Provided Surgical Procedures

 

Provided Surgical
Procedures

 

A lack of access to safe, surgical care kills more people every year than HIV/AIDs, TB, and Malaria combined. With this overwhelming statistic in mind, Mercy Ships began sailing on our mission to provide hope and healing to the world’s forgotten poor in 1978. Each year, we’ve been able to reach more people to provide life-changing surgeries. Every port brings new challenges, new successes — and new lives transformed forever.

View the information below for a detailed list of the surgical procedures we currently provide.

General Surgical Procedures

Adults

  1. Hydocele Repair (in combination with inguinal hernia)
  2. Unilateral & Bilateral Hernia Repair with / without Mesh
  3. Umbilical Hernia Repair with / without Mesh
  4. Incisional Hernia Repair with / without Mesh
  5. Orchidopexy
  6. Benign Soft Tissue Tumor Excision
  7. Thyroidectomy Unilateral Lobectomy or total
  8. Amputation: Lower and upper extremity
  9. Breast Lumpectomy for benign disease
  10. Mastectomy
  11. Non – surgical, outpatient Sclerotherapy treatment for hydroceles 

Pediatric

  1. Hydrocele Repair 
  2. Unilateral & Bilateral Hernia Repair
  3. Umbilical Hernia Repair
  4. Circumcision in conjunction with hernia repair

Pediatric Surgical Procedures

  1. Resection of soft tissue tumors
  2. Hydrocele Repair
  3. Inguinal Hernia Repair (Unilateral or Bilateral)
  4. Umbilical Hernia Repair (Large)
  5. Ventral Hernia Repair +/- mesh (special pediatric mesh used)
  6. Orchidopexy
  7. Repair of Anorectal anomalies
  8. Resection of sacrococcygeal tumors (teratoma)
  9. Resection/Sclerosis of lymphatic malformation
  10. Resection of Pediatric thyroid masses
  11. Sistrunk Procedure for Thyroglossal duct
  12. Branchial cleft anomalies
  13. Circumcision
  14. Myotomy for Esophageal Achalasia
  15. Pediatric (non-neonatal) diaphragmatic hernia
  16. Resection of Ovarian Masses

Ophthalmic Surgical Procedures

  1. CHALAZION EXCISION
  2. ENTROPION REPAIR
  3. ECTROPION REPAIR
  4. REPAIR OF LID LACERATION
  5. TARSORAPHY
  6. EXCISION CONJUNCTIVAL LESION
  7. PTERYGIUM EXCISION
  8. CONJUNCTIVAL FREE GRAFT
  9. SUTURE CORNEAL LACERATION
  10. EXCISION OF BAND KERATOPATHY
  11. SPHINCTEROTOMY
  12. EXCISION PROLAPSED IRIS
  13. SUTURE REPAIR OF IRIDODIALYSIS/KEY HOLE PUPIL
  14. IRIDECTOMY/IRIDOTOMY
  15. SUTURE SCLERAL LACERATION
  16. REPOSITIONING PROLAPSED IRIS POST OP
  17. INTRACAPSULAR CATARACT EXTRACTION
  18. PHACOEMULSIFICATION CATARACT EXTRACTION
  19. MANUAL SMALL INCISION CATARACT SURGERY
  20. CATARACT EXTRACTION NEC
  21. I&A REMOVAL OF CONGENITAL CATARACT
  22. PARS PLANA VITRECTOMY
  23. PRIMARY POSTERIOR CAPSULOTOMY
  24. YAG CAPSULOTOMY
  25. INSERTION OF IOL AT CATARACT EXTRACTION
  26. SECONDARY INSERTION OF IOL
  27. IMPLANTED LENS EXTRACTION
  28. REPOSITIONING DISLOCATED IOL POSTOP
  29. ANTERIOR VITREOUS EXCISION PEDS CONGENITAL CATARACT VITRECTOMY
  30. MECHANICAL VITRECTOMY
  31. ONE EXTRAOCULAR MUSCLE RECESSION
  32. ONE EXTRAOCULAR MUSCLE RESECTION
  33. REMOVAL PENETRATING FOREIGN BODY TO EYE
  34. EVISCERATION WITH SYN IMPLANTATION
  35. ENUCLEATION WITH IMPLANT
  36. ENUCLEATION WITH NO IMPLANT
  37. EXENTERATION
  38. REPAIR EYEBALL RUPTURE
  39. REMOVAL OF SUPERFICIAL FOREIGN BODY EYE

Maxillofacial Surgical Procedures

Congenital and Developmental Malformation Repair/Correction

  1. Unilateral Cleft Lip Repair
  2. Correction of Unilateral Cleft Lip Nasal Deformity (At time of primary repair)
  3. Bilateral Cleft Lip Repair
  4. Pre-maxillary Repositioning
  5. Nasal Tip Rhinoplasty
  6. Cleft Palate Repair – Two Flap Palatoplasty
  7. Cleft Palate Repair – Furlow Palalasty
  8. Cleft Palate Repair-Furlow Palatoplasty, with bilateral buccal fat flap augmentation
  9. Cleft Palate Repair- Other (Langenbeck, Veau-Kilner, Etc.)
  10. Secondary Correction of Velopharyngeal  Insufficiency – Superiorly based Pharyngeal Flap (Hogan)
  11. Secondary Correction of Velopharyngeal Insufficiency – Pharyngoplasty
  12. Secondary Correction of Velopharyngeal Insufficiency – Furlow Palatoplasty with bilateral buccal fat flap augmentation
  13. Tonsillectomy in combination with Pharyngoplasty or Pharyngeal Flap
  14. Tonsillectomy and Adenoidectomy
  15. Oro-Nasal Fistula Repair – Anterior Maxillary Vestibule
  16. Oro-Nasal Fistula Repair – Anterior Hard Palate
  17. Oro-Nasal Fistula Repair – Posterior Hard Palate and/or Soft Palate
  18. Cleft Alveolar Bone Graft 
  19. Rare (Tessier #1-14, etc.) Facial Cleft Repair
  20. Fronto-Nasal-Orbital Encephalocele Repair – Extra-cranial Approach only
  21. Fronto-Nasal-Orbital Encephalocele Repair  – Intra-cranial Approach
  22. Management of Persistent Cranial CSF Leakage
  23. Occipital Encephalocele Repair
  24. Orbital Osteotomies to correct Hypertelorism
  25. Telecanthus Correction
  26. Maxillary Osteotomy –  LeFORT 1 (maxillary repositioning)
  27. Maxillary Osteotomy – LeFORT 2 (maxillary nasal repositioning)
  28. Maxillary Osteotomy – LeFORT 3 (maxillary nasal orbital repositioning)
  29. Mandibular Osteotomy – segmental subapical
  30. Mandibular Osteotomy-Ramus, Subcondylar, extra oral
  31. Mandibular Osteotomy-Ramus, Subcondylar, intraoral
  32. Mandibular Osteotomy-Ramus, Sagittal
  33. Mandibular Genioplasty-inferior mandibular sliding ostostomy for advancement
  34. Thyroglossal Duct Cyst Excision
  35. Branchial Cleft Cyst Excision
  36. Ranula-excision
  37. Cutaneous Tracheal Fistula (Laryngocele) Repair
  38. Cervical Tracheoesophageal Fistula Repair
  39. A-V malformation Excision
  40. Lymphatic Malformation  (Lymphangioma, Cystic Hygroma) Excision, Debulking, Sclerosis
  41. Hemangioma Excision or Debulking
  42. Neurofibroma Excision or Debulking

Nasal Surgery

  1. Rhinoplasty
  2. Septoplasty
  3. Nasal and Nasopharyngeal Polyp-excision
  4. Choanal Atresia-repair
  5. Caldwell-Luc Antrostomy
  6. Intranasal Ethmoid surgery
  7. External Ethmoidectomy
  8. Sphenoid Sinusotomy
  9. Frontal Sinusotomy
  10. External Frontoethmoidectomy

Neoplasms – Early or Benign

  1. Orbit
    • Orbital Exenteration with Temporalis Muscle Flap Obliteration
    • Orbital Exenteration with application of Split Thickness Skin Graft (when orbital  prosthesis can be made)
    • Enucleation of globe
    • Enucleation of globe, excision of Lacrimal Gland and Conjunctiva, Lid Closure
    • Enucleation of globe, excision of Lacrimal Gland & Conjunctiva, Free Dermal Graft Placement, Lid Closure
    •  Lacrimal Gland Tumour-excsion
    • Dacryocystorhinostomy
    • Lacrimal Duct-Sac-Canaliculi Repair during Maxillectomy with Silastic Tube (Crawford Tubes) placement
    • Lower Eye Lid Reconstruction
    • Upper Eye Lid Reconstruction
    • Medial Canthoplasty
    • Lateral Canthoplasty
    •  Lateral Tarsorrhaphy (also see included with Parotidectomy) 
    • Medial Tarsorrhaphy
  2. Maxilla
    • Maxillectomy-partial
    • Maxillectomy-complete, with Temporalis Muscle Flap Reconstruction
    • Maxillectomy + orbital exenteration, with Temporalis Muscle Flap Reconstruction
  3. Mandible
    • Mandibulectomy-partial, condyle preserved, midline not crossed
    • Mandibulectomy-hemi, condyle preserved
    • Mandibulectomy-hemi, including condyle
    • Mandibulectomy-hemi, including condyle, in child, with primary costo-condral  graft reconstruction
    • Mandibulectomy-anterior, condyles and rami preserved, midline crossed
    • Mandibulectomy-subtotal, one condyle and proximal ramus preserved
    • Mandibulectomy-total
    • Mandibular Reconstruction with Ileac Crest Bond Graft applied to Titanium Mandibular Bone Plate
    • Temporomandibular Joint (TMJ)-bony ankylosis release,  gap arthroplasty + interartcular temporalis flap (above 10 years of age)
    • Temporomandibular Joint-bony ankylosis release, costo-condral graft reconstruction (above 10 years of age)
    • Coronoidotomy
  4. Cranium
    • Fibrosseous Lesion  Resection / Debulking 
  5. Soft Tissue Tumors of Head and Neck
    • Parotidectomy-superficial
    • Parotidectomy-total
    • Parotidectomy-superficial or total, with VII nerve graft and/or repair
    •  Lateral Tarsorrhaphy-with Parotidectomy when VII function is lost
    • Parotectomy-“lumpectomy”
    • Submandibular Gland-excision
    • Thyroidectomy-hemi
    • Thyroidectomy-subtotal
    • Thyroidectomy-total
    • Neck Dissection (node clearance)-Radical, Modified, Functional
    • Carotid Body Tumour Excision
    • Hard and/or Soft Palate lesion excision
    • Pharyngeal Tumour excision-intraoral approach
    • Pharyngeal Tumour excision-extraoral approach
    • Laryngectomy-partial, total

Reconstructive Techniques

  1. Temporalis Muscle and/or Fascia Flap
  2. Pectoralis Major Myocutaneous  Flap
  3. Deltopectoral Flap
  4. Forehead Flap-midline
  5. Glabellar Flap
  6. Forehead Flap-temporal
  7. Scalping Flap-Total External Nasal Reconstruction
  8. Latissimis dorsi Flap
  9. Trapezius Flap
  10. Abbe Flap
  11. Estlander Flap
  12. Karapandzic Flap
  13. Naso-labial Flap
  14. Cervical Advancement Flap
  15. Tongue Flap-dorsal
  16. Tongue Flap-lateral
  17. Free Vascular Flaps
  18. Skin Graft-full thickness
  19. Skin Graft-split thickness
  20. Dermal Graft Harvest
  21. Fascia lata Harvest
  22. Sural Nerve Graft Harvest
  23. Ileac Crest Bone Graft Harvest
  24. Rib Graft Harvest-bone and/or cartilage
  25. Cranial Bone Graft Harvest

Airway and Hemorrhage Management

  1. Tracheostomy-non-urgent, adult
  2. Tracheostomy-non-urgent, paediatric <2 years
  3. Tracheostomy-urgent (emergency)
  4. External Carotid Artery Ligation

Trauma

  1. Mandibular Fractures
  2. Maxillary Fractures
  3. Orbital Fractures
  4. Zygoma Fractures
  5. Nasal Fractures
  6. Frontal Bone Fractures
  7. Skull Base Fractures
  8. Burn Contractures Release / Skin Grafts: Facial, Neck

Miscellaneous Procedures

  1. Facial Paralysis-facial slings
  2. Face Lift-post tumour resection
  3. Keloid Tumour Excision-Head & Neck
  4. Wound debridement; Removal of Infected / Exposed bone grafts, bone plates, etc
  5. Dental Extractions
  6. Lateral Pharyngostomy – feeding tube placement 
  7. Placement and Change of Wound Vac

Orthopedic Surgical Procedures

  1. Tendo Achilles / Hamstring Lengthening
  2. Tendon Transfers
  3. Tenotomy
  4. Plantar Fascia Release
  5. Contracture Release
  6. Amputation: lower and upper extremity
  7. Arthrodesis and Epiphyodesis: lower and upper limb
  8. Repair of malunion / fracture of upper (elbow to hand) / lower limb (knee to foot) –  (Neglected trauma in children and adults)
  9. Osteotomy (femoral and tibial) for correction of valgus and varus deformites
  10. Tumor Excision
  11. Other Soft Tissue Excision
  12. Sequestrectomy – removal of dead bone in currently non-infected tissue (i.e. old osteomyelitis only)
  13. Fasciotomy
  14. Guided Growth: 8 plate insertion and removal (to be reviewed per Field Service)
  15. Bone Graft
  16. Adults (18-30)
    • Osteotomy for varus and valgus deformity – (Lower limb only)
    • Arthrodesis knee fusion (18-30)
    • Neglected club feet 
    • Carpal tunnel release
    • Trigger finger release

Reconstructive Plastics Surgical Procedures

  1. (Noma) Facial Reconstruction
  2. Repair unhealed facial wounds (non-infectious)
  3. Repair and Grafting of Tendon injuries upper and lower limbs
  4. Peripheral nerve repair and grafting (upper, lower limbs or face)
  5. Burn contracture release/reconstruction – Post burn and electrical injuries – (earlier than 4 or greater than 12 months post burn)
  6. Facial soft tissue reconstruction with flap/suspension (See Maxillofacial Procedure list for specific flaps)
  7. Haemangioma, lymphangioma, and cystic hygroma (Patient Review may be needed depending on size, location, CT report)
  8. Neurofibroma debulking/excision
  9. Cleft Lip
  10. Other Facial Clefts
  11. Stump Revision
  12. Amputation – (Upper and Lower limb)
  13. Soft tissue Repair/Reconstruction/z-plasty
  14. Benign tumor/lesion excision
  15. Malignant tumor/lesion excision skin (Patient Review if needed)
    • Premalignant lesions
    • Basal cell carcinoma
    • Squamous cell carcinoma
    • Other malignant skin tumors
  16. Ear Repair/Reconstruction
  17. Eyelid Repair/Reconstruction 
  18. Flexor/Extensor tendon injury and reconstruction
  19. Scar release/excision – *Large keloids only*
  20. Graft, skin split/full thickness or bone graft
  21. Reconstruction with bone plate/implants
  22. Polydactyly and Syndactyly correction
  23. Correction of Duplication of digits upper and lower extremity
  24. Congenital abnormalities of the hands and feet (excluding club feet)
  25. Hypo – and Epispadias
  26. Placement of tissue expander
  27. (Foot Reconstruction) associated with burn contracture release
  28. (Hand and upper limb reconstruction) associated with burn contracture release
  29. Dupuytren Disease (Contracture)
  30. Soft tissue masses; head and neck, upper and lower limbs and torso  (all soft tissue tumors of the body)
  31. Lower leg ulcers with specific criteria; age < 40, history of trauma or infection, but no hypertension, diabetes or varicose veins
  32. Lymphoedema of lower legs

Obstetric Fistula Surgical Procedures

  1. VVF (Vesico Vaginal Fistula) repair
  2. UVF (Urethra Vaginal Fistula) repair
  3. RVF (Recto Vaginal Fistula) repair
  4. Re-implantation of ureters via Vaginal or Abdominal approach
  5. PV (Pubo vaginal) sling
  6. Urethral Dilation
  7. Singapore Flap
  8. Gracilis muscle flap
  9. Other VVF related surgery
  10. Elective Sterilization (Tubal Ligation) in conjunction with planned Laparotomy for repair
    See Surgical Sterilization Policy for Women’s Health Program for further guidance in decision for sterilization
  11. Elective Sterilization (Tubal Ligation) without planned laparotomy – done as secondary procedure with primary procedure

Gynecologic Surgical Procedures

 Minor Surgery Procedure List (Less than 3 Day Length of Stay)

  1. Anterior / Posterior Colporrhaphy – Diagnosis: Cystocele and Rectocele
  2. Enterocele repair – Diagnosis: Enterocele
  3. Perineoplasty
  4. Bartholin cystectomy/Marsupialization of Bartholin Cyst – Diagnosis: Bartholin cyst
  5. Removal Bladder stone – Diagnosis: Bladder stone
  6. Repair Vaginal stenosis – Diagnosis: Vaginal stenosis
  7. Labial separation, surgical – Diagnosis: Labial Fusion
  8. Vulvar/Vaginal: lesion/cyst removal – Diagnosis: Vulvar/vaginal cyst
  9. Hymenectomy – Diagnosis: Persistent intact hymen
  10. Polypectomy – Diagnosis: Cervical/Vaginal polyp
  11. Repair 3rd and 4th degree anal laceration – Diagnosis: 3rd and 4th degree anal laceration
  12. Ovarian Cystectomy

Major Surgery Procedure List (Greater than 3 Day Length of Stay)

  1. Vaginal Vault Suspension  – Diagnosis:  Vaginal Vault prolapse
  2. Total Vaginal Hysterectomy (TVH)/Total Abdominal Hysterectomy(TAH)/+/- (BSO – Bilateral Salpingoopherectomy) – Diagnosis: Menorrhagia (Bleeding), Leiomyomata uteri (Fibroids), and Uterine Prolapse

* Any combination of the above listed procedures, under minor and major may be performed based on the diagnosis of the patient –  uterine prolapse, cystocele, rectocele, enterocele, menorrhagia, leiomyomata (fibroids) , and vaginal vault prolapse

Procedures for Urinary Stress Incontinence

  1. Abdominal Sling – Fascia Latta or Rectus sling

Elective Sterilization (Tubal Ligation) In Conjunction With Planned Laparotomy Within The List Of Gynecologic Procedures Or With Unplanned Laparotomy,  Doing It As The Secondary Procedure

See Policy “Surgical Sterilization Guidelines for Women’s Health Program” for further guidance in decision for sterilization

 

Ambulatory Surgical Procedures

  1. Simple excisions/biopsies of small skin lesions
  2. Surgical biopsies of head/neck tumours for clinical diagnosis and surgical pathway
  3. Simple flaps – Where ellipse incision is not possible may be used for closing larger lesions. Depending on size and complexity may include: Rotation flap closure, rhomboid flaps, bi-lobe rotation flaps, H and V-Y advancement and island flaps, keystone flaps, full thickness and and Halo grafts
  4. Wedge resections ears and lips.
  5. Excision lipomas( up to the size of  a fist)
  6. Excision sebaceous/epidermal inclusion cysts
  7. Enucleation Meibomian/chalazion eyelid cysts
  8. Pleurocentesis/Paracentesis (with USS if possible)
  9. Non-surgical Sclerotherapy treatment for Hydroceles
  10. Banding haemorrhoids

Crew (or Day Crew) Only

  1. Incision/drainage abscesses, could be done under ring block if not too big, or regional field block depending on the site
  2. Wedge resection toenail and nailbed
  3. Other office procedures include ear suction toilet, cryotherapy, steroid joint and soft tissue injections, diathermy/curettage, punch biopsy, implant insertions, plastering/casting