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Laparoscopy
This surgeon is performing a laparoscopic procedure on a patient. (Photo Researchers, Inc. Reproduced by permission.)

Laparoscopy
The surgeon has a choice of incision options for laparoscopy, depending on the needs of the procedure (A). In this abdominal procedure, carbon dioxide is pumped into the cavity to create a condition called pneumoperitoneum, which allows the surgeon easier access to internal structures. The laparoscope is connected to a video monitor, and special forceps are used to carry out any necessary procedure (C and D) (Illustration by GGS Inc.)

Appendectomy
To remove a diseased appendix, an incision is made in the patient's lower abdomen (A). Layers of muscle and tissue are cut, and large intestine, or colon, is visualized (B). The appendix is located (C), tied, and removed (D). The muscle and tissue layers are stitched (E). (Illustration by GGS Inc.)

Laparotomy, Exploratory
During a laparotomy, and an incision is made into the patient's abdomen (A). Skin and connective tissue called fascia is divided (B). The lining of the abdominal cavity, the peritoneum, is cut, and any exploratory procedures are undertaken (C). To close the incision, the peritoneum, fascia, and skin are stitched (E). (Illustration by GGS Inc.)

Ileostomy
An ileostomy can be placed in different sites on the abdomen (A). Once the incision is made, the ileum is pulled through the incision (B), and a rod is placed under the loop. The loop is cut open, one side is stitched to the abdomen (C). The portion of intestine is flipped open to expose the interior surface (D), and the opposite side is stitched in place (E). (Illustration by GGS Inc.)

Splenectomy
There are two options for accessing the spleen for a splenectomy (A, 1 and 2). After the abdomen is entered, the spleen is located, and the artery leading to it is tied off (B). The ligament connecting the stomach and spleen is cut (C), as is the ligament connecting the spleen and colon (D). This frees the spleen for removal (E). (Illustration by GGS Inc.)

Abdominal Ultrasound
An ultrasound screen shows a patient's kidney. (Photograph by Brownie Harris. The Stock Market. Reproduced by permission.)

Gastrectomy
To remove a portion of the stomach in a gastrectomy, the surgeon gains access to the stomach via an incision in the abdomen. The ligaments connecting the stomach to the spleen and colon are severed (B). The duodenum is clamped and separated from the bottom of the stomach, or pylorus (C). The end of the duodenum will be stitched closed. The stomach itself is clamped, and the portion to be removed is severed (D). The remaining stomach is attached to the jejunum, another portion of the small intestine (E). (Illustration by GGS Inc.)

Hemorrhoidectomy
Hemorrhoids can occur inside the rectum, or at its opening (A). To remove them, the surgeon feeds a gauze swab into the anus and removes it slowly. A hemorrhoid will adhere to the gauze, allowing its exposure (B). The outer layers of skin and tissue are removed (C), and then the hemorrhoid itself (D). The tissues and skin are then repaired (E). (Illustration by GGS Inc.)

Umbilical Hernia Repair
Baby with an umbilical hernia (A). To repair, the hernia is cut open (B), and the contents replaced in the abdomen. Connecting tissues, or fascia, are sutured closed (D), and the skin is repaired (D). (Illustration by GGS Inc.)

Adrenalectomy
To remove the adrenal glands, an incision is made below the patient's ribcage (A). The adrenal gland, which sits on top of the kidney (B), is visualized (C). The vein emerging from the gland is tied off and cut (D), and the adrenal gland is removed (E). (Illustration by GGS Inc.)

Gastrostomy
For a percutaneous endoscopic gastrostomy procedure, the stomach is inflated with air (A). An incision is made into the abdomen and the stomach, and a plastic cannula is inserted (B). A catheter is inserted into the patient's mouth, pulled down the esophagus, and into the stomach (C). When the catheter is in place, access to the stomach is maintained (D). (Illustration by GGS Inc.)

Inguinal Hernia Repair
This patient has an indirect inguinal hernia (A). To repair it, the surgeon makes an incision over the area and separates the muscle and tisses to expose the hernia sac (B). The sac is cut open (C), and the contents are replaced into the abdomen (D). The neck of the hernia sac is tied off (E), and the muscles and tissues are sutured (F). (Illustration by GGS Inc.)

Endotracheal Intubation
The doctor inserts the laryngoscope into the patient's mouth, advancing through the trachea to the vocal cords (A). An endotracheal tube is inserted into the airway (B). The balloon cuff is inflated, and the laryngoscope is removed (C). (Illustration by GGS Inc.)

Pyloroplasty
In a pyloroplasty, an incision is made in the area that connects the stomach to the duodenum (small intestine), called the pylorus (A). The pylorus is divided laterally (B), and then stitched longitudinally (C and D), allowing for a larger connection. (Illustration by GGS Inc.)

Hepatectomy
To remove a portion of the liver, the surgeon enters the patient's abdomen, and frees the affected part of the liver from the connecting tissues (B). The artery to the liver and hepatic duct are disconnected from the liver (C). The diseased part of the liver is cut away, and a cauterizing tool is used to stop the bleeding as the surgeon progresses (D). (Illustration by GGS Inc.)

Incisional Hernia Repair
An incisional hernia occurs at the site of a previous incision (A). Intestinal contents break through the abdominal wall and bubble up under the skin. In a laparoscopic repair, the surgeon uses laparoscopic forceps to pull the material, omentum, from the hernia site (B). A mesh pad is inserted into the site to line the hernia site (C and D), and is tacked into place (E). (Illustration by GGS Inc.)

Small Bowel Resection
To remove a diseased portion of the small intestine, an incision is made into the abdomen, and the area to be treated is pulled out (A). Clamps are placed around the area to be removed and the section is cut (B). Three layers of sutures repair the remaining bowel (C). (Illustration by GGS Inc.)

Gastroduodenostomy
An abdominal incision exposes the stomach and duodenum (small intestine) (A). The duodenum is freed from connecting materials (B), and is clamped and severed. The stomach is also clamped and severed (C). The remaining stomach is then connected to the duodenum with sutures (D and E). (Illustration by GGS Inc.)

Intussusception Reduction
Intussusception of the bowel results in the bowel telescoping onto itself (A and B). An incision is made in the baby's abdomen to expose the bowel (C). If the surgeon cannot manipulate the bowel into a normal shape manually, the area of intussusception wil be removed and remaining bowel sutured together (D). (Illustration by GGS Inc.)

Meckel's Diverticulectomy
During Meckel's diverticulectomy, the abdomen is opened above the area of the diverticulum, which is exposed along with the bowel (A). The diverticulum is clamped off at the base, and then cut off (B). Two layers of stitches are used to repair the bowel (C and D). (Illustration by GGS Inc.)

Abscess Incision and Drainage
This lung abscess is a build-up of fluid near the lung (A). To drain it, the patient is placed on his or her side, and an incision is made (B). A rib is exposed (C) and cut (D). The fluid in the abscess is suctioned (E), and the incision is closed around a temporary drainage tube (F). (Illustration by GGS Inc.)

Gastroesophageal Reflux Surgery
In a laparoscopic surgery to alleviate gastroesophageal reflux, the surgeon makes several incisions to gain access to the stomach and esophagus (A). Using the videoscope, the stomach is visualized (B), and the ligament connecting the stomach to the liver is divided (C). The upper part of the stomach is brought up around the base of the esophagus (D), and stitched into place (E). (Illustration by GGS Inc.)

Rectal Resection
A tumor in the rectum or lower colon can be removed by a rectal resection (A). An incision is made around the patient's anus (B). The tumor is pulled down through the incision (C). An attached area of the colon is also removed (D). The area is repaired, leaving an opening for bowel elimination (E). (Illustration by GGS Inc.)