General Surgery is the broad area of surgery that encompasses all surgical interventions from the head to the toe. Included in the training of a general surgeon is operative and non-operative treatment of diseases of the head and neck, endocrine glands, breast and chest, gastrointestinal organs, hernias, soft tissue and muscles. Training is also received in the management of cancer. Operations may be via traditional open procedures, laparoscopic approaches (minimally invasive surgery) or flexible endoscopic approaches. General surgery requires five years of residency training after completion of medical school and attainment of a medical degree. Further sub-specialization into areas such as transplant surgery, thoracic surgery, vascular, pediatric or cardiac surgery requires additional time in training. [Altenhein] [Amaral] [Biffl] [Cioffi] [Craybas] [Dunican] [Gass] [Graves] [Harrington] [Iannitti] [Majercik] [Migliori] [Miner] [Morrissey] [Potenti] [Pricolo] [Roye] [Shahinian] [Vezeridis]
Minimally invasive surgery uses four to five, 5-10mm incisions rather than large, conventional incisions to do a surgical procedure. A laparoscope or telescope is used to view the intra-abdominal organs via these small incisions. The image is transferred from this scope to a television monitor allowing the surgeon to view the operation under magnification. Since all organs are normally in contact with the abdominal wall, the abdomen is expanded first with carbon dioxide gas and kept constantly expanded. This creates a space in which we can work to carry out major abdominal surgical procedures such as gallbladder, spleen, or adrenal gland removal, hernia repair, bowel surgery and hiatus hernia/reflux surgery. Even weight reduction procedures for morbid obesity can be performed this way. The advantages of small incisions in minimally invasive procedures are an early discharge from the hospital, often the same day, minimal pain, often requiring no narcotic medications, and a return to normal activities measured in days rather than weeks. [Amaral] [Iannitti] [Luks] [Migliori] [Potenti] [Roye] Vascular surgery is the discipline of surgery devoted to the treatment of diseases of the arteries and veins of the body. Common disorders treated include: atherosclerosis (hardening of the arteries); abdominal aortic aneurysms, carotid artery stenosis, diabetic vascular disease, varicose veins and chronic venous stasis ulcers. University Surgical Associates has three surgeons whose practice is devoted to vascular surgery. All have undergone subspecialty training in a vascular surgery fellowship and are certified by the American Board of Surgery with special qualifications in vascular surgery. A state of the art vascular laboratory is also available at the main office to provide rapid diagnosis and treatment New, minimally invasive treatments, such as endoluminal aortic stenting and endoscopic varicose vein removal are provided by members of University Surgical Associates. Surgical nutrition is the area of surgery that cares for the nutritional needs of both surgical and non-surgical illnesses which require prolonged nutritional supplementation or even total non-oral nutritional support. Routes of nutritional supplementation include the oral route with high caloric supplements; intravenous route either acute or long term via parenteral nutrition, and the enteral route via tubes placed into the stomach or intestine. The oral route is always preferred over the enteral route which in turn is preferred over the parenteral or intravenous route. Dr. Jorge Albina directs the Nutritional Support Service at University Surgical Associates and Rhode Island Hospital. He is assisted by Ms. Marion Winkler, a certified dietitian and by Ms. Elizabeth Hagan, a registered nurse. Dietary consultation with regards to diets such as low fat, anti-dumping, etc. is also provided. [Albina] Obesity is a major problem in the United States. Although diet is always the best way to lose weight, it is not always successful. In addition, weight loss with diets is often slow and difficult to maintain. As a result surgical treatments are available to induce significant and sustained weight loss. These are available by members of University Surgical Associates. Currently, we are members of a national trial to investigate the safety and efficacy of a laparoscopic banding procedure. [Harrington]
[Roye] Thoracic surgery is the area of surgery devoted to the treatment of non-cardiac diseases of the chest. Specific organs treated are the esophagus, lungs and pleural cavity. Diseases may be benign or malignant. Pediatric thoracic surgical care is provided by the pediatric surgeons. [Kurkchubasche] [Luks] [Ng] [Tracy] [Wesselhoeft] Colorectal surgery is the area of surgery that deals with disease of the colon and rectum. Treatment may be non-operative; endoscopic in the form of colonoscopy or sigmoidoscopy; or operative. The main offices of University Surgical Associates contain an endoscopy suite for endoscopic procedures. Advanced diagnostic procedures, such as rectal motility and ultrasound are offered within Rhode Island Hospital. Operative services provided range from the treatment of hemorrhoids to ileoanal pouch procedures used in the management of ulcerative colitis and familial polyposis. Screening for colorectal cancer is available at University Surgical Associates. Trauma surgery is the area of surgery devoted to treatment of traumatic disorders. These vary from blunt trauma associated with motor vehicle accidents or falls to penetrating trauma associated with stab wounds and gunshots. Members of University Surgical Associates direct and staff the busy Level I Trauma Center at Rhode Island Hospital. Over 2,500 patients per year are treated for traumatic injuries by members of University Surgical Associates. In addition, the acute and chronic care of burn victims is provided by University Surgical Associates. [Biffl] [Cioffi] [Harrington] Critical surgical illness often requires complex management of key body functions in an intensive care unit. University Surgical Associates has three surgeons with special training and qualifications in critical care who staff the surgical intensive care units at Rhode Island Hospital. Up-to-date management of respiratory and cardiac function as well as use of new and experimental drugs is provided. [Biffl] [Cioffi] [Harrington] Pediatric surgeons specialize in the care of infants and children. Their practice is not limited to the complex congential problems of the newborn, but extends through the ages to adolescence and covers most organ systems including the chest. Care ranges from the acquired lumps and bumps of the skin and soft tissues to the tumors of childhood, and from the common appendicitis to the complexities of Crohn's disease and ulcerative colitis. This breath of training is reflected in the ability to care for the multiple injured patient. University Surgical Associates has four pediatric surgeons who are board certified in general surgery and pediatric surgery. Both standard and advanced laparoscopic techniques are available for treatment of disorders of the chest and abdomen. Surgical care is provided in conjunction with other pediatric specialists at the Hasbro Children's Hospital and Women and Infants Hospital.
[Kurkchubasche] [Luks] [Tracy] [Wesselhoeft] Oncology refers to the treatment of cancer and includes management of benign and malignant diseases of the breast. Oncologic surgery often requires a multi-modal therapy involving radiation therapy and chemotherapy. Surgeons at University Surgical Associates work closely with oncologists, radiation therapists and radiologists throughout the state to provide rapid diagnosis and intervention. There also is active participation in NSABP, ECOG and other cancer protocols to provide the latest in cancer therapy. [Altenhein] [Cady] [Chung] [Gass] [Graves] [Kazin] [Vezeridis] Transplantation involves the replacement of diseased organs with health ones. The most commonly transplanted organ is the kidney followed by the liver, heart and pancreas. Healthy organs are procured from live donors (kidneys) or patients with irreversible brain injury who progress to brain death (cadaver organ donors). Presently, University Surgical Associates provides kidney transplantation and will offer kidney-pancreas transplantation in the near future to patients with insulin dependent diabetes who require kidney transplantation due to end stage renal disease. Currently, 50-55 kidney transplant procedures are performed each year in children and adults at Rhode Island Hospital. The clinic follows over 400 patients pre and post transplant. A considerable effort is made to identify potential live donors so that each kidney transplant recipient may benefit from the shorter waiting time (generally 2-3 months) and immediate graft function that accompanies these procedures. University Surgical Associates also offers the full scope of surgical therapy required in end stage renal disease including: peritoneal dialysis catheter placement; A-V fistula creation; temporary and permanent catheters for hemodialysis and renal transplantation. We also offer expertise in the treatment of general surgical and urologic problems in patients with renal failure. |