Other Specialty Surgeries

At the OU Physicians Center of Excellence for Minimally Invasive and Hernia Surgery, we specialize in more than just complex hernia repair. We are the region’s experts in a variety of abdominal procedures spanning the range of acute medical conditions including:

Laparoscopic Cholecystectomy (Gallbladder Removal):  The gallbladder is a small pear-shaped organ that stores bile created by the liver. Bile helps the body digest food by breaking down the fat in food so it can be absorbed. The gallbladder can become infected or develop gallstones that block the flow of bile into the bile duct, causing pain and nausea. In less common cases, the gallbladder can become cancerous, and it becomes necessary to remove it.

Symptoms of Gallstones:

  • Abdominal Pain, especially on the right side
  • Back or Shoulder Pain located on the right side
  • Nausea and/or vomiting

    These symptoms can come and go, and may be particularly severe after eating a meal high in fat, such as fried foods.

Who is at Risk for Gallstones: Gallstones can affect any person, but there are factors that can increase the chances of developing a gallstone, such as:

  • Female
  • Adults over the age of 40
  • Family history of gallstones
  • Pregnancy
  • Birth Control or Estrogen Replacement use
  • Overweight
  • Frequent fasting or rapid weight loss
  • Inactivity
  • Diabetic
  • Sickle Cell Disease
  • Heavy alcohol use

During a laparoscopic gallbladder removal, the surgeon will make small incisions in your abdomen instead of one large incision. The surgeon will insert a small camera to see your gallbladder into one of the incisions and will insert long surgical instruments into the other incisions to safely remove the gallbladder. This surgical method allows the you to recover quicker and there is less risk for infection compared to traditional “open” surgical methods.

Recovery

The majority of patients undergoing laparoscopic gallbladder removal will be able to go home the same day as surgery and resume normal activity within a few days of the procedure. To allow the body time to fully recover, do not participate in heavy exercise or physically strenuous work for at least one week post-surgery.

Laparoscopic Splenectomy (Spleen Removal): The spleen is a small organ on the upper left side of the abdomen that filters bacteria and damaged blood cells out of the blood. The spleen may have to be removed due to an injury, infection, underlying medical conditions such as sickle cell disease, lupus, or leukemia. Other reasons the spleen may need to be removed include an overactive spleen, or conditions where the body naturally makes abnormal blood cells.

During a laparoscopic splenectomy, the surgeon will make several small incisions in your abdomen. A small tube with a camera inside it will be inserted into one of the incisions while the surgeon will use long, thin surgical instruments in the other incisions to remove the spleen. This minimally invasive procedure results in a quicker recovery with a smaller risk of infection for the majority of patients.

Recovery

Although recovery from a splenectomy is relatively quick with minimal pain, people who no longer have a spleen are at greater risk for a blood infection called sepsis. Although the overall risk of getting sepsis is relatively low, without a spleen to help filter the blood, patients who have had a splenectomy must be diligent in getting immunizations and taking prescribed medications as directed. This will be a lifelong commitment.

Sepsis occurs when certain infection causing bacteria build up in the blood. Without a spleen to help filter the bacteria, the patient must take antibiotics and seek medical treatment at the first sign of any of the following sepsis symptoms:

  • Fever of 100.4 degrees or higher
  • Body chills or shivering
  • Headache
  • Severe abdominal (stomach) pain
  • Nausea or vomiting
  • Diarrhea
  • Feeling drowsy, confused or disoriented
  • Rapid heartbeat
  • Dizziness, feeling lightheaded or fainting
  • Purplish red rash or large bruises on the skin

Patients who undergo a spleen removal are also advised to keep their vaccinations current. While the vaccinations cannot guarantee that the patient will not get the disease, it will greatly reduce both the severity of symptoms and reduce the risk of a sepsis infection. It is highly recommended that adults without a spleen receive the following vaccinations on a regular, ongoing basis:

  • Pneumococcal – helps prevent and reduce the symptoms of pneumonia, a bacterial infection of the lungs and respiratory system
  • Influenza – helps prevent and reduce the symptoms of the flu virus, which can cause pneumonia and other secondary infections
  • Hib – helps prevent an infection caused by bacteria that can affect the upper respiratory tract or cause meningitis
  • Meningococcal – helps prevent or reduce the symptoms of meningitis, an infection that attacks the lining of the brain and spinal cord

Fundoplication (Gastroesophageal Reflux Surgery):  Gastroesophageal Reflux Disease, or GERD, is a common condition where the acid in the stomach backs up into the esophagus. It is commonly referred to as acid reflux. This can cause symptoms that can become painful and even inhibit everyday activities. People experiencing the following symptoms at least three days per week should be evaluated by a physician for GERD:

  • Heartburn (a burning pain in the chest or throat)
  • An acid or sour taste in the throat
  • Trouble swallowing or a choking feeling
  • Food regurgitation
  • Throat feels like there is a lump that won’t go away
  • Sore throat not due to illness
  • Hoarse voice not due to illness
  • Chronic cough
  • New or worsening asthma symptoms
  • New or worsening tooth or gum erosion
  • Recurring pneumonia
  • Chronic sinus infections

GERD can cause serious health complications if left untreated, including:

  • Esophageal ulcers where the acid erodes the lining of the esophagus
  • Narrowing or stricture of the esophagus, leading to difficulty swallowing
  • Chronic inflammation of the lungs, throat, and vocal cords
  • Asthma
  • Barrett’s esophagus, a condition where the cells in the esophagus mutate
  • Esophageal cancer

While many symptoms of GERD can be controlled or eliminated through lifestyle changes and medication, some people may need to undergo surgery to resolve GERD issues by controlling stomach acid from backing up into the esophagus.  This is called a fundoplication procedure. The most common type of fundoplication is a Nissen fundoplication.

During this minimally invasive surgery, the physician will make several small incisions in your abdomen and insert a thin tube with a camera attached into one of the incisions. In the other incisions, the surgeon will use long, thin surgical instruments to take the upper part of your stomach where it attaches to the esophagus and wrap it entirely around the esophagus.

The Toupet fundoplication uses a similar technique but the upper stomach is not wrapped completely around the esophagus. Both types of fundoplication work to control GERD by preventing acid from backing into the esophagus.

Recovery

Patients undergoing fundoplication surgery usually are admitted to the hospital for at least one night for recovery. Most patients require a liquid diet for two to 12 weeks after surgery. How long it will take to resume eating a normal diet will vary with each patient and the type of fundoplication completed.  Patients may also experience difficulty swallowing or feel a sticking sensation in the throat after swallowing right after the procedure. This sensation will lessen after a few weeks’ post-surgery. Bloating due to the inability to belch after the procedure can also occur in patients.

Most patients will be back to their normal routine within a couple of weeks’ post-surgery and will not experience any further symptoms of GERD.

Adrenal Surgery (Adrenalectomy): The adrenal glands are located on the top of each kidney and help regulate three different hormones: glucocorticoids, mineralcorticoids, and androgens. Each of these hormones plays an important role in the function of the body.

Glucocorticoids include the hormone cortisol and helps the body regulate blood sugar levels and fat storage as well as help protect the body against infection and stress.

Mineralcorticoids help control blood pressure and the volume of blood as well as the level of sodium and potassium found in the bloodstream.

Androgens include the hormones testosterone, DHEA, and DHEA sulfate, which are present in both men and women. Androgens help control the development of sexual characteristics such underarm and public hair in adults.

There are two types of adrenal insufficiencies: primary insufficiency, which is also called Addison’s disease; and secondary insufficiency.  Primary insufficiency is a very rare disease and occurs when the adrenal glands cannot produce an adequate number of hormones for the body.

Symptoms of Addison’s disease include:

  • Fatigue
  • Feeling weak
  • Dehydration
  • Otherwise unexplained weight loss
  • Loss of appetite
  • Darkening of the skin on the face, hands, or neck
  • Feeling lightheaded or dizzy upon standing
  • Low blood pressure
  • Abdominal pain or nausea
  • Joint or muscle pain
  • Salt cravings
  • Loss of hair in pubic and armpit areas in females

Secondary adrenal insufficiency is more common and occurs when the adrenal glands do not make enough hormones for the body to regulate itself. It shares many of the same symptoms as Addison’s disease, including:

  • Fatigue
  • Feeling weak
  • Otherwise unexplained weight loss
  • Loss of appetite
  • Feeling lightheaded or dizzy upon standing
  • Low blood pressure
  • Abdominal pain or nausea, although not as common as in Addison’s disease
  • Joint or muscle pain
  • Salt cravings
  • Loss of hair in pubic and armpit areas in females
  • Low blood sugar
  • Heart palpitations

Adrenal surgery is performed when one or both of the adrenal glands are cancerous or show signs of invading organs such as the kidneys. During this procedure, the surgeon will make several small incisions in the abdomen and place a thin tube with a camera in one of the incisions so that the surgeon can view the adrenal glands and surrounding organs. Long, thin surgical instruments will be inserted into the other incisions so that the surgeon can remove the gland.  Using a minimally invasive technique shortens recovery time and lessens the risk of infection.

Recovery

Having a minimally invasive adrenalectomy shortens recovery time for most patients undergoing the procedure. Many patients can return to normal activity within a few weeks post-surgery. Patients will need to continue to take and monitor adrenal supplements daily throughout their lifespan after surgery.