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Dr. Mohamad Al-Jabban, MD

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Procedure Costs

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Available Procedures

Gastrectomy
Gastrectomy is the surgical removal of all or part of the stomach and reconnection with the small intestine. This surgery used to treat stomach cancer, noncancerous polyps, gastric ulcers, or a hole in the stomach wall. The surgery is performed under general anesthesia and usually involves a hospital stay of seven to ten days. If combined with other procedures, the stay can be lengthy.

Procedures used can include:

  • Esophagectomy – An esophagectomy is the partial or complete removal of the esophagus (the tube from the mouth to the stomach) and the top part of the stomach. An esophagectomy is performed using one of two methods. Transhiatal Esophagectomy is performed with surgical incisions at the upper abdomen and the neck area. The second method, Transthoracic Esophagectomy is also known as the Ivor Lewis procedure and is performed with an upper abdominal incision and an incision into the chest area.
  • Esophagoenterostomy – In this procedure, a connection is made between the esophagus and the small intestine following a gastrectomy.
  • Roux-en-Y Reconstruction – In this procedure a small pouch is formed and connected to the intestine.
  • Gastroduodenostomy – In this procedure, a connection is made between the stomach and duodenum (the first portion of the small intestine).
  • Gastrojejunostomy – In this procedure, a connection is made between the stomach and the jejunum (the portion of the small intestine that extends from the duodenum to the ileum).
  • Vagotomy – In this procedure the vagus nerve is cut to reduce acid secretion in the stomach. The vagus nerve has branches that go to different parts of the stomach.
  • Pancreatectomy – This procedure involves the total or partial surgical removal of the pancreas.
  • Whipple Procedure – Also known as a pancreaticoduodenectomy , this procedure is the removal of the duodenum with all or part of the pancreas.
Back and Neck Surgery (Spinal Fusion)

Heart bypass surgery or coronary artery bypass grafting (CABG) is a surgical procedure in which a section of a coronary artery, which has been partially or completely blocked, is bypassed by transplanting a healthy section of blood vessel around the diseased area. The conduit to route blood around the obstructed area may be an artery or a vein. There is some information that arteries may have a better long-term patency rate (chance of staying open for years) than veins. The arteries and veins used for the bypass procedure are taken from the patient's own body; they may be harvested from within the chest, the arms or the legs.

This procedure is performed in a hospital under general anesthesia.

Coronary artery bypass is performed by a cardiothoracic surgeon who makes an incision in the patient's chest to expose the patient's heart. Incisions may also be made in the legs or the arms to obtain a vein or artery for the bypass. The patient is connected to a heart-lung machine that takes over the function of the heart and lungs while the surgeon works on the heart. An opening is made in the diseased artery or arteries above and below the blockage. A section of artery or vein is then sewn to the points above and below the blockage in the affected artery, effectively providing a detour around the obstruction. At the conclusion of the bypass procedure the heart-lung machine is disconnected, allowing blood to flow back through the heart, and the incision is closed.

Most bypass operations are performed by dividing the breastbone to provide access to the heart. Some bypass operations are now performed through "limited" incisions made either between the ribs or partially through the breastbone, with or without the use of the heart-lung machine.

Most patients experience some discomfort at the incision site for a few days but most preoperative angina will resolve.

Alternative Names
Bypass surgery - heart; CABG; Coronary artery bypass graft
Back Surgery

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.

    Bone Marrow Biopsy

    Hemorrhoid surgery (also called hemorrhoidectomy) is the surgical removal of hemorrhoids. Hemorrhoids are swollen or enlarged veins located inside (internal) or outside (external) the anus. They are usually caused by straining when constipated or during pregnancy. The surgery can remove large internal hemorrhoids that do not respond to nonsurgical treatment and large external hemorrhoids.

    The surgery is performed in a surgery center under general or spinal anesthesia. The surgeon will make an incision in the tissue surrounding the hemorrhoid. The surgeon then ties off the swollen vein in the hemorrhoid to prevent bleeding and removes the hemorrhoid. The surgeon can remove the hemorrhoid with a knife (scalpel), a laser, or a cautery pencil. The area of the surgery is then either sewn closed or can be left open with gauze covering the wound.

    Most patients can be released after the anesthetic wears off and the patient is able to urinate, although an overnight stay is not uncommon.

    Hernia Repair

    Hernia repair (or Herniorrhaphy) involves surgery to correct an abnormal protrusion of an organ through the wall of the area that normally holds the organ. This can happen when the outer layers of the abdominal wall weaken, bulge or rip. There are four types of hernias:

    • Inguinal Hernia – The most common type of hernia; it occurs in the groin area.
    • Umbilical Hernia – This is a hernia that develops through the navel.
    • Incisional Hernia – This is a hernia that protrudes through a past surgical or operation site.
    • Hiatal Hernia – This is a hernia that forms when the upper portion of the stomach slides into the chest cavity through the normal opening created by the esophagus.

    If the protrusion can be pushed back into place, the hernia is referred to as reducible. If it cannot be, the hernia is referred to as irreducible, incarcerated or imprisoned. A strangulated hernia occurs when the blood supply to the tissue is cut off, causing worsening pain.

    Most hernia repairs can be done on an outpatient basis. There are two methods used:

    • Conventional Method – An incision is made over the site of the hernia. The surgeon returns the tissue to the abdominal cavity and removes the sac that has formed. The surgeon then sews strong surrounding muscle over the area.
    • Laparoscopic Method – The surgeon inserts a scope through a small incision in the abdomen that the surgeon will use to view the contents of the abdomen with the use of a camera. The surgeon then makes repairs using instruments inserted into another small incision in the abdomen.

    Both surgeries are performed using general anesthesia.

    Kidney Transplant

    Kidney transplant is a surgical procedure to implant a healthy kidney into a patient whose kidneys have failed. The donated kidney may be from a living related donor (genetically related to the patient, such as a parent, sibling or offspring), a living unrelated donor (such as a friend or spouse), or deceased donor (a recently deceased individual with no known kidney disease).

    The kidney is an organ responsible for cleansing the blood. Damage to the kidneys can occur because of other diseases, such as diabetes, lupus, sickle cell anemia, gout, or rheumatoid arthritis.

    During a kidney transplant, the patient will be under general anesthesia. The surgeon makes an incision above the groin on the side where the kidney will be removed and replaced with the donor kidney. The surgeon then connects the donor kidney to the patient's iliac artery and vein. Sometimes the surgeon will place a small drain in the abdominal cavity to drain any excess fluid.

    The patient will be immediately started on immunosuppressive drugs in order to prevent rejection of the organ by the patient's body, or the body might consider the new organ an infection and try to destroy it. The drugs help prevent that from happening.

    Breast Reconstruction
    Breast reconstruction surgery is performed when a breast has been removed due to cancer or other disease. Virtually any patient who loses their breast can have it rebuilt (with artificial implants and native tissue) through econstructive surgery, but there are risks associated with any surgery.

    There are several different procedures that are associated with breast reconstruction. The first stage of reconstruction, the creation of the breast mound, is almost always performed in a hospital setting under general anesthesia. Follow-up surgery, however, may be performed at a hospital or an outpatient facility.

    The surgery can take place immediately following the mastectomy or can be delayed.

    Procedures include:

    • Breast Prosthesis – This procedure involves inserting a breast implant.

    • Nipple/Areola Reconstruction – This procedure involves either rebuilding the nipple or the areola (the circular area of darker pigmentation around the nipple). The nipple can be rebuilt using a skin flap or graft. The areola can be rebuilt using a graft or tattooing process.

    • Breast Expander – A breast expander is used to stretch the skin. A surgeon inserts a balloon expander beneath the skin and the chest muscle. Periodically, the surgeon will inject a salt-water solution over a period of several weeks or months to stretch the skin. Once stretched, the surgeon can insert a more permanent implant. Some expanders can be left in place as the final implant.

    • Flap Reconstruction – Flap reconstruction is the process of creating a skin flap using tissue from other areas of the body. Latissimus Dorsi Flap uses the tissue on the upper back. Free Flaps transplant non-essential donor tissue from one part of the body. Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps use tissue from the lower abdominal wall.
    Breast Reduction

    A liver biopsy is a medical procedure to remove a small amount of tissue from the liver for examination. The biopsy helps diagnose a number of liver diseases or assess the stage (early, advanced) of liver disease. This is especially important in hepatitis C infection. The biopsy also helps detect infections, cancer, unexplained enlarged liver, or abnormal liver enzymes detected by blood tests.

    The biopsy is performed in a hospital setting under local anesthesia. The physician will use a needle to remove a small piece of liver tissue, which is sent to the laboratory for evaluation. The patient usually will remain lying down for one or two additional hours, to ensure that there have been no complications. The patient is then released and sent home.

    The surgeon can also explore the bile ducts during the liver biopsy for congenital abnormalities such as atresia, in which the bile may back up into the liver.

    Lumpectomy (Partial Mastectomy)

    Lumpectomy is the surgical procedure in which a cancerous lump or tumor in the breast is removed. The procedure is recommended only for those patients with less than 25 percent of the breast involved.

    Lumpectomies can include excisional biopsy procedures. Biopsies are obtained either by needle or tissue sampling using either a scalpel or vacuum-assisted devices while under the guidance of ultrasound, MRI or other stereotactic diagnostic imaging.

    To perform the lumpectomy, the surgeon will make a small incision over or near the breast tumor and cut free the lump and at least one-half inch of healthy tissue surrounding the tumor. The surgeon will submit the tissue to the pathologist for evaluation, often while the patient is still on the operating table, and if the extra tissue does not contain any cancerous cells, the excision will be sufficient. If cells are present, the surgeon may perform another sampling or perform a partial mastectomy.

    Mastectomy Total (Radical)
    Mastectomy is the surgical removal of the breast for treatment of cancer. There are four types of mastectomies:
    • Simple or Total Mastectomy – Removal of the breast, its skin, the nipple, but no lymph nodes.
    • Subcutaneous Mastectomy – Removal of entire breast but leaves nipple and areola (dark pigmented area around the nipple) in place.
    • Radical Mastectomy – Removal of the entire breast, nipple/areolar region, the major and minor chest muscles, and the lymph nodes.
    • Modified Radical Mastectomy – Removal of the entire breast, nipple/areolar region, and the axillary lymph nodes.

    Mastectomies are performed by a surgeon while the patient is under general anesthesia. The surgeon makes an incision near the site of the tumor and removes the breast tissue, and makes another incision to remove the lymph nodes, if scheduled. Drains are inserted either in the breast or under the arm to collect any fluid during the healing process. The surgery time averages two to three hours, but can increase due to reconstruction of the breast. Most patients can leave the hospital in two to three days.

    Open Bladder Surgery

    Open bladder surgery is performed to repair the bladder, to place incisions or insertions for drainage, to remove cysts, diverticulum, or tumors, or to remove the bladder completely.

    Open bladder surgeries cover many different procedures.

    • Ureteroncystostomy – This procedure involves the surgical fusion of a single or duplicated ureter to the bladder. This procedure may also include a bladder flap or extensive tailoring to help prevent reflex.
    • Cystotomy – This is a surgical incision into the bladder which can be used to insert radioactive material, a stent or ureteral catheter, or a drain, remove a bladder stone, or to perform cryosurgery (freezing tissue in order to destroy it).
    • Excision and Cystotomy – These procedures involve removing bladder cysts, lesions, diverticulum and tumors.
    • Partial Cystectomy – This procedure involves the partially removing the bladder and can include reimplanting the ureters into the bladder.
    • Complete Cystectomy – This procedure involves completely removing the bladder and can include fusion to the small and/or large intestines to create a "neobladder."
    • Cystoplasty or Cystouterthroplasty – This procedure involves plastic or reconstructive surgery on the urinary bladder or ureter(s).
    • Cystorrhaphy – This procedure is the suturing of the bladder to repair a wound.
    • Closure – These procedures are repairs done on the bladder, vagina, or vaginal fistulas.

    Most procedures are done in a hospital setting under general anesthesia.

    Prostate Removal Surgery

    Prostate removal surgery (also known as Prostatectomy) is the removal of all or part of the prostate. The prostate gland is an organ at the base of the bladder in men, surrounding the urethra. When the gland becomes enlarged, the prostate can compress the urethra, causing problems with urination.

    The removal of the prostate gland can be done in different ways, depending on the size of the prostate and the cause of the enlargement. The most common prostate removal surgical procedures are:

    • Transurethral Resection of the Prostate (TURP)- is the most common treatment for benign hyperplasia (prostate gland overgrowth). The procedure is performed using either a general or a spinal anesthesia. A tubelike instrument called a cystoscope is inserted into the penis through the urethra. A cutting instrument is then inserted through the cystoscope to remove the prostate gland piece by piece. Any blood vessels are cauterized during the surgery to stop the bleeding. A catheter will be placed following surgery to help the bladder drain and is usually removed within one to three days. The hospitalization time is approximately one to five days.

    • Open Prostatectomy – Using general or spinal anesthesia, an incision is made in the lower abdomen between the navel and the penis. The gland is then removed through this incision. Catheters inserted following surgery will remain in place from five days to a few weeks until the bladder has healed. The hospitalization time is longer than five days. This surgical procedure is also known as suprapubic or retropublic prostactomy.

    • Transurethral Incision of the Prostate (TUIP) – is a procedure that is recommended for men with only slightly enlarged prostates. In this procedure, under general or spinal anesthesia, the surgeon will use an instrument inserted into the penis through the urethra that generates an electric current or laser beam to make incisions in the prostate where the prostate meets the bladder. This relaxes the opening to the bladder, allowing for greater flow out of the bladder. A catheter is inserted in the bladder following surgery and is left in for one to three days. This procedure can be done in a hospital setting with a short stay of one to three days, or in an outpatient setting.

    Shoulder Surgery
    Shoulder surgery involves the repair or reconstruction of bones, tendons or muscles that help the shoulder rotate smoothly and properly. Shoulder surgery is usually performed to restore movement, stability, function and comfort following an injury.

    Depending on the extent of damage, repairing the shoulder could involve:

    • Repairing a torn rotator cuff (the tendons and muscles that help the shoulder rotate properly)
    • Repairing a broken collarbone (clavicle) with pins, plates, or wires
    • Replacing the shoulder joint with an artificial implant
    • Cutting of tendons to lengthen a muscle
    • Repair of scapula using synthetic material
    • Muscle transfer

    An orthopedic surgeon usually performs this type of surgery as either open surgery (larger incision to expose the joint) or arthroscopic surgery (where the physician uses a camera or arthroscope inserted in small incisions in the joint). Shoulder surgery is done under general anesthesia. Recovery time can be from one to six months, depending on the procedure and severity of injury. For many patients of shoulder surgery, physical therapy may help them regain range of motion and strength.

    Cesarean Section Delivery (Patient Choice)

    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.

    Tonsils Removal Surgery (Tonsillectomy)

    Tonsillectomy is the surgical removal of the tonsils. Tonsils are glands located on both sides of the opening to the throat) that serve as protection against infections. When the tonsils become enlarged or inflamed, they can cause infections in the throat and the ear and can obstruct breathing. Enlarged adenoids (lymphatic tissue located in the back of the throat) can also obstruct breathing and can be removed at this time. This is called an adenoidectomy.

    An ear, nose and throat surgeon (ENT) performs the operation, usually in an outpatient setting. While the patient is under general anesthesia, the surgeon uses a device to hold the mouth open to expose the tonsils and/or the adenoids. The tonsils are either cut away with an instrument or burned away using cautery. Some surgeons will chose to cauterize the adenoids instead of removing them, because cautery heals naturally without stitches and has a minimum of blood loss. The recovery can take up to two weeks. The patient may have some throat and ear pain the first few days. The use of ice packs, sucking on ice chips and eating ice cream can help provide comfort.

    Cornea Transplant

    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.

     
     

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