Surgical Specialties

General Surgery

General surgeons once did most everything, from setting broken bones to removing appendixes. But as surgery became more specialized, they fashioned their own area of expertise. Today's general surgeons primarily treat problems of the abdominal organs, as well as breast and skin cancers. Some general surgeons operate on the body's vascular system as well.

Training to become a general surgeon requires a five-year residency following medical school. Some surgeons then complete a fellowship to enhance their skills in a particular area of practice. Most surgeons discover a field of special interest, and with additional education and experience, develop a practice niche.

General surgeons once did most everything, from setting broken bones to removing appendixes. But as surgery became more specialized, they fashioned their own area of expertise. Today's general surgeons primarily treat problems of the abdominal organs, as well as breast and skin cancers. Some general surgeons operate on the body's vascular system as well.

Training to become a general surgeon requires a five-year residency following medical school. Some surgeons then complete a fellowship to enhance their skills in a particular area of practice. Most surgeons discover a field of special interest, and with additional education and experience, develop a practice niche.

In the 1980s general surgery was revolutionized by laparoscopy, an approach to some common abdominal procedures that uses a fiberoptic video camera to visualize the abdomen without cutting a long incision through the abdominal wall. This approach results in a shorter, less painful recovery for most patients.

During the procedure, harmless carbon dioxide gas is injected to inflate the abdominal cavity; a slender illuminating laparoscope equipped with a small camera is then inserted through a small incision in the belly, giving the surgeon a view of the internal organs on a video monitor. Miniaturized surgical instruments are then passed through other small incisions and manipulated within the abdomen. The patient usually goes home the same day with the incisions covered by small bandages.

Many surgical tasks can be performed with the aid of the laparoscope. In addition to imaging parts of the body for examination, tissue can be vaporized, cut, cauterized, or removed for biopsy. Among the most common laparoscopic procedures are removal of the gallbladder, called cholecystectomy, usually done when gallstones are obstructing the bile duct, appendectomies, and inguinal hernia repairs. A laparoscopic procedure called Nissen fundoplication is now used to treat chronic heartburn.

General surgeons also perform bowel surgery, including resections, in which diseased portions of intestine are removed and the healthy intestine is reconnected. Resections may be performed to treat localized conditions resulting in intestinal blockages or to treat Crohn's disease, colitis, or other inflammatory disorders of the bowel. Bowel surgery may also involve creating a temporary or permanent ostomy, in which an outlet is made through the abdominal wall for the passage of solid waste from the digestive tract to a collection pouch.

“Pull-through” bowel procedures that involve removing the large intestine and making a reservoir from the small intestine, which is then pulled through to the functioning sphincter, can sometimes be used to prevent the need for a permanent ostomy. In another relatively new procedure, an ultrasonic dissector is used to remove diseased or cancerous segments of the liver.

Gastric bypass surgery is an option for some people who are more than a 100 pounds overweight. It involves reducing the size of the stomach, which causes the person to get full much more quickly and be less tolerant of fattening foods. People who have failed in other efforts to lose weight often have long-term success with gastric bypass surgery.

General surgeons working at CMMC praise the work of local gastroenterologists, whose diagnostic exams play a key role in successful surgical treatment of many abdominal problems.