Endoscopy

  • Esophago-gastro-duodenoscopy (EGD) including biopsy
  • Sigmoidoscopy with biopsy and polypectomy
  • Colonoscopy with/without biopsy or polypectomy including colonic dilatation and placement of stent
  • Percutaneous endoscopic gastrostomy (PEG)

General Surgery

Vascular access procedures

  • Insertion and management of central venous catheter, pumps and ports – elective

Alimentary tract procedures

  • Gastric procedures excluding bariatric surgery
  • Bowel procedures including biopsy; enterolysis; small bowel, diverticulectomy; appendectomy
  • Procedures on the anus and rectum including hemorrhoidectomy; rectal prolapse procedures; anoplasty, anal fissures, fistula and abscess incision/drainage

Abdominal and pelvic procedures

  • Basic laparoscopic procedures, including appendectomy, cholecystectomy, bile duct, closure of intestinal perforations; biopsy; and hernia repair
  • Biliary tract surgery including cholecystectomy and common duct exploration
  • Drainage intra-abdominal abscess
  • Fine needle aspiration
  • Incidental drainage of abscess of genitalia
  • Incidental Hydrocelectomy
  • Drainage pancreatic abscess
  • Abdominal wall hernia repair/abdominoplasty
  • Retroperitoneal pelvic node dissection
  • Repair of diaphragmatic hiatal hernia
  • Inguinal hernia repair
  • Skin biopsy, excision, soft tissue repair, treatment of burns, muscle biopsy and graft placement
  • Lymphatic excisions including cervical, supraclavicular, axillary, retroperitoneal and extremities

Additional thoracic procedures available to the general surgeon

  • Insertion of chest tubes 

Privilege Cluster: Breast Disease and Surgical Privileges

  • Lymph node dissection
  • Major lymphadenectomy
  • Sentinel node biopsy
  • Breast biopsies, including stereotactic core breast biopsy, percutaneous core biopsy
  • Duct excision
  • Simple (total) mastectomy, subcutaneous mastectomy, skin-sparing mastectomy, modified radical and radical mastectomy
  • Ultrasound guided breast procedures including placement of localizing wires, clips, and irradiation catheters

Orthopaedic Surgery

  • Non-complex (i.e. digital) amputation surgery including immediate prosthetic fitting in the operating room
  • Arthrocentis and joint injection
  • Arthrography
  • Arthrodesis, osteotomy (non-spine)
  • Bone grafts and allografts
  • Acute and secondary muscle and tendon repair including tendon grafts
  • Ligament reconstruction versus repair
  • Tenotomy/tendonitis
  • Debridement, excision and biopsy of soft tissue and bony masses or lesions related to a musculoskeletal lesion; open or closed
  • Management of infectious and inflammations of bones, joints and tendon sheaths
  • Incision and drainage of infection and mass
  • Open and closed reduction and internal/external fixation of fractures and dislocations of the skeleon including use of instrumentation
  • Reconstruction of nonspinal congenital musculoskeletal anomalies
  • Diagnostic and therapeutic arthrosopy (excluding small joints and wrist)
  • Arthroplasty excluding total joint replacement
  • Metastatic malignancy and benign lesion of the bone including resection
  • Use of radiofrequency ablation for coagulation or ablation of metastatic lesions in the bone in a procedural area where concurrent operative privileges are held
  • Endoscopic intervention in a procedural area where the applicant is an existing privilege holder
  • Hand surgery procedures including repair of lacerations; superficial/deep infection; digital tip injuries; skin grafts; amputations; trigger finger (DeQuervain’s disease); carpal tunnel decompression; fractured metacarpals, phalanges and wrist; ganglion (palm or wrist, flexor sheath); arthodesis (metacarpophalangeal, interphalangeal)
  • Arthroplasty of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints
  • Ligament reconstruction versus repair of hand and wrist
  • Small joint and wrist diagnostic and therapeutic arthroscopy
  • Tendon transfer
  • Nerve repair verses nerve transfer
  • Cubital tunnel release
  • Soft tissue procedures including transposition or flap of the upper extremity

Musculoskeletal Oncology Privileges

  • Primary bone tumor and soft tissue resection
  • Surgically address tumors of the hand

Joint Replacement and Revision

  • Shoulder
  • Hip
  • Knee

Podiatry

  • Soft tissue surgery involving a nail or plantar wart excision, avulsion of toenail, excision or destruction of nail matrix, removal of foreign body
  • Onychoplasty
  • Debridement of ulcer
  • Excision of soft tissue mass (neuroma, ganglion, fibroma)
  • Digital surgery including digital exostectomy; digital fusions; tenotomy/capsulotomy; open/closed reduction of digital fracture; simple digital amputation, syndactylization and polydactylism; digital tendon transfers, lengthening, repair
  • Metatarsal surgery including open/closed reduction of fractures; metatarsal exostectomy; metatarsal osteotomy
  • Excision of sesamoids
  • Tenotomy/capsulotomy, metatarsal, phalangeal joint
  • Hallux valgus repair with or without metatarsal osteotomy (including 1st metatarsal cuneiform joint)
  • Midtarsal and tarsal exostectomy (include posterior calc spur)
  • Excision of benign bone cysts and bone tumors, forefoot
  • Plantar fasciotomy with or without excision of calc spur
  • Neurolysis of forefoot nerves
  • Treatment of deep wound infections, osteomyelitis
  • Metatarsal excision
  • Implant arthroplasty forefoot
  • Neurolysis or nerve decompression, rearfoot
  • Open/closed reduction of foot fracture other than digital or metatarsal excluding calcaneal
  • Skin graft
  • Excision of benign bone cyst or bone tumors, rearfoot
  • Tarsal coalition repair; Tendon lengthening; Tendon rupture repair
  • Excision of accessory ossicles, midfoot and rearfoot
  • Tenodesis
  • Osteotomies of the midfoot and rearfoot
  • Tendon transfers
  • Rearfoot fusion
  • Endoscopic plantar fasciotomy
  • Arthrotomy
  • ORIF and closed reduction of rearfoot and calcaneal fractures
  • External fixation (multiplane) confined to the foot

Ankle procedures

  • Treatment  of fractures  with or without instrumentation
  • Tendon and ligament repair
  • Diagnostic arthroscopy
  • Therapeutic arthroscopy including debridement and soft tissue repair

Urology

Ureteral Procedures

  • Ureteroscopy; flexible and rigid – including stone manipulation, biopsy and excision

Bladder Procedures

  • Percutaneous and cystourethroscopic bladder procedures
  • Incontinence surgery with or without prosthesis including mesh, collagen and implant
  • Neuromodulation for bladder control (InterStim)
  • Cystocele repair

Urethral Procedures

  • Urethrotomy, urethrectomy, urethral diverticulectomy
  • Urethropexy, open and endoscopic suspension
  • Repair of hypospadias; distal
  • Biopsies or fulguration of urethral lesions, including prolapsed caruncles, skenes

Prostate Procedures

  • Prostate biopsy
  • Transurethral lifting or repositioning of the prostate

Genital Surgery

  • Impotency surgery; revascularizations and prosthesis
  • Performance of circumcision, dorsal slit
  • Repair of Peyronie’s Disease/Chordee
  • Priapism surgery; all revascularization and shunts
  • Surgery of the scrotum including orchiectomy; orchiopexy; excision of hydrocele or spermatocele; reduction of torsion; epididymectomy; vasovasostomy; varicocelectomy; testis biopsy; vasectomy; drainage of abscess and inguinal hernia repair

Miscellaneous Procedures

  • Basic diagnostic laparoscopy including pelvic lymphatic dissection; incidental biopsy and tissue removal

Urogynecology Privileges

  • Sacrocolpopexy
  • Enterocele, perineoplasty and vaginal vault repair