Laparoscopic and Robotic Surgery for Benign Diseases

Stomach and Duodenal Ulcers

Dr. Pereira has extensive experience in the surgical management of ulcers of the stomach and duodenum. Ulcers are erosions or wounds of the inner lining of the stomach and duodenum. They can be shallow or very deep, and can erode into blood vessels causing internal bleeding. Alternatively, ulcers can erode completely through the wall of the stomach and duodenum, causing a hole that allows acid, stomach contents, and bacteria to leak into the abdominal cavity causing dangerous infections and peritonitis. Emergency surgery is required to treat these complications of bleeding and perforation caused by stomach and duodenal ulcers. Less commonly, ulcers can fail to heal with medications and surgery is required to treat the ulcer.

Perforated Ulcers

Unsuspected ulcers of the stomach or duodenum can continue to erode the lining and wall of the stomach and duodenum causing life-threatening perforations or holes to form. This results in a phenomenon called peritonitis in which the caustic stomach acid and enzymes cause massive inflammation of the abdominal cavity and it’s organs, leading to potentially lethal sepsis and infection. Laparoscopic surgery requires highly skilled and experienced surgeons to provide this life-saving treatment.

Bleeding or Hemorrhaging Ulcers

Ulcers of the stomach and, more commonly, of the duodenum can erode into blood vessels causing internal bleeding. Bleeding from these ulcers can frequently be stopped by gastroenterologist who use endoscopes passed through the mouth of you and into the stomach and duodenum to visualize the ulcers and stop the bleeding by cauterizing or clipping the bleeding vessel. Occasionally massively bleeding ulcers cannot be stopped by endoscopic techniques, or the bleeding recurs after several attempts at stopping the bleeding. These instance require surgical intervention to stop life-threatening hemorrhage. In select patients, laparoscopic surgery can be employed to stop the bleeding by either cutting out the ulcer or suturing the bleeding vessel.

Dr. Pereira is frequently called upon to perform emergency laparoscopic surgery to repair and patch perforations and holes caused by ulcers of the duodenum or stomach or to stop hemorrhage caused by bleeding ulcers.

Non-healing Ulcers

On rare occasions, ulcers fail to heal with medications and laparoscopic surgery is employed to remove the ulcer and/or surgically reduce acid production by the stomach to allow the ulcer to heal and prevent other ulcers to form in the future. This can involve removing a portion of the stomach involved in the stimulation of acid production and/or cutting the nerves to the stomach that stimulate acid production by the stomach. These surgical techniques have a very high degree of success.

Gastric Outlet Obstruction (Blockage of the Stomach)

Under certain circumstances the outflow of the stomach can become blocked by either tumors or scar tissue. This results in food backing up causing vomiting and malnutrition. Laparoscopic and robotic surgery can be used to treat these conditions by either removing the blockage or bypassing it.

Laparoscopic and Robotic Surgery for Tumors of the Stomach

Both malignant and benign tumors of the stomach can be treated and cured with laparoscopic and robotic surgery. Examples of cancers of the stomach that are treated by laparoscopic and robotic removal include adenocarcinoma, GIST (gastrointestinal stromal tumors), and carcinoid tumors. Benign tumors include polyps and leiomyomas.

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