Clinical and Research Specialties of the Emory Endosurgery Unit

In 1998, when open gastric bypass was still the standard, Emory general surgeons began refining and developing laparoscopic bariatric methods. In 2000, Dr. C. Daniel Smith, director of the Endosurgery Unit from 2001-2006, established the Emory Bariatric Center as a multidisciplinary program that used nutrition and exercise therapy, lifestyle education, pharmacotherapy, liquid meal replacement, and surgery to treat obesity.

The Emory Bariatric Center has since become one of the leading programs of its type in the Southeast and an MBSAQIP Accredited Comprehensive Facility. Current Endosurgery Unit associate program director Dr. Edward Lin directs the center's surgical services, which provide laparoscopic gastric band (lap band) surgery, gastric bypass surgery, sleeve gastrectomy, and post-surgery body contouring.

Surgeons of the Emory Endosurgery Unit have performed hundreds of laparoscopic colorectal operations and have refined such procedures as single-incision laparoscopic surgery for colon cancer.

Unit surgeons can apply laparoscopic techniques to treat such benign and malignant conditions of the colon as bleeding lesions, and can perform simultaneous laparoscopic colon and liver resections for colon cancer with liver metastasis, diverticulitis, inflammatory bowel disease, large pre-cancer polyps, and rectal prolapse. They have also developed minimally invasive methods for colostomy formation, colostomy/ileostomy reversal, hemorrhoid stapling and screening, and diagnostic colonoscopies.

The unit is a primary referral center for the most difficult hernia cases in the region. Our faculty surgeons established the second course in the nation for laparoscopic ventral hernia repair in 1994 and have participated in some of the world's largest multi-institutional studies of laparoscopic ventral hernia repair and inguinal hernia repair. These procedures are now two of the most frequently performed minimally invasive surgeries in the country.

The Endosurgery Unit's foregut program is a leading gastroesophageal disease treatment center. For example, in 2004, Dr. Edward Lin performed the first endoscopic plication for GERD to be done in the nation at Emory University Hospital Midtown.

Unit surgeons have compiled one of the largest foregut laparoscopic procedure and patient outcomes databases in the world; evaluated and developed endoluminal techniques; refined single incision laparoscopic surgery for gall bladder procedures; and regularly perform laparoscopic surgery for GERD, hiatal hernia, achalasia, esophageal tumors, Barrett's esophagus, and redo procedures for failed attempts at operative treatment. The unit also offers such minimally invasive approaches for diagnosing GERD as catheterless/wireless esophageal pH testing.

Laparoscopic nonanatomical resections and peripheral resections of up to two segments of the liver are routinely performed at Emory. Our surgeons also employ laparoscopic techniques to manage liver cysts.

In 2008, Dr. Juan Sarmiento, a specialist in the unit's solid organ program and director of hepaticopancreaticobiliary surgery at Emory University Hospital, implemented a minimally invasive liver surgery program with other unit surgeons and pioneered techniques for laparoscopic-assisted full right hepatectomies involving three-to-four small incisions. Emory surgeons are now nationally recognized for their expertise in this area. Since Emory is a major transplant center, it is also an ideal site for Dr. Sarmiento's additional focus on making laparoscopic living-related liver donation a viable alternative to open organ procurement.

When appropriate, Dr. Sarmiento and other unit surgeons perform such laparoscopic pancreatic resections as distal pancreatectomy. Emory's world-class endocrine service has also benefited from the addition of laparoscopic enucleation of insulinomas to its practice.