Breast Surgery

Is fibrocystic condition dangerous?
No. Fibrocystic condition is not malignant. It causes a broad spectrum of symptoms including pain, discharge, swelling and masses. It can also cause radiographic changes on mammogram. These findings must be evaluated by ultrasound and physical evaluation. Fibrocystic condition should not be taken for granted since it can mask an underlying malignancy.

Can breast cysts be aspirated in your office?
Yes. Palpable cysts can be readily aspirated painlessly. The fluid may be sent for cytologic evaluation. Mammographic lesions can be successfully aspirated using our in-office ultrasound. Our vascular technologist, is a trained ultrasonographer. With her assistance, we can aspirate most breast cysts.

Is breast pain normal?
Most of the time, yes. Hormonally induced changes in the breast cause discomfort and swelling. This may be a simple monthly event or it may last for several months. The treatment is typically conservative such as heat, anti-inflammatory agents and pain control.

Is breast biopsy an out-patient procedure?
Yes. Most breast procedures are done as an out-patient. Even some of the more involved cancer operations can be done on an out-patient basis if the patient is motivated to do so.

Vascular Surgery

What is a stroke?
A stroke is loss of part of the brain due to lack of flood flow. This leads to symptoms such as paralysis, difficulty with speech or difficulty with vision.

Can strokes be prevented?
Yes. Some strokes are caused by fragments of plaque that separate from the walls of the carotid arteries in the neck and travel to the brain. Others are caused by severe narrowing of these arteries by atherosclerosis These strokes can be prevented by an operation to clean out the plaque in the carotid artery.

Am I at risk of having a stroke?
A test of the carotid arteries can be done for patients deemed to be at high risk. This is a non-invasive test done in our office by an experienced vascular technician.

What is claudication?
If the circulation to the legs is insufficient to meet the needs of the leg muscles when walking, one will experience tightness and pain in the calves. This pain is called claudication. This causes the person to stop walking until the blood flow can catch up.

Is claudication dangerous?
There is no damage to the legs when experiencing this symptom. In fact, there is some benefit to walking as it stimulates the circulation. Claudication should be investigated in the vascular lab to see if correctable narrowings are found in the arteries to the legs.

Will I lose my leg?
Most people with claudication can expect a fairly benign course. However, pain in the foot at rest, ulcers that do not heal, or gangrene of the foot are dangerous and warrant immediate evaluation.

Do I have an aneurysm?Most aneurysms give no symptoms until they begin to leak or rupture. Screening for the presence of aneurysm should involve a physical exam and possibly an ultrasound of the aorta, available in our Vascular Lab.                                                         

I have heard that aneurysms can be repaired without a large incision. Is this surgery available locally?
Yes. The standard surgery to repair abdominal aortic aneurysms is a large operation. Now there is technology available that will allow these aneurysms to be repaired through smaller incisions in the groin. This allows patients to leave the hospital sooner and suffer much less pain and disability.

What are varicose veins?
Varicose veins are abnormally dilated veins that are most common in the legs. They cause lumps that can be seen and felt. Symptoms can be heaviness or tiredness of the legs with standing. These veins may clot off and become painful.

What can be done for varicose veins?
Multiple treatments exist. We can do injections in our office on some patients while others may need laser treatments or surgery. Some people may require even less treatment, such as compressive stockings. Of course, we also offer state of the art minimally invasive techniques.

Pacemakers

Will the battery wear out?
Yes. Typically, this takes 5-7 years. The pacemaker will be monitored through its life by phone. It will emit a special signal when the battery needs replacing. This is done in the operating room as an out-patient procedure.

Will microwaves bother the pacemaker? Can I fly?
Today's pacemakers are very durable. They have been made so that they are shielded from most microwaves. The kitchen microwave should not affect your pacer. Pacemaker patients may safely fly.

Can a pacemaker be programmed?
Yes. Typically your cardiologist will reprogram you pacemaker several times. This enables it to last longer by using less energy. It can also be reprogrammed to meet changing medical needs. This is done electronically and does not require surgery.

Chest Surgery

What is a pneumothorax?
A pneumothorax is a condition in which air escapes from the lung and causes the lung to collapse. The air fills the cavity between the lung and the rib cage. The symptoms of a pneumothorax may include shortness of breath, chest pain, and the feeling of motion in the chest when breathing. Most pneumothoraces are spontaneous, caused by the rupture of surface blebs on the lung. Treatment involves placing a small chest tube under local anesthetic to expand the lung. Rare cases may require surgery, often using minimal incisions (thoracoscopy).                     

Laparoscopic Surgery

Why is carbon dioxide used to inflate the abdomen?
Carbon dioxide is an inert gas. It is not flammable and is readily absorbed after the termination of a procedure.

Can laparoscopic procedures be done on most patients?
Yes. However, patients who have had major abdominal surgical procedures may not be good candidates for a laparoscopic procedure. We attempt to do procedures laparoscopically with the understanding that a patient may have to have a laparoscopic procedure converted to an open procedure to assure safety and completion of the operation, if necessary. We recommend a one on one consultation with our surgeons if a patient is interested in having laparoscopic surgery.

What types of problems can be dealt with laparoscopically?
A myriad of surgical problems can be treated using laparoscopic techniques. These include problems associated with the esophagus, stomach, liver, spleen small and large intestine, adrenal gland, appendix, and pancreas, as well as hernias of all types.

Are all gallbladders successfully removed laparoscopically?
No. A certain percentage of all laparoscopic cholecystectomies have to be converted to an open procedure. This is an intraoperative decision and is based on the degree of disease of the gallbladder. Patients with extremely difficult gallbladders may have to undergo an open procedure. In addition, patients with abnormal anatomy or dense adhesions may also have to be converted to an open procedure.

Colon & Rectal Surgery

Am I at risk for colon cancer?
Men and women over the age of forty with a history of polyps or a close relative with colon cancer are at increased risk. They should have a screening colonoscopy Everyone over the age of fifty, with or without symptoms, should similarly have a colonoscopy.

What is involved with colonoscopy?
This examination is performed as an out-patient at Centennial Surgical Center in Voorhees and takes about 30 minutes. Preparation involves drinking a laxative drink the night before which cleanses the colon. An anesthetist induces a light sleep, rendering the exam painless. The procedure examines the entire colon and rectum. Polyps (small growths) can be removed and other lesions biopsied. Anyone having colonoscopy needs a ride home and may return to full activity the following day.

What are hemorrhoids?
Hemorrhoids are anal lumps composed of dilated veins and are caused commonly by pressure on the rectum from pregnancy or constipation. They cause symptoms either by bleeding painlessly on the toilet or by clotting off painfully. Bleeding hemorrhoids can be treated without surgery in the office with painless rubber banding. Painful hemorrhoidal lumps require surgery in the worst cases. We offer to appropriate patients hemorrhoid stapling surgery (PPH Procedure), a newer less painful minimally invasive technique.

Has colon surgery changed any for the better?
Yes. Many colon operations can now be performed laparoscopically, reducing postoperative pain and recovery time. Colostomies have become more uncommon. We also routinely use epidural anesthesia (similar to childbirth) to minimize postoperative discomfort.