Specialties
"General Surgery" was the first surgical specialty, having become separate from the general practice of medicine more than one hundred years ago. It is based upon a central core of knowledge that embraces anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care and neoplasia (cancer).
General Surgeons certified by the American Board of Surgery have, through their training, acquired knowledge and experience related to the diagnosis; preoperative, operative, and postoperative management; and management of complications involving surgical patients.
SurgOne physicians specialize in one or more of the following specialties:
General Surgery today has evolved into a field that encompasses surgical treatment of the abdominal organs and intestines including the esophagus, stomach, colon, liver, gallbladder, pancreas, adrenal glands and appendix. General surgery also entails surgical treatment of breast disease, thyroid and parathyroid disease, skin and soft tissue ailments, and hernias.
All SurgOne physicians are Board Certified in General Surgery and have demonstrated mastery of knowledge and skill in surgical care of the surgical patient.
Surgery of the breast involves a wide variety of breast diseases, which can be divided into two groups: benign and malignant breast disease.
Benign breast disease includes evaluation of a variety of breast maladies such as breast pain, breast lumps, nipple discharge, breast infections and abscess, fibrocystic disease, and inflammatory lesions. Though a majority of breast lumps may be benign, the surgeon's role is to evaluate and rule out the possibility of breast cancer or a pre malignant disease.
Breast cancer is a leading cause for death in women of all ages. The surgeon’s role in breast cancer diagnosis and treatment has become more prominent. Breast cancer screening tools, including mammography, ultrasound, MRI, and breast examination and biopsy, are all mastered by the adept breast surgeon. Specific surgical skills utilized by the surgeon include excisional biopsies, lumpectomies, mastectomies, lymph node dissections, and sentinel lymph node biopsies.
In early diagnosis of breast cancer the surgeon’s role is central in a multidisciplinary approach including primary care physicians, oncologists, and radiologists. Surgical care can also mandate cooperation with other specialties. These include radiologists for stereotactic marking of lesions requiring biopsies, oncologists for local and systemic chemoradio therapeutic options pre and post operatively, and plastic surgeons for breast reconstruction following mastectomy.
SurgOne physicians specializing in breast surgery are qualified in all aspects of benign and malignant diseases of the breast. These surgeons maintain excellent standing in the medical community to facilitate multidisciplinary and comprehensive care of the breast cancer patient.
Bariatric Surgery involves surgical treatment of the morbidly obese patient. Obesity is a serious problem that can contribute to medical conditions including diabetes, hypertension, coronary artery disease, congestive heart failure, arthritis, restrictive lung disease, sleep apnea, gastroesophageal reflux disease, depression, and infertility.
There are two main surgical options for the obese patient. The first is the adjustable gastric band. This procedure is commonly performed laparoscopicaly through small incisions. It involves placement of a silicone band around the upper portion of the stomach. This in turn creates a smaller stomach pouch, which slowly empties and allows the patient to feel full faster and longer leading to weight loss. Additionally, the band is adjustable to accommodate the changing needs of the patient over time.
The second surgical procedure is referred to as the Roux-en-y gastric bypass surgery. This is also commonly performed laparoscopically unless mitigating circumstances (i.e. previous surgeries, scar tissue, or abnormal anatomy) require an open, traditional incision. The procedure involves dividing the stomach so that food travels into a small pouch of remnant stomach. A limb of small intestine is then connected to this pouch in order to bypass the main calorie absorption section of the bowel. The small pouch leads to a sensation of feeling full faster and the bypass leads to less calorie absorption; both contributing to weight loss.
SurgOne physicians trained in bariatric surgery, skillfully carry out these surgical procedures, as well as other surgical options. These surgeons are trained also in the thorough evaluation of appropriate candidates, which entails nutrition management, mental health assessment, and evaluation of comorbid medical issues. As such, all bariatric surgeons in SurgOne, have been designated with Bariatric Centers of Excellence by the American Society of Bariatric Surgery. This designation recognizes surgical programs with a demonstrated track record of favorable outcomes in bariatric surgery.
Colon and Rectal Surgery encompasses specific disease treatment of the colon, rectum, and anus. Benign diseases of the rectum and anus involve hemorrhoids, rectal pain, anal fissures, rectal abscesses, anal fistulas, pilonidal cysts, rectoceles, incontinence and rectal prolapse. Benign diseases of the colon that are managed include constipation, diarrhea, colon polyps, inflammatory bowel disease (ulcerative colits and Crohn’s disease), and diverticulitis.
The Colon and Rectal Surgeon is certified in the performance of colonoscopies for evaluation and treatment of benign and malignant conditions. SurgOne physicians trained in Colon and Rectal Surgery perform upward of 400 colonoscopies a year. These procedures are done to evaluate symptoms of constipation, diarrhea, change in bowel habits, abdominal pain, and rectal bleeding. Routine screening colonoscopies are performed as well for the early detection and treatment of colon and rectal polyps and cancer.
Colon and rectal surgery for cancer involves a multidisciplinary approach to evaluation, treatment, and surveillance. This includes working with radiologists, oncologists, radiation oncologists, and gastroenterologists to maximize success in the care of the patient with colorectal cancer. Specific surgical treatment of the colon and rectum can be performed laparascopically in most cases and all SurgOne physicians are trained in this technique. Surgical treatment for colon and rectal cancer also focuses on avoidance of a colostomy or bag when at all possible.
SurgOne physicians possess excellent knowledge and skill in the mangagemet of diseases of the colon, rectum, and anus.
Endocrine glands produce hormones that affect the function of other body organs or systems. While many organs in the body secrete hormones, the endocrine glands that frequently require surgery include the adrenal, pancreas, thryoid and parathyroid glands.
Endocrine surgery involves treatment of benign and malignant diseases of these organs. Endocrine surgeons are also trained in the evaluation and diagnosis of these varying diseases. This includes thryoid cancer, thyroid nodules and cysts, Grave’s disease, hyperparathyroidism, parathyroid cancer, bengin and malignant adrenal masses, benign and malignant pancreatic masses, and pancreatitis along with its potential complications. Evaluation of these endocrine disorders involves a close working relationship with endocrinologists, radiologists, gastroenterologists, and oncologists in determining surgical candidates and maximizing successful patient care.
Sugical options are varied based on the organ involved but they often involve newer minimally invasive techniques. This allows for faster recovery, reduced postoperative pain, and better cosmetic outcomes.
SurgOne general surgeons are all trained in the intricacies of endocrine surgery.
Hepatobiliary surgery encompasses surgery of the liver, bile ducts, gallbladder, and pancreas. Hepatobiliary surgeons work in close conjunction with gastroenterologists, radiologists, and oncologists in evalation and treatement of surgical maladies within this field. Surgical diseases of the gallbladder include gallstones (cholelithiasis), inflammation (cholecystitis), or gallbladder cancer. Pancreatic masses, benign or malignant, as well as chronic inflammation of the pancreas (pancreatitis) along with its varying complications all require surgical treatment. Bile duct surgery is required for cancer, injury, or strictures and often mandates resection or bypass of the affected segment. Liver surgery is performed for benign symptomatic or premalignant lesions as well as malignant tumors, which are either primary or metastatic in origin.
Hepatobiliary surgeons are adept in varying techniques of treatment for the above-described diseases. Laparoscopy or minimally invasive surgery is commonly used for gallbladder surgery and has been more recently used in treatment of liver lesions. Previously, cancerous lesions of the liver were slated for resection of a portion of the liver. Newer techniques including chemoembolization and radiofrequency ablation have diversified the arsenal in treating such lesions allowing for sparing of liver function and tissue. Laparoscopy has played a signifcant role in advancing these newer modalities in liver surgery. Comprehensive care with radiologists ensures successful treatment plans and outcomes in these patients.
Hernia surgery involves repair of an abdominal wall muscle defect, or hole, through which tissues inside the abdomen may protrude. Hernias may occur because of a congenital weakness in this area or because of an induced injury to the abdominal wall musculature (i.e. lifting, straining, or previous surgical incision). They are most commonly seen in the groin and abdomen, presenting as a noticeable lump with associated discomfort. Less commonly, internal hernias can occur when congenital scar tissue or postoperative scar tissue leads to entrapment of internal organs or intestines.
General surgeons are specifically trained in the diagnosis, treatment, and postoperative management of hernias. Multiple techniques have evolved in the treatment of hernias. Surgical treatment often, but not always, includes use of mesh to create a tension free repair. Hernia surgery can be performed in both an open incision fashion or laparoscopically through smaller incisions. The majority of hernia surgery is performed on an elective outpatient basis, allowing for rapid recovery and return to work. Occasionally hernia surgery can become urgent and life threatening if tissue trapped in the hernia becomes strangulated and gangrenous (dead). In these cases, surgical treatment is carried out on an emergent basis.
Laparoscopic or Minimally Invasive Surgery Laparoscopy or minimally invasive surgery allows general surgeons to provide surgical treatment of many intra-abdominal conditions through small incisions. This in turn minimizes pain and discomfort allowing for more rapid recovery and return to normal activities. The benefits of laparoscopy have been proven in many controlled studies since its inception.
Laparoscopy first began gaining favor with treatment of gallbladder disease and general exploration of the abdomen. Soon after laparosocpic cholecystectomy (removal of the gallbladder) became standard of care; laparoscopy became favorable in other surgical situations. These include appendectomy, hiatal hernia repair, gastroesophageal relfulx disease, inguinal hernia repair, incisional hernia repair, and bowel obstruction. Large organ operations can also be performed laparoscopically. This includes surgery of the colon, liver, spleen, adrenal glands, and kidneys.
Laparoscopic surgery has demonstrated benefits in patient recovery across the board. Although it is not always possible in every situation, it has now become the first line of surgical treatment in the majority of surgical disease processes. SurgOne physicians are all trained in laparoscopy and its feasibility in the management of the surgical patient.
Surgical oncology is a specialized area of oncology that engages surgeons in the cure and management of cancer. Cancer has become a medical speciality warranting its own surgical area because of advances in biology, pathophysiology, diagnostics, and staging of malignant tumors. The surgical oncologist functions within a multidisciplinary team as a coequal partner with medical oncologists and radiation oncologists. The overriding function of this team is to communally devise an optimal treatment plan for each individual patient prior to the application of therapeautic components.
The surgical oncologist is specialty trained in combining advanced surgical care with appropriate adjuncts including chemotherapy, radiotherapy, and ablative therapy, among many others. The surgical oncologist performs local tumor excision, regional lymph node removal, the handling of cancer recurrence (local or widespread), and in some cases, with surgical resection of metastases from the primary tumor.
Traumatic injury is one of the leading causes of death and disability in our country. Management of the trauma patient has become a critical specialty provided by general surgeons. Trauma surgeons are surgeons who have specific training and expertise in managing the initial evaluation and resuscitation of the trauma patient as well as the subsequent critical care management of these patients. Trauma general surgeons work in conjunction with other trauma specialists including emergency physicians, orthopedists, neurosurgeons, cardiothoracic surgeons, vascular surgeons, and plastic surgeons to evaluate and treat injuries expediently. Doing so avoids progression of injury and prevents complications while maximizing recovery and rehabilitation of the traumatized patient.
SugOne physicians who are trained in trauma surgery maintain Advanced Trauma Life Support (ATLS) certification which designates knowledge and skill in the rapid assessment, resuscitation, and treatment of the traumatically injured patient.
SurgOne has several transplant surgeons that run the Centura Health Transplant Program, located at Porter Adventist Hospital. The program involves liver transplants, kidney transplants, and combined kidney/pancreas transplants. The program was instituted in 1986 and has grown overtime to become the premier transplant program in Colorado and the surrounding areas. Its success is based on a comprehensive care plan for all transplant patients, pre and post operatively. This includes physicians, surgeons, nurses, social workers, and financial coordinators all specialized in the care of the transplant patient.
The transplant surgeon’s role is evaluation of disease processes, which will determine eligibility of a transplant candidate. This evaluation is done in conjunction with other physicians including gastroenterologists, nephrologists, and endocrinologists. Transplant surgeons are not only trained in the intricacies of the surgeries themselves, but have thorough knowledge of systemic immunology, which allows for successful care of the post-transplant patient.
Liver transplantation is potentially applicable to any acute or chronic condition resulting in irreversible liver dysfunction, provided that the recipient does not have other conditions that will preclude a successful transplant. Most liver transplants are performed for chronic liver diseases that lead to irreversible scarring of the liver, or cirrhosis.
The indication for kidney transplantation is end-stage renal disease regardless of the primary cause. Common diseases leading to ESRD include hypertension, infection, diabetes, and glomerulonephritis; genetic causes include polycystic kidney disease. Kidney/pancreas transplantation is performed for patients with ESRD secondary to Type 1diabetes. The majority of renal transplant recipients are on some form of dialysis at the time of transplantation. In some cases, however, individuals with chronic renal failure, who have a living donor available, often elect to undergo transplantation before dialysis is needed. Kidney transplant surgery with live donors has become particularly successful with the advent of laparoscopic nephrectomy for kidney procurement. This has allowed for faster recovery of the donor patient, which consequently has increased the willingness and overall numbers of potential kidney donors.
SurgOne transplant surgeons have maintained excellent outcomes through the Centura Health Transplant Program. Their multidisciplanary approach, skillful surgical technique, comprehensive care, and dedication have created a strong, successful program in the field of liver, kidney, and kidney/pancreas tranplantation.
Vein surgery includes treatment of varicose veins and spider veins, which are commonly found in patients with underlying venous disorders. Often thought to be mainly cosmetic, vein surgery for venous disease is important in preventing serious health complications such as blood clots, ulceration, and spontaneous bleeding.
Minimally invasive techniques are used to treat these ailments. For spider veins, scleorotherapy or laser therapy is entertained. Sclerotherapy involves injecting a solution into the vein,which causes collapse and absorption of the vein. Laser therapy uses light energy to coagulate the blood in the abnormal vein, thereby destroying it.
For varicose veins, endovenous laser ablation of the saphenous vein is performed under ultrasound guidance to collapse the damaged saphenous vein, which is the cause of the varicosities. This is often combined with ambulatory phlebectomy in which the varicose veins themselves are removed through tiny incisions under local anesthetic. Scleortherapy can also be used to treat these varicose veins.
These varying treatment options are all performed in a minimally invasive, outpatient manner with tremendous success and efficiency.
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