LOCATION:
21216 Northwest Freeway
Suite 210
Cypress, Texas 77429

TEL: 281-955-8884
FAX: 281-897-9536

OFFICE HOURS:
Monday - Friday
8:00 am - 5:00 pm
American Cancer Society
Reach to Recovery
Susan G. Komen Foundation
National Breast Cancer Foundation
North Cypress Medical Center
Methodist Willowbrook Hospital
Cypress Fairbanks Medical Center
Cy-Fair Surgery Center
American College of Surgeons
Dr. Keller welcomes new patients to his practice. Please call the office number to schedule an appointment. For your convenience, downloadable forms are available by clicking on the link at the top of the page.
 
 

 

Breast Ultrasound
Breast Biopsy
Breast Surgery
Ductoscopy
Cryoablation
Laparoscopic Cholecystectomy

Laparoscopic Appendectomy
Laparoscopic Hernia Repair
Open Hernia Repair
Hemorrhoids
Laparoscopic Colorectal Surgery

 
I perform this test in my office and give you the test results immediately.  The breast ultrasound will help distinguish between solid masses and fluid-filled cysts as well as cancerous lesions. “Echoes” from painless sound waves are converted into a visual image of the interior of your breast.
 
 

Biopsy is a technique for removing cells from a lump and examining them under a microscope to confirm a diagnosis.

Fine needle aspiration biopsy or ultrasound guided core needle biopsy may need to be performed in the office, often the same day of your initial visit, depending on the type of lump you have.

Stereotactic biopsy:  Ultrasound does not replace the need for mammograms on a very early cancer called ductal carcinoma in situ or DCIS.  Often, this is only seen on mammograms as microcalcification.  This requires a core biopsy with mammogram guidance.

Open biopsy is performed when the core biopsy is non diagnostic.  After surgery, a small scar remains, but you’ll have little change in the contour of your breast.

Sentinel node biopsy is a surgical procedure that most breast surgeons use to stage (determine the severity of) certain types of cancer in patients who have been recently diagnosed with cancer. Sentinel node biopsy is most commonly associated with staging breast cancer; however, the procedure is also commonly used to stage malignant melanoma (a type of skin cancer). The sentinel node is the one lymph node that the cancer spreads to first.  If it is negative (no cancer), then you can avoid taking additional lymph nodes unnecessarily.
During the procedure, the surgeon usually removes 1 or 2 sentinel lymph nodes from the underarm of the breast involved with cancer and tests those nodes to determine if cancer cells have spread to them. If cancer cells are found in these lymph nodes, additional lymph nodes can be taken to help determine the prognosis. A sentinel node biopsy is a very important tool to determine what further treatment is necessary to get rid of the breast cancer, as well as what the patient's prognosis is.

 
 

Lumpectomy is a procedure that preserves as much of your breast tissue as possible but removes the cancerous lump and some normal tissue around it.  It is used in conjunction with radiation and also called “wide local excision,” lumpectomy is most often recommended for women with a small cancer that is localized to one area of the breast.

Mastectomy

A modified radical mastectomy removes the breast and axillary lymph nodes.  Because chest muscles are left intact, your chest wall contour and arm strength are not affected and recovery is shorter.
A simple mastectomy leaves axillary lymph nodes intact.
A radical mastectomy removes deep chest muscles.

The choice of the procedure is based on the size of your cancer and whether or not the muscles are involved  Most mastectomy patients can have breast reconstruction, either at the time of surgery or in the future.

 
 

Breast endoscopy with intraductal biopsy is a minimal invasive, non-radiological microendoscopic procedure conducted on an outpatient basis that permits physicians to directly visualize abnormalities in breast tissue, biopsy and diagnose tissue samples and potentially guide surgeons toward maximum breast conservation by identifying precise locations of abnormal tissue.  The procedure is particularly useful in patients presently with abnormal nipple discharge when other standard diagnostic methods, such as physical exam and mammography, have been negative.

Breast endoscopy uses a tiny (0.7 mm in diameter) fiberoptic, flexible endoscope, along with a 0.2 mm working channel that is inserted into the milk duct through the nipple and threaded through the labyrinth of milk ducts deep in the breast.  The procedure generally can be performed with only a topical local anesthetic.

 
 

Cryoablation is a technology that is used to treat benign breast tumors called fibroadenomas by engulfing them in ice.  Cryoablation is done in the comfort of a doctor’s office.  The typical treatment is completed in less than 30 minutes.  A small probe (about the size of a match stick) is inserted into the tumor through a small nick in the skin.  The probe then freezes the tumor causing cell damage and break down, thereby destroying the fibroadenoma and preventing re-growth.

Dr. Kim Keller has been doing all the above procedures for at least five years and some for well over 20 years.  He goes to conferences at least twice a year to keep updated on the newest procedures.

 
 
 
A cholecystectomy is the surgical removal of the gallbladder. Using advanced laparoscopic technology, it is now possible to remove the gallbladder through a tiny incision at the navel. The technique is performed as follows. The patient receives general anesthesia. Then a small incision is made at the navel and a thin tube carrying the video camera is inserted. The surgeon inflates the abdomen with carbon dioxide, a harmless gas, for easier viewing and to provide room for the surgery to be performed. Next, two needle-like instruments are inserted. These instruments serve as tiny hands within the abdomen. They can pick up the gallbladder, move intestines around, and generally assist the surgeon. When the gallbladder is freed, it is then teased out of the tiny navel incision. The entire procedure normally takes 30 to 60 minutes. The three puncture wounds require dissolvable stitches and may leave very slight blemishes. The navel incision is barely visible.
 
 
The laparoscopic (minimally invasive) surgical technique involves making three tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen. The camera projects a magnified image of the area onto a television monitor which helps guide the surgeons as they remove the appendix.
 
 
In laparoscopic hernia surgery, a telescope attached to a camera is inserted through a small incision that is made under the patient's belly button. Two other small cuts are made (each no larger than the diameter of pencil eraser) in the lower abdomen. In most cases the hernia defect is reinforced with a 'mesh' (synthetic material made from the same material that stitches are made from) and secured in position with stitches/staples/titanium tacks or tissue glue, depending on the preference of your individual surgeon.
 
 

In a small number of patients the laparoscopic method is not feasible because of an inability to visualize or manipulate the organs involved. Factors that may increase the possibility of converting to the "open" procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, or bleeding problems during the operation. The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. The decision to convert to an open procedure is strictly based on patient safety.

 
 

Hemorrhoidectomy is a procedure in which the hemorrhoids are removed in a hospital setting using surgical tools, such as a scalpel or cautery (sealing device).  The incision is then closed with sutures.  In some cases, the incision may be left partially open.  This allows fluid to drain and helps the healing process.  There is a stapling procedure that will remove the hemorrhoids without an incision.

Hemorrhoid Banding is done in the office setting with little or no pain.  The banding method is done by placing tight elastic bands around the base of the hemorrhoid.  This cuts off blood supply to the hemorrhoid, causing it to fall off.  This usually takes about a week.  The area then heals within a few days.

 
 
Laparoscopic colon surgery was introduced approximately 12 years ago. Yet, only 3% of all colon resections are performed this way in the United States. Explanations for this may include, surgeon resistance to accepting this procedure as comparable to traditional operations; lack of surgeon experience with minimally invasive techniques; that laparoscopic colon surgery is an advanced procedure that takes a long period of time to master. The surgeon makes about four or five small one-half inch long incisions. A laparoscope (a tiny telescope attached to a video camera) is inserted into one of the openings, allowing the surgeon to see inside the abdomen. Instruments are inserted through the other openings and are used to remove the diseased section of bowel and reattach the healthy segments ('end-to-end anastomosis'). A slightly larger incision is usually made to remove the diseased section of colon from the body. The surgery takes 2 to 3 hours. The patient is frequently out of the operating room more quickly than after an open procedure, and there is no large incision to suture.