Splenectomy is the surgical removal of a diseased or damaged spleen. A splenectomy can also be performed as a treatment for some blood disorders and some cancers. A complete splenectomy removes the entire spleen, while a partial splenectomy removes only a part of the spleen. A splenectomy can be performed in conjunction with another partial organ removal, such as the pancreas.

The spleen is in the uppermost area of the left side of the abdomen, just under the diaphragm. In healthy people, the spleen plays a role in immunity against bacterial infections and acts as a reservoir for blood.

During a splenectomy the artery to the spleen is tied to prevent blood loss, and surgeon detaches the ligaments and removes the spleen. A splenectomy can be performed as either open or laparoscopic surgery.

• In the open procedure, the surgeon makes an incision in the abdomen, under general anesthesia. This is performed in a hospital setting only and involves a hospital stay.

• The laparoscopic method is also performed in the hospital under general anesthesia but involves a shorter stay. The surgeon makes several small incisions in the abdomen, and using a tiny camera and instruments inserted through one of the openings, performs the removal of the spleen.

Thyroidectomy is the surgical removal of all or part of the thyroid gland. A thyroidectomy can be used to correct conditions such as hypothyroidism (low thyroid function), hyperthyroidism (overactive thyroid function), thyroid cancer, and nontoxic goiter.

The surgery is performed while the patient is under general anesthesia. An incision is made through the skin in the low collar area of the neck. Incisions can also be made near the sternum (breastbone). The muscles in the area are spread aside to reveal the thyroid gland. All or part of the gland will be cut free from the surrounding tissues and removed. The surgeon will then use stitches to bring the neck muscles back together and the outer incision will be closed. A suction catheter is inserted near the incision to help drain any accumulating fluid. The catheter is removed within 24 hours, and most patients leave the hospital in one or two days after the surgery.

Back and Neck Surgery, also called spinal fusion, may be necessary when the vertebrae (small bony segments that make up the spine) become displaced, inflamed, or injured, and cause pain. Fusion surgery is performed to strengthen and limit motion of the spine until it can heal, and can involve metal rods and screws and/or bone grafts. Back and neck fusion may be needed to correct:

A developmental defect

A fracture

A degenerative disease, such as arthritis

Damage caused by infection or a tumor

Degeneration of the cushioning disk

An orthopedic surgeon usually performs this surgery, which requires a hospital stay. Recovery time will vary, and depends upon the patient, the extent of the injury, and the judgment and expertise of the physician.

Back surgery involves removal of all or part of a vertebra or disk in order to relieve pressure and pain on the nerves in the spine. A vertebra is one of 33 small bones making up the spine. Disks are the cushioning between the vertebrae that prevent the bones from coming into contact with each other.

A herniated disk is one that has ruptured or bulged from a tear in the disk covering. If the herniated disk presses on a nerve, surgery may be required to relieve the pressure and the pain associated with it.
Surgery may include:

Removal of part of a vertebra

Removal of a herniated disk

Incision of ligaments in the spinal cord to relieve pressure

Incision of nerves in the spinal cord

Removing damaged tissue on a vertebra

Back surgery is usually performed by an orthopedic surgeon, and is done under general anesthesia. It is an inpatient procedure, which means that it requires a hospital stay. The surgery will relieve pain and allow the back to heal. Recovery time is typically 1-3 months.

Bariatric surgery, or gastric bypass surgery, is surgery that can be used to achieve significant weight loss in individuals who are very obese (morbidly obese). A thumb-sized stomach pouch is created (using a stapling or banding technique) then the outlet of the pouch is connected directly to the intestine, essentially bypassing the lower stomach. After the surgery, the amount of calories your body can intake is reduced which leads to weight loss.

Different procedures used include:

• Vertical-banded Gastroplasty – The upper stomach near the esophagus is stapled to form a small pouch. The outlet from the pouch to the stomach is restricted by the use of a band made of special material. This band delays the emptying of food from the pouch, causing a fullness sensation.
• Short-limbed Roux-en-Y Gastroenterostomy – The surgeon will divide the stomach into a small upper section. The surgeon will staple off the small section from the larger section. Then, they will reconnect a section of the small intestine to this new pouch, bypassing the larger stomach area remaining and connecting the base to the remaining portion of the small intestine.
• Small Intestine Reconstruction – In this procedure, more of the small intestine is bypassed than with the short-limbed Roux-en-Y procedure.

All procedures are performed under general anesthesia. A hospital stay of two to four days is expected.

Bone marrow is a soft, fatty tissue inside the bones where blood cells (red blood cells, platelets, and white blood cells) are produced and developed. Bone marrow biopsies (collection of a small sample for examination) are used to evaluate blood disorders and diagnosis certain types of cancers. They can also be helpful in diagnosing fevers of unknown origins.

A bone marrow biopsy can be an aspiration, a needle biopsy, or both. A local anesthetic is applied to numb the skin and the tissue down to the surface of the bone. A special needle is then used to penetrate the outer shell of the bone. Once inside, the center part of needle is replaced by a syringe and the liquid is collected. For a biopsy, the center of the needle is not replaced and the needle cuts a core that is collected by the needle. The core is extracted and prepared for examination by a pathologist.

Since the area is very small, usually a bandage is applied and the patient is released.

Transurethral bladder surgery is performed to repair the bladder, to place incisions or insertions for drainage, and to remove cysts and tumors. For this surgery, a cystoscope (a tube with a tiny camera used to perform tests and surgeries) is inserted through the urethra into the bladder. This procedure is performed under regional or general anesthesia. No abdominal incision is necessary. After surgery, the patient is usually released the same day or after an overnight stay.

During this procedure, it is possible to irrigate and evaluate clots, perform biopsies, inject directly to tissue, remove tissue, use cryosurgery or laser procedures to remove tumors, or insert stents. The surgeon may also perform a meatotomy, which is an incision to enlarge the opening.

Brain surgery is sometimes necessary to repair an injury, remove a tumor or lesion, or to stop bleeding or infection. Before surgery, an incision is made in the skull, and bone is removed to provide access to the brain. After surgery, the bone is replaced. This inpatient surgery is performed under general anesthesia by a neurosurgeon and requires a hospital stay. Brain surgery is performed in order to:

• Repair a fracture
• Remove a tumor or lesion
• Remove a blood clot
• Treat an area of infection
• Stop bleeding
• Implant electrodes to monitor seizures
• Treat an aneurysm (weakness in a blood vessel wall)

The patient may achieve partial recovery from brain surgery in one to four weeks; full recovery may take up to eight weeks, depending on patient health, the extent of the disease or injury, and the surgical procedures used by the physician.

Risks for any surgery are:

• Bleeding
• Infection

Additional risks of brain surgery are:

• Injury to brain tissue
• Injury to blood vessels
• Nerve or muscle paralysis or weekness
• Loss of mental functions (memory, speech, understanding)

Tubal ligation is a surgery where a woman's fallopian tubes are cut and sealed. It is commonly known as “tying one's tubes.” Tubal ligation permanently sterilizes a woman by preventing an egg from traveling from the ovary down to the uterus, so that the male sperm cannot make contact with the egg. If the sperm and the egg cannot make contact, fertilization cannot take place and pregnancy cannot occur.

Tubal ligations can be performed in a hospital or an outpatient setting under general anesthesia. It can be performed at any time when the patient is not pregnant. Often, tubal ligations are performed following childbirth in a hospital setting.

During this procedure, the physician makes one or two small incisions in the abdomen (usually below the navel) and a laparoscope (a tiny camera) is inserted. Using surgical instruments, the fallopian tubes are sealed shut with either cautery (burned), or a small clip placed on the tube. (Cautery heals naturally without stitches and has a minimum of blood loss.) The skin incision(s) is then stitched closed. The patient can return home a few hours after the procedure. Most patients recover fully within a week.

Breast reduction surgery is performed to reduce the size of a patient's breasts. Many patients choose this operation to reduce back, neck and shoulder pain. Some choose this operation to make it easier to participate in sporting activities, to eliminate sleeping problems or poor posture resulting from large breasts, or to avoid unwanted attention and comments about large breasts.

Often called Reduction Mammoplasty, this surgery involves the removal of excess skin and fat from the breasts, reshaping of the breasts to form smaller breasts, and repositioning of the nipples.

The surgery is performed in a hospital setting under a general anesthesia and involves an overnight stay, sometimes longer.

Urinary incontinence is the accidental leakage of urine. The condition can range from occasional leakage to an inability to hold any urine. The two main types of urinary incontinence are:

• Stress Incontinence – Occurs with an activity that can put stress on the bladder, such as coughing, sneezing, exercise, or laughing.
• Urge Incontinence – Involves a strong sudden urge to urinate followed immediately by bladder contraction and involuntary loss of bladder control.

Urinary incontinence is most common among the elderly. Additionally, women are more likely to experience urinary incontinence due to the stress placed on the urinary tract by childbirth. Men can experience urinary incontinence due to prostate problems. Nerve problems and diseases such as diabetes and stroke can affect urinary incontinence in both sexes.

There are several surgical options for both men and women.

• Sling – For the male, the surgeon creates support for the urethra by wrapping a strip of material around the urethra and attaching the ends of the material to the pelvic bone. For female patients, the surgeon fashions a piece of material or muscle into a sling that lifts the urethra back into a normal position.
• Artificial Sphincter – This implanted device for men has three parts: a cuff that fits around the urethra, a small balloon reservoir placed in the abdomen, and a pump placed in the scrotum. The patient squeezes the pump when he wants to urinate, which deflates the cuff and allows the urine to flow. When the bladder is empty, the cuff automatically refills to keep the urethra tightly closed.
• Retropubic Suspension – This surgery for women lifts the sagging bladder neck and urethra by attaching their supporting tissues to the pubic bone.

All surgeries are performed using general anesthesia in a hospital setting. Stays in the hospital can average one to two days but could be more depending on the type of surgery and whether or not an abdominal incision is involved.

Carotid surgery is a surgical procedure to remove the lining and fatty obstruction of a carotid artery that has been narrowed by atherosclerosis. Atherosclerosis is the narrowing of arteries usually due to the buildup of fatty tissue. The largest and most common clinical problems associated with atherosclerosis of a carotid artery are stroke or transient ischemic attack (TIA).

A carotid surgery restores normal blood flow to the brain, reducing stroke or TIA risk. Before surgery, the site of narrowing is located by means of an x-ray procedure called angiography.

Carotid surgery is a delicate procedure that may take several hours to perform. The procedure is performed in a hospital setting with general anesthesia. The artery is exposed, clamps are applied, an incision is made, and the diseased lining is removed along with the atherosclerotic material and any thrombus (blood clot) that has formed. The incision is closed with stitches. Most patients are able to leave the hospital within a day or two.

A vaginal hysterectomy is a surgical procedure in which the uterus is removed through the vagina. As part of the hysterectomy, the fallopian tubes and cervix may also be removed.

Hysterectomies are performed for uterine fibroids (benign tumors in the womb), abnormal uterine bleeding, endometriosis (the formation of cells outside of the uterus) and uterine prolapse, which involves the loosening of support muscles and tissue in the pelvic area. A hysterectomy can also be performed to treat cancer of the uterus.

In a vaginal hysterectomy, the uterus is removed through the vagina. A laparoscopic-assisted vaginal hysterectomy is performed with the help of a tiny lens that allows the surgeon to inspect the abdomen while performing surgery through small incisions.

Types of vaginal hysterectomies include:

• Partial Hysterectomy – The surgeon removes only the uterus and the fallopian tubes. The cervix is left intact to help support the vagina.
• Radical Hysterectomy – This involves the removal of the uterus and the cervix and tissue surrounding the cervix and some removal of the upper vagina. This procedure is usually performed for early cervical cancer.

All hysterectomies are performed in a hospital setting and involve a stay of a few days.

A cataract is the clouding of the eye's natural lens that lies between the iris and the pupil. Cataract surgery is performed to remove the clouded lens and replace the lens with a permanent implant. This implant is known as an intraocular lens implant (IOL). This surgery usually results in a return to normal vision. It is the most common surgery performed in the United States.

The surgery is usually performed on an outpatient basis by an ophthalmologist. The patient is given eye drops and sometimes medication to help the patient relax. A local anesthetic is applied to help make the operation painless.

The surgeon will make a small incision in the eye using an operating microscope. The lens is then removed or the surgeon will use a laser, ultrasound or other surgical solution to break up the lens for removal. The surgeon will then insert the lens implant (IOL) and close the incision. A patch is placed over the eye and after a short stay in the recovery area the patient is ready to go home.