Dr. John Muffoletto  MD  PC

2751 DeBarr Road  Suite 290

Anchorage AK  99508

Phone   907-276-1046

Fax        907-222-6898

Laparoscopic Surgeries

With laparoscopic surgery, patients experience less pain, less overall trauma to the body and have a shorter length of stay in the hospital as compared to open surgery. Quite often, patients go home the same day of surgery. This technique uses fine instruments and a camera through small incisions. Laparoscopic surgery requires extensive and highly specialized training. Dr. Muffoletto has performed thousands of these operations throughout his career.

Laparoscopic Inguinal Hernia Repair

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. In the case of an inguinal hernia, the weak spot is a narrow opening in the inguinal canal in the groin. The resulting bulge can be painful, especially when one coughs, bends over or lifts a heavy object. An inguinal hernia does not improve on its own and can lead to life-threatening complications. A laparoscopic inguinal hernia repair uses three small incisions for two working ports and a camera. The operation returns any protruding tissue to its normal anatomic location, permanently reduces the bulge and patches the defect with screen or mesh. The mesh allows for the strongest possible repair with the least amount of recurrences. Typically, Dr. Muffoletto's patients return to normal activity within two weeks of the repair.

 

Laparoscopic Umbilical Hernia Repair

An umbilical hernia occurs when part of the intestine or fatty tissue bulges through the muscle near the belly button (navel, umbilicus). The laparoscopic repair requires only three or four small incisions in order to return all bulging tissue to its normal anatomy and fixate a mesh over the defect reducing the risk for any future hernia.

 

Laparoscopic Ventral Hernia Repair

A ventral hernia results from a weakness in the midline of the abdominal wall. Typically, a bulge will occur above the belly button and below the breast plate. The bulge is a result of tissue and/or intestine that is protruding from the midline defect. The laparoscopic repair dissects out all tissue from the hernia site and fixates a mesh over the defect. Trying to suture the defect closed without mesh quite often leads to tension and a recurrence.

 

Laparoscopic Incisional Hernia Repair

An incisional hernia occurs as a result from a complication from conventional open surgery. Open surgery must use large incisions unlike minimum invasive surgery. These larger incisions create a weakness in the abdominal wall which may not fully health. This weakness results in tissue or intestine bulging through the incisional scar, which can be potentially life threatening. The laparoscopic incisional hernia repair uses three or four small incisions in order to dissect all protruding tissue, scar tissue or intestinal structures out of the hernia defect. This dissection can often be very challenging and requires laparoscopic experience and expertise. The defect is then patched with mesh material to help prevent recurrence.

 

Laparoscopic Femoral Hernia Repair

A femoral hernia usually occurs when fatty tissue or a part of the bowel pokes through a small defect in the groin through a space called the femoral canal. The femoral canal is adjacent to the femoral vein, which is located near the inner thigh. These hernias can be difficult to diagnose because they sometimes only present as pain in the inner groin without a lump. Similar to the laparoscopic inguinal hernia repair, all tissue and/or bowel must be dissected carefully out of the femoral space and mesh is used to cover the defects. 

Laparoscopic Paraesophageal/Hiatal Repair

The hiatus is a normal opening in the diaphragm which allows important structures such as the esophagus and the aorta to pass between the chest cavity and the abdomen. The diaphragm is a muscular wall that separates these two cavities. When the muscles surrounding the hiatus get overly stretched, structures like the stomach are able to abnormally herniate through the hiatal opening. A paraesophageal hernia is when part of the stomach comes along side of the esophagus and squeezes through the hiatal hernia up in to the chest. These types of hernias can be dangerous because the part of the stomach stuck in the hernia may be cut off from its normal blood supply leading to injury. Symptoms include: chest pain, epigastric pain, cardiac arrhythmia, shortness of breath, difficulty swallowing and ulcer formation. This condition will need to be corrected by dissecting the stomach out of the chest and positioning it back into the normal abdominal cavity. The muscles of the hiatus will need to be sewed back together and sometimes patched with a biological mesh. This procedure can be done through five small incisions using small instruments and a camera.  

 

Laparoscopic Nissen Fundoplication/Hiatal Hernia Repair

A laparoscopic nissen fundoplication is a minimal invasive technique used to treat debilitating gastroesophageal reflux disease, or GERD. GERD may develop when part of the stomach slides through a hiatal hernia up into the chest and allows for stomach acid to reflux more readily into the esophagus. This acid can be very corrosive to the esophagus and cause mucosal injury and pain. A nissen fundoplication repairs the hiatal hernia and wraps part of the stomach around the esophagus in order to create a greater pressure zone at the gastroesophageal junction and prevent acid from refluxing back up. 

 

Laparoscopic Appendectomy

The appendix is a small, tube-shaped pouch coming off of the colon and is located in the right lower side of your abdomen. The appendix can get obstructed causing an emergency inflammatory condition known as appendicitis. A laparoscopic appendectomy uses three small incisions for two working ports and a camera in order to remove the appendix before it ruptures. 

 

Laparoscopic Cholecystectomy with Cholangiogram

Laparoscopic cholecystectomy is the surgical removal of the gallbladder through four small incisions. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. An intraoperative cholangiogram is a procedure where a small catheter is placed into the cystic duct and dye is injected in order to display the entire ductal anatomy coming from the gallbladder and the liver. The procedure is useful for preventing ductal injury and to determine if any gallstones have dropped out of the gallbladder and remain lodged in the ductal system which may cause future obstruction.

Laparoscopic Colectomy

A colectomy is a type of surgery used to treat a variety of colon diseases. These conditions may include: inflammation (Diverticulitis), bleeding (Diverticulosis or Arterial-Venous Malformation), infection (Colitis), ischemia (a calcified plaque or clot in the artery preventing blood supply to the colon) and cancer. Laparoscopy provides a delicate dissection without the necessity of a big incision. 

 

Laparoscopic Splenectomy

The spleen is an organ that sits under the rib cage on the upper left side of the abdomen. The spleen helps fight infections and filters unneeded material, such as old or damaged blood cells. A laparoscopic removal of the spleen, a splenectomy, is performed using three small incisions in the patient's left upper quadrant. The most common reasons for splenectomy include: traumatic rupture, enlargement of the spleen (Splenomegaly), certain blood disorders, cancer, infection and noncancerous cysts and tumors.

 

Laparoscopic Adrenalectomy

The adrenal glands are two small organs, one located above each kidney. These glands secrete hormones that regulate many bodily functions, including the immune system, metabolism, blood sugar levels and blood pressure control. Sometimes the adrenal gland needs to be resected due to functional benign tumors and/or cancer. Laparoscopic adrenalectomy is a minimal invasive technique requiring just three small incisions to remove the gland.