Treatments

Mount Sinai offers the following treatments in Laparoscopic surgery:

Bariatric Surgery

Distinguished as an American Society for Bariatric Surgery (ASBS) Center of Excellence, the Mount Sinai Program for Surgical Weight Loss has extensive experience performing the latest techniques in minimally invasive weight-loss surgery.

Gastric bypass
The most common weight loss operation performed in the United States, gastric bypass creates a small stomach pouch and bypasses three to five feet of intestine. Patients typically lose 50 to 75 percent of their excess weight as a result of this procedure.

Adjustable gastric banding
For this procedure, the surgeon wraps a small adjustable band around the upper stomach, creating a small stomach pouch that fills quickly. Injecting saline solution into a small access port under the skin adjusts the amount of restriction. After receiving this surgery, patients usually lose 40 to 60 percent or more of their excess weight.

Sleeve gastrectomy
This operation removes the left side of the stomach. The procedure creates a new stomach that is roughly the size and shape of a banana. The operation does not involve any intestinal “rerouting” or reconnecting. Patients typically lose 80 to 100 pounds.

For patients with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a two-stage operation that also includes the biliopancreatic diversion with duodenal switch (BPD-DS).

Biliopancreatic diversion with duodenal switch (BPD-DS)
This operation reduces the stomach to roughly the size and shape of a banana. Then, a large amount of small intestine is bypassed. This operation results in less restriction than the gastric bypass, but more malabsorption. This more complex operation can produce weight loss of 60 to 80 percent of excess weight.

Revisional bariatric surgery
Bariatric surgery provides excellent results for most patients. But some patients may not have had the positive outcome they expected, especially if they had older procedures performed. If you have had a prior bariatric operation but have not achieved successful weight loss, you may be a candidate for a revisional operation.

Colon Surgery

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.

Laparoscopic ileocolic resection
Doctors perform this procedure for the majority of patients with Crohn’s disease who require surgery. It removes the part of the small intestine that enters into the colon (terminal ileum) and the first part of the colon (cecum), as well as 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. We are one of the world’s most experienced centers in treating Crohn’s disease.

Laparoscopic colectomy for cancer
For this operation, the surgeon removes the part of the colon with the tumor as well as nearby tissues containing lymph nodes. Recent scientific data shows the same survival rates as with open surgery. Most patients who undergo laparoscopic surgery recover much more quickly.

Mount Sinai surgeons participated in the national randomized trial on laparoscopic surgery for colon cancer.

Laparoscopic sigmoid resection for diverticulitis
Using laparoscopic technology, the surgeon removes the segment of sigmoid colon containing the diverticulitis and rejoins the healthy ends of the intestine. The minimally invasive approach decreases length of hospital stay and minimizes scarring, while allowing a more rapid return to normal activities.

Laparoscopic total colectomy and restorative proctocolectomy (RPC)
This minimally invasive 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 in patients with ulcerative colitis and familial adenomatous polyposis (FAP). Individuals who have dysplasia or do not respond to medical therapy are also candidates for this procedure. This operation creates a relatively small “bikini” incision on patients.

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.

Laparoscopic resection for volvulus
This relatively uncommon disease can be treated with laparoscopic resection.

Donor nephrectomy

Mount Sinai surgeons performed the first laparoscopic donor nephrectomy in New York State in 1996. Using a tiny surgical telescope to see inside the patient, the physician removes the kidney through an incision that is roughly three inches long. The procedure has a shorter recovery time than traditional, open surgery.

Gastroesophageal surgery

Our extensive expertise allows minimally invasive treatment of most gastroesophageal problems requiring surgery. Common conditions include achalasia, paraesophageal hiatal hernia and gastroesophageal reflux disease (GERD).

Laparoscopic repair of paraesophageal hiatal hernia
These large, potentially life-threatening hernias require surgical repair. In patients with this condition, most of the stomach has migrated to the chest, allowing it to twist. Mount Sinai surgeons pioneered this repair in 1994. Thanks to laparoscopic surgery, the procedure is performed through the abdomen and not the chest. The operation requires only a one-night hospital stay in most cases.

Laparoscopic antireflux surgery (fundoplication)
While gastroesophageal reflux disease (GERD) is very common, only the most severe cases require surgery to correct. About 30 percent of these patients also have a hiatal hernia.

If a hiatal hernia is present, the surgeon repairs that condition at the same time. Working through five small incisions, he or she 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 reflux. Patients usually stay in the hospital one night.

Laparoscopic achalasia surgery (Heller myotomy)
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 allows for easier swallowing. The surgeon may also combine the esophagomyotomy with fundoplication, a procedure used to treat gastroesophageal reflux disease (GERD).

The operation typically requires an overnight stay. 99 percent of patients are completely and immediately relieved of their dysphagia, or discomfort when swallowing.

Mount Sinai is one of the world’s most experienced centers in treating this relatively rare disorder of the esophagus.

Laparoscopic removal of leiomyoma
In rare cases, a benign smooth muscle tumor develops either in the lower end of the esophagus or in the stomach. Complete removal cures this condition. Mount Sinai has extensive experience treating this rare disease with laparoscopic surgery.

Laparoscopic gastrectomy
This procedure involves surgical removal of all or part of the stomach using a minimally invasive approach. Gastrectomy is often used to remove malignant tumors, such as gastric adenocarcinomas, primary gastric lymphomas and gastrointestinal stromal tumors (GIST). In rare cases, severe and complicated peptic ulcer disease requires gastrectomy as well.

Tumor removal
When cancer, precancerous polyps, or benign tumors are diagnosed early, surgeons can remove these small growths and not the adjacent organ.

Hernia repair

The Mount Sinai Health System repairs more hernias than any other institution in New York City. Division surgeons have expertise treating inguinal and ventral hernias with laparoscopic techniques that reduce complications and shorten recovery time.

Inguinal hernia repair
Surgeons can repair inguinal, or groin, hernias with a variety of simple outpatient procedures, including a tension-free mesh repair.

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 a biodegradable mesh device. Surgeons often perform the repair laparoscopically. A multidisciplinary approach with plastic surgery may be necessary for complicated cases.

Gallbladder and biliary tract surgery

The Mount Medican Center 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.

Laparoscopic 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 laparoscopic 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.

Solid organ surgery

Working through several tiny incisions, surgeons use a small camera and other tools to remove all or part of a diseased organ. These procedures are commonly used to remove adrenal gland tumors and benign pancreatic tumors, as well as serious and mucinous cystadenomas. In most cases the spleen can be saved, but splenic salvage depends upon the final pathology.

Spleen removal, or splenectomy, is required for many conditions affecting the blood, including idiopathic thrombocytopenic purpura (ITP), hemolytic anemia, spherocystosis, and hypersplenism. Laparoscopic technology has reduced the hospital stay to two days.