The gastrointestinal tract includes the the mouth, esophagus, stomach, small intestines, and colon all the way to the anus. It is responsible for absorbing nutrients and fluids from the things we eat and drink and then expelling the waste. Because of the multiple organs involved, common stomach and small intestinal surgeries are referenced below. Colon and rectum surgeries have their own categories. The information below is general and every patient is different. We would be happy to talk about your specific case and discuss the appropriate work-up and treatment of your issue.
There are many reasons to need an operation on the stomach. Tumors, feeding tube placement, ulcers, and even revision of operations that have been done in the past. Feeding tubes and ulcers are discussed below.
The types of tumors that can arise in the stomach are multiple, but the most common are adenocarcinomas (gastric cancers) and gastrointestinal stromal tumors. Surgical resection is the mainstay of treatment and the amount of stomach that has to be removed is dictated by the size of the tumor, location of the tumor, and type of tumor.
We have extensive experience operating on the stomach and are comfortable doing most of the operations required. We can even discuss a laparoscopic approach depending on the situation.
Most feeding tubes are needed for folks that are not able to swallow on their own. For these folks placement of a feeding tube through the skin into the stomach or the small intestine can be life saving. A lot of these feeding tubes are able to be placed endoscopically with the assistance of a lighted scope placed into the stomach through the mouth. Sometimes, however, this is not possible due to scar tissue from previous operations or the patient needs the feeding tube placed into the small intestine instead of the stomach. Consultation with a surgeon is generally required in these situations.
We try to place as many of these feeding tube laparoscopically as possible, however, because scar tissue from previous operations is sometimes an issues small open incisions are also used. Recovery times are typically very short and the feeding tube can start to be used the next the day.
Ulcers are a common problem and can arise in both the stomach and first part of the small intestine, which is call the duodenum. Most ulcers can be treated with acid suppressing medicines and sometimes antibiotics to kill a specific bacteria called H. pylori, which can cause ulcers. Surgery for the treatment of ulcers is rare. However, consultation with a surgeon may be needed for ulcers that don't heal with the above treatment or other complications of ulcer disease like blockage of the stomach outlet.
When evaluating a non-healing ulcer the main concern is to rule out cancer. A surgical biopsy may be needed to fully evaluate. This is generally done laparoscopically so that if additional operations are needed, they can be performed with minimal scar tissue. If multiple non-healing ulcers are present a tumor called a gastrinoma must be ruled out.
Though the need for surgery for ulcer disease is rare, we are more than comfortable with the operations required and would be to discuss the possibilities with you.
The small intestine is approximately 6 meters long and its main function is to absorb nutrients from the things we eat. The most common surgical problem encountered with the small intestine is obstruction that is caused by scar tissue from previous operations. This is not really an elective problem and will not be discussed here in depth.
Tumors of the small intestine are fairly uncommon and fortunately are often benign. However, even when benign they are usually discovered when they are causing issues by blocking the passage of GI contents, creating pain, or something called intussusception, which is when one part of the intestine telescopes into another. These tumors include lipomas, hamartomas, hemangiomas, and adenomas. These tumors can generally be treated with resection and no further treatment is needed. Tumors such as gastrointestinal stromal tumors (GIST), carcinoids, adenocarcinomas, and lymphomas are also treated with resection and possibly additional medical treatmtent.
Strictures are tight spots that when they occur in the intestinal tract make it hard for contents to pass. These can be caused by inflammation or as a result of low blood flow at some point. Treatment is generally surgical.
Many of these issues of the small intestine can be addressed laparoscopically with small incisions and short recovery. We would be happy to discuss your specific issue and the options available for treatment.