General Surgery

General Surgery includes the diagnosis and treatment of diseases that are resolved by surgical or potentially surgical procedures, both elective and emergency, in the following systems: digestive, endocrine, breast, skin and soft tissues, wall, abdominal cavity and retroperitoneum.

The general surgeon must also resolve the emergencies of some pathologies of surgical specialties such as vascular and thoracic surgery, in order to initiate treatment, stabilize and transfer the patient to a more complex center.

The most commonly performed procedures are:

Reflux is a disease caused by incontinence of the lower esophageal sphincter that allows gastric content to pass into the esophagus, with or without the presence of a hiatal hernia, this reflux cannot be controlled by commonly used medications and generates heartburn, the need to sleep sitting up or with several pillows, aphonia or irritation of the pharynx when it´s severe. Before deciding to operate, esophageal impedance pH metry, endoscopy and manometry should be performed, as well as evaluation by a surgeon. Surgery is performed minimally invasive as the ideal standard. If the patient also has a hiatal hernia, it must be reduced and biological mesh placed to extend the life of the surgery and its results. It is worth mentioning that not all patients with hiatal hernia have reflux and that patients without hiatal hernia can also have reflux, by this I mean that the surgery is performed to correct the reflux, not the hiatal hernia.

It consists of the removal of the gallbladder due to gallbladder pain after the intake of food that causes it to contract, due to the presence of food in the stomach, the presence of bile sludge, stones inside it or due to alterations in the gallbladder. movement of it. The ideal standard for this surgery is minimally invasive.

Generally it is a procedure that can be performed as an outpatient or maximum with one night of hospital stay in the cases of scheduled patients, in the case of patients with acute urgency of the gallbladder they must stay longer in the hospital to manage the infection added. Ideally, drains should not be left but there are surgeons who prefer to do so even though this practice is no longer in use.

Appendicitis is one of the most common problems faced by the surgeon, generally attending the patient in the emergency department of a hospital and where blood studies are ideally carried out to determine mainly the level of white blood cells and an axial tomography. computed to be able to directly observe the appendix and delimit its shape, alterations and possibly even the cause of the condition, which is generally due to a fecalith, treatment is urgent and surgery is imperative to avoid complications, although there are some series of studies that speak of management conservative appendicitis but this is reserved for very specific cases. La cirugía se realiza por mínima invasión y la recuperación suele ser rápida e painless when diagnosed and treated early, in cases with infection or peritonitis, antibiotic treatment is necessary for long periods of time, likewise when the base of the appendix is in poor condition, it may be necessary to section part of the cecum (first portion of the large intestine) or even a bypass surgery where the continuity of the intestine is disconnected leaving an ileostomy to save the life of the patient, this ileostomy can be reconnected in approximately 3 months after the initial surgery.

Generally, drains should not be left since this practice is in disuse, but in special cases there may be a need to leave a drain to better monitor the evolution of the patient.

Hernias in general are generated by the protrusion of material contained in a cavity that emerge from a wall defect, generating pain discomfort or masses, the most common types of hernias are: Inguinal, umbilical, femoral, or intracavitary. Hernias can be reducible (that is, they return on their own to their site), Incarcerated (when they do not return to their place), or strangulated (when they do not return to their place and are permanently painful), the treatment for this condition is corrective surgery with meshes to reinforce the walls of the cavity that has the defect and thus avoid recurrences. Surgery can be performed by minimally invasive and generally the recovery achieves that the patient can be managed as an outpatient without the need to spend the night in the hospital, each case must be studied and individualized to determine the times.

Laparoscopic surgeries are procedures that are performed through the placement of minimally invasive trocars that allow us to review the entire abdominal cavity in order to find problems and correct them, some of the pathologies that require this type of procedure are: Intestinal occlusions, abdominal trauma, bleeding, perforation of the viscera, lesions of the liver, base or kidneys, and also in patients with previous surgeries who present new abdominal complications, sometimes previous surgeries and intra-abdominal adhesions do not allow us to perform surgery laparoscopically but this is almost always possible with proper care.

Many emergency procedures as well as scheduled surgeries require disconnection of the intestine for adequate recovery and to avoid catastrophic abdominal infections, after these procedures and generally after 3 months or more, if the structures allow it, intestinal reconnection is performed, this procedure generally It is much simpler than the first surgery performed and it manages to restore normal intestinal transit, thereby providing adequate function for the patient.On many occasions this surgery can be performed openly, but it has been determined on many occasions that the open approach combined with laparoscopic it helps the surgeon a lot to achieve ideal results.

The colon in particular is a part of the intestine, also called the large intestine, that has its own pathologies such as diverticula, polyps, cancer or nonspecific inflammatory processes that generate various problems for patients and sometimes require removal of a part or the All of it, these pathologies can be managed by minimally invasive, which means that the patient has less postoperative discomfort and can leave the hospital early, being on average no more than 2 nights.