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Surgical Services & Procedures

General Laparoscopic Procedures

At Surgical Associates of La Jolla, our surgeons are highly trained in the safe, effective use of the laparoscopic technique. This is a minimally invasive method of surgery that may be applied to a number of procedures that we offer, including Anti-reflux procedures (Fundoplication), Incisional hernia repair, and solid organ surgery, in addition to the procedures described on this page.

About laparoscopy

During a laparoscopic procedure, several small incisions are made in the area to be treated. Carbon dioxide gas is passed into the abdominal cavity in order to move the abdominal wall away from the organs and therefore create a larger area in which to work. Through one of the incisions, the surgeon then inserts a laparoscope. This is a tiny camera that projects the images it records onto a large monitor, allowing the surgeon to see inside of the body without having to make a long incision. The advantages of laparoscopy are numerous and include the following:

  • Less post-operative discomfort
  • Faster recovery
  • Smaller, more discrete scars
  • Reduced risk of complications

Inguinal Hernia

hernia is a condition in which tissue or an organ, usually fatty tissue, but possibly even part of the intestine, protrudes through an opening of the abdominal wall. When it occurs in the part of the groin area known as the inguinal canal, it is called an inguinal hernia. The inguinal canal is the passageway between the abdomen and the reproductive organs. The abdominal wall in this area has an opening to allow blood vessels to reach the testicles. This opening may not close properly after birth or may enlarge during life. There are other factors, however, that can occur later in life to make this area prone to a hernia, including chronic cough, chronic constipation, smoking, pregnancy, and certain medical conditions.

Although some inguinal hernias do not manifest symptoms, others may involve pain and/or a heavy sensationin the groin area. Often, the tissue that is protruding through the abdominal wall creates a visible bulge. This bulge may become more obvious when the person is bending over, coughing, or otherwise straining. In some cases, the hernia may become trapped in the opening of the abdominal wall ("Incarcerated Hernia"). This can be extremely serious if blood flow to the tissues of the bowels is cut off ("Strangulated Hernia").

Surgery is often necessary to treat a hernia. During inguinal hernia surgery our surgeons return the protruding tissue or organ back into the abdominal cavity and repair the hole in the abdominal wall. Fortunately, advanced technology has made it possible for us to treat hernias in a minimally invasive manner. Laparoscopic surgery eliminates the need for the long incision associated with traditional hernia surgery and is the favored surgical method among the patients of our La Jolla-based surgical practice.

Gallbladder Removal

The gallbladder is located under the liver and is used to store the bile that the liver produces to aid in the absorption of foods. In some individuals, small crystals can enlarge to create stones in the gallbladder. If the flow of bile from the gallbladder becomes obstructed by these stones, gallbladder disease may develop. The symptoms of gallbladder disease may include abdominal pain, nausea, fever, and other symptoms.

Whereas traditional "open" gall bladder surgery typically involves a five- to eight-inch long incision, laparoscopic gallbladder removal entails several smaller incisions. During laparoscopic gallbladder removal surgery, one of our skilled surgeons inserts a laparoscope, a thin tube attached to a tiny scope or camera, through one of these incisions. The laparoscope allows clear view of the internal organs. Special tools are then inserted through the other incisions and used to remove the gallbladder.

It is now possible to remove the gallbladder through a single incision at the umbilicus (belly button) using the da Vinci® Robotic System. Please refer to the da Vinci pages on this site for more information.


An appendectomy is a surgical procedure to remove an infected appendix. Although the exact cause of an inflamed appendix is usually unknown, appendicitis may occur due to a viral infection of the digestive tract or a blockage in the tube that connects the large intestine to the appendix. Symptoms of appendicitis may include abdominal pain, constipation, vomiting, nausea, loss of appetite, fever, and chills. If left untreated, the appendix may rupture and the infection may spread.

For many patients of our San Diego-area medical practice, an appendectomy can be performed laparoscopically. A laparoscopic appendectomy involves the creation of a number of small incisions through which the surgeon inserts a tiny camera called a laparoscope and the surgical instruments necessary to remove the infected appendix. Because the laparoscope allows the surgeon to see inside the abdominal cavity, the laparoscopic method eliminates the need for the much longer incision associated with a conventional appendectomy.