Other Surgical Procedures

Endocrine surgery (thyroid and parathyroid surgery)

Thyroid surgery may be recommended for cancer, a suspicious nodule or a benign (non-cancerous) condition, such as a large thyroid gland (goiter), overactive thyroid (Graves’ disease) or toxic nodule. The most common thyroid operations are the lobectomy, which removes half of the gland, and the total thyroidectomy, which removes all identifiable thyroid tissue. The advantage of having a lobectomy is that patients may not need to take thyroid hormone pills.
The most common reason for surgical removal of the parathyroid is hyperparathyroidism. Treatment typically consists of surgery to remove the one parathyroid gland (there are four) that is over-producing hormone. The abnormal gland often can be localized with imaging prior to surgery, which may allow the surgeon to perform a minimally invasive parathyroidectomy through a smaller incision. In the rare case where all four glands are involved, surgery retains enough of one gland to maintain hormonal function.

Diagnostic laparoscopy

Diagnostic laparoscopy is performed for several reasons, including to conduct lymph node biopsies or when a diagnosis for unexplained abdominal pain cannot be made through other diagnostic testing. The diagnostic laparoscopy:
– Enables a complete look at the entire abdomen without a major open surgical procedure
– Prevents patients from having unnecessary open surgery
– In some cases, allows immediate treatment

In some instances, a hernia or adhesion resulting from an earlier surgery, infection or inflammation is discovered through this procedure. In these cases, the surgeon can then perform a hernia repair immediately or, if adhesions are found, perform a procedure called lysis. During lysis of adhesions, the surgeon carefully cuts away the scar tissue, freeing the abdominal organs and the source of pain.

Soft tissue procedures

– Sebaceous cysts and epidermal inclusion cysts are very common. They occur when skin grows ‘upside down.’ In cases where they become infected, they can be removed in the office.
– Lipomas, which are slow-growing, benign lumps, may be removed in the office or the operating room, depending on their size and location. They most commonly occur on the neck, shoulders, back, abdomen, arms and thighs and can be painful if they begin to press on nearby nerves.
– Muscle biopsy is the removal of a small piece of muscle tissue for examination. The biopsy involves making a small cut in the skin and into the muscle to remove the tissue. This test is performed to identify or detect diseases of the connective tissue and blood vessels, infections that affect the muscle, muscular disorders such as muscular dystrophy or metabolic defects of the muscle.
– A temporal artery biopsy is a procedure in which a small piece of tissue is removed from the temporal artery and then studied under a microscope to check for signs of inflammation and damage. This procedure is performed when temporal arteritis (also known as giant-cell arteritis or cranial arteritis) is suspected. The patient can go home on the same day as the procedure.

Pilonidal cysts

These cysts, which are caused by hairs that grow inward, are almost always located near the tailbone or buttocks. Pilonidal cysts occur most frequently in young men and women. They are harmless, but they are vulnerable to infection. If a patient develops pain and swelling in the area, and the skin becomes red, surgery is usually performed in the office to drain the cyst. If drainage becomes chronic, more definitive surgery is performed in the operating room to excise the “pits” that are the source of the inflammation. Wound closure can take two or more weeks.