General surgery focuses on the abdomen, digestive tract, endocrine system, breast, skin, and blood vessels. Nearly every part of the body! General surgery addresses common conditions like hernias, gallstones, appendicitis, pancreatitis, bowel obstructions, and colon issues and cancer, among others.
Hiatal hernias are a common problem and become more frequent as we age. About 50-60% of people over 50 years old have a hiatal hernia and about 10% of these are symptomatic. A hiatal hernia is a widening of an opening in your diaphragm where the esophagus travels from the chest into the abdomen. This space is normally present so food you eat can pass down, but if this opening becomes too large, patients may start to feel common symptoms such as heartburn and regurgitation. If severe, the stomach can migrate up into the chest and remain there at all times. Very large hernias can have other organs such as the colon, pancreas, and the spleen going into the chest. There are many other milder symptoms that also may be seen, such as: dysphagia (trouble swallowing), asthma, hoarse voice, poor sleep, bad breath, tooth and gum disease, persistent cough and sore throat, and chest pain.
Surgery can help to treat symptoms by pulling the stomach back down into the abdomen and repairing the opening that allowed the stomach to slip into the chest. This surgery can often provide immediate symptom relief and patients can stop taking acid reducing medications.
Gallbladder removal is one of the most commonly performed surgeries in the United States every year. This is a safe procedure and can usually be performed as an outpatient surgery if there is no active infection of the gallbladder at the time of surgery. It is performed laparoscopically or robotically through small incisions in the abdomen to remove the gallbladder.
The gallbladder is an organ under the liver which stores bile to help with digestion. There are a number of reasons the gallbladder may be functioning abnormally, which can cause symptoms such as pain (especially with eating), nausea, vomiting, bloating, and diarrhea. Gallstones are the most common cause of gallbladder dysfunction. There are many causes of gallstones. They are usually found with an ultrasound which is a quick imaging procedure and requires no radiation. Unfortunately, once they form and cause issues, they will continue to cause problems and require surgery to remove the gallbladder. This will treat the pain they cause as well as prevent them from coming back and other problems such as infections of the gallbladder, liver, and pancreatitis.
Gallbladder dysmotility can also occur. This is when the gallbladder functions abnormally and either contracts too much or too little. This can cause similar symptoms without the presence of gallstones. It still does require removal of the gallbladder. This is diagnosed with a HIDA scan which can measure how effectively the gallbladder contracts when you eat a meal.
A hernia is a defect, or hole, in the fascia - the strength layer - of the abdomen. This hole allows abdominal contents such as fat or intestines to protrude out of the abdominal cavity. This can be felt as a bulge, pain, or discomfort. There are many areas that are natural weak spots that are predisposed to forming hernias, such as the inguinal canal (groin), around the belly button, and at prior surgical incisions. Hernias are extremely common. In fact, 25% of men will have an inguinal hernia in their lifetime and about 10%-25% of women will have an umbilical hernia. Risk factors include obesity, family history of hernias, chronic coughing, pregnancy, constipation and straining when using the bathroom, and prior surgeries. Unfortunately, hernias will get bigger over time and do not go away without surgery. Hernias are fixed by closing the hole in the fascia. Usually this also includes placing a piece of mesh which will reinforce the repair and greatly reduce the risk of the hernia coming back. Certain types of hernias, when small, may also be repaired without mesh. Repairs can usually be done robotically which improves recovery time, decreases pain, and reduces risk of infection. However, for very large or emergent surgeries, they may need to be performed through open incisions. Common hernias that Dr. Bailey repairs include Inguinal, Umbilical/Ventral, Incisional, Spigellian, and complex abdominal wall hernias.
There are a number of skin lesions which can be removed for various reasons. Depending on size and location, many of them can be removed in the office without a trip to the operating room.
Lipomas: Lipomas are benign fatty growths that can happen anywhere on the body. They can appear as soft bumps or sometimes painful nodules. They do not spread to other places, but you can develop multiple lipomas in multiple locations.
Cysts: Cysts can develop throughout the body for a number of reasons. A common cyst is the sebaceous (or epidermal) cyst which starts as an ingrown hair and develops into a cyst. These commonly present as a small bump which may intermittently drain fluid but come back after time. They also run the risk of becoming infected. Complete removal is the only treatment for these cysts.
Skin Tags: Skin tags are small growths of extra skin that can occur anywhere on the body. They typically form in areas of irritation or rubbing against other skin, clothes, and jewelry. These are benign but can be removed if they frequently become irritated, cause pain from rubbing against clothing/seatbelts, pain or bleeding with shaving, or if you are unhappy with how they look.
Skin Cancers: There are many different types of skin cancer which need to be removed. Common types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Risks for skin cancer include fair skin, peeling sunburns, and frequent sun or UV light exposure, as well as genetics. Skin cancers can take many different appearances based on the type, but concerning signs can include darkening or changing moles, raised dome shaped growths, itchy scaly areas, and non-healing or bleeding wounds. Skin cancer is very treatable if diagnosed early. The only way to diagnose skin cancer is with a biopsy. This can be performed by resecting the entire spot, usually with a margin of healthy tissue, or taking a sample of the suspicious spot to send for analysis. Any suspicious lesions should be treated right away to ensure early treatment or provide peace of mind.
Other Skin Conditions: Sometimes after surgery, scars can become painful or unsightly. Usually scars will take a full two years to fully mature and can become much less noticeable in that time. Measures such as scar massage, avoiding stretching of the tissue, and avoiding UV light exposure can help with this. If a scar persists despite this, a revision can be performed where the scar tissue is cut out and skin closed to attempt to make a more pleasing appearance or deal with pain from the scar. Other conditions such as hypertrophic scarring and keloid type reactions cause an excess buildup of scar tissue. These can also be removed with attempts to improve their appearance but individuals with these conditions are at risk of developing excess scar tissue whenever any surgical procedure is performed, even scar revision.
Hidradenitis suppurativa is a condition of abnormally thick secretions from the sweat glands which can lead to infections in the armpit, groin, and under the breasts. This is a chronic problem that is usually managed medically. For chronic infections that keep coming back in the same locations (that do not respond to medical treatment), surgery may be indicated to remove those sweat glands and infected tracts that can form. This does not remove all the sweat glands, so the hidradenitis is still present but can help to remove problematic areas that allow the disease to be better controlled with medical therapy.
Adhesions can form inside the abdomen in response to a prior surgery. These can cause a number of issues such as obstructions or blockages of the bowel, as well as pain or problems with digestion and eating. Adhesions can be treated with a procedure called adhesiolysis which involves cutting the scar tissue to free up any bowel which may be blocked or restricted as a result of the scar tissue in the abdomen. This is usually performed laparoscopically or robotically but sometimes will require an open surgery depending on the thickness of the scar tissue. This may be performed as an outpatient procedure or require a stay in the hospital depending on scar tissue thickness. There are a number of other issues which may require small bowel surgery.
Acute care and emergency surgery
Colon surgery
Feeding tube placement
Muscle biopsy
Lymph node biopsies
Peritoneal dialysis catheter placement
Temporal artery biopsy
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