Procedures

procedures Cutting edge technology, world-class physicians utilizing the most modern techniques, and the dedication of a highly trained and personable staff make USMD Hospital at Fort Worth your hospital of choice.

Back & Spine Procedures

At USMD Hospital at Fort Worth, we work closely with you and your family to determine the most effective and least invasive spinal treatment options available. We can assist you with issues including degenerative disc disease, herniated discs, arthritis of the spine and injuries to the spine. And as always, an emphasis is placed on educating you about the implications of your unique diagnosis and treatment options.

Conditions that our skilled physicians frequently treat include:

Injury to the back/neck/spine
Strains and sprains
Herniated discs
Spinal stenosis
Cervical and Lumbar Radiculopathy
Myelopathy
Chronic pain (see Pain Management Procedures below)

Our multidisciplinary approach to spine care involves a team of spine specialists, pain management specialists and physical therapists. You will receive a customized, comprehensive treatment plan designed by your team of physicians.

Surgical Options

With minimally invasive techniques, surgeons have improved ways of accessing the spine, resulting in smaller incisions and less trauma to surrounding muscles and tissues, shorter anesthesia and surgery time, shorter hospital stay and quicker return to work. Many of the spinal procedures at USMD may be performed either through an open incision or a minimally invasive technique. Your surgeon will recommend the type of surgery that is best suited to your particular condition.
The list of procedures regularly performed at USMD includes, but is not limited to, the following:

Endoscopic Spine Surgery
Spinal Stenosis Surgery
Kyphoplasty
Microdiscectomy
Artificial Disc Replacement
Corpectomy
Discectomy
Foraminotomy
Hemilaminectomy
Laminectomy
Lumbar Fusion
Odontoid Screw
Cervical Lumbar Fusions
Vertebroplasty

ENT Procedures

Ears, nose, and throat surgery comprises many different types of surgical procedures and spans all age groups regardless of gender or ethnicity. USMD ENT physicians, also known as Otolaryngologists, are trained in the medical and surgical treatment of conditions found in the ears, nose, throat and related structures of the head and neck.

ENT surgery is the oldest surgical specialty in the United States, and it is one of the most elaborate fields of surgical specialty services, using advanced technology and a broad range of procedures.

Ear Procedures

Typically, ear surgery is utilized to correct defects causing hearing loss or impairment. Such procedures include stapedectomy (removal of all or part of a bone in the middle ear called the stapes), tympanoplasty (reconstruction of the ear drum), and cochlear implants (implantation of a device to stimulate nerve ends within the inner portion of the ear to enable hearing). Surgery of the ear also includes myringotomy (insertion of ear tubes to drain fluid in persons with chronic ear infections).

Throat Procedures

Common surgical procedures of the throat include removal of tonsils (tonsillectomy) or adenoids (adenoidectomy). The tonsils (either side and in back of the throat) and adenoids (higher up the throat behind the nose) are masses of lymph tissue that play an active role in body defenses to fight infection. The tonsils and adenoids can get chronically infected, in which case surgical removal is usually indicated to relieve breathing problems and infection recurrence. Furthermore, chronic inflammation of the adenoids can cause repeated middle ear infections that can ultimately impair hearing.

Nose and Sinus Procedures

Surgery of the nose can include procedures that treat sinus diseases (sinus surgery). Advanced endoscopic surgery for sinus and nasal disorders can eliminate the need for external incisions and allow for greater surgical precision. New advances such as balloon dilation of sinus openings has allowed for less invasive and safer surgery. Rarely is packing used in this type of surgery today. (Go to www.balloonsinuplasty.com to read more about this innovative procedures.) Other common surgical procedures include correction of a deviated nasal septum (septoplasty) and turbinate reduction for chronic nasal obstruction (congestion).

ENT surgeons also treat sleep-related disorders such as sleep apnea and excessive snoring. Multiple levels of obstruction can be addressed including the nose, palate and tonsils, base of tongue, and epiglottis.

General Surgery

USMD general surgeons use a variety of techniques, including minimally invasive procedures, to diagnose and treat disease, injury or deformity almost anywhere on the body. In addition to providing many options for the surgical diagnosis and treatment of breast cancer, including lumpectomy and mastectomy, USMD general surgeons perform the following procedures.

Gallbladder Surgery
Hernia Repair
Appendectomy
Abdominal Laparoscopic Procedures
Colon Resection
Thyroid Surgery
Parathyroid surgery
Hemorrhoid Surgery and
Removal of Benign and Malignant Skin and Soft Tissue Tumors

Breast Surgical Biopsy

If your healthcare provider discovers a suspicious area, calcification or lump, a biopsy may be used to analyze the condition. Sometimes a lump or suspicious area has to be removed surgically and examined under a microscope to determine if cancer is present. Usually this can be done on an outpatient basis, with either local or general anesthesia.

Sentinel Lymph Node Biopsy can be used to help determine the extent or stage of cancer. With a Sentinel Lymph Node Biopsy the sentinel lymph node is removed and examined under a microscope to determine whether cancer cells are present. SLN biopsy is based on the idea that cancer cells spread in an orderly way from the primary tumor to the sentinel lymph node(s), then to other nearby lymph nodes.

Breast Cancer Surgical Treatment Options

The majority of women with breast cancer will undergo surgery as part of their cancer treatment. Breast cancer treatment depends on a variety of factors including the size and location of the tumor, the stage of the cancer, and results of laboratory tests

Lumpectomy
With a lumpectomy, your surgeon removes only the cancerous area and some of the surrounding breast tissue. Most women who have lumpectomies will also have a course of radiation therapy after their surgery.

Mastectomy
Depending on the type of cancer you have, the standard treatment may be a mastectomy. However, today’s surgeons have less radical, more cosmetically acceptable options for mastectomy than in years past.

Simple or Total Mastectomy – The entire breast is removed, but the surgeon does not take out any lymph nodes in the underarm area or any muscles under the breast.
Modified Radical Mastectomy – The entire breast is removed along with some underarm lymph nodes.

Gynecological Procedures

USMD Hospital at Fort Worth stays on the leading edge of technology in order to provide individualized services and treatments for women’s unique needs. Our gynecologists offer surgical procedures for diagnosis and treatment of:

abnormal uterine bleeding,
sterilization,
management of pelvic pain,
ovarian cysts (and/or tumors/masses)
ectopic pregnancies,
precancerous cervical lesions and
pelvic support defects
urinary incontinence (Also see Urology Procedures below.)
uterine fibroids and polyps

USMD gynecologists specialize in compassionate patient care and perform a variety of surgical procedures only when all non-surgical treatments options have been explored and proven to be non-viable. Gynecology procedures commonly performed at USMD include:

Hysterectomy - A hysterectomy is an operation to remove a woman’s uterus (womb). A hysterectomy is the second most common surgery among women in the United States . (The most common is cesarean section delivery.) Each year, more than 600,000 are done. One in three women in the United States has had a hysterectomy by age 60.There are several types of hysterectomies:

Complete or total. Removes the cervix as well as the uterus. (This is the most common type of hysterectomy.)
Partial or subtotal. Removes the upper part of the uterus and leaves the cervix in place.
Radical. Removes the uterus, the cervix, the upper part of the vagina, and supporting tissues. (This is done in some cases of cancer.)

Pelvic laparoscopy - The typical pelvic laparoscopy involves small incisions in the belly button AND lower abdomen.

D&C - Often used to diagnose or treat abnormal uterine bleeding, the D&C is one of the most common GYN operative procedures. Dilation and Curettage also provides important information about whether uterine cancer is present.

Oophorectomy – removal of the ovaries – and usually fallopian tubes

Cervical conization - removes abnormal cervical cells for the management of precancerous cervical lesions

Endometrial ablation - .a less invasive, less expensive, quicker to recover from procedure for management of abnormal uterine bleeding.

Plastic Surgery

In addition to reconstruction and repair of conditions resulting from trauma or disease, USMD plastic surgeons specialize in a variety of cosmetic procedures, including facial rejuvenation, body contouring and breast reconstruction.

Breast Reconstruction

Most women who have had a mastectomy are candidates for breast reconstruction, where a plastic surgeon rebuilds the breast shape as well as the nipple and areola, if desired.

Implant Procedures – Generally you have the option of either a saline-filled implant or silicone gel-filled implant. There are other types of implants filled with different materials, but these are available only in clinical trials.
Tissue Expansion – A balloon-like device is used to create a space in which a breast implant is placed to recreate breast volume.
Flap Reconstruction – The plastic surgeon may use tissue from elsewhere on your body, such as the abdomen or back, to reconstruct the breast shape.

Nipple and Areola Reconstruction – This is an optional, separate procedure that is done after the reconstructed breast has had time to heal. The tissue to create the nipple can be taken from the reconstructed breast or elsewhere on the body, and tattooing recreates the areola, or dark skin around the nipple.

Orthopedic Procedures

USMD Hospital at Arlington provides comprehensive orthopedic care for the body’s bones, joints, ligaments, muscles and nerves. When the health of these structures is compromised by injury, accident, arthritis or other disease, our orthopedic physicians use the most advanced diagnostic and treatment options available – both surgical and non-surgical – to maximize each patient’s potential for recovery.

USMD Hospital at Fort Worth provides comprehensive orthopedic care for the body’s bones, joints, ligaments, muscles and nerves. When the health of these structures is compromised by injury, accident, arthritis or other disease, our orthopedic physicians use the most advanced diagnostic and treatment options available – both surgical and non-surgical – to maximize each patient’s potential for recovery.

Arthroscopy

Arthroscopy is a versatile, minimally invasive procedure that USMD orthopedic surgeons may use to both evaluate and treat joint disease. It involves tiny instruments, including a video camera and lighting system, inserted into the joint through small punctures. With these instruments, the surgeon is able to view the inside of the joint, remove damaged tissue or repair structures to relieve pain and swelling, often preventing further damage to the joint.

Joint Replacement

Patients who suffer from joint pain and reduced mobility because of arthritis or other conditions – and have tried other treatment options without success – may be candidates for joint replacement surgery. With today’s advanced implant materials and surgical techniques, USMD orthopedic surgeons are able to offer patients a variety of ways to treat their condition. These procedures reduce pain and restore mobility. Joint replacement procedures, including some that are minimally invasive, can be performed on the knee, hip, shoulder, elbow, hand or wrist.

Sports Medicine

USMD orthopedic surgeons who specialize in sports medicine are particularly focused on the diagnosis and treatment of sports-related injuries and other conditions. These sports medicine specialists deal with a variety of situations, from a broken finger to tennis elbow to torn ligaments, and work with athletes to help them prevent injury, improve fitness, and quickly return to play.

Pain Management

USMD surgeons and pain management specialists utilize some of the most advanced techniques available for patients whose chronic pain has not responded to any other therapeutic measures. Some of these techniques include:

Botulinum Toxin Type A (Botox®)
Epidural Steroid Injections
Facet Injections
Facet Neurotomies/Neuroablation
IDET
Intrathecal Pain Pump
Lumbar Discography
Nucleoplasty
Occipital Nerve Block
Peripheral Nerve Stimulator
Rhizotomy Median Branch
Sacroiliac Joint Injection
Selective Nerve Blocks
Spinal Cord Stimulator
Trigger Point Injection
Vertebroplasty

Pediatric Dental Rehabilitation

USMD pediatric dentists are specially trained to determine if pediatric dental rehabilitation is the best option for your child. Young children, those who are extremely uncooperative and children with physical and/or mental limitations often pose a challenge when needing dental treatment. Also, lack of cooperation, combative behavior and other limitations can make conventional treatment under local anesthesia challenging and sometimes impossible. As a result, difficult children or those with special needs often undergo general anesthesia for dental treatment as a way to avoid risks of injury and excessive stress.

Unfortunately, many children suffer from serious painful dental diseases. Without treatment, dental caries can lead to tooth pain, infection, swelling, the spread of new decay, damage to developing adult teeth and possible life threatening hospitalization from a dental infection. Hence, general anesthesia is a well accepted standard of care for situations involving children who have limited comprehension or children who are extremely uncooperative and require dental care that is technically difficult and sensitive to deliver. Due to the rise in both comfort and safety, increasing numbers of children are undergoing dental rehabilitation under general anesthesia.

Urology Procedures

USMD urologists are the specialists to see for the treatment of sexual dysfunction, male birth control, infertility, incontinence and infections, as well as bladder and kidney stones. They are also experts on congenital abnormalities and cancers of the male reproductive/urinary systems. Urologic surgery has been revolutionized and is effectively being used to treat a number of conditions including:

Prostate Cancer – the most common cancer affecting males in the United States. One in 10 men will have the disease at some time in his life.
Enlarged Prostate – Is a very common condition in males and often treated with surgery.
Urinary Incontinence - Incontinence is an increasingly diagnosed problem among the aging population in the United States. Many surgical procedures are now available to correct urinary incontinence in both men and women.
Erectile and Sexual Dysfunction
Minimally Invasive Treatment of Urinary Stones

Urologic operations routinely performed at USMD include:

renal (kidney) surgery
bladder surgery
prostatic surgery
testicular (scrotal) surgery
urethra surgery
surgery to the penis including penile implants for Erectile Dysfunction
insertion of slings for urinary incontinence,
artificial sphincter implants for urinary incontinence
bladder surgery for restoration of voiding function.