Dr. Refat Baridi, MD

Ovary removal surgery (also known as oophorectomy or ovariectomy), is the surgical removal of one or both ovaries. The surgery is performed to remove ovaries affected by cancer, to remove the source of estrogen that may stimulate some cancers, to remove large ovarian cysts, or to treat endometriosis.

The surgery is performed under general anesthesia and can be either open or laparoscopic surgery.

• Open Surgery – The surgeon makes a horizontal or vertical abdominal incision and the abdominal muscles are pulled apart, allowing the surgeon a better view of the abdominal cavity and the ovaries. The surgeon then removes the ovaries and often, the fallopian tubes. If cancer is not present, the patient may be started on hormone therapy ease the symptoms of menopause. The patient is usually discharged from the hospital in two to five days.
• Laparoscopic Surgery – A tube containing a tiny lens is inserted through a small incision made in the navel. Other instruments are inserted through another small incision made in the pubic area. The ovary is disected into smaller pieces and removed through the small incision at the top of the vagina. If cancer is not present, the patient may be started on hormone therapy to ease the symptoms of menopause. The recovery time is normally shorter than that for the open procedure.

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.

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.

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.

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.

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.

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.

Carpal tunnel release is a surgery performed by an orthopedic and/or hand surgeon to relieve hand and wrist pain caused by the compression of the medial nerve at the wrist. The medial nerve and the tendons are located in one wall of the carpal tunnel. The other wall holds the bones of the wrist. Most conditions are caused by wrist fracture, rheumatoid arthritis, or overuse of the wrist.

The surgery is usually performed on an outpatient basis using either local or general anesthesia. The surgery can be performed two different ways:

• Using Endoscopy – The surgeon makes a small cut at the patient's wrist, reaches the carpal ligament using an endoscope, and makes repairs.

• Open Method – The surgeon makes a cut in the palm of the patient's hand and reaches the ligament by cutting through the underlying tissue and muscle.

The recovery time after the surgery depends on how damaged the nerve was before the surgery.

 

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.

A cesarean section, also called a C-section, is the delivery of the fetus through a surgical abdominal incision. A C-section is performed when a vaginal delivery is not safe for the mother or child. The most common reasons for a physician to perform a C-section are:

• Developmental abnormalities of the fetus
• Abnormal fetal heart rate
• Abnormal position of the fetus
• Extreme maternal illness
• Active genital herpes infection
• Maternal HIV infection
• Previous uterine surgery, including previous C-section
• Prolonged or arrested labor
• Placenta attached in abnormal location

Both regional and general anesthesia may be used. Regional anesthesia is most frequently used for labor and delivery. Regional anesthesia is when narcotics may be given by continuous infusion into the epidural space in the spine. General anesthesia is not recommended for routine deliveries, but is often the method used for an emergency cesarean section. Most mothers and infants recover well.

A cesarean section, also called a C-section, is the delivery of the fetus through a surgical abdominal incision. A Cesarean Section by Patient Choice is defined as a first-time, pre-planned C-section for which there is no medical necessity. Some reasons why a woman would choose a C-section as an alternative to vaginal birth are the fear of labor pain, fear of incontinence that is due to wear and tear on the pelvic muscles, fear of tearing that may happen during a vaginal delivery, or even apprehension about a friend or relative who's had a difficult vaginal birth.

This major surgery carries significant risks that need to be considered. For the mother, these risks are:

• Hemorrhage
• Pain
• Infection
• Placental implantation problems in future pregnancies

There are also risks to a child born by a C-section:

• Respiratory problems
• Accidental surgical cuts
• Breastfeeding difficulties
• Asthma

Both regional and general anesthesia may be used. Regional anesthesia is most frequently used for labor and delivery, and is administered by continuous infusion into the epidural space in the spine. General anesthesia is not recommended for routine deliveries, but is often the method used for an emergency cesarean section. The average hospital stay after a cesarean section is 2-4 days.