General Surgery at Arch Bariatrics, St Louis

At Arch Bariatrics our surgeon Dr.Kumaran Chinnappan is board certified and fellowship trained in laparoscopic and bariatric surgery and offers patients the surgical knowledge, expertise and compassion that come with his advanced training and many years in practice.

Dr.Kumaran Chinnappan performs a variety of laparoscopic general surgeries including procedures for:

Gallbladder Disease/Stones


Abdominal Hernias

Surgery for Gallbladder Diseases:

The gallbladder is a small pear-shaped pouch situated under the liver in the upper right part of the abdomen. It stores bile (a liquid produced by the liver) and then releases it into the intestine to help digestion.

Gallstones are small, hard stones that can sometimes develop in the gallbladder. They can result in a blockage of the flow of bile out of the gallbladder, resulting in symptoms including pain, jaundice (yellowed skin) and fever. The body can function well without a gallbladder, and removing it is a common treatment for gallstones that cause symptoms.

Sometimes the gallbladder can cause similar symptoms even without the presence of stones due to Biliary Dyskinesia (Lazy Gallbladder). Even in such situations removal of the gallbladder is advised.

Cholecystectomy – Gallbladder Removal

Laparoscopic cholecystectomy – the removal of the gallbladder with very small incisions— is one of the most commonly performed surgical procedures in the United States. Most times it is an outpatient procedure and the patient can go home the same day.

A traditional laparoscopic cholecystectomy uses approximately four small incisions to extract the gallbladder. In most cases, the surgery is well tolerated and the patient is discharged home the same day. Although there are many advantages to performing the procedure laparoscopically, the procedure may not be appropriate for some patients who have had previous upper abdominal surgery or who have some pre-existing medical conditions.

Dr.Kumaran Chinnappan will perform a complete evaluation to determine whether laparoscopic gallbladder removal is an appropriate procedure for you.

Acid Reflex Disease: Surgery for Reflux Disease/GERD

What is GERD?

Gastroesophageal reflux disease, known as GERD, occurs when the acid “backs up” from the stomach into the esophagus. The burning sensation in your chest – is actually a symptom of reflux disease. The feeling may go down into the abdomen or up into the throat and neck. Other symptoms of GERD include vomiting or regurgitation, difficulty swallowing and chronic coughing or wheezing.

What causes GERD?

When we eat, food travels from your mouth to your stomach through your esophagus. At the lower end of the esophagus is a small ring of muscle called the lower esophageal sphincter (LES). The LES acts like a one-way valve, allowing food to pass into the stomach. Normally, the LES closes immediately after swallowing to prevent your acidic stomach juices from backing up into the esophagus. GERD occurs when the LES does not function properly, allowing acid to flow back and burn the lower esophagus. This irritates and inflames the esophagus, causing heartburn and eventually may damage the esophagus.

Some people are born with a naturally weak sphincter (LES). For others, however, fatty and spicy foods, certain types of medication, smoking, drinking alcohol or changes in body position (bending over or lying down) and obesity may cause the LES to relax, causing reflux. A hiatal hernia is found in many patients who suffer from GERD. This refers to the condition in which the top part of the stomach bulges above the diaphragm and into the chest cavity. This phenomenon is thought to contribute to the development of acid reflux.

How is GERD treated?

When symptoms are first noted, simple changes in diet and over-the-counter antacids can reduce how often and how harsh your symptoms are. Losing weight, reducing or eliminating smoking and alcohol consumption, and altering eating and sleeping patterns can also help. 

If symptoms persist after these lifestyle changes, drug therapy may be required. Antacids neutralize stomach acids and over-the-counter medications reduce the amount of stomach acid produced. Both may be effective in relieving symptoms. Prescription drugs may be more effective in healing irritation of the esophagus and relieving symptoms. This therapy needs to be discussed with your primary care provider and your surgeon

Surgical treatment of GERD

Patients who continue to suffer with symptoms despite lifestyle changes and medications or those who are concerned with a lifetime of medication and its potential side effects, may consider minimally invasive surgical treatment for GERD.

Laparoscopic Nissen fundoplication – This minimally invasive laparoscopic procedure is an anti-reflux surgery that involves fixing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus (like a hot dog in a bun) to reinforce the lower esophageal sphincter.

Laparoscopic Hiatal hernia repair with mesh- Sometimes the same surgery may in addition involve placing an absorbable mesh over the diaphragm for longer term durability of the repair.

Surgical treatment of GERD is a safe and effective option for many patients with proven benefits:

Eliminate the need for heartburn medications

Restore the ability to eat your favorite foods again

Significant percentage of patients remain symptom free 10 years after surgery

Minimally invasive procedures have short recovery times and quick return to work. Typically patients stay 1 night in the hospital.

Please contact us if you need to be evaluated by Dr.Chinnappan for management of your general surgery problems.


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