General Surgery

Remedy Surgery Center offers specialized general surgical services and procedures in the DFW metroplex, administered by physicians who are board certified by the American Board of Surgery. Our subspecialty includes colorectal surgery.

What is a General Surgeon?

A general surgeon is a physician who has been trained in diagnosis, pre-operative and postoperative care, and management of patient treatment. This general discipline requires knowledge of a large number of medical concepts, including emergency care, human anatomy, immunology, metabolic care, nutrition, disease pathology, wound healing and triage, treatment for varicose veins, and patient physiology. In most cases in the United States, trauma care and treatment is generally under the purview of a general surgeon or general surgery staff.

Electrophysiology Study

An EP Study is the monitoring and recording of the electrical activity the heart. This test is used to help find out the cause of your rhythm disturbance and the best treatment option for you. During the test, the doctor may safely reproduce your arrhythmia to diagnose your specific type and locate the site of origin of the abnormal heart rhythm.

In most cases, EP testing and the Radio-frequency therapy performed during the same setting can cure the arrhythmia. The procedure takes approximately two to four hours to complete.

Implantable Defibrillators

Each year more than 300,000 people die suddenly in the United States. This is termed sudden cardiac death or sudden cardiac arrest. The most common arrhythmia leading to sudden cardiac arrest (SCA) is ventricular fibrillation (VF), an arrhythmia of the heart in which the heart quivers rather than beats effectively. When this happens, the heart no longer supports circulation, the patient loses consciousness and, if the normal rhythm is not restored quickly, the patient will not survive. VF is often preceded by another abnormal, fast rhythm called ventricular tachycardia (VT). In VT the heart usually maintains some pumping function although in the majority of patients it is not enough to support circulation either. VT usually degenerates into VF if the normal rhythm is not restored quickly.

There are several types and manufacturers of ICD. Generally, they consist of an oval-shaped device generator and two or three leads. The generator contains the small computer that monitors the rhythm, detects arrhythmia and determines if treatment is needed. It also houses the battery and the device that delivers the shock through the leads. The leads are essentially wires that are attached to the ICD on one end, with the other ends positioned in different locations within the heart chambers. Implanting an ICD is generally considered a minor surgical procedure and is usually done with sedation and local anesthetic. Following the implant, the doctor will monitor you and your device regularly to maintain proper functioning.

Pacemaker Placement

A pacemaker is a small, battery-powered device that sends out weak electrical impulses that cause the heart muscle to contract. A pacemaker can be used to replace the function of the natural pacemaker of the heart when the heart is beating too slowly. It consists of wires (leads), which transmit electricity to the heart, and the pulse generator and battery, which generate the electrical impulses. The battery in a permanent pacemaker usually lasts 5 to 15 years. Your doctor will monitor your pacemaker regularly to decide when the battery should be changed.

Pacemakers are surgically placed into the chest (a permanent pacemaker) through a small incision. There are several types of implantable pacemakers.

• A fixed-rate pacemaker gives off electrical impulses at a steady, regular rate, regardless of your level of activity. A rate-responsive pacemaker changes the rate of electrical impulses as your activity level changes.
• A single-chamber pacemaker controls only the lower chamber of the heart (ventricle).
• A dual-chamber pacemaker controls both the top (atrium) and bottom (ventricle) chambers of the heart.
• Many times the pacemaker is set to work only when the heart rate falls below a certain predetermined rate (demand mode).

The surgery needed to implant a permanent pacemaker is considered a minor surgical procedure. It can usually be done using local anesthesia, which means part of your body is numbed, but you stay awake. A small incision is made in the chest wall. The pacemaker leads are usually threaded through the incision into a large blood vessel in the upper chest and into the heart. Using the same incision, a small pocket is created under the skin to hold the pulse generator. The leads are then hooked up to the pulse generator. The entire procedure usually takes about 1 hour.

Radiofrequency Ablation

A non-surgical procedure called radiofrequency catheter ablation is utilized to cure many heart rhythm disturbances. In this procedure thin, flexible wires are inserted into a vein in the groin and threaded up through the vein and into the heart. Through an electrode at the tip of the wires, radio waves can be delivered to selectively destroy heart tissue responsible for the abnormal heart rhythm.

Radiofrequency catheter ablation can also be used when persistent chronic atrial fibrillation does not respond to treatment with medication and symptoms continue to be bothersome. It is most often used in people who have difficult-to-control heart rates. The normal conduction area is ablated which then requires a pacemaker be implanted to maintain normal heart rhythm after the ablation. Ablation followed by pacemaker implantation reduces cardiac symptoms and improves exercise tolerance, quality of life, and the amount of blood pumped with each heartbeat.

Radio-frequency ablation has also been utilized to cure certain patients with atrial fibrillation. These patients, however, are usually younger who have had the arrhythmia for a short time.

Intravascular Ultrasound

Through the use of intravascular coronary ultrasound (IVUS), it is now possible to thread a tiny ultrasound “camera” into the coronary arteries to give a valuable cross-sectional view from the inside-out, showing the physician where the normal artery wall ends and the plaque begins. In certain situations, IVUS can assist in the selection and sizing of stents and balloons and can help to verify that a stent has been properly deployed. This is of increasing importance in the era of drug-eluting stents.

Traditionally, coronary angiography has and still is being used to identify narrowing of the coronary arteries. IVUS, an expansion of traditional angiography, shows a more detailed depiction of the type and levels of plaque. This has proven to be useful in selecting the form of angioplasty that would be most effective.

Orthopedic Medicine

Orthopedic medicine is devoted to the diagnosis, treatment and prevention of injuries and diseases of the body’s musculoskeletal system. Our orthopedic surgeons provide the following orthopedic medical services: fracture repair, sports medicine; care of the back, neck, shoulder, elbow, hand and wrist, hip, knee and ankle; pain management and epidural injections; work-related injuries; arthritis/osteoporosis. Our orthopedic surgeons also specialize in the following types of surgery: neck and back; foot and ankle; knee; hip; hand and wrist; elbow; shoulder; and total joint replacement.

Orthopedic Medicine

For patients in the DFW Metroplex area coping with musculoskeletal pain and dysfunction, Remedy Surgery Center’s Orthopedic physicians provide top-rated orthopedic care. Our orthopedic specialists pinpoint and treat disorders that can strike vulnerable areas in your body — including your neck and back, foot and ankle, hip and thigh, knee and lower leg, shoulder and elbow, and hand and wrist zones.

The orthopedic team at Remedy Surgery Center is highly trained in a range of surgical innovations, including joint replacement, soft tissue repair and bone fusion procedures. Other surgeries available at our facility include arthroscopy, which diagnose and treat joint problems; and osteotomy, which re-positions malformed bones.

Orthopedic professionals at Remedy Surgery Center not only offer the latest surgical techniques, but also provide prescription medication, epidural injections and other pain management techniques. Our orthopedic surgeons will also consult with you on the most effective exercise and alternative healing treatments.

Common Symptoms and Disorders

Remedy Surgery Center provides expert evaluation and treatment for your pain, injury or chronic condition. Among the many problems addressed are:

Spine Procedures

Procedures for the spine help alleviate chronic back pain. Patients will be advised on which procedure is best for them.

• Lumbar Laminectomy
• Anterior Cervical Fusion (ACF)
• Lumbar Discectomy

Disc Decompression

Disc Decompression using a minimally invasive approach – a percutaneous discectomy probe is a less invasive option for patients suffering from low back and leg pain due to contained disc herniations. It is performed under live x-ray using local anesthetic and minimal sedation with minimal recovery time.

Lumbar Discectomy

A lumbar discectomy is a surgical procedure that removes part of a herniated, or ruptured, disc which pads and separates the vertebrae in the lower back. This alleviates pressure placed on the nerve root.

What to expect

Lumbar discectomy is usually performed under general anesthesia while the patient is lying face down or in a kneeling position. During the procedure, the surgeon will make a small incision in the skin over the affected area of the spine. Muscle tissue is removed from the bone above and below the affected disc while retractors hold the muscle and skin away from the area so the surgeon has a clear view of the vertebrae and disc. In some cases, bone and ligaments may have to be removed for the surgeon to be able to gain access to the disc without damaging the nerve tissue.

Once the surgeon can see the vertebrae, disc and other surrounding structures, he or she will remove the section of the disc that is protruding from the disc wall and any other disc fragments that may have broken off from the disc. Some surgeons will implant a special foam pad or piece of fat over the nerve to prevent scar tissue from growing onto the nerve. The incision is then closed with sutures and the patient is taken to a recovery room.

How to prepare

Patients will be examined prior to surgery to ensure they are healthy enough for the procedure. Smokers should cut down or stop in the days before the surgery. Do not eat or drink anything after midnight the night before. Loose clothing is recommended for ease of dressing after the procedure, and arrangements should be made for a ride home. The doctor will advise the patient of any medications prohibited before the surgery.

Lumbar Laminectomy

Lumbar laminectomy is a procedure done to relieve pressure on the spinal nerves. This procedure is done when back pain fails to improve with more conservative treatments. A laminectomy removes a section of the bony covering over the back of the spinal canal.

What to expect

Patients are sedated and given a general anesthesia or spinal anesthesia. Spinal anesthesia is injected in the low back into the space around the spinal cord. This numbs the spine and lower limbs.

This one to three hour surgery is usually done with the patient kneeling face down in a special frame. The frame supports the patient so the abdomen is relaxed and free of pressure. This position lessens blood loss during surgery and gives the surgeon more room to work. The surgeon will make a straight incision over the desired vertebrae and down the lamina, or bony arches of the vertebrae.

The doctor will then remove the ligament joining the vertebrae as well as all or part of the lamina in order to see the nerve root. The surgeon will then pull the nerve root back to the center of the spinal column and remove the disk, or part of the disk. The doctor will close the incision and the patient’s large back muscle will protect the spine or nerve roots.

How to prepare

Patients will be examined prior to surgery to ensure they are healthy enough for the procedure. Smokers should cut down or stop in the days before the surgery. On the day of the surgery patients will be admitted early in the morning. Do not eat or drink anything after midnight the night before. Loose clothing is recommended for ease of dressing after the procedure, and arrangements should be made for a ride home. The doctor will advise the patient of any medications prohibited before the surgery.

Podiatric Surgery

Remedy Surgery Center offers specialized Pediatric services and procedures in the DFW metroplex, administered by physicians who are board certified by the American Board of Surgery. Our subspecialties include Bunion and Hammer toe surgery, Arthroscopy, Ankle surgery, Achilles repair, Cyst removal, Flat foot correction, Foot Neuromas and more.

Pain Management

Chronic pain comes in a variety of forms, which can have a notable effect on your everyday life, impacting your overall productivity, mobility, and mental & emotional well-being. Our pain care specialists are trained to identify and minimize pain caused by a variety of factors by narrowing down the nature and type of pain, as well as the cause and extent of a condition. Remedy Surgery Center is located in Hurst, Texas, with board certified pain management physicians who specialize in a variety of pain management techniques.

Common Pain Management Methods

Proper pain management requires an approach that considers both the physical and emotional implications of a chronic condition. Depending on the cause and nature of chronic pain, there are a variety of pain management tools available for consideration.