Dr. Héctor Morera

The appendix is an organ that’s attached to the beginning of your large intestine or colon. It is usually located below and to the right of your belly button.

If the appendix gets inflamed, surgery to remove it will be necessary. You can live without your appendix and not develop any long-term issues.

With this surgical technique, an incision (surgical wound) is made in the lower right part of the abdomen to reach the appendix and remove it. We choose this technique when for some reason it cannot be done laparoscopically.

It should be noted that on some occasions it is convenient to make an incision in the midline of the abdomen to carry out the procedure with greater safety, always ensuring the patient’s well-being.

Gallbladder removal surgery, also known as a cholecystectomy, is a very common procedure.

The gallbladder is a small organ located in the upper right part of your tummy. It stores bile, a fluid produced by the liver that helps break down fatty foods.

When you develop problems with the gallbladder, it’s often recommended to extract it so you don’t develop more serious problems.

During this procedure, general anesthesia will be applied for laparoscopic removal of the gallbladder in patients with acute inflammatory pathology. This means that you are asleep during the surgery.

Once you are asleep, the surgeon makes an incision near your belly button and inserts a small device called a port.

The port creates an opening that your surgeon can use to fill your abdomen with gas (CO2). This creates space to perform the surgery.

Next, he will insert a small camera through the port, that shows the surgery on a screen in the operating room.

Once the surgeon can see clearly, he places more ports to insert long, narrow instruments.

Finally, they gently disconnect the gallbladder and remove it through one of the incisions.

Most surgeries require 3 or 4 small incisions.

When the surgery is done, the surgeon closes your incisions with tiny sutures, staples, surgical tape, or glue.

These go away as you heal, so the doctor doesn’t need to remove them later.

The acute abdomen is defined as any inflammatory or non-inflammatory pathology within the abdomen that requires a surgical approach for its relief.

An acute abdomen demands urgent attention and treatment. Patients usually present abdominal pain that lasts for hours or even days. 

The treatment for acute abdomen requires several intrabdominal processes that need rapid intervention in diagnosis and treatment. This problem may present in an obvious or subtle manner, but must always be recognized to determine the specific management of the pathology that’s causing the pain.

Some of the studies that may be needed are Computerized Axial Tomography, endoscopic studies, Ultrasound, etc.

An inguinal hernia is the most common type of hernia. It occurs in the inguinal canal, which is a passageway that runs down either side of your pelvis into your sex organs. It can appear as a swelling or lump in your groin. The lump often appears when you’re lifting something and disappears when you lie down.

A hernia happens when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

Even though an inguinal hernia isn’t necessarily dangerous, your doctor may recommend surgery to avoid life-threatening complications, and to relief the pain and enlargement in some cases.

There are two ways to treat this problem: through open surgery, or laparoscopy.

The open approach is done from the outside through a three to four-inch incision in the groin or hernia area. The incision will extend through the skin, and subcutaneous fat and allow the surgeon to reach the defect.

Surgical mesh is placed to repair the defect or hole.

This technique can be performed under local anesthesia and sedation, using spinal anesthesia or general anesthesia.

Laparoscopic hernia repair is a minimally invasive technique, performed with the use of a laparoscope (a small telescope) connected to a special camera that is inserted through a cannula (a small hollow tube) which allows the surgeon to view the hernia and surrounding tissue in detail.

Mesh is always placed in the inguinal region to prevent reoccurrence of the hernia.

A ventral or incisional hernia is a type of hernia that occurs after a prior incision was made during a previous surgery. The size of the hernia can vary from small to gigantic.

To diagnose this type of hernias, the doctor takes a thorough medical history and conducts a physical examination. The patient may be asked to stand and cough so the doctor can see and feel the hernia as it protrudes from the abdominal wall. The doctor checks to see if it’s possible to gently massage back the hernia into its proper position in the abdomen.

Only after a complete examination can it be determined if a laparoscopic ventral hernia repair is right for you.

It could be possible that the procedure isn’t the best for some patients who have had previous extensive abdominal surgery, hernias found in unusual or hard-to-reach places, or underlying medical conditions.

In cases where surgery is an option, there can be two approaches, open surgery, and laparoscopic surgery.

In an open surgery general anesthesia is needed. The surgeon makes an incision on the abdomen, releases scar tissue, and moves the hernia contents (most of the time bowel or fat) back into the abdomen, and reinforces the muscle wall with stitches. Usually, the area of muscle weakness is reinforced with a synthetic or biologic mesh to provide additional support to reduce recurrence.

Laparoscopic hernia repair is a minimally invasive technique, performed with the use of a laparoscope (a small telescope) connected to a special camera that is inserted through a cannula (a small hollow tube) which allows the surgeon to view the hernia and surrounding tissue in detail.

Mesh is always placed in the inguinal region to prevent reoccurrence of the hernia.

Patients who undergo laparoscopic surgery generally experience a somewhat shorter recovery time and the scars are smaller. However, if the hernia is very large or if there is too much prior scar tissue, the doctor may determine laparoscopic surgery is not the best option for you.

Be sure to consult your doctor about your specific case.

Thyroidectomy is the removal of all or part of the thyroid gland.

The thyroid is a butterfly-shaped gland located at the base of the neck. It produces hormones that regulate all aspects of your metabolism, from your heart rate to how quickly you burn calories.

Thyroidectomy is used to treat thyroid disorders, such as cancer, a noncancerous enlargement of the thyroid (goiter), and overactive thyroid (hyperthyroidism).

The procedure is done through a transverse incision in the neck of about 5-7 cm depending on the injury presented by the patient. The portion of the thyroid gland that is removed during this procedure depends on the reason for the surgery.

If only part of it is removed (partial thyroidectomy), the thyroid may still function normally after surgery.
If your entire thyroid is removed (total thyroidectomy), you’ll need daily thyroid hormone treatment to replace your natural thyroid function.

Each year, more than 600,000 surgical procedures are performed in the United States to treat a number of colon diseases.

Patients undergo colon surgery for a number of conditions including colorectal cancer, polyps, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), colonic inertia, colonic stricture, and diverticulitis surgery to remove all or part of the colon (colectomy).

Traditional open colon surgery procedures may require a single long abdominal incision. It results in an average hospital stay of a week or more and usually 6 weeks of recovery.

Less invasive options are available to many patients facing colon surgery, the most common of these is laparoscopic surgery, in which smaller incisions are done.

In most laparoscopic colon resections, 4 or 5 small openings (each about a quarter inch) are used while viewing a magnified image of the patient’s internal organs on a monitor.
In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure.

The latter guarantees better aesthetic results, shorter hospital stays, and better recovery for the patient.

Stomach surgery is generally performed in patients with conditions such as acid-peptic disease refractory to medical treatment, gastric cancer, and metabolic surgery for weight loss.

In all cases, open or laparoscopic surgery can be performed, but generally, the technique commonly used is laparoscopic, where 4 or 5 trocars are placed to perform the minimally invasive procedure.

The open technique is optional mostly in cases of gastric cancer, where patient survival does not depend on the surgical technique used.

Anorectal pathology is more frequent than it seems and includes benign diseases such as acute and chronic anal fissures, perianal fistula, internal or external hemorrhoidal disease, and perianal skin diseases.

On the other hand, there are premalignant lesions and cancer of the rectum and anus, which in most cases require surgical management.

We offer comprehensive management of these pathologies.