In Office Procedures

In Office Procedures

At Midland Surgical Associates, we are able to perform several basic, minimally invasive, outpatient procedures in the comfort of our office setting. Below are some of the procedures that we conduct for our patients:


A Mammotome is a device used to assist in a breast biopsy, an outpatient procedure done with a local anesthetic and the assistance of ultrasound. The incision is usually small and does not require stitches or a long recovery time. The procedure determines if cancer cells are present or if a mass in the breast is benign.


After a cancerous tumor has been removed from the breast in a lumpectomy procedure, some patients may be candidates for this procedure, which reduces the length of radiation treatment to ensure that all cancerous tissue is gone.

In the procedure, a MammoSite balloon is attached to a catheter and placed inside the lumpectomy cavity through a small incision. The balloon is then filled with saline and remains inflated during a five-day treatment of radiation. The catheter is attached to a device, and a radiation oncologist distributes the radiation during each treatment. The catheter remains in place for the five days and is removed when the radiation regimen is complete.

Radiofrequency Ablation (RFA)

Radiofrequency ablation is a procedure used to treat varicose veins using heat from a catheter placed inside the diseased vein. Using ultrasound for guidance, a RF catheter is inserted into the vein and treats the vessel with heat, which causes the vein to close. RFA treats the greater saphenous, lesser saphenous, and perforator veins. These procedures are minimally invasive and have very short recovery time.


Sclerotherapy is a cosmetic procedure for spider veins. The vein is injected with a sclerosing agent, which causes the vein to close. The patient then wears compression stockings or bandages for a few weeks, during which the spider veins gradually disappear.

Rubber Band Ligation

This in-office procedure treats second-degree internal hemorrhoids. A small band is placed on the base of the hemorrhoid to stop the blood supply, and the hemorrhoid shrinks over the next few days. Recovery time and post-procedure pain are less than with traditional surgery for this type of hemorrhoid.

Colonoscopy / Sigmoidoscopy

Both a colonoscopy and sigmoidoscopy are minimally invasive examinations of the large intestine from the rectum. A sigmoidoscopy examines up to the sigmoid (the most distal part of the colon), while a colonoscopy examines the entire colon. These are both good tests to have as preventive care or to find suspected disease. They can determine, for example, if there are polyps or cancerous tissue.

Shaves and Biopsies

For some growths on the skin, “shaves” and “curettes” are used to aid in diagnosis and treatment. These tools are used for quick removal of the growths in the office. The shaves and curettage biopsies are sent to a pathologist to determine if any disease is present.

A superficial layer of skin is removed using a scalpel or a round blade called a “curette.” The wound results in a scab but heals on its own within one to two weeks.

Other Skin Problems 

Lumps and other types of benign skin tumors can often be removed through excision in our office. Wide excision and minimal excision are in-office procedures that are routinely performed by Midland Surgical Associates. They are simple and require a minimal dressing for about a week.

Wound Care

Debridement: This process involves the removal of damaged or infected tissue to help promote healing of the remaining healthy tissue surrounding the wound.

ACell: This is a type of medicine that helps develop and grow human tissue. When tissue is lost, this technology helps to regenerate skin and other tissues for better healing.