Minor surgery describes simple surgical operations, which are usually completed within a day. Patients usually undergo operations as out-patient basis without requiring hospital stay.

Minor surgery is performed for various conditions, such as lipoma, epidermal cyst, lymph nodes, ganglion, benign breast tumor (mass), gynecomastia, abscess, laceration repair and even ingrown toenails.

At often times, general hospitals administer general anesthesia even for minor surgeries. However, it is at the discretion of hospitals to determine which method of anesthesia to use for what type of surgery.

There are different types of anesthesia, such as local, sedation, general and spinal. And according the determination of the attending surgeon, we would administer the best possible anesthesia for the best result.

You may visit us at GIBBEUM Hospital without an appointment, and we will do our best to attend to you on the same day. However, we do advise you to make an appointment in advance by telephone.

Please call us at 822-570-1234 to make an appointment between 9:00 a.m. to 8:00 p.m. Our staff will be happy to answer any questions you may have.

Or you may make an appointment online. Visit us at www.GIBBEUMhospital.com

Most operations are performed under local anesthesia. For patients who are more sensitive to pain, we combine local anesthesia with sedation anesthesia.

When the surgery requires removal of large tumors, general anesthesia would be administered while some may require spinal or caudal anesthesia.

When local anesthesia is administered, you may feel a slight pain. For patients who are more sensitive to pain, a painkiller is given before local anesthesia is administered to remove any such discomfort. For the removal of large tumors, you may feel some pain during the operation, but can be eased with a small dose of anesthetic injection.

The operation generally takes 10-20 minutes. It usually takes one or two hours from the time you come into the hospital until you are discharged. A condition requiring more extensive surgery, such as a large cyst may require an operation that lasts about an hour, and perhaps even an overnight stay.

In the old days, curing the sickness is the most important part of medical treatment. In present days, however, the quality of treatment is considered just as important as curing the illness. Quality of treatment is mostly determined by the lack of scar following operation.

To achieve this, we at GIBBEUM Hospital carefully operate along the crease of the skin to minimize a scar as much as possible much like plastic surgeons would.

Stitches are usually pulled out a week after operation. At times, they may be removed in 4-5 days in order to minimize scarring. After a surgery, follow up check up is done a day after and one more visit to remove the stitches are needed. If it is difficult to visit the hospital, you may go to local hospital to be treated. Abscess and ingrown nails are exempt from this as these procedures do not require stitches.

A lipoma is a benign (non-cancerous) tumor that grows from fat cells. It often forms in the fatty tissue under the skin. It typically feels soft and elastic, and can feel it move slightly under your skin when you press on it.

It is one of the most common tumors. It may vary in size from the size of a pea to several centimeters in diameter. It may not grow for a few years, and may grow very slowly. A lipoma can occur in any part of the body where there are fat cells, in particular the trunk, neck, thigh, and arm. Some lipomas can occur simultaneously. Less commonly, a lipoma may form inside the body too. Generally you will not be aware that you have lipoma as you cannot see it and it rarely causes any problems.

Anyone can develop a lipoma at any age. Some people inherit a tendency to develop lipomas and may have several in different parts of the body. Lipomas can occur in people who are of normal weight as well as people who are overweight.

A lipoma is not serious and causes no symptoms or problems. However, at times, a lipoma may cause problems, for example, if one presses on a nerve, causing pain, or if one develops in the gut wall, causing pain or a blockage of the gut.

A lipoma is always benign and non-cancerous. Treatment for a lipoma is usually not needed. If you are not bothered by a lipoma, then it is best just to leave it alone. However, if you wish to remove it for cosmetic reasons, this is possible by a simple minor operation performed under local anesthesia. The wound will be stitched up, leaving a minimum scar.

An epidermal cyst is also known as a sebaceous cyst. It is a collection of keratin-like material, usually white, cheesy, or firm, contained in a cyst wall. It normally has a small opening through which germs can infect the inside of skin. Epidermal cysts can occur on any skin surface, but are most common on the face, back or base of the ears, chest, and back.

Epidermal cysts do not have to be removed unless for cosmetic reasons or if they become infected. An infected epidermal cyst is red, swollen, and painful. It should be treated with antibiotics and then removed when it is not inflamed. If they are infected, the pus will be removed, and because the infected cyst has high likelihood of recurrence, we recommend removal of entire cyst wall.

The lymphatic system is one of the most important parts of the immune system. Lymph is a clear fluid that travels through the body's arteries and circulates through tissues to cleanse them and keep them firm, and then drains away through the lymphatic system. Lymph nodes are the filters along the lymphatic system. Their job is to filter out and trap bacteria, viruses, cancer cells, and other unwanted substances, and to make sure they are safely eliminated from the body.

Lymph nodes are found in every part of the body, mainly in neck, axilla and inguinal area. They vary in size, but most of them are small like a sesame seed and undetectable. However, if they are infected by bacteria they will swell up. Their growth may be also caused by scars, reaction to medication, tattoos, and cancer. It is painful when you press on a swollen lymph node. This requires a biopsy for tuberculous lymphadenitis, which is also needed when lymph nodes become too hardened. This biopsy is mostly done under local anesthesia.

A ganglion is a little cyst filled with a jellylike fluid that originates from a tendon sheath or joint capsule. The cyst is most commonly a soft-tissue mass or lump that forms below the surface of the skin.

Although it occurs mostly on the wrist, it can also develop on the foot – usually on top of the foot but also on ankle and knee at times. It usually occurs suddenly. Ganglion cysts vary in size, and may get smaller and larger, and may even disappear completely only to return later. They are common in women. Although the exact cause of ganglion cysts is unknown, cysts may arise from trauma – whether a single event or repetitive micro-trauma.

The main symptoms are a noticeable lump (often the only symptom experienced), tingling or burning if the cyst is touching a nerve, dull pain or ache, which may indicate the cyst is pressing against a tendon or joint and difficulty in wearing shoes due to irritation.

A ganglion cyst is diagnosed by examining the foot. The lump will be visually apparent, and when pressed in a certain way, you would feel it move freely underneath the skin. Sometimes surgeon will shine a light through the cyst or remove a small amount of fluid from the cyst for evaluation. In some cases, an x-ray or ultrasound may be taken.

If the cyst causes no pain and does not interfere with walking, surgeon may decide it is best to carefully watch the cyst over a period of time. Wearing shoes that do not rub against the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst. It may be necessary to drain the fluid from the cyst and then inject a steroid medication into the mass. More than one session may be needed. Although this approach is successful in some cases, the cyst may return.

When other treatment options fail or are not appropriate, the cyst may need to be surgically removed.

If you have following symptoms from ganglion cyst, you need to see your doctor
1. If you have pain, especially during exercise
2. If you feel weakness in your muscle and joints due to cyst
3. If you feel tingling sensation in fingers, hands, arms and other loss of sensations
4. If you are infected
5. If it is not aesthetically pleasing
6. If you have extension in your wrist tendon or other tendons

Breast tumors are typically found among women between the ages of 30 – 50. Often times, they are not causes for concerns.

A benign breast tumor is an area of abnormal cell growth in the breast or around the milk duct which is not considered to be cancerous. It is caused by a genetic defect in a cell which causes it to multiply uncontrollably, leading to the formation of a lump of tissue.

A tumor has smooth edges when it is palpated, and it can be moved around in the breast tissue. Some women also experience fibrocystic changes which increase and decrease with the menstrual cycle. It may occur even when breasts are normal, and easily appears before menstruation. It occasionally disappears after menopause. It may reappear in response to normal hormonal stimulation.

The majority of benign breast tumors detected by mammography or breast ultrasonography are non-cancerous or benign. They include fibrocystic disease, fibroadenomas, and intraductal papillomas.

Fibrocystic disease
A fibrocystic disease is associated with the symptom that breast feels soft and rubbery, and a person may feel pain. As it is caused by hormones, it is rarely found in women over 50 in age.

Fibroadenoma
A fibro adenoma is a benign tumor that is marble-like lumps in the breast that can range in size from microscopic to several inches in diameter. It may be painful when touched, and it may change in size according to women’s menstrual period. Although it may appear at any age, it is more common in women in their twenties. It can be diagnosed by fine needle aspiration or core needle biopsy. If it continues to grow or is large enough to distort the shape of a woman's breast, a physician may advise to remove it surgically.

Intraductal papilloma
An intraductal papilloma is a small, wart-like, non-cancerous growth in the breast ducts that sometimes causes a bloody nipple discharge. For young women it may occur in both breasts. It can be diagnosed by using a core needle biopsy if it is large enough to be detected by touch. It is treated by removing the tumor and a segment of the duct it is found in, which is usually done through an incision at the edge of the areola. Breast cancer Breast cancer can be detected through self examination. Often times one may feel solid and hard tumor when self-examined and it is not painful. The shape of the tumor is uneven and feels as if it is fixed, as it is attached to adjacent tissue.

The above breast diseases can be diagnosed by mammography and breast ultrasonography. Sometimes the precise nature of the diseases can be diagnosed by a breast biopsy, for instance a fine needle aspiration biopsy or an incisional biopsy. Breast biopsies are used to collect a small sample of the suspected tumor for it to be examined under a microscope by a pathologist. The pathologist can determine whether the lump is benign or malignant, and a treatment plan can be developed accordingly.

An accessory breast is where one has additional degenerated breast tissue. It often occurs when the breast tissue increases in the time of puberty, pregnancy, and breast feeding. It is composed of both the central accessory breast tissue and adjacent fat tissue. It is most frequently found in the axilla and the inguinal region, rarely in the nipple, and it rarely secretes milk.

It may be removed if it causes pain or if it is unsightly cosmetically. A minimal incision of 10-20mm in the axilla is made for the procedure. You may leave hospital on the day of operation. The recovery takes about 4-6 weeks.

Gynaecomastia is an abnormal growth of male breast tissue that grows under the nipples, and expands like that of women’s’. It occurs when there is excessive female hormone or deficiency of male hormone. A third of teenage boys suffer from gynaecomastia usually during puberty. It usually disappears without treatment within a couple of years.

If an adult suffers from gynaecomastia, he may need tests to determine the cause of the problem. Occasionally it is caused by diseases such as hepatoma, lung cancer, liver cirrhosis, hyperthyroidism, pituitary tumor, adrenocortical cancer, or testicular cancer. Sometimes it is caused by the use of certain drugs such as alcohol, marijuana and heroin. The drugs used for treatment include ulcer medication like adrenocorticoid and cimetidine, antiepileptics like dilantin, anticancer drugs, antiandrogen, anti anxiety drugs, antidepressants and lavender oil. It can be diagnosed by external observation without requiring any special examination.

When gynaecomastia occurs in response to hormonal stimulation, proper medication can reduce the growth. If it results from the use of drugs, ceasing use will stop growth. Surgical treatment may be the only answer if the tissue is too large in size, appears only on one side or is cosmetically unsightly.

An abscess is a localized collection of pus, often called furuncle that generally develops in response to infection. It is typically painful, and appears as a swollen area. The skin surrounding an abscess typically appears pink or red.

It can develop in many parts of the body, but it usually involves the skin surface. It can also affect the brain, kidneys, liver, lung, teeth and tonsils.

The shortest and best way to treat it is by surgery. Unlike other infections, it cannot be cured by antibiotics alone. Although sometimes an abscess will open and drain spontaneously, it generally needs to be opened and drained by a surgeon. Only the minimum amount of antibiotics must be applied after cutting the pus open.

A laceration is a wound caused by a sharp object producing edges that may be jagged or dirty. Lacerations most often affect the skin, but any tissue may be lacerated, including subcutaneous fat, tendon, muscle, or bone.

Laceration repair mends a tear in the skin or other tissue in order to promote healing and minimize the risks of infection, premature splitting of sutures and poor cosmetic result.

A laceration should be repaired
• If it continues to bleed after application of pressure for 10–15 minutes;
• If it is more than one-eighth to one-fourth inch deep;
• If it exposes fat, muscle, tendon, or bone;
• If it causes a change in function surrounding the area of the laceration;
• If it is dirty or has visible debris in it;
• If it is located in an area where an unsightly scar is undesirable

Lacerations are less likely to become infected if they are repaired soon after they occur. Many physicians will not repair a laceration that is more than eight hours old due to the greater risk of infection.

The laceration is cleaned by carefully removing any foreign material or debris. The wound is then cleansed with saline solution and a disinfectant. Once the wound has been cleansed, the physician anesthetizes the area of the repair. Most lacerations are anesthetized by local injection of lidocaine, with or without epinephrine into the wound edges. The physician may trim edges that are jagged or extremely uneven. Tissue that is too damaged must be removed to prevent infection. If the laceration is deep, several absorbable stitches are placed in the tissue under the skin to help bring the tissue layers together. Suturing also helps eliminate any pockets where tissue fluid or blood can accumulate. The skin wound is closed with sutures. Suture material used on the surface of a wound is usually non-absorbable and will have to be removed later. A light dressing or an adhesive bandage is applied for 24–48 hours. In areas where a dressing is not feasible, an antibiotic ointment can be applied. If the laceration is the result of a human or animal bite, if it is very dirty, or if the patient has a medical condition that alters wound, a broad-spectrum antibiotic may be prescribed.

The laceration is kept clean and dry for at least 24 hours after the repair. Light bathing is generally permitted after 24 hours if the wound is not soaked. The physician will provide directions for any special wound care. Sutures are removed 3 to 14 days after the repair is completed.

The repair should be examined frequently for signs of infection, which include redness, swelling, tenderness, drainage from the wound, red streaks in the skin surrounding the repair, chills, or fever. If any of these occur, the physician should be contacted immediately. Infection is the most serious risk associated with laceration repair.

All lacerations will heal with a scar. Wounds that are repaired with sutures are less likely to develop scars that are unsightly, but it cannot be predicted how wounds will heal and who will develop unsightly scars. Plastic surgery can improve the appearance of many scars.

An ingrown toenail occurs when the nail penetrates the skin at the side of the nail plate. It can occur on all toes but usually affects the big toe. This causes a wound that can become infected. In some instances this results in extra tissue forming (hyper granulation tissue). If dirt and sweat enter this area, infection can occur causing the skin at the side or tip of the nail to become red, swollen, and tender. In addition, a small amount of pus will come out of the edge.

Often times, this condition occurs due to the shape of the nail plate. Some people have wide nail plates while others have curved nail plates that cause the difficulty for nail to grow free at the sides. This makes cutting the sides of the nail very difficult and often results in the nail being pulled at this point. Other causes are trimming the nail too short, tight shoes or socks, and inherited condition.

If the symptoms are not treated, they are likely to get worse. To relieve the symptoms, you can wear well fitted shoes, take care when cutting nails, bathe the foot in warm salt water daily, keep the toe covered with a clean / sterile dressing, have a course of antibiotics and see a podiatrist.

For more severe or recurring cases, surgery is required to prevent recurrence. There are two types of operation: partial nail removal (avulsion) with destruction of the nail bed / root, and surgical excision.

For partial nail avulsion using chemical ablation, you can walk immediately after the operation; although it is generally best to rest that day. You will need to bathe the foot in warm salt water for 15 minutes, twice daily and redress the toe until it has healed. This generally takes between 2-4 weeks due to the chemical burn but it is not usually painful during this period.

For surgical excision you will need to rest your foot for 2-3 days and stitches are removed after two weeks.

The operation is performed safely under local anesthetic. You are awake and do not feel pain during the operation. Many patients are able to go home on the day of surgery.

Please call us at 822-570-1234 to make an appointment between 9:00 a.m. to 8:00 p.m.
Our staff will be happy to answer any questions you may have.
Or you may make an appointment online. Visit us at www.GIBBEUMhospital.com

Come and see what we can do for you for your health.