General/Gastrointestinal Surgery Services Provided

Following is a comprehensive, but not all-inclusive, list of services provided by the Division of Bariatrics, Foregut, and Advanced Gastrointestinal Surgery at Stony Brook Medicine. Open denotes conventional surgery; laparoscopic denotes minimally invasive surgery involving smaller incisions.

  • Anti-Reflux Surgery (Treatment of GERD)
    • Open
    • Laporascopic: Performed to treat chronic heartburn caused by gastroesophageal reflux disease (GERD), this anti-reflux surgery can be carried out safely and effectively with similar positive results to the conventional open operation and with all of the advantages of the minimally invasive approach. Open anti-reflux surgery involves opening the chest and wrapping part of the stomach around the esophagus to prevent stomach acids from surging up into the esophagus because of a weakened muscle between the two organs. The standard operation called Nissen fundoplication has been around for years, but is considered too invasive for all but the most severe cases of chronic heartburn. With the new laparoscopic procedure, patients are generally out of the hospital in one to two days instead of a week, with five tiny scabs rather than a 5- to 7-inch scar. Laparoscopic surgery is also used for the LINX Reflux Management System, a new device implanted to treat GERD (see video, plus LINX website for FAQs and patient testmonials).
  • Appendectomy (Appendix Removal)
    • Open
    • Laporascopic: Advances in laparoscopic procedures include minimally invasive surgery as a safe and effective technique for managing acute appendicitis. The patient also benefits from a shorter hospital stay, faster return to normal activities, and a decreased need for pain medication when compared to the open/traditional method of having the appendix removed. The overall majority of patients return to a normal diet anywhere from several hours post-operatively to one day following surgery, and require less pain medication. Bowel function returns quickly and patients are discharged quicker from the hospital. Because the traditional “abdominal transverse” incision is not required and is instead replaced by small and precise incisions, the procedure is performed with enhanced cosmetic results.
  • Cholecystectomy (Gallbladder Removal)
    • Open
    • Laparoscopic: This operation for the removal of a diseased gallbladder has quickly replaced the conventional approach as the procedure of choice. Introduced in the late 1980s, it changed the practice and expectations of general surgery, as it captured the attention of the surgical profession and the public and spawned the tremendous growth in minimally invasive surgery.
  • Choledocholithotomy (Common Bile Duct Exploration)
    • Laparoscopic: In the past, if bile duct stones were found on x-rays taken during surgery, the procedure was converted to an open operation. Now, with laparoscopic common bile duct exploration, removal of the stones as well as the gallbladder, if indicated, can be addressed with just one minimally invasive operation. We have all the latest complex equipment, including minute laparoscopic flexible choledochoscopes for looking inside the common bile duct at the same time as looking inside the abdomen. Our surgeons have the expertise to explore the common bile duct both through the cystic duct as well as directly through the common bile duct.
  • Inguinal Hernia Repair (Treatment of Groin Hernia)
    • Open (including Shouldice hernia repair)
    • Laparoscopic: This laparoscopic operation involves the insertion of a mesh material for correcting hernias in the groin. Recent studies have shown that it is a good technique with low recurrence and complication rates. Patients have found this operation to be remarkably pain-free, and 50% of them require no pain medication after discharge from the hospital. Most can return to work within one week of the operation.
  • Myotomy (Treatment of Achalasia)
    • Open
    • Laparoscopic: Performed to treat achalasia (severe swallowing difficulty) which increases pressure at the lower esophagus, this operation disrupts the muscular fibers of the lower esophagus and allows the food to get to the stomach without delay; an anti-reflux procedure (partial fundoplication) is performed to avoid postoperative gastroesophageal reflux. This operation has established itself as the procedure of choice for treating achalasia. It is safe and effective, and recovery is fast, usually with an overnight or outpatient hospital stay. Minimally invasive surgical techniques have had a profound impact on the treatment of achalasia over the past decade and several modifications of both the myotomy and the concomitant anti-reflux procedure are currently advocated. Nearly all of the more contemporary published studies report a 90% or greater success in relieving dysphagia (inability to swallow), one of the most common symptoms of achalasia.
  • Per-Oral Pyloromyotomy (POP) Procedure (Treatment of Gastroparesis)
  • Paraesophageal/Hiatus Hernia Repair (Treatment of Stomach Hernia)
    • Open
    • Laparoscopic: Paraesophageal hernias — in which the stomach protrudes through the opening (hiatus) in the diaphragm where the esophagus meets the stomach — are associated with advanced age and co-existing medical problems. True paraesophageal hernias (not the sliding type associated with reflux) with incarcerated stomach put patients at risk for gastric volvulus (intestinal obstruction due to knotting/twisting of the bowel), which is a potentially lethal problem. Therefore, all such hernias need to be repaired. Laparoscopic repair offers a reasonable alternative to traditional surgery, especially for high-risk patients. In a 1998 comparative study, short-term outcomes for laparoscopic repair were found to be superior to open repair, suggesting that the laparoscopic approach is the preferred approach to paraesophageal hernia repair.
  • Perforated Peptic Ulcer Repair
  • Splenectomy (Spleen Removal)
    • Open
    • Laparoscopic: As a result of ongoing advances and increased proficiency in the performance of laparoscopic procedures, laparoscopic splenectomy has evolved in the treatment of diseases of the spleen. In carefully selected patients, this operation has proven to be as safe and effective as conventional open surgery.
  • Ventral Hernia Repair (Treatment of Abdominal Wall Hernia)
    • Open
    • Laparoscopic: Ventral hernias are anterior abdominal wall hernias, which may occur independently (primary ventral hernia) or, more commonly, in conjunction with an incision from prior abdominal surgery (incisional hernia). All such hernias should be fixed once found, and they can be repaired using mesh in a laparoscopic procedure. Laparoscopic ventral hernia repair, a recent development, has been shown to be safe and effective in the repair of ventral hernias.
  • Weight Loss (Bariatric) Surgery

For information about the services we provide, please visit the online Health Library of Stony Brook Medicine University Physicians.