Services

The mission of SCOSA is to provide our patients with cutting-edge surgical care, whatever their needs might be. We provide a full array of general surgical care, with special emphasis on laparoscopic surgery and bariatric surgery.

Through experience and highly specialized training, we are able to perform very complex surgical procedures utilizing laparoscopic techniques, which are minimally invasive and offer a quicker recovery time. We also perform open general surgery, caring for masses or abscesses in the skin, as well as other traditional general surgery procedures.

Your choice of a surgeon is extremely important. Everyone at SCOSA wants you to have a safe operation and achieve your desired results with the minimum possible impact on your day-to-day life.

The links on this page will let you learn more about the variety of services that we offer. This is a good starting place to explore different treatment options and decide what’s right for you. This information is not medical advice, but it is an honest assessment of options from a voice you can trust.

Laparoscopic Gallblader & Bile Duct Surgery

Laparoscopic Gallblader & Bile Duct Surgery

The gall bladder is a hollow organ located just under the liver. Its function is to store bile and release it when stimulated by the intake of food. Bile is used by the body help us digest our food.  Sometimes the concentrations of cholesterol and bile salts in the bile lead to formation of crystals, which can become sludge or stones (calculi).
View Full Description

SYMPTOMS/DIAGNOSIS

Stones in the gallbladder can lead to obstruction of the duct (tube) that drains the bile from the gallbladder. When food is ingested, the gallbladder contracts, trying to release bile. If the outlet is blocked with stones or sludge, patients experience pain in the right upper abdomen.

TREATMENT

Gallstones will not go away on their own, and medical (non-surgical) therapies are not successful in the management of gallstones. Surgical removal of the gallbladder is the standard of care.

SURGERY

You should schedule a routine follow up with your SCOSA surgeon two weeks after the operation. Some patients experience a transient diarrhea after their gallbladder is removed.  Although this operation is very safe and has a less than 1 percent mortality rate, this is an important decision for you and your physician.
Laparoscopic Treatments for GERD

Laparoscopic Treatments for GERD

Gastroesophageal reflux – sometimes called heartburn – occurs when stomach contents leak back, or reflux, into the esophagus. Heartburn that occurs more than twice a week may be considered gastroesophageal reflux disease (GERD). Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing.
View Full Description

SYMPTOMS/DIAGNOSIS

When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion.

TREATMENT

There are a number of lifestyle changes you can make that will help alleviate symptoms, to include: Stop smoking, lose weight, eat small meals, and avoid lying down for 3 hours after a meal. Your doctor may suggest you try medication for your pain. A number of over-the-counter and prescription drugs, including antacids, foaming agents, H2 blockers, and proton pump inhibitors, can help you at this time.

SURGERY

Who should have surgery? Most GERD will respond to lifestyle changes and medical management. People who do not respond to conservative management should consider surgery. Over time, the cost of the medicines can be significant and some patients will elect to have surgical correction. The standard surgical treatment for GERD is Nissen Fundoplication. In this operation, the upper part of the stomach is wrapped around the lower end of the esophagus, and the hiatal hernia is repaired.
Laparoscopic Inguinal Hernia Repair

Laparoscopic Inguinal Hernia Repair

A hernia is a condition in which abdominal contents bulge through a weak area in the muscles. An inguinal hernia occurs in the groin (the area between the abdomen and thigh). It is called “inguinal,” because the intestines push through a weak spot in the inguinal canal, which is a triangle-shaped opening between layers of abdominal muscle near the groin.
View Full Description

SYMPTOMS/DIAGNOSIS

Symptoms of an inguinal hernia may include a lump or a bulge in the groin near the thigh; pain in the groin especially with lifting, coughing, or straining; pain in the testicle or cord; partial or complete blockage of the intestine. Redness of the skin over a hernia or constant severe pain are serious findings that may suggest strangulation. This is a surgical emergency.

TREATMENT

The doctor diagnoses hernia by a physical exam, X-rays, ultrasound, CT (computed tomography), and blood tests to check for blockage in the intestine. The treatment for an inguinal hernia is surgical repair of the opening in the muscle wall.

SURGERY

This surgery is called herniorrhaphy, and reinforces the weak area with mesh.
Laparoscopic Ventral / Umbilical Hernia Repair

Laparoscopic Ventral / Umbilical Hernia Repair

A hernia is a defect in the muscle lining of the abdomen that allows abdominal contents to bulge through. These defects may be congenital or at the site of a previous surgery. A ventral hernia is one that occurs on the front wall of the abdomen. A hernia in the belly button or an umbilical hernia is a type of a ventral hernia.
View Full Description

SYMPTOMS/DIAGNOSIS

Patients will typically notice a bulge or swelling in the area of the hernia. A ventral hernia can cause pain, bloating, or bowel obstruction. The pain may worsen with straining or coughing. If the skin overlying a hernia becomes red and extremely painful, you should seek immediate medical attention. This may represent a surgical emergency.

TREATMENT

Traditionally, these hernias have been repaired by re-opening the old incision and re-closing the abdominal muscles with the aid of a prosthetic mesh. With this type of repair, patients typically spend five to six days in the hospital and can usually return to normal activity in six to eight weeks.

SURGERY

Your SCOSA surgeon will review with you the risks and benefits of the procedure at your clinic appointment. You will be sent for some routine lab work, X-rays, and an EKG. In addition, your SCOSA surgeon will set up any further testing required before surgery.
Laparoscopic Colon Resection

Laparoscopic Colon Resection

The colon or large bowel is the part of the intestine that transfers waste material from the small bowel to the rectum. Removal or resection of a portion of the colon (or the entire organ) can be indicated for infectious or inflammatory problems, such as complications of diverticulitis and ulcerative colitis, poor blood supply, bleeding lesions, polyps, and cancers.
View Full Description

SYMPTOMS/DIAGNOSIS

The colon or large bowel is the part of the intestine that transfers waste material from the small bowel to the rectum. Removal or resection of a portion of the colon (or the entire organ) can be indicated for infectious or inflammatory problems, such as complications of diverticulitis and ulcerative colitis, poor blood supply, bleeding lesions, polyps, and cancers.

TREATMENT

Traditionally, a colon resection was performed with a long midline abdominal incision. Patients would spend a week or more in the hospital and not able to return to normal activities for at least six weeks after surgery. 

SURGERY

In preparation for laparoscopic colectomy, the patient is asked to completely clean the bowel. Four to six tiny incisions are made, and through these incisions, a camera and instruments are placed into the abdomen. One larger incision is made to bring out the colon.
Laparoscopic Resection of Adrenal Gland

Laparoscopic Resection of Adrenal Gland

The adrenal glands are small but important organs located just above the kidneys. They release hormones that regulate salt levels in the blood, the body’s response to stress, and blood pressure amongst other things. In addition, the adrenal glands make some of the sex hormones.
View Full Description

SYMPTOMS/DIAGNOSIS

Your doctor may check for an adrenal tumor if you have certain medical problems, but many times a tumor will be found if you are getting an X-ray test for something else. Certain blood and urine tests can be done to see if the tumor is making any of the various hormones.

TREATMENT

If the decision is made to remove the adrenal gland, there are two options for surgery: laparoscopic surgery or traditional open surgery. Your surgeon will discuss the best approach for you. The benefits of laparoscopic surgery include smaller incisions, decreased hospital stay, decreased recovery time and decreased risk of wound infection and hernia.

SURGERY

Before the surgery, you will likely need some blood tests and X-rays. Some patients will need medical clearance for surgery. Your surgeon will go over the risks of surgery, and may want you to cleanse your colon prior to surgery.
Laparoscopic Splenectomy

Laparoscopic Splenectomy

The spleen is a solid organ located in the left upper abdomen. It functions to remove old red blood cells and to assist the immune system in fighting infection.
View Full Description

SYMPTOMS/DIAGNOSIS

The spleen is a solid organ located in the left upper abdomen. It functions to remove old red blood cells and to assist the immune system in fighting infection. In certain diseased states, the spleen may become enlarged, inflamed, or may cause destruction of normal blood elements.

TREATMENT

Removal of the spleen (splenectomy) is usually very well tolerated once the patient recovers from the surgery. Patients require a vaccination to help prevent infection as a result of partial loss of immune function secondary to splenectomy.

SURGERY

 Your SCOSA surgeon will review with you the risks and benefits of the procedure at your clinic appointment. You will be sent for some routine lab work, X-rays, and an EKG.
Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass

One of the earliest bariatric procedures created in the 1970s, the Gastric Bypass has stood the test of time. We’ve been performing this procedure since 1982, and we were among the first in South Texas to perform the Gastric Bypass laparoscopically (minimally invasive) in mid-2000.
View Full Description

THE PROCEDURE

A surgical stapling device divides and seals the upper stomach to create a new, smaller stomach pouch. The pouch is about the size of an egg yolk and holds 15 ml or less. The stomach pouch is attached to a segment of the small intestine (the Roux limb), which carries food downstream for digestion.

THE RESULTS

The gastric bypass has a history of success dating back to the early 1980′s. Among common bariatric procedures, the gastric bypass is the best studied has excellent long term weight loss results with the minimum amount of long term complications. Gastric bypass is the gold standard for weight loss surgery.

THE CONSIDERATIONS

One special effect of this surgery is that the intestine can no longer handle concentrated sugars or starches. If a patient consumes sweets or starchy foods, they have a temporary illness called Dumping Syndrome.
Gastric Sleeve (Vertical Sleeve Gastrectomy)

Gastric Sleeve (Vertical Sleeve Gastrectomy)

The Gastric Sleeve operation is appealing because it appears simple and clean. It was originally conceived as a first stage operation for very heavy and very high-risk patients, but is now accepted as a worthwhile option for lighter patients.
View Full Description

THE PROCEDURE

A surgical stapling device is used to remove the large reservoir section of the stomach. The operation leaves a narrow tubular section of stomach that has 10-15% of the capacity of the original stomach.

THE RESULTS

The stomach fills quickly with small amounts of food, so patients feel satisfied after eating less. Medical research also seems to show that some hunger-related hormones such as ghrelin are reduced or even eliminated by removing the stomach that produces them; the sleeve gastrectomy seems to eliminate some of the hunger system.

THE CONSIDERATIONS

The Sleeve is a relatively new procedure, long-term research won’t be available until around 2020. Some of the risks with sleeve include bleeding, leaks, kinking of the stomach, weight regain, etc. Sleeve is not recommended for patients with significant reflux.
Gastric Banding

Gastric Banding

Banding is an option or surgical weight loss, however, it is losing favor/ prominence nationwide, if a band is something you are interested in, Dr. Reiss will be happy to talk to you about it at your appointment.
View Full Description

THE PROCEDURE

The Lap-Band became available in 2001, and we began using it in 2002. We’ve come to understand that the Band is not a lasting treatment for obesity in most patients.

THE RESULTS

We continue to see many patients who have already had a Band placed, and have removed many bands for weight gain, erosion into the stomach, and slippage of band out of position. We can simply remove your band or convert your band to a different weight-loss surgery.

THE CONSIDERATIONS

Banding is an option or surgical weight loss, however, it is losing favor/ prominence nationwide, if a band is something you are interested in, Dr. Reiss will be happy to talk to you about it at your appointment.
Revision Surgery

Revision Surgery

We always recommend that the patient’s original surgeon complete a revision operation if possible. If there’s some reason that a patient can’t continue care with their original surgeon, then we can help.

More than 20 years of experience has taught us that revision surgery has the best chance of success if the patient is thoroughly prepared for lifestyle change to work with their surgical anatomy. We help patients get prepared by starting every revision evaluation with a full metabolic work up.

It’s possible for any bariatric surgical procedure to require surgical revision at some point. Many patients had surgery in the 80’s and 90’s using techniques that are now abandoned because of long-term problems such as persistent vomiting or reflux.
View Full Description

THE PROCEDURE

It’s possible for any bariatric surgical procedure to require surgical revision at some point. Many patients had surgery in the 80’s and 90’s using techniques that are now abandoned because of long-term problems such as persistent vomiting or reflux.

THE RESULTS

In a revision surgery, weight loss may or may not be the primary goal. Often, a patient needs revision surgery in order to swallow more normally or to correct a nutritional problem.

THE CONSIDERATIONS

Repeat surgery on the stomach is significantly more difficult and more risky. The prior operation always leaves scar tissue that distorts the normal anatomy. Organs that normally separate easily are often “stuck together” by scar tissue, so that the risk of abdominal organ damage is significantly higher in a revision operation.
Open General Surgery

Open General Surgery

While we do emphasize Laparoscopic surgery here at Surgical Consultants of San Antonio, Dr. Dana L. Reiss is a committed general surgeon and can perform open surgeries when needed. Patients who need treatments for abscesses, thyroid surgery, skin mass, and more, can make an appointment for a one-on-one consultation to discuss surgery and post-operative care. […]
View Full Description

Services: