Minimally Invasive Surgery

Specializing Institutions

Minimally invasive surgery, also called laparoscopic surgery, allows surgeons to operate on patients using small precision instruments that minimize pain, scaring, blood loss and recovery time. During these procedures, doctors make one or more incisions, each about a half-inch long, to insert a tube. The number of incisions depends on the type of surgery. The tubes allow the doctors to slip small video cameras and other specially designed surgical instruments for the procedure. Depending on your condition, you may need only a short hospital stay. Conditions that can be treated with minimally invasive surgery include, LAP-BAND Surgery, Hernia Surgery, Anti-Reflux Surgery, Adrenal Surgery, Hysterectomy and Ulcerative Colitis.

Institutions at the South Texas Medical Center offer non-invasive surgery performed with the latest medical equipment by da Vinci technology and Gamma Knife. Thanks to this breakthrough surgical technology patients can receive effective, minimally invasive alternatives to both open surgery and laparoscopy. The da Vinci Surgical System helps surgeons in procedures that treat a range of conditions, such as Bladder Cancer, Colorectal Cancer, Coronary Artety Disease, Endometriosis, Obesity, Thyroid Cancer, Kidney Disorders, Uterine Fibrosis and more.

The South Texas Medical Center also offers alternatives to open heart surgery that have many advantages over traditional surgery. The da Vinci Surgical System provides surgeons and patients with an effective and minimally invasive treatment to even the most complex cardiothoracic procedures such as mitral valve repair. Non-invasive surgeries reduce the risk of infection, minimize blood loss, shorten the hospital stay, leave less scaring and lead to faster recovery. Institutions at the South Texas Medical Center also offer Hysterectomy, Gynecologic and Prostatectomy surgeries using the da Vinci Surgical System.

Patients can also find a newer, less invasive treatment for Craniosynostosis at the South Texas Medical Center, where the founders of Endoscopic Craniectomy have been working in the last twelve years to help hundreds of children grow up to live a normal life.

The most accurate and advanced version of Gamma Knife radiosurgery is also available at the South Texas Medical Center. Surgeons at our institutions have dramatically increased the precision of radiation delivery during surgery while improving the comfort for patients with this non-invasive treatment. Gamma Knife radiosurgery is used to treat tumors and lesions in the brain.

Surgery Articles

  • Second D.C.-area man stricken with flesh-eating bacteria -media

    By John Clarke and Ian Simpson

    Aug 22 () - (Reuters) - A flesh-eating bacterial disease has infected another Washington, D.C.-area man, local media reported on Thursday, just days after a man was released from a hospital following a near-deadly bout with the germ.

    Joe Wood of Stafford, Virginia, said he was swimming in the Potomac River near the town of Callao earlier this month when a scratch on his left leg became infected with vibrio vulnificus, an aggressive bacteria that feeds on flesh, Washington D.C.'s WTOP radio reported.

    Wood was admitted to the Mary Washington Hospital in Fredericksburg on July 5 where an infectious disease specialist performed skin graft surgery on Tuesday, the report said. Doctors told the radio station that Wood would likely survive.

    The report could not be immediately confirmed as the hospital did not return repeated calls by a Reuters reporter on Thursday.

    The news comes just days after a 66-year-old Maryland man was released from a hospital after nearly losing a leg and his life to the flesh-eating bacterial infection that he contracted in Chesapeake Bay earlier in the month.

    The bacterial strain causes severe illness characterized by fever and chills, septic shock and lesions. Symptoms include vomiting and diarrhea.

    Vibrio cases are on the rise in the region. In a 2009 study, the Chesapeake Bay Foundation found that the increase in infections was linked to pollution and unusually hot summers.

    In Maryland, the number of all vibrio cases, including the strain that afflicted the two men, reached 57 last year, a 10-year high, according to the Maryland Department of Health and Mental Hygiene.

    Virginia had eight vibrio vulnificus cases last year, according to the Virginia Department of Health. There have been 27 cases involving vibrio species overall so far this year.

    Nationwide, there are as many as 95 cases of vibrio vulnificus infections each year, 35 of which result in death, according to CDC statistics.

  • Men, substance users less likely to have weight-loss surgery

    By Ronnie Cohen

    NEW YORK (Reuters Health) - A one-size-fits-all approach to weight-loss surgery may be keeping obese men, substance users and older people out of the operating room, a new study suggests.

    The study analyzed data from a Canadian program intended to encourage obese people to undergo weight-loss surgery. More than half the patients dropped-out without having the operation, researchers found.

    Men, smokers, drinkers, drug users and people age 60 and older were the most likely to quit the program before having the operation, senior author Dr. Fayez Quereshy from the University of Toronto in Ontario told Reuters Health in a telephone interview.

    More than one-third of U.S. adults are obese and cost an estimated $147 billion a year in medical care, according to the Centers for Disease Control and Prevention.

    Weight loss operations, formally known as bariatric surgery, are known to cut obesity-related disease and healthcare costs. Prior research has shown they result in substantial weight loss and can reverse the course of some related diseases (see Reuters story of December 24, 2013 here:

    In some studies, the surgery has been more effective in helping obese people shed weight than diet, exercise, therapy and drugs (see Reuters story of October 31, 2013 here:

    The operations reduce the size of the stomach so patients can eat only small amounts of food. Doctors recommend the procedures for people who are severely obese or moderately obese with serious weight-related health problems.

    But while bariatric surgery is becoming increasingly popular, the drop-out rate has also been growing, the authors write in the Journal of the American College of Surgeons.

    In the current study, they examined the records of 1,664 patients referred to the bariatric-surgery program between 2008 and 2011. Patients ranged in age from 19 to 80, with an average age of 48. They waited an average of nearly 15 months to have the surgery, the authors write.

    Body mass index (BMI), a ratio of weight to height, was higher than 40 in nearly nine of every ten people. A BMI of 40 would be roughly equivalent, for example, to a height of 5 foot 2 inches (157 cm) and a weight of 218 pounds (99 kg), or a height of 6 feet (183 cm) and a weight of 294 pounds (133 kg).

    About one in every 13 people had a BMI above 60, roughly equivalent to a height of 5 foot 2 inches and a weight of 330 pounds (150 kg),

    Most patients - 74 percent - referred to the program were women. Men were not only less likely to be referred, they were also nearly half as likely to undergo the surgery.

    Heavier patients were more likely to have the operation and older patients (i.e., those over 60) were less likely, the study found.

    Distance from home to the program appeared to have no impact on attrition.

    Smokers, drinkers and other substance users were more likely to quit before surgery. The study did not determine if they left the program on their own or were refused treatment. Substance abusers must demonstrate prolonged abstinence to be eligible for weight-loss surgery, the authors write.

    Knowing which patients are dropping out should help administrators tailor future bariatric-surgery services, Quereshy said.

    The best way to most efficiently move more patients through the system, he believes, would be to tailor the care for certain groups of people. For example, he suggested, patients with limited social networks should be connected to social workers early on.

    "In environments where resources are scarce and obesity-related complications carry a significant cost burden and patient complications, we need to think of novel ways to reduce wait times, patient dropouts and disappointments while improving satisfaction," Quereshy said.

    Bariatric surgeon Dr. Erik Dutson, from the University of California, Los Angeles, said the study's message rings just as true in America as it does in Canada. He was not involved with the current study.

    "If we are going to continue to look at bariatric surgery as the gold standard for weight loss, then we should keep our eyes open about preemptively anticipating problems with patients and make special care considerations for certain subgroups," Dutson said.

    Bariatric surgery is not risk-free. Gastric-bypass operations, for example, carry the risk of blood clots, breathing problems, heart attacks, strokes, infections and allergic reactions to anesthesia, according to the National Institutes of Health.

    Still, Dutson believes that bariatric surgery is the safest way to reduce obesity and prevent related complications, such as diabetes. He described the operation as safer than a gall bladder removal.

    "It's ironically safer to undergo an operation than to not undergo an operation," he said.

    SOURCE: Journal of the American College of Surgeons, online August 11, 2014.

  • Knee replacement may go poorly for people who think life isn't fair

    By Kathryn Doyle

    NEW YORK (Reuters Health) - People who tend to blame others for their suffering and think setbacks in their lives are irreparable tend to report more pain after knee replacement surgery, according to a new study.

    This is not the first time feelings of personal injustice have been tied to longer recovery times and increased disability after injury, the authors write.

    "Pain is a complex phenomenon that is influenced by biological, social, and psychological factors," said lead author Esther Yakobov, a doctoral student in clinical psychology at McGill University in Montreal.

    "Studies conducted with patients who suffer from chronic pain because of an injury demonstrated that individuals who judge their experience as unfair, focus on their losses, and blame others for their painful condition also tend to experience more pain and recover from their injuries slower than individuals who do not," she told Reuters Health by email.

    But those studies had been with victims of injuries, where externalizing blame is a bit easier than for degenerative conditions like osteoarthritis, she noted.

    For the new study, a group of 116 men and women with severe osteoarthritis, between ages 50 and 85 years old and scheduled for knee replacement surgery in Canada, first filled out questionnaires assessing perceived injustice, how much they think about or worry about pain and their fear of movement or re-injury.

    They rated their agreement with statements like, "It all seems so unfair" and "I am suffering because of someone else's negligence."

    With another clinical questionnaire the patients gauged their pain levels and physical functioning.

    After the knee replacement surgeries, which were all deemed successful, the patients rated their pain and function again at a one-year checkup.

    The more a patient agreed before surgery that life seems unfair and others are to blame for their problems, the more pain they reported experiencing one year after surgery. That was true even when age, sex, other health conditions and pre-surgery pain levels were accounted for, according to the results in the journal Pain.

    The more the patient thought about pain and felt helpless because of it before surgery, the more severe their disability during recovery seemed to be.

    "A decade ago, we reported that preoperative anxiety and depression influenced the outcome after surgery," said Dr. Victoria Brander, a physical medicine and rehabilitation specialist at Northwestern Orthopaedic Institute in Chicago.

    This new study adds to the effort to refine the concept, identifying specific psychological characteristics that serve as risk factors for complicated or painful recovery, Brander, who was not part of the new study, told Reuters Health by email.

    "All of these psychological factors point to the fact that patients who perceive themselves as helpless, those who are afraid, those who feel loss of control, have a more difficult time," Brander said.

    "The contrary is also true - patients who exhibit high levels of 'self-efficacy' (that is, patients who have a high degree of confidence in their own ability to achieve a goal) appear to do best after knee replacement," she said.

    Osteoarthritis, the wearing away of cartilage, joint lining, ligaments and bone in a joint, affects one third of people over age 65 in the U.S., according to the Centers for Disease Control and prevention.

    Knee replacement surgery can relieve pain and restore mobility, but about 20 percent of patients will have a problematic recovery or intense pain, based on previous research.

    How individuals perceive pain as just or unjust can vary widely between patients, and it can be influenced by many factors, so it's hard to say if having a more negative outlook is common or uncommon, Yabokov said.

    Researchers don't yet know if people with more negative outlooks only perceive their pain as worse than others or if their psychological state affects the physiology of healing and actually leads to more pain, she said.

    Nevertheless, findings like this suggest patients should be screened for their psychosocial outlook before surgery, she said.

    "This might suggest the usefulness of screening patients in terms of 'catastrophizing,' perceived injustice, fear of movement, and recovery expectancies before treatment or surgery," she said. "With this screening information, appropriate psychological intervention that targets specific risk factors of each patient can then be matched to patients' needs."

    SOURCE: Pain, online July 25, 2014.

  • Hundreds rally in Ireland after rape victim says denied abortion

    By Conor Humphries

    DUBLIN (Reuters) - Hundreds of people rallied in Dublin to call for a change to Ireland's abortion laws on Wednesday after a rape victim said she was refused a termination and instead gave birth by Caesarean section.

    The young migrant's case has reignited a debate about Roman Catholic Ireland's abortion laws, among the most restrictive in Europe, that sparked large protests before parliament voted to allow limited access to abortion for the first time last year.

    "I'm here because I was horrified. This poor girl suffered because she didn't understand the convoluted, stupid system here in Ireland," said Aoife McLysaght, a 38-year old science professor, holding a sign saying 'Forced pregnancy is torture'.

    "We are trying to put pressure on the government, but it seems to be one of those things they'd prefer to ignore. I feel it's only a matter of time before this law is changed. I just want that time to be sooner so fewer people suffer."

    The young foreign national, who cannot be named for legal reasons, told the Irish Times that she became pregnant as a result of rape that took place before she arrived in Ireland.

    She sought help to end the pregnancy when she discovered she was expecting a child, but was turned down by medical authorities. While Irish women seeking abortions typically travel to Britain, which has less strict laws, the woman said she could not do this because she did not have enough money.

    Under the Protection of Life During Pregnancy bill, which was passed a year ago in the wake of the death of an Indian woman who was refused an abortion, a pregnancy can be terminated if the life of the mother is in danger, including by suicide.

    The woman said she had attempted to commit suicide, but was interrupted. But by the time she was assessed by a psychiatrist, she was told her pregnancy was too far advanced to halt it.

    Protesters gathered in central Dublin chanted 'repeal the eighth' in reference to the eighth amendment to the constitution which followed the passing of a 1983 referendum giving the unborn an equal right to life as its mother.

    A United Nations human rights committee told Ireland last month that it should revise its abortion laws to provide for additional exceptions in cases of rape, incest, serious risks to the health of the mother or fatal fetal abnormality.

    The Committee's Chairman Nigel Rodley said Irish law treated women who were raped as a "a vessel and nothing more."

    Ireland's Health Service Executive said in a statement it could not comment on the circumstances of the case until an investigation to be completed by late September.

    Prime Minister Enda Kenny's government has indicated it does not plan to address the issue before the next general election, due by early 2016. It would need to hold another referendum to further amend the law.

    The Pro Life Campaign group said in a statement that the clamor for wider access to abortion laws was obscene as a premature baby clings to life and a chilling and disturbing reminder of the inhumane reality of legalized abortion.

  • California lawmakers pass bill banning inmate sterilizations

    By Sharon Bernstein

    SACRAMENTO, Calif. (Reuters) - California lawmakers sent a bill to ban sterilization surgeries on inmates in California prisons to Governor Jerry Brown on Tuesday, after media reports and a later audit showed officials failed to follow the state's rules for obtaining consent for the procedure known as tubal ligation from incarcerated women.

    The bill prohibits sterilization in correctional facilities for birth control reasons unless a patient's life is in danger or it is medically necessary and no less drastic procedure is possible.

    "It's clear that we need to do more to make sure that forced or coerced sterilizations never again occur in our jails and prisons," said state Senator Hannah-Beth Jackson, who wrote the bill. "Pressuring a vulnerable population into making permanent reproductive choices without informed consent violates our most basic human rights."

    The measure passed the Senate floor with a unanimous vote of 33-0 and now goes to Democratic Governor Jerry Brown for his signature.

    The bill was introduced earlier this year in the wake of allegations, first raised by the non-profit Center for Investigative Reporting, that the state failed to obtain informed consent in cases of women inmates who had their fallopian tubes tied.

    An audit released in June showed that errors were made in obtaining informed consent from 39 women inmates out of 144 who had their tubes tied while incarcerated between 2005 and 2011.

    Prison rules make tubal ligation available to inmates as part of regular obstetrical care. But until the issue was brought to officials' attention in 2010 by an inmates rights group, proper authorization for the procedure was rarely obtained, the state auditor's report said.

    In 27 of those cases, a physician failed to sign the consent form as required, the audit showed. In 18 cases, there were potential violations of a mandated waiting period after women gave consent.

    The audit was the latest blow to the state's troubled prison system and came as California is struggling to meet court-ordered demands to improve medical and mental healthcare in its overcrowded prisons.

    Medical care in California's prisons has been under the supervision of a federally appointed receiver since 2006.

    The current receiver, J. Clark Kelso, was appointed in 2008, but did not learn about problems with tubal ligations until 2010, the audit said.

    Just one such procedure, deemed medically necessary, was performed after the concerns were brought to Kelso's attention, the audit said.