Department of General Surgery

In addition to outpatient services, Carilion’s general surgeons provide 24/7 inpatient acute care with Emergency Department coverage and consultation services. Our surgeons collaborate with other specialists to develop a comprehensive treatment plan for each patient.

We believe it is important to treat the whole patient through a multidisciplinary team approach. Our surgeons routinely work with gastroenterology, medical oncology, radiology, endocrinology and medical bariatrics to provide the best care possible. Minimally invasive surgical techniques combined with our enhanced recovery protocols have greatly reduced postoperative pain and lowered our use of opioids.   

Our areas of expertise include: 

Breast Surgery 

Our providers care for both benign and malignant breast disease. Cancer procedures performed by our surgeons include partial mastectomy (breast-conserving surgery), skin-sparing mastectomy, nipple-sparing mastectomy, axillary sentinel node biopsy and axillary dissection. We work closely with our Plastic Surgery colleagues to ensure access to both breast reconstruction after mastectomy, either immediate or delayed as dictated by disease and patient preference, and oncoplastic surgery that combines breast conservation (partial mastectomy) with breast reduction to improve cosmesis after breast cancer treatment. The breast surgeon typically initiates involvement of the other multidisciplinary breast cancer team members, such as medical oncologists, radiation oncologists, plastic surgeons, genetic counselors and radiologists, to coordinate a multidisciplinary breast cancer treatment plan. With the assistance of our nurse navigator and advanced care practitioners, we coordinate care for breast cancer patients from diagnosis through survivorship.  

Our practice also provides care for patients with benign breast disease. We evaluate and offer excisional biopsy for benign breast disease (papilloma, fibroadenoma, radial scar and phyllodes tumors) and treat complicated breast infections such as acute and chronic breast abscess. We also manage and coordinate care for patients at high risk for breast cancer due to family history, genetic predisposition (BRCA or other pathogenic mutation) or high-risk biopsy (ADH, ALH, LCIS). 

Colorectal Surgery 

Our colorectal surgeons cover the full spectrum of colon, rectal and anorectal surgeries. Our surgeons were trained at premier academic colorectal institutions and bring a wealth of knowledge and expertise to the area. We provide minimally invasive and robotic-assisted procedures for abdominal operations, with enhanced recovery protocols to accelerate healing and reduce post-operative pain. We manage colon and rectal adenocarcinoma with the latest treatment regimens as outlined by the National Comprehensive Cancer Network (NCCN) and the American Cancer Society Commission on Cancer (ACS CoC), and we work collaboratively to manage all cancer patients in a multidisciplinary fashion. Our surgeons collaborate with Infectious Diseases physicians to manage high-risk patients with HPV-related anal and perineal dysplasia, offering high-resolution anoscopy for surveillance, management and cancer prevention. In addition, we provide screening, diagnostic and surveillance colonoscopies in the battle for prevention of colon and rectal cancer.   

Our surgeons treat benign conditions of the colon, rectum and anus, including inflammatory bowel disease such as Crohn's disease, ulcerative colitis and indeterminate colitis; diverticulitis and related complications; rectal prolapse; and fecal incontinence. We are experienced in treating anorectal conditions including infections, hemorrhoids and pilonidal disease. Our team of enterostomal therapists works directly with our surgeons to manage colostomy- and ileostomy-related complications. We are involved with local and state agencies, such as the American Cancer Society's Cancer Action Coalition of Virginia, to improve access to colorectal screening for all Virginians. Nationally, we work with the American College of Surgeons and the American Society of Colon and Rectal Surgery to improve education, quality of care and value of care provided to our patients.  

Complex Hernia Repair 

We offer consultations to review hernias and offer surgical repair when appropriate. In our multidisciplinary approach, patients may be referred to other medical teams to optimize care. From routine repairs to complex abdominal wall reconstructions, our surgeons have the training, expertise and resources to address every patient with a hernia and to offer appropriate treatment options to improve our patients' overall abdominal core health. We offer state-of-the-art open, laparoscopic and minimally invasive robotic repairs for ventral hernias, incisional hernias, umbilical hernias, inguinal hernias and flank hernias.  

We are involved in the Americas Hernia Society, an international society for the treatment of hernias. Our most recent advancement is the addition of minimally invasive robotic surgery, particularly for advanced abdominal wall reconstructions, that results in faster recovery times and lower complication risk for patients.  

Robotic and Minimally Invasive Surgery (advanced laparoscopy) 

The Carilion Clinic section of Robotic and Minimally Invasive Surgery is the largest and most diverse area in the Department of Surgery. All of our surgeons are board certified in general surgery and many are subspecialized in other areas, including colorectal, bariatric, minimally invasive surgery and surgical oncology. We perform innovative surgeries with the most advanced robotic and laparoscopic systems available. The use of these technologies results in a quicker recovery with less pain for our patients. The dual console for our robotic platform allows two surgeons to operate simultaneously on complex cancer and hernia patients. Many of these patients in the past would have required open operations.

The procedures we perform laparoscopically or robotically include appendectomy, cholecystectomy and common bile duct explorations; colorectal surgery; splenectomy; adrenalectomy; liver and pancreatic surgery; hiatal hernia and paraesophageal hernia repairs; achalasia surgery; bariatric surgery; small bowel resections; and hernia surgery, including inguinal and sports hernias, ventral, incisional and umbilical hernias. 

Surgical Oncology 

Our team of surgical oncologists is uniquely dedicated to patients with advanced tumors. Our approach to patient care reflects the importance of our multidisciplinary approach, with surgical resection serving as one of several treatment plans that work toward a definitive cure. We treat patients with tumors from one or three main tumor sites: HPB-upper GI tumors, cutaneous-soft tissue tumors and peritoneal carcinomatosis. 

Our team uses robotic or laparoscopic minimally invasive approaches whenever possible to safely excise malignancies. We typically perform major liver and biliary resections, pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, splenectomy and gastrectomy. In addition to wide local excisions, our surgeons are trained to perform sentinel lymph node biopsies as well as complete lymph node dissections of the neck, axilla and inguinofemoral regions. We’re trained in completing limb-sparing musculoskeletal resections as well as multi-organ en-bloc retroperitoneal resections for patients with soft tissue tumors like sarcomas, desmoid tumors, solitary fibrous tumors and paragangliomas. Our surgeons perform cytoreductive surgery to remove all tissue with disease for patients with peritoneal carcinomatosis (mesothelioma) or tumors that are metastatic to the peritoneum from the large bowel, small bowel and appendix. 

Our team includes a dedicated patient clinic navigator as well as an advanced care practitioner. For most of our advanced cancers, our oncologic responsibilities extend well past the curative surgery as we take on long-term disease management and surveillance through our survivorship clinics. Complex surgical oncology is an expanding field that continues to innovate and find novel approaches to caring for cancer patients. We are dedicated to being a part of this change as we push to provide our patients with access to future national clinical trials along with the highest level of specialized care close to home and family.