).
    Sour taste in your throat usually occurs in the morning. If you experiencing this symptom every morning and taste is really sour it is time to do something about your heartburn. Nightime heartburn in a very bad stage you must work hard to put it under control.
    Sore throat is tricky, since it is very easy to confuse it with cold.
    Swallowing difficulties is pretty scary. If your heartburn is causing you swallowing problems run to the doctor now. This symptom could be a sign of something serious. Usually based on this symptom your family doctor will refer you to gastroenterologist who will perform an endoscopy.
    Chest pain, a very confusing one. But if you have this symptom it does makes sense to consult with your doctor. It is better to make sure that it is not a problem with your heart than have unpleasant surprises later.

  10. Peripheral Arterial Bypass Surgery

    Peripheral Arterial Bypass Surgery

    What is Peripheral Vascular Disease?
    Your arteries are normally smooth and unobstructed on the inside but they can become blocked through a process called atherosclerosis, which means hardening of the arteries. As you age, a sticky substance called plaque can build up in the walls of your arteries. Cholesterol, calcium, and fibrous tissue make up the plaque. As more plaque builds up, your arteries can narrow and stiffen. Eventually, as the process progresses, your blood vessels can no longer supply the oxygen demands of your organs or muscles and symptoms may develop.
    What is surgical bypass?
    Surgical bypass treats your narrowed arteries by creating a bypass around a section of the artery that is blocked. During a bypass, your vascular surgeon creates a new pathway for blood flow using a graft. A graft is a portion of one of your veins or a man-made synthetic tube that your surgeon connects above and below a blockage to allow blood to pass around it. You may be familiar with bypass surgery on heart arteries, but vascular surgeons also use bypasses to treat peripheral arterial disease (PAD). Surgeons use bypasses most commonly to treat leg artery disease, which is hardening of the arteries in the leg. Surgeons also use bypass to treat arm artery disease.

  11. Thyroidectomy

    What is the thyroid gland?

    The thyroid gland is shield-like organ located just below the larynx or Adam’s apple. It is a small gland that wraps around the trachea or windpipe. The gland converts iodine from the diet into the thyroid hormone, thyroxine. The levels of this hormone control most of your body’s metabolic functions including temperature, heart rate and growth.

    What are the indications for thyroid surgery?

    Thyroid surgery (thyroidectomy) may be required if there is:
    -A lump that could be a malignant tumour (thyroid cancer). This is usually determined by a fine needle biopsy of the lump.
    -A goitre (enlargement of the thyroid) causing pressure on surrounding organs resulting in symptoms such as difficulty swallowing, difficulty breathing or a persistent cough.
    -Growth of your thyroid down into the chest cavity (a retrosternal goitre)
    -Excessive activity of the thyroid (hyperthyroidism or thyrotoxicosis)

    Thyroidectomy

    A thyroidectomy is the procedure performed to remove all or part of the thyroid gland. Located in the front of the neck, the thyroid is a butterfly-shaped gland, consisting of two lobes connected by an isthmus. The gland is responsible for regulating metabolism by secreting hormones. When diseases affect the thyroid, its size or activity may become abnormal. These diseases include thyroid cancer, goiter, and hyperthyroidism. Thyroid problems can often be treated medically, but in some cases, the thyroid needs to be removed. The extent of thyroid removal depends on the patient’s condition.

  12. Esophagogastrectomy
    An Esophagogastrectomy is a surgery to remove the esophagus and part of the stomach. The esophagus is then replaced in one of two ways: by moving the remaining portion of the stomach upwards, or by replacing it with a section of the large bowel (colonic reconstruction). Lymph nodes near the esophagus may also need to be removed. Your doctor will discuss with you what procedure is most likely to be needed for your situation. This surgery is typically done for people with esophageal cancer or people with Barretts .
    Esophagitis, is for those who are at high risk for developing esophageal cancer. This operation removes the diseased portion of the esophagus.
    Swallowing problems or dysphagia are common in people with esophageal cancer. Often times these swallowing problems cause people to have a difficult time eating. Surgery should help reduce swallowing problems.
    You should get a good understanding of the purpose of this surgery when you discuss this with your doctor. It may be to remove all of the cancer, or the diseased area. Or, it may be to help lessen your symptoms. Please always ask questions that you have. Our care team will try to give you the information you need.
  13. Ultrasound Guided Thyroid Fine Needle Aspiration
    Ultrasound Guided Thyroid Fine Needle Aspiration

    What are Thyroid Nodules?

    Simply put, thyroid nodules are lumps that commonly arise within an otherwise normal thyroid gland. Often these abnormal growths of thyroid tissue are located at the edge of the thyroid gland, so they can be felt as a lump in the throat. When they are large or when they occur in very thin individuals, they can even sometimes be seen as a lump in the front of the neck.
    Once a thyroid nodule has been detected (or suspected), there are a few things that the physician will want to know before any recommendations can be made regarding treatment. Remember, the vast majority of thyroid nodules are benign and nothing to worry about, so the focus is on determining which ones have any reasonable chance of being cancerous.

    How can I know if I have a thyroid nodule?

    One of the first tests that is routinely performed is the ultrasound.This simple test uses sound waves to image the thyroid. The sound waves are emitted from a small hand-held transducer that is passed over the thyroid. A lubricant jelly is placed on the skin so that the sound waves transmit more easily through the skin and into the thyroid and surrounding structures. This test is quick, accurate, cheap, painless, and completely safe. It usually takes only about 10 minutes and the results can be known almost immediately. Not all nodules need this test, but it is almost routine.

    How do I know if I should have surgery?

    Certain characteristics of thyroid nodules seen on an ultrasound are more worrisome than others. Keep in mind, however, that an ultrasound alone cannot make the diagnosis of cancer. The FNA will usually (but not always) tell if a nodule is benign or malignant. This is often the only test needed. This test will usually help determine that the nodule has a low chance of being cancerous (has characteristics of a benign nodule), or that it has some characteristics of a cancerous nodule, and therefore a biopsy is indicated.