The gallbladder is an organ in the upper right side of the abdomen that functions to store bile. When stones form within the gallbladder, or it becomes inflamed, symptoms such as abdominal pain, bloating, nausea/vomiting or fever can occur. Disease of the gallbladder is usually diagnosed with a sonogram or HIDA scan. Surgical removal of the gallbladder (cholecystectomy) is typically performed laparoscopically. While most patients can go home the same day of surgery, hospitalization may be required for more severe episodes of infection or inflammation.
Hernias are defects in the muscular layer of the abdomen that allow abdominal contents to protrude at times. They may have no symptoms, or present as a painful mass or bulge that gets worse with straining or lifting. Most hernias can be repaired electively in an outpatient setting. Incarcerated hernias may present as a surgical emergency, and occasionally require resection of their contents (usually intestine). There are several types of hernias:
Inguinal hernias are present in the groin, and are due to a natural weakness in the musculature that can allow the abdominal contents to protrude. Surgery can be performed both laparoscopically under general anesthesia, or using a single incision in the groin under local anesthesia. Surgical mesh is usually implanted.
Umbilical hernias are present at the umbilicus, or belly button. These can also be repaired laparoscopically, or using an open technique with local anesthesia. Surgical mesh is frequently employed.
Ventral or incisional hernias occur in prior surgical sites where the muscles have not completely healed. These can also be repaired using open or laparoscopic techniques, usually with the implantation of mesh.
Hiatal hernias are defects in the breathing muscle (diaphragm) that allow the stomach to slide from its normal location in the abdomen up into the chest. These may be asymptomatic if small, or cause heartburn, reflux, cough, or regurgitation. Hiatal hernias are usually diagnosed with an endoscopy (EGD), which involves passing a flexible scope through the mouth into the stomach. Initial treatment of small hernias may consist of acid-reducing medications, but surgery is effective for patients who do not get adequate relief or choose not to take these medications long-term. Surgery is generally laparoscopic, and may involve wrapping the stomach around the esophagus (Nissen fundoplication). In patients who undergo bariatric surgery, hiatal hernias are frequently repaired at the same time if present.
A variety of intestinal procedures are performed at South Texas Surgeons: colon resections for diverticulitis or tumors, and small bowel surgery for tumors, inflammation, or obstruction. Surgery can be performed laparoscopically or open, if necessary. Appendicitis is almost always treated by laparoscopic removal of the appendix, with the patient frequently being able to go home the same day.