Gastrointestinal Surgery

The Gastrointestinal System generally refers to the esophagus, stomach and intestine, but can also indicate all structures from the mouth to the anus as well as the organs that assist the stomach and intestine in their digestive work: The salivary glands, liver, gallbladder and pancreas are accessory organs to this system.

The Gastrointestinal problems that Dr. Jossart can treat with Minimally Invasive Surgical techniques are listed below. Please contact his office for specific details, as many of these problems are complex and require detailed clinical information.

Conditions Dr. Jossart can treat with laparoscopic surgery in San Francisco:

GERD

GERD (reflux): GERD or Gastroesophageal Reflux Disease is a digestive disease. GERD occurs when the lower sphincter becomes too weak, which then allows stomach acid or contents within the stomach to backflow into the esophagus. This backflow can lead to irritation to the lining of the esophagus and that is what causes GERD. A common reason of why GERD occurs is due to obesity. Patients usually suspect they have GERD when they start noticing continuous acid reflux and/or heartburn many times a day disrupting their daily lives. Get a check up with Doctor Jossart of San Francisco if you believe you might have this condition.

Non-surgical treatment of GERD includes:

• Weight Loss
• Medication
• Lifestyle Changes

Dr. Jossart will give a proper examination and determine if surgery is the right option. Patients with GERD may have a hiatal hernia. The operation to repair this would be a Laparoscopic Hiatal Hernia Repair with Fundoplication (several types) or a LINX procedure, which involves a ring of magnets. If you had one of these procedures before and are experiencing complications, Dr. Jossart does over 100 Hiatal hernia repairs a year.  Many of them are for very large hernias known as Paraesophageal hernias or reoperations for previously failed repairs

When GERD is left untreated it can lead to more problems, which include:

• Ulcers
• Internal Bleeding
• Trouble Swallowing & Breathing 

Achalasia 

Achalasia: This is an esophagus disorder that causes patients immense difficulty swallowing solids and liquids. The lower sphincter is the valve that opens up to move food from your esophagus to your stomach, and then closes up again to prevent food from flowing back into the esophagus. When the lower sphincter begins to have difficulty moving food to the stomach or is unable to open up completely; it results in the patient developing a difficulty swallowing their food. Common Symptoms associated with Achalasia are:

• Frequently throwing up (regurgitating) solid and liquid food items
• Difficulty swallowing
• Experiencing chest pain after eating
• Heartburn & Coughing

“Achalasia affects 5 of every 100,000 adults nationwide” – Washington University School of Medicine.

Dr Jossart’s medical clinic in San Francisco’s solution for this condition is the Laparoscopic Heller Myotomy. The procedure involves the following action.

• Small incision above the navel to identify to esophagus and the stomach
• Myotomy: This is referred to the opening of the muscles. This is to reduce the pressure in the lower sphincter.
• Opening of the muscles allows the stomach fluids which have leaked to the back of the stomach to be relieved

Tumors 

Tumors:  Doctor Jossart is able to offer minimally invasive surgery to help remove tumors within areas of the esophagus, stomach and intestines. Dr Jossart is experienced with a wide variety of tumor types, locations and sizes from years of experience operating his clinic in San Francisco. The removal process involves:

• Small incisions in areas like the upper belly, chest, or lower back to reach the tumors
• A small camera will be inserted to where the incisions were made to directly view the cavity on a video displayed on a monitor for the operation
• For tumors on the esophagus, the procedure involves removing parts of the esophagus, removing the tumors and later rebuilding the esophagus.

• For some tumor types (GIST, lipoma), Dr. Jossart is able to remove just a limited part of the stomach and preserve the normal function of the stomach.

This procedure is a good option for patients who are experiencing the earlier stage of their tumors. Later stages and patients with modest lung disease might be at a higher risk for complications.

Gastroparesis 

Gastroparesis: Is the improper functioning of the stomach.  This leads to the stomach being unable to empty out its contents properly. Gastroparesis affects the muscles in the wall of your stomach from working efficiently or even from working at all. Gastroparesis and hypertensive pylorus cause vomiting and are most common in diabetics. There are several operations that can be offered and include gastric stimulators and pyloroplasty.

• Gastric Stimulators: or Gastric Electrical Stimulation is the process of using a device that will be implanted in the abdomen to send mild electrical pulses to nerves and muscles of the lower stomach, in an effort to decrease the effects of Gastroparesis, which may involve nausea or vomiting. This procedure is only for patients who experience gastroparesis from diabetes or unknown causes only, and only when medication is no longer proving to be effective.
• Pyloroplasty: This procedure is to treat gastroparesis by widening the lower parts of the stomach to allow the contents trapped to empty out into the small intestine. The procedure is done laparoscopically with small incisions being made in the area around the belly. The procedure involves cutting the pylorus to reduce the thickness of the muscle in order to widen the stomach.  The cut is then repaired in a way that allows the pylorus to remain open and allow contents to leave the stomach.

Revisional surgery: if you have had any prior upper abdominal operation and have an active problem related to this surgery, Dr. Jossart does offer consultation to determine if he can offer you any additional treatment or surgery.