Procedures & Information

General Surgery | Wickenburg Community Hospital Surgical Clinic

At Wickenburg Community Hospital Surgical Clinic, state-of-the-art technology allows our team of medical professionals to be progressive across the complete continuum of care for our patients. Our highly-skilled, board-certified general surgeon Dr. Robert Ripley, MD, FACS, consults with patients about symptoms, performs surgery, and aids in the recovery process. He provides expert care for a host of medical ailments that require either outpatient or inpatient surgical intervention. Some conditions such as melanoma, moles, cysts, external hemorrhoids, and lumps under the skin (small tumors) can be performed as outpatient procedures.

If inpatient surgery is required, rest assured, you are in good hands. Dr. Ripley is board-certified and a member of The American College of Surgeons with over forty years of specialized surgical experience. Common operations and procedures performed include colonoscopy, hernia repair, gallbladder removal, and surgery for colon and breast cancers.

If you need to schedule a general surgery procedure that does not require a physician referral or are unsure whether you need a physician referral, please call Wickenburg Community Hospital Surgical Clinic at 928-668-5506.

Our list of general surgery procedures and operations include:

Eight Commonly Performed General Surgery Procedures | Wickenburg Community Hospital Surgical Clinic

WCH General Surgery | Appendectomy

An appendectomy is the surgical removal of the appendix.  It’s a common emergency surgery performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen.

You may need an appendectomy to remove your appendix if you show symptoms of appendicitis. Appendicitis is a medical emergency. It is when your appendix becomes sore, swollen, and infected. If you have appendicitis, there is a serious risk your appendix may burst or rupture. This can happen as soon as 48 to 72 hours after you have symptoms. It can cause a severe, life-threatening infection called peritonitis in your belly. ^[1]

WCH General Surgery | Breast Biopsy

A breast biopsy is a procedure usually performed if your doctor finds something concerning or questionable during a mammogram, breast exam, or ultrasound. During a breast biopsy, tissue or sometimes fluid is removed from the suspicious area. The removed cells are examined under a microscope and further tested to check for breast cancer. ^[2]

A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous. The good news is that 80% of women who have a breast biopsy do not have breast cancer. There are three types of biopsies: fine-needle aspiration, core-needle biopsy, surgical biopsy. The latter two are the most commonly used on the breast. Several factors help a doctor decide which type of biopsy to recommend. These include the appearance, size, and location of the suspicious area on the breast. ^[3]

WCH General Surgery | Colonoscopy

A colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon. Colonoscopies are an important part of colon cancer detection. The updated screening age recommendations for those at average risk are ^[4]:

• • • People at average risk of colorectal cancer should start regular screening at age 45.
    • People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.
    • People ages 76 through 85 should decide with their medical provider about whether to be screened, based on their own personal preferences, life expectancy, overall health, and prior screening history.
    • People over 85 should no longer get colorectal cancer screening.

   

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  WCH General Surgery | Skin Condition Services | Lump, Cyst, Bump, Mole, and Small Tumor Removal Specialist

  

  Even if it turns out to be nothing, it’s important to know for sure that your lumps and bumps aren’t something more serious. Dr. Ripley performs evaluations and removes various skin cysts, skin tags, soft tissue tumors, and moles as an in-office procedure. 

  Skin Cysts are common and can occur on all parts of the body. They may occur due to injury or infection, around a clogged pore, or a foreign body like a splinter or even a new earring. Cysts are extremely slow-growing, painless, and they feel smooth. 

  Lipomas are subcutaneous (below the skin) benign soft tissue tumors. The word tumor can be frightening, but lipomas are usually slow-growing and benign. They can occur anywhere on the body, but lipomas most often appear on the neck, shoulders, and trunk.

  A mole is a cluster of skin cells — usually brown or black — that can appear anywhere on your body. They usually show up before age 20. Most are benign, meaning they’re not cancerous.

  Skin tags are common skin growths that hang from the skin’s surface on a thin piece of tissue called a stalk, which can be commonly removed using cryotherapy. 

   

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  WCH General Surgery | Gastrointestinal Services | Colon & Rectal Conditions | Hemorrhoids | Hemorrhoidectomy 

  

  Hemorrhoids, also known as piles, are swollen veins in the anus and lower rectum. They can cause itching, bleeding, and pain. A hemorrhoidectomy is a surgery to remove hemorrhoids, whether they’re internal or external. ^[5] Surgery is typically not the first line of treatment. But when all else fails, hemorrhoidectomy is a safe, effective treatment that doesn’t just make external hemorrhoids easier to live with — it gets rid of them altogether. Classification of Internal Hemorrhoids ^[6]:

  Grade 1 (minor)- A hemorrhoid is present but only visualized by a doctor with anoscopy or colonoscopy. Hemorrhoid does not extend out of the anus.
  Grade 2- Hemorrhoid (s) extend out of the anus with a bowel movement or straining. After your BM, hemorrhoid goes back inside on its own.
  Grade 3– Hemorrhoid(s) extend out of the anus with a bowel movement or straining. After your BM you have to push hemorrhoid back inside the anus manually. If you have this you should seek medical attention, but it is not urgent.
  Grade 4 (severe) Hemorrhoid(s) extends outside of the anus and are not able to be manually pushed back inside.

   

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  WCH General Surgery | Skin Cancer Screening 

  

  We routinely perform skin exams and biopsies that can quickly determine whether a patient is at risk of developing skin cancer or has already developed the disease. Skin cancer can develop on any part of the body including, the face, ears, arms, thighs, and feet. With early detection and treatment, most skin cancers are almost one hundred percent curable. ^[7]

  Having regular skin exams is especially important for people who are at high risk of skin cancer, such as people with a weakened immune system (for example, those who have had an organ transplant) or people with conditions such as basal cell nevus syndrome (Gorlin syndrome) or xeroderma pigmentosum (XP). Talk to your doctor about how often you should have your skin examined.^[8]

  Pay close attention to any changes in your skin, and if you are concerned about any moles, freckles, or other spots, please call to make an appointment for a skin cancer screening with Dr. Ripley at 928-668-5506. 

   

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  WCH General Surgery |  Skin Cancer Removal

  

  General Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. The surgery can often be done in a doctor’s office or hospital clinic using a local anesthetic (numbing medicine). For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy. ^[9] Two types of skin cancer removal techniques include:

  Excision: For this procedure, the skin is first numbed with a local anesthetic. The tumor is then cut out with a surgical knife, along with some surrounding normal skin. Most often, the remaining skin is then carefully stitched back together. ^[10]

  Curettage and electrodesiccation: In this treatment, the doctor removes the cancer by scraping it with a long, thin instrument with a sharp looped edge on one end (called a curette). The area is then treated with an electric needle (electrode) to destroy any remaining cancer cells. This process is often repeated once or twice during the same office visit. Curettage and electrodesiccation are good treatment for superficial (confined to the top layer of skin) basal cell and squamous cell cancers.^[11]

   

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  WCH General Surgery |  Skin Grafting

  

  After surgery to remove a large basal or squamous cell skin cancer, it may not be possible to stretch the nearby skin enough to stitch the wound’s edges together.

  In these cases, healthy skin can be taken from another part of the body and grafted over the wound to help it heal and restore the affected area’s appearance. Other reconstructive surgical procedures, such as moving ‘flaps’ of nearby skin over the wound, can also help some cases. ^[12]

   

   

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  WCH General Surgery | What to Expect
  

  We provide expert pre-operative, operative, and post-operative management of general surgery patients with a broad spectrum of conditions:

  • • • • • Inpatient surgeries are performed at Wickenburg Community Hospital Surgical Center — a 10,500 square-foot surgery center located on-campus equipped with state-of-the-art diagnostic imaging machines and operating theater. 
          • Comprehensive pre-surgery exams, which may include routine tests and labs performed on-campus.
          • Fully accredited on-campus state-of-the-art diagnostic imaging
          • Individualized inpatient and outpatient rehabilitation services are available on-campus for post-operative patients. 
          • Currently, all patients referred for surgery receive rapid COVID-19 testing as part of the pre-surgery checklist.

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  References:

  [1] Johns Hopkins Medicine: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/appendectomy
  [2,3] National Breast Cancer Foundation: https://www.nationalbreastcancer.org/breast-cancer-biopsy
  [4] American Cancer Society: https://www.cancer.org/latest-news/american-cancer-society-updates-colorectal-cancer-screening-guideline.html
  [5] NCBI:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118483/
  [6] American Family Physician: https://www.aafp.org/afp/2018/0201/p172.html
  [7,8] Skin Cancer Foundation https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/, https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/detection.html, https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/surgery.html
  [9,10,11,12] American Cancer Society: https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/detection.html,https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/surgery.html, https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/detection.html