The Canandaigua Medical Group
General Surgery Services

Office Procedures Performed by the Physicians of the Surgery Department Include:

Consultation: Involves a thorough history and physical examination of the patient to determine the presence of absence of physical problems. Upon completion of the consultation, which may involve additional procedures and testing; a diagnosis and proposed treatment plan is provided to the patient.

Pre-Operation Examination: Care before a surgical procedure. Involves a thorough history and physical examination of the patient to determine the presence or absence of physical problems. The provider will discuss the procedure with the patient and allow the patient to express any concerns he/she may have.

Post-Operation Care: Care following a surgical procedure. May involve one or more visits to the provider, who monitors the healing status of the wound and the patients overall recovery.

Monitoring Laboratory tests.

Diagnosis and Management of acute and chronic diseases.

Review of various ancillary procedures:

• X-rays:a procedure used to diagnose illness or injury which involves using small amounts of electromagnetic waves.
• CAT Scan (Computerized axial tomography): use of a computer to produce from x-ray data, a cross sectional view of the anatomical part being investigated.
• MRI Scan (Magnetic resonance imaging): a type of diagnostic radiography using electromagnetic energy. This technique is valuable in providing soft tissue images of the central nervous and muscular skeletal system.
• Ultrasound procedure: uses ultrasound to produce an image or photograph of an organ, or tissue for diagnostic and therapeutic purposes.
• Mammography: x-ray examination of the breast.

Unna's (paste) boot: A boot like dressing of the lower extremity made of layers of gauze and Unna's paste. It is used in treating chronic ulcers of the leg.

Incision and drainage of abscess: An abscess is a localized collection of pus in any body part that results from an infection. An abscess may produce intense heat, redness, swelling and pain. The tissue over the abscess becomes elevated, soft and eventually unstable and discolored as the abscess come to a head (points). The surgeon, using a sharp knife, makes a cut in the abscess to allow the area to drain, thus allowing the provider to treat the infection.

Incision and Drainage of pilonidal cyst: A cyst is a closed sac with a definite wall, that contains fluid, semifluid, or solid material. A pilonidal cyst is located in the buttocks/rectal area. This cyst contains hairs in a nest-type formation. The surgeon using a sharp knife makes a cut in the cyst and removes the material in the cyst. The cyst is then allowed to drain.

Excision of lesion: A lesion is an area of altered tissue. Primary or initial lesions include moles (nevi), macules, vesicles, pustules, tumors, etc. Secondary lesions are a result of primary lesions. They may be crusts, fissures, scars, ulcers, etc. The surgeon excises (removes) the lesion by using a sharp knife. The lesion is generally sent to the laboratory to be evaluated and identified.

Removal of ingrown nail: An ingrown nail (fingernail or toenail) is caused when the edge of the nail grows into the soft tissue, thus causing inflammation and sometimes an abscess. The provider will examine the nail and determine what treatment is needed to remove the ingrown nail. The provider may chose to excise (remove) all or part of the nail.

Wart removal: A wart is a small, hard bump on the skin. The surface feels rough and may look like cauliflower. Warts vary in color (white, pink, brown). The inside of the wart appears speckled with tiny black spots. Warts can affect any area of the body, but they appear most commonly on fingers, hands, arms and feet. Warts on the sole of the foot (plantar warts) generally are more uncomfortable than other forms of warts. Warts on the palm or sole of the foot may appear flattened instead of as little bumps. Providers have many different ways of removing warts. Applying strong chemicals to the wart, freezing it with liquid nitrogen, burning it off with electricity, numbing the skin and scraping the wart off represent some of the most common wart removal techniques. Small warts usually fall off a few days after treatment. Sometimes wart removal requires several treatments.

Breast Cyst Aspiration: A breast cyst is a benign fluid-filled sac. A patient may or may not feel a cyst, but they do appear on a mammogram or ultrasound. Cyst aspiration is a quick and simple procedure to remove cyst fluid. The surgeon inserts a needle into the cyst and drains the fluid. The patient can usually return to her normal activities following the procedure. A sample of the fluid may be sent to the laboratory for evaluation and identification.

Needle Biopsy of Breast: The surgeon performs a breast biopsy if he/she detects abnormal tissue. Biopsies determine whether tumors and abnormal tissue growths are cancerous. A physician can obtain a specimen from below the skin using a number of techniques including: aspiration, needle and punch biopsies. In a needle biopsy, the surgeon rotates the needle inside the tissue. This movement traps a small amount of tissue within the needle. A sample of the tissue is sent to the laboratory for evaluation and identification.

Ligation/Excision of Varicose Veins: A varicose vein is an enlarged, twisted superficial vein. This condition may occur in almost any part of the body but is most common in the lower extremities. In general, treatment consists of rest, elevation of the extremity and use of an external support (elastic stockings). Unna's paste boots are recommended for elderly or fragile persons with leg ulcers. Injection of hardening solution may be used for small varicosities. High ligation and removal of the vein by stripping may be necessary for major varicosities.

Hemorrhoidectomy: A hemorrhoid is a mass of dilated, inflamed veins in the anus/rectal area. There are two kinds; external and internal. A hemorrhoidectomy is the removal of hemorrhoids by one of several methods including surgery, cryotherapy and ligation by use of rubber bands. The surgeon will determine the most effective treatment technique for the patient.

Vasectomy: A vasectomy is a simple procedure used to make a man sterile. The most common method requires the making of one or two small incisions in the skin of the scrotum. He then cuts and removes a small piece of the vas deferens (the tube that carries sperm from the testis to the ejaculatory duct). The surgeon ties the two ends of the cut vas deferens together and sews up the scrotal sac. He repeats the entire procedure on the other side.

Doppler Studies: Surgeons use Doppler technology to examine the speed and direction of blood flow in the heart and blood vessels. Doppler studies involve bouncing ultrasound waves off blood cells as they move through the blood stream. Surgeons use Doppler imaging to detect and evaluate obstruction of blood flow.

Services Performed by the Surgical Nursing Staff:

• Interviews and collection of data.
• Nursing advice and teaching.
• Dressing changes.
• Suture removal.
• Administrative of various medications and immunizations.
• Comfort patients.