Category: All Services

Lipomas are benign masses that are comprised of fat cells. They can be subcutaneous (beneath the skin) or in the deeper tissues. Dr. Sandler will evaluate your mass and frequently remove them in the office. If your mass is not suitable for office excision appropriate recommendations will be made.

Dr. Sandler performs minor surgical procedures in the office. These include excision of lipomas (fatty tumors), and sebaceous cysts, excision of skin lesions, and “incision and drainage” of minor infections/abscesses.

Hernia Repair

GENERAL INFORMATION

A hernia is a “defect” or weakness in the abdominal wall. There are several locations and types of hernias, all requiring different types of surgery. The bulge associated with most hernias is not the hernia itself, but the hernia contents protruding through the defect. The common areas where hernias occur are in the groin (inguinal or femoral), belly button (umbilical), above or below the belly button (ventral), and the site of a previous operation (incisional). Hernias are repaired to prevent the hernia from becoming larger and uncomfortable and to prevent the contents from becoming entrapped (incarcerated) or strangulated.

PRE-OP PREP

Labs and other studies are ordered prior to surgery based on the patient’s age and the presence of any existing medical problems. Patients should not eat or drink anything after midnight the night before surgery. Drugs such as aspirin, blood thinners (Coumadin, warfarin, Pradaxa, Xarelto, Eliquis), Plavix, and anti-inflammatory medications (Ibuprofen, Naproxen) should be stopped before surgery. Ask your doctor how long you should be off your medication. A bowel prep may be given to patients with incisional or ventral hernias.

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OPEN INGUINAL/FEMORAL HERNIAS

Indications:

Except in rare circumstances, most groin hernias require repair.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

Depending on whether you and your surgeon decide to pursue a laparoscopic or open repair, the procedures(s) are somewhat different. A 2-3 inch incision is made in the groin. The contents of the hernia are returned to the abdomen and the hernia defect is repaired using a synthetic mesh patch.

Length of Stay:

Outpatient.

Recovery:

1–2 weeks.

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LAPAROSCOPIC INGUINAL HERNIA REPAIR

Indications:

Groin hernias can also be repaired laparoscopically.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

The defect(s) are repaired using a synthetic mesh that covers all of the defects from the “inside” behind the muscles of the abdominal wall. The mesh material is fixed to the abdominal wall in a way that eliminates the defects.

Length of Stay:

This procedure is usually done as an outpatient, with an overnight stay in the hospital occasionally necessary for ventral and incisional hernias.

Recovery:

Appropriately selected patients may have less pain and quicker recovery when compared to the open procedures.

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OPEN INCISIONAL AND VENTRAL HERNIAS

Indications:

These are hernias that develop at previous incision sites or on the abdominal wall (including the “belly button”). Most of these hernias require repair.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

An incision is made over the hernia. The contents are returned to the abdomen and a synthetic mesh patch is usually used to complete repair.

Length of Stay:

Outpatient except in the case of large hernias which might require brief hospitalization.

Recovery:

1–2 weeks. No lifting over 5-10 pounds for six weeks.

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LAPAROSCOPIC VENTRAL/INCISIONAL HERNIA REPAIR

Indications:

Ventral and incisional hernias can be repaired laparoscopically.

Pre-Operative Evaluation:

A history and physical examination confirm the presence of a hernia.

Procedure:

The defect(s) are repaired using a synthetic mesh that covers all of the defects from the “inside” behind the muscles of the abdominal wall. The mesh material is fixed to the abdominal wall in a way that eliminates the defects.

Length of Stay:

This procedure is usually done as an outpatient, with an overnight stay in the hospital occasionally necessary for ventral and incisional hernias.

Recovery:

Appropriately selected patients may have less pain and quicker recovery when compared to the open procedures.

Gallbladder Removal

LAPAROSCOPIC CHOLECYSTECTOMY:

INDICATIONS:

Most gallbladder surgery is done for people who have symptomatic gallstones. Common symptoms include right-sided or upper central abdominal pain, which commonly occurs after eating fatty or greasy foods. The pain can be associated with nausea, vomiting, and / or a bloating sensation. The pain can also radiate into the back and / or right shoulder. A small percentage of patients have these symptoms without gallstones, but can be shown to have gallbladder dysfunction. Gallbladder dysfunction is identified on a test called a CCK – HIDA which measures how well the gallbladder functions.

PRE-OP EVALUATION AND PREP:

All patients have an ultrasound of the gallbladder, liver and bile ducts. Other imaging tests may be ordered if necessary. Routine blood work and x-ray studies are ordered prior to surgery based on the patient’s age and the presence of any existing medical problems. Patients should not eat or drink anything after midnight the night before surgery. Drugs such as Coumadin, Plavix, Aspirin and anti-inflammatory medications should be stopped before surgery.

PROCEDURE:

Laparoscopic gallbladder removal is performed under general anesthesia and involves four small incisions less than one-half inch in length. A camera is inserted into the abdomen through one of these incisions. The other incisions are used for the insertion of instruments the surgeon uses to remove the gallbladder instead of making a large incision as was commonly done in the past.

INPATIENT VS OUTPATIENT:

Gallbladder surgery can usually be done as an outpatient procedure. Some patients require extended observation, with discharge later in the day or the next morning. This occasionally is required in elderly patients, those with other medical problems, or in patients who may be nauseated or uncomfortable postoperatively.

RECOVERY:

This seems to vary from patient to patient. Some patients return to work shortly after surgery, others require several weeks until full recovery. On the average, one to two weeks after surgery patients are ready to resume all normal activities.