Delaware Today magazine Top Doctors 2011, The Surgeons: Common surgical procedures

The Most Common Procedures 

The surgical procedures performed most often in Delaware aren’t major heart procedures, tumor removals or even joint replacements. They’re far more mundane, usually requiring nothing more than an office visit and little or no anesthesia. Here’s how they’re listed on your medical bill, with a description, from most common to less.

Arthrocentesis, aspiration or injection of a joint

Water on the knee? These procedures amount to removing fluid from a joint via a needle in order to relieve spasms or diminish pain caused by injury, arthritis, tendonitis or other issues. Doctors might also inject anesthesia
in connective tissue to relieve pain, such as an epidural to diminish chronic back pain.

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Destruction via laser surgery, electrosurgery or cryosurgery

Those “spots” the doctor wants to remove from your forehead? Destruction means the removal of benign, premalignant or malignant tissues by any method that requires local anesthesia but no closure such as stitches. Methods include electrosurgery, freezing with liquid nitrogen and laser treatment of precancerous spots on the skin, common warts, plantar warts, papules or nodules on the skin, lesions from herpes and other problems.


Debridement of nail, any method

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Debridement means reducing the thickness and length of a diseased toenail or nail infected by a fungus. It can be done by hand or with an electrical burr. It is performed when the pain is so severe it prevents the patient from walking.


Destruction, by any method, with or without surgical curette

Ditto above for “destruction.” “Any method” can include injection of drugs to destroy a lesion. A curette can also be used to cut or scrape away lesions.


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Endoscopy of the upper gastrointestinal tract, including esophagus

An upper gastrointestinal endoscopy enables a doctor, using a thin, flexible instrument called an endoscope that is slid down the patient’s throat, to examine the lining of the esophagus, stomach and part of the small intestine for ulcers, tumors, infection or bleeding. The scope can also be used to take tissue samples for biopsy and to remove polyps.


Diagnostic flexible colonoscopy and colonoscopy to near splenic fixture

The procedure Katie Couric made famous: doctors use a flexible, lighted tube, or colonoscope, to examine the rectum and colon for tissue abnormalities such as polyps or cancer.


Removal of impacted cerumen

Simply put, this means removing clogs of hardened ear wax by scraping or by blasting it out with warm water.


Injection of a single tendon sheath or ligament

Injecting a local anesthetic or corticosteriod is often done to relieve pain from issues such as carpal tunnel syndrome or some types of cysts. The joint treated could be the elbow, knee, foot, shoulder, wrist, toe or finger.


Injection of triamcinolone acetonide

Injections of the medication, a corticosteroid hormone, may be made into muscle, skin lesions or joints to treat collagen and skin diseases, allergic disorders, some cancers, arthritis and other problems.


Injection of methylprednisolone acetate

Also a corticosteroid hormone, this medication is used to reduce joint pain and swelling from arthritis. It is also used to treat allergic reactions, blood diseases, breathing problems, certain cancers, eye diseases, intestinal disorders and skin diseases.


Trimming of nondystrophic nails

Trimming of healthy nails is performed for people with conditions such as diabetes, peripheral neuropathy or arteriosclerosis of the extremities when it is no longer safe for the patients to care for them personally.


Transforminal injection of anesthetic and/or steroid

A transforminal steroid injection is a shot of local anesthetic (such as lidocaine) and a steroid (such as cortisone) in the space around an irritated nerve root to relieve pain and swelling, most often in the lower back.


Extracapsular cataract removal with insertion of intraocular lens

You know it as cataract surgery, the common procedure of removing the cloudy lens of an eye and replacing it with an artificial intraocular lens implant.


Paring or cutting of benign hyperkeratotic lesion

This is the routine removal and/or trimming of corns and calluses on the foot, usually due to conditions such as diabetes.


Biopsy of skin, tissue under the skin or mucous membrane

Removal of live tissue for examination and diagnosis, usually for skin cancers.


Intravitreal injection of pharmacologic agent

Common in ophthalmology, this means injection of medicines to treat eye problems such as infection or inflammation, necrosis of the retina, age-related macular degeneration, cysts in the retina, damage to the retina from diabetes, inflammation of the middle layer of the eye, blood clots and detached retinas.


Diagnostic nasal endoscopy

The procedure uses a slender telescope, passed through the nostrils, to examine the nasal passages and the sinuses. It helps to determine the effects of severe allergies, immune deficiencies, disorders that affect mucous membranes and cilia, and other issues.



The procedure allows a doctor, using a specialized endoscope called a cystourethroscope, to examine and biopsy the inside of a bladder and urethra. Your doctor may perform one if you have blood in your urine, incontinence, tumors or an enlarged prostate gland.

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