Mount Sinai is one of very few medical centers nationwide to have fellowship-trained endocrine surgeons. This advanced training gives patients access to state-of-the-art therapies for conditions such as thyroid cancer and hyperparathyroidism in addition to adrenal disorders that include Conn’s disease, Cushing’s syndrome, pheochromocytomam, and adrenal cancer. Our surgeons focus on minimally invasive approaches, which minimize complications and recovery times.

Fine needle aspiration
In this procedure, the surgeon inserts a small needle into a mass like the thyroid nodule and collects a tissue sample. This diagnostic test analyzes whether the mass is benign or cancerous.

Ultrasound diagnosis
Mount Sinai offers office-based ultrasound diagnosis. This technology allows the surgeon to pinpoint the location of abnormal masses on the parathyroid, which makes a minimally invasive approach possible. This technique is also used for biopsies of thyroid nodules that are difficult to find in exams.

Thyroidectomy
This procedure removes the thyroid gland. A subtotal thyroidectomy or a lobectomy takes out only part of the gland. A total thyroidectomy removes the entire gland and is the preferred technique for treating thyroid cancer. The surgeon can often perform the procedure through a mini-incision.

Parathyroidectomy
With a parathyroidectomy, the surgeon studies the four parathyroid glands to see which ones are overactive, or producing too much hormone. A surgeon can remove a single overactive gland with a minimally invasive technique. If all four glands are overactive, the surgeon typically removes three-and-a-half glands through a mini-incision. Our surgeons use the latest technology, including intraoperative parathyroid hormone monitoring. This tool provides instant feedback in the operating room to determine if the patient is cured.

Total parathyroidectomy
This advanced procedure removes all four parathyroid glands. The surgeon also transplants parathyroid tissue in the patient’s forearm to remove the potential need for future neck surgeries that could damage the voice box. We also use cryopreservation, which freezes a portion of parathyroid tissue in case the patient requires additional parathyroid function in the future.

Pancreatectomy, or pancreas resection
Often performed through tiny incisions with a small camera that displays the interior area, this procedure removes part of the pancreas. Many endocrine tumors of the pancreas, such as an insulinoma, can be shelled out to spare the need for major pancreas resection. If removal of the entire pancreas is required, Mount Sinai surgeons offer an advanced technique that leaves the spleen intact and preserves the patient’s immune system. This procedure is called a splenic-sparing pancreatectomy.

Adrenalectomy
In this common treatment for adrenal tumors, the surgeon removes one or both of the adrenal glands. The procedure is usually performed with a minimally invasive approach, working through several tiny incisions and using a special camera called a laparoscope.

Mount Sinai surgeons offer an advanced technique known as a cortical-sparing adrenalectomy. This procedure leaves part of the adrenal glands intact and prevents the need for life-long medication following surgery. It is often used to treat patients with diseases like pheochromcytoma that require the removal of both adrenal glands.

Our surgeons have expertise in treating all forms of gastroesophageal disease that require surgery. Common conditions include achalasia, diverticulitis, and gastroesophageal reflux disease (GERD).

Achalasia surgery (esophagomyotomy)
This treatment for achalasia divides the muscle at the lower end of the esophagus and the top of the stomach. The procedure reduces the pressure in the esophagus and eases swallowing. The surgeon may also combine the esophagomyotomy with fundoplication, a procedure used to treat gastroesophageal reflux disease (GERD).

Antireflux surgery (fundoplication)
Here the surgeon wraps the upper part of the stomach around the lower part of the esophagus. This procedure increases the pressure of the sphincter at the bottom of the esophagus to prevent acid reflux, or gastroesophageal reflux disease (GERD). The surgeon can also a repair a hiatal hernia simultaneously if one is present.

Gastrectomy
This procedure involves surgical removal of all or part of the stomach. Gastrectomy is often used to remove malignant tumors such as gastric adenocarcinomas, primary gastric lymphomas, and gastrointestinal stromal tumors (GIST). Though rare, severe and complicated peptic ulcer disease may also require gastrectomy.

Mount Sinai surgeons have special expertise in treating a wide range of diseases involving the colon. Common conditions include colon cancer, diverticulitis, and diverticulosis as well as inflammatory bowel diseases (IBDs) like Crohn’s disease and ulcerative colitis.

Local excision of rectal cancer and polyps
The surgeon inserts an instrument into the rectum and removes the tumor without the need for an abdominal operation. This procedure is often appropriate for rectal cancers found at an early stage.

Colectomy
The surgeon removes the part of the colon with the tumor and nearby tissues containing lymph nodes. The procedure typically reconnects, or anastomoses, the healthy colon with the rectum.

Mount Sinai surgeons frequently perform this type of surgery with minimally invasive techniques (laparoscopy) that allow for less pain, faster recovery, and superior cosmetic results.

Colostomy
In rare cases, the surgeon cannot safely reconnect the two ends of the colon. Should this happen, the surgeon brings the free end of the colon through the abdominal wall, where it empties waste into a special appliance worn underneath the clothing. Though usually temporary, there are some cases in which the colostomy is permanant.

Ileostomy
Occasionally, the surgeon cannot safely reconnect the two ends of the small intestine. When this happens, the surgeon brings the free end of the small intestine through the abdominal wall, where it empties waste into a special appliance worn underneath the clothing. Usually a temporary condition, there are some cases in which the ileostomy is permanant.

Proctocolectomy, or total colectomy
This procedure removes the colon entirely. It is often used to treat ulcerative colitis when patients do not respond to other treatments.

Restorative proctocolectomy (RPC)
In most cases, the surgeon performs an ileoanal pull-through with a small bowel reservoir called a J-pouch [also known as an ileal pouch to anal anastomosis (IPAA)] to preserve the sphincter function and anus. This operation removes the colon and most or all of the rectum. The surgeon then creates a pouch from the patient’s normal small intestine and joins it to the anus.

This procedure is performed on patients with ulcerative colitis and familial adenomatous polyposis (FAP). Individuals who do not respond to medical therapy or have dysplasia are also candidates for this procedure.

Mount Sinai surgeons have completed more than 2,000 of these operations since 1979, more than almost any other medical center’s staff in the world.

Ileocolic resection
Doctors perform this procedure for those patients with Crohn’s disease who require surgery. It removes the part of the small intestine that enters into the colon (terminal ileum), the first part of the colon (cecum), and the appendix. Mount Sinai surgeons were the first in the world to routinely perform this procedure using minimally invasive techniques (laparoscopy), and now perform the majority of them in this manner.

Sigmoid resection for diverticulitis
The surgeon removes the segment of sigmoid colon containing the diverticulitis and rejoins the healthy ends of the intestine. The procedure is often performed with a minimally invasive approach that decreases length of hospital stay and minimizes scarring, allowing for a more rapid return to normal activities.

Small bowel resection
This procedure removes part of the small intestine. The surgeon typically reconnects the two healthy ends of intestine with staples or stitches.

Strictureplasty
Unlike resection, this procedure involves reconfiguring only the blocked part of the intestine in a patient with Crohn’s disease.

The Mount Sinai Division of Laparoscopic Surgery specializes in laparoscopic treatment of gallbladder disease. A Mount Sinai surgeon performed the first laparoscopic cholecystectomy in New York in 1990. Today, the institution continues to treat more cases of gallbladder disease than any other hospital in New York City.

Cholecystectomy
Working through several tiny incisions, the surgeon separates the gallbladder from the liver and other structures before removing the pear-shaped organ. This procedure is used to treat cholecystitis and problematic gallstones.

Common bile duct (CBD) exploration
When performing a cholecystectomy, the surgeon commonly x-rays the bile duct at the same time. A small percentage of patients will have gallstones in the CBD. This small tube carries fluid, or bile, from the liver to the intestine to aid in digestion.

This exploration can be performed with laparoscopic techniques. More than 90 percent of cases do not require further procedures to remove the stones. Patients typically stay in the hospital for one or two nights with this procedure.

The Mount Sinai Medical Center repairs more hernias than any other institution in New York City. Our surgeons have expertise in treating paraesophageal hiatal, inguinal, and ventral hernias.

Paraesophageal hiatal hernia repair
Treatment of paraesophageal hiatal hernias often involves returning the stomach to its normal position in the abdomen before narrowing the opening (hernia) in the diaphragm. The surgeon may also attach a small biodegradable mesh to reinforce the repair and help prevent recurrence.

Inguinal hernia repair
Surgeons can repair inguinal, or groin, hernias using different methods (primary repair and tension-free mesh repair) and approaches, both laparoscopic and traditional.

Ventral hernia repair (incisional)
Incisional hernia can occur months to years after surgery. To prevent hernias from enlarging or causing intestinal strangulation, surgeons repair the bulge or defects in the abdominal wall using either a traditional repair or a mesh device. Surgeons can perform the repair using laparoscopic or traditional methods. A multidisciplinary approach with plastic surgery may be necessary for complicated cases.