Comprehensive and Innovative
Surgical Care for Northern Virginia

Our office is adjacent to Inova Loudoun Hospital and is equipped to perform minor excisions and procedures. Hospital in-patient care is at Inova Loudoun Hospital with outpatient surgery performed at Inova Loudoun Hospital, Inova Surgery Center Lansdowne.

Surgeons:  C. Bernard Cross, MD, FACS | James A. Lesniewski, MD, FACS | Virginia P. MadeyMD, FACS

Inpatient and Outpatient Services and Procedures

robotic surgeryNote: Some procedures link are on
our site and some are external links.

* on our site

Robotic Assisted Laparoscopic Surgery

Gallbladder Removal
  Classical Four port Technique
  Single-Site:  One small umbilical incision
Hernia Repair
  Hiatal Hernia (often combined with anti-
  reflux surgery)
Anti-reflux Surgery-Nissen fundoplication
Stomach Surgery
Colon Resection for Colon Cancer and Diverticulitis

Laparoscopic Surgery

Gallbladder Removal *
Inguinal Hernia Repair *
Ventral Hernia Repair *
Diagnostic Laparoscopy (brochure*)
Bowel Surgery
Hiatal Hernia Repair
Anti-reflux Surgery (brochure*)
Splenectomy (brochure*)

Vascular Surgery

Peripheral Arterial Obstruction causing leg pain or ulcers
Abdominal and Peripheral Aneurysms
Carotid Artery Disease
Venous Stasis Ulcers (YouTube Video)
Diabetic Foot Ulcers
Dialysis Access Procedures *
Long Term Venous Access for Chemo / Antibotics

Thoracic Surgery

Lung Lesions and Cancer
Chest Wall Surgery
Chest Tube Placement
Thoracoscopy-Pleurodesis   ( Brochure)



General Surgery

Adrenal Tumors
Anal Fissures
Fistula in ano
Appendectomy (brochure)
Colon Adenocarcinoma
Colon and Rectal Tumors, Colon Resection *
Hernias, (Adult and Pediatric)
Umbilical Hernia
Evaluation of Abdominal Pain
Multiple Trauma 
Rectal Bleeding
Skin Cancer/Melanomas
Thyroid Nodules
Thyroid Goiter
Thyroid Cancer
Pilonidal Abcess
Pancreatic Cancer
Stomach Tumors
Parathyroid physiology
ParaThyroid Cancer
Minimally Invasive ParaThyroidectomy
Thyroid FNA Biopsy

Breast Surgery

Comprehensive Breast Care *
    *Maintaining Good Breast Health
Breast Biopsy Options *
     *Mammotome EX Breast Biopsy
     *Core Needle Breast Biopsy
     *Ultrasound Guided Biopsy
     *Breast Cyst Vacuum Assisted Biopsy
Breast Cancer Diagnosis *
    *Breast Cyst Aspiration
Breast Surgery *
     *Lumpectomy for Breast Cancer
     *Types of Mastectomy to Treat Breast         Cancer
     *Preventive Mastectomy
     *Partial Mastectomy
     *Modified radical mastectomy








     Back to top

    Office Procedures

1. Excision skin lesions, suspicious moles, skin cancers

Skin lesions should be considered for removal for symptoms of pain, bleeding, increasing size, history of infection, change in color or margins and for anxiety of possible skin cancer. Some risks include possible bleeding, bruising, infection, scar formation, wound separation, chronic pain or numbness, changes around the incision, anesthesia, and need for reoperative surgery for wider excision of cancer, drainage of infection or control of bleeding.

2. Excision cysts, skin masses, lipomas

Skin Mass: We all have lumps and bumps in our body. The typical reasons to consider surgery for removal include masses that are enlarging, painful, history of infection, hard nodules, rapid appearance of multiple lesions, and anxiety relief. Most small lesions that are superficial can be removed in the office under local anesthesia. Larger masses or deep lesions under fascia or muscle will require surgery in the operating room with either sedation and local anesthesia, or general anesthesia for both patient comfort and safety of resection in an adequate manner. Anxious patients or young children are often scheduled also in the operating room. Risks discussed include bleeding, hematoma, infection, scar formation, numbness and tingling around incisions, recurrence of lesions, anesthesia, and follow up procedures. All specimens are evaluated by pathology and we will call with the result or discuss in the office on return for a postoperative visit as necessary.

3. Drainage of skin abscess, cyst infections and direction of follow up wound care

Cyst Infection / Skin Abscess: Minor infections can on occasion be treated with antibiotic therapy alone. If successful the decision follows to monitor or schedule for an excision of the site to decrease risk of recurrence. For more severe infections an urgent excision and drainage/debridement is needed under local anesthesia in the office vs. outpatient with general anesthesia for severe deep or large infections. Wounds are then left open to heal by secondary intention (from inside out) by cleaning with quips' or packing with gauze to keep skin open till the inside heals and fills in the empty space occupied by the infection. Again the decision for excision in the future to decrease risk of reoccurrence is an option. Cyst infection can reoccur and unfortunately patients can get infection in cysts elsewhere. Risk for drainage include chronic pain or numbness around the incision, scar formation, anesthesia, persistent infection, need for repeat drainage should skin heal too quickly, bleeding and recurrent cyst infection.

    Ultrasound Guided Needle Biopsies

1. Breast Lumps
2. Thyroid Nodules
3. Lymph Nodes
4. Soft Tissue Masses

    Local Anesthesia

Office local anesthesia works very well for small skin lesions, superficial masses and for deeper needle biopsy techniques. Many patients worry much more than they need to and are surprised it was not as uncomfortable as they were anticipating. We use a very tiny needle to inject the area and a buffered solution of local anesthesia know as "Sting Free". Injecting "Sting Free" there is a slight burn feeling, but much less than older solution. Patients with active infection / inflammation will experience more pain due to the underlying infection. Anesthesia at the hospital or surgery center will be recommended for large skin lesions, melanoma, masses that are large or deep or near vital structures. Anxious patients or young children are often scheduled also in the operating room.

     Back to top



Surgical Specialists of Northern Virginia

Breast Care Consultants of Northern Virginia




office hours