Surgery

Our surgeons can help you with many types of breast problems.

Our skilled breast surgeons focus on surgical care for breast diseases and breast problems, such as:

• Breast cancer
• Breast cysts
• Fibroadenomas or other lumps in the breast

Breast surgery may be suggested to help with many breast problems, including:

• Invasive breast cancer or non-invasive breast cancer (DCIS and LCIS)
• Atypical ductal hyperplasia (a marker that may make your chances of getting breast cancer go up)
• Atypical lobular hyperplasia (growth of abnormal cells in the breast)
• Intraductal papilloma (a type of benign lump in the breast)
• Flat epithelial atypia (non-cancerous, but abnormal cells found in the breast)
• Phyllodes tumors (a type of tumor found in the breast)
• Microcalcifications (abnormal calcium deposits in the breast)
• Breast abscess (a swollen area of tissue)
• Bloody nipple discharge (when fluid leaks out)
• Metastasis (the spread) of breast cancer

Available services include: 

• Genetic counseling or talking to a specialist to better understand your family's chances of inheriting or being born with a higher chance of getting a disease
• Breast cancer risk assessment (to look at your chances of getting breast cancer)
• BRCA gene testing (to look at your inherited chances of getting breast cancer)
• Chemoprophylaxis (using medicine) to help stop breast cancer 
• Cryoablation of benign (not harmful) breast tumors
• Lymphedema (swelling of arms or legs) therapy
• myRisk^® gene testing (to look at your inherited chances of getting breast cancer)
• Nutritional counseling (help with healthy eating)
• Oncotype DX testing (to look at your inherited chances of getting cancer)
• Physical therapy referral     
• Referral for breast MRI (an imaging service)
• 3D mammography (breast X-ray)

Minor surgeries include: 

• Axillary lymph node dissection (removing lymph nodes)
• Axillary reverse mapping (a technique that uses dye to look at the lymph system)
• Central duct excision (removing part of breast) to correct bloody nipple discharge
• Excision of gynecomastia (removing extra male breast tissue)
• Lumpectomy (removing a lump in the breast)
• Modified radical mastectomy (removing part of the breast)
• Needle-localized (in a particular place) lumpectomy
• Nipple-sparing mastectomy (removing part of breast while saving nipple)
• Oncoplastic surgery (breast reconstruction after breast removal)
• Port placement for chemotherapy (putting a tube in the skin to help with cancer care)
• Radical mastectomy (removal of breast as well as other muscle and tissue near it)
• Reconstruction (when surgeons help recreate breast shape after breast removal)
• Sentinel lymph node biopsy (when tissue is taken from the body for testing)
• Skin-sparing mastectomy (removing breast while saving skin)
• Simple mastectomy (a type of breast removal that saves breast skin)
• Total mastectomy (removing the entire breast and breast tissue around it)

We use cryoablation as a minimally invasive way to take care of breast fibroadenomas without surgery. Fibroadenomas are benign (not cancerous) tumors and not life threatening.

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• Steve Martinez, MD
• Darryl Schuitevoerder, MD
• Perry Soriano, MD

Colon and rectal surgery (colorectal surgery) is a specialty that focuses on care and surgeries for lower digestive tract problems. Our colon and rectal team are experts in colon and rectum surgery and colon resection.

Colorectal surgeons specialize in screening and testing, such as colonoscopy (an exam of the inside of the large intestine that uses a tube that bends easily with a lens at the end). They are also experts in care before and after surgery.

Our colorectal team works closely with providers and staff in other medical specialties, including:

• Gastroenterology (digestive system and liver)
• Gynecology (female reproductive system)
• Urology (male and female urinary tract systems)
• Internal medicine (care for adults)
• Family medicine (care for people of all ages)

They also work with other specialties to make sure you get the care you need when you need it. 

Some of the colon and rectal surgeries and disorders our team can help you with include:

• Anal issues, including hemorrhoids, abscesses (swollen tissue), fistulas (abnormal tissue connecting two body parts) and fissures (a small tear in the lining of the anus)
• Cancer of the colon and rectum (colorectal cancer)
• Colorectal cancer and screening
• Colorectal polyps (growths in the colon and rectum)
• Diverticular disease (diverticulitis or when the large intestine is swollen or infected)
• Fecal incontinence (not able to start or stop bowel movements)
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
• Irritable bowel syndrome (IBS)
• Laparoscopic colon resection (a colon surgery done with small incisions or cuts in the abdomen or middle of the body)
• Pelvic floor disorders (rectal prolapse)
• Pilonidal disease (a type of skin infection in the crease of the buttocks or backside)
• Severe constipation problems or problems with lack of bowel movements

• Darryl Schuitevoerder, MD 
• Perry Soriano, MD
• Sara Worden, MD

Our endocrine surgery team specializes in surgeries on the endocrine glands (thyroid, parathyroid and adrenal glands) or the part of the body that puts hormones into the blood.

Usually surgery is done to remove a tumor on or within the endocrine gland for a hormonal response in the body.

Endocrine surgery can help with a range of problems, including:

Adrenal (glands near the kidney or the part of the body that filters blood)

• Primary hyperaldosteronism (Conn's Syndrome or problem with the adrenal gland)
• Cushing's syndrome (a type of tumor)
• Pheochromocytoma (a type of rare tumor)
• Adrenal mass (a type of abnormal growth)

Pancreas (an organ near the intestines, liver and stomach)

• Gastrinoma (a type of tumor)
• Insulinoma (a type of tumor)

Thyroid (a gland in the neck)

• Papillary thyroid carcinoma (carcinoma is a type of cancer)
• Follicular thyroid carcinoma
• Hurthle cell thyroid carcinoma
• Medullary thyroid carcinoma
• Thyroid lymphoma (a type of cancer)
• Anaplastic thyroid carcinoma
• Thyroid nodule (a lump in the thyroid)
• Thyroid adenoma (a benign tumor)
• Goiter (a large thyroid that isn't normal)
• Multinodular goiter (a goiter with many nodules)
• Hashimoto’s thyroiditis (a type of thyroid disease)
• Graves’ disease or hyperthyroidism (a type of thyroid problem)
• Thyroid cysts (a type of growth in the thyroid)

• Joseph Drosdeck, MD
• Steve Martinez, MD
• Perry Soriano, MD
• William Truong, MD

Foregut, esophageal and acid reflux surgery focuses on caring for problems of the upper digestive tract or the esophagus, the part of the body that connects the throat and stomach.

Our foregut and esophageal surgeons are board certified in general surgery and also have fellowship or specialty training in the diagnosis and treatment of disorders affecting these parts of the body.

Our surgical team works closely with other providers and staff in other specialties, including gastroenterology, internal medicine and family medicine to make sure you get the care you need, when you need it.

Common signs of foregut, esophageal (in the esophagus) and acid reflux (burning pain or heartburn in the chest area caused by stomach acid) issues include:

• A burning or sharp sensation of the upper abdomen (middle of the body) or chest made worse by changing position
• Regurgitation or effortless vomiting
• Problems with swallowing
• A long-term cough or hoarseness that won’t go away 

Some types of foregut and esophageal disorders we can help with include:

• When the lower esophageal sphincter or esophagus doesn't work normally
• Benign and malignant (cancerous) tumors of the esophagus and stomach
• Delayed emptying of the stomach
• Esophageal motility disorders or problems moving food through the esophagus (for example, achalasia or a swallowing problem)
• Gastroesophageal reflux disease (also known as GERD)
• Hiatal or paraesophageal hernia (when part of an organ pushes out)
• Increased gastric acid production

• Joseph Drosdeck, MD
  
• William Truong, MD

General surgery focuses on care of the abdominal (middle of the body) area, including the:

• Esophagus
• Stomach
• Small bowel
• Colon
• Liver
• Pancreas
• Gallbladder
• Bile ducts
• Thyroid gland
• Parathyroid gland

Our general surgery team of providers work to use minimally invasive techniques (laparoscopic, robotic) to surgical disorders of the:

• Esophagus
• Stomach
• Liver
• Gallbladder (a small pouch near the liver)
• Pancreas
• Spleen
• Adrenal glands
• Small and large intestine
• Abdominal wall (for a hernia)
  

Minimally invasive techniques can also be provided to patients who may benefit from bariatric (weight loss) surgery.

Our expert surgeons do the following surgeries:

• Adrenalectomy (a surgery to remove tumors on the adrenal glands)
• Breast
• Cholecystectomy (removal of gallbladder)
• Colon
  
• Colectomy (a surgery to remove part of the colon)
• Heller myotomy (a type of surgery to help with swallowing problems)
• Hernia
• Liver
• Pancreas
• Splenectomy (surgery to remove the spleen)
• Thyroid

• Joseph Drosdeck, MD
• John Michael Gavereski, PA-C
• Steve Martinez, MD
• Perry Soriano, MD
  
• Darryl Schuitevoerder, MD 
• William Truong, MD
• Patrick Willauer, MD
  
• Sara Worden, MD

Gynecological surgery refers to surgery on the female reproductive system and includes procedures for benign (not serious or related to cancer) problems, cancer, infertility and incontinence (not being able to start and stop urination).

Gynecological surgeons are experts in the surgical diagnosis and care of gynecological medical problems and issues, including:

• Heavy or irregular menstrual periods (periods that aren't normal)
• Pelvic pain
• Recurrent pregnancy loss (unwanted loss of pregnancy that happens more than once)
• Ovarian cysts

Types of gynecological surgery we do include:

• Colposcopy or a minor surgery to look at the cervix (tissue that connects the vagina and uterus), vagina and vulva
• Cryosurgery (a surgery that uses intense cold to remove tissue)
• Hysteroscopy (a surgery to look inside the uterus or womb)
• Pelvic laparoscopy (a type of surgery on the pelvic organs)
• D and C or dilation and curettage (a surgery to remove tissue from the uterus)
• Hysterectomy (a surgery to remove the uterus)
• Laparoscopic pelvic surgeries (surgery that goes through the abdomen or middle of the body)

The da Vinci surgical system provides surgeons with an alternative to both traditional open surgery and conventional laparoscopy or a type of surgery done with a special tool by going through the abdomen or the middle of the body.

Robotic surgery enables surgeons to do even the most complex and delicate surgeries through very small incisions with extreme precision. The da Vinci surgical system allows for enhanced visualization of the surgery site and greater surgical precision.

Our obstetrics and gynecology (ob/gyn) department performs laparoscopic hysterectomy and other advanced laparoscopic pelvic surgeries using the da Vinci surgical system.

Your doctor will talk to you if your surgery will work well with the da Vinci surgical system or whether a traditional laparoscopy should be done.

The da Vinci surgical system allows for minimally invasive (using less incisions or cuts) surgery for patients that would usually need traditional surgery. Recovery times for da Vinci patients are much shorter, with lower infection rates and a faster return to work.

Other benefits include smaller incisions (cuts), less blood loss, less pain after surgery, a shorter hospital stay and less scarring.

• Anne Anholm, MD
• Quan Dau, MD
• Shannon Demas, MD
• Dennis Goulet, MD, MPH
• Nariman Heshmati, MD
• Christine Koo, MD
• Dorcas (Dori) McLennan, MD
• Laurent Nicolov, MD
• Leif Vold, MD
• Ayaba Worjoloh-Clemens, MD

Minimally invasive (also known as laparoscopic) surgeries are done with tiny incisions (cuts), instead of one large opening. A long, thin tube with a miniature camera at the end (called a laparoscope) is passed through one of the incisions.

With minimally invasive surgery, patients heal faster. There is also less scarring than with traditional surgery.

Our minimally invasive surgery team performs surgeries in women’s health, breast care and general surgery.

Some positive aspects of minimally invasive surgery include:

• A faster recovery for the patient
• Less pain
• Going back to normal daily life and movement faster
• Shorter hospital stays
• Lower total cost of care to both the patient and insurance plan

• Quan Dau, MD
• Dennis Goulet, MD, MPH
• Leif Vold, MD

The pelvic floor is a group of muscles, nerves and connective tissue that support organs in the pelvis, including the bladder, rectum, uterus (womb), vagina and prostate (a gland in the male body that makes sperm).

If the pelvic floor becomes weak or damaged, it can affect urinary control (if you can start and stop urination) and cause pain or pressure. It can also affect if you're able to start and stop bowel movements.

People who have pelvic floor dysfunction often have tight, weak or out of balance pelvic floor muscles. As we age, pelvic floor disorders are more common. About one in four women has a pelvic floor disorder. Pelvic floor disorders can be helped with medical care.

Source:
The Mayo Clinic

Common signs of pelvic floor dysfunction include:

• Urinary problems, including incontinence, urgency, frequency, painful or incomplete urination (when the urinary tract is blocked)
• Bowel problems, including incontinence, constipation, unable to empty bowels completely, straining or pain during movement
• Heavy feelings or pain in the lower abdomen or back
• Pain during intercourse

Common causes of pelvic floor dysfunction include:

• Childbirth can raise a woman’s chances for pelvic floor issues
• Obesity or being overweight
• Repeated heavy lifting
• Genetics (you can be born with the trait from your family)
• Constipation that happens often
• Trauma that has damaged nerves and or other structures in the pelvic floor

If you have any of the symptoms above, talk to your provider for more information about how we can help you.