A variety of surgeries are performed daily including general, laparoscopic minimally invasive, vein, obstetric, gynecological, orthopedic, podiatry, ENT and urological procedures. All surgeons provide evaluations, consultations and follow-up with their patients. If you need us, we will be here to care for you and your family.
Tri-County Health Care's talented and professional surgical staff is complete with Certified Registered Nurse Anesthetists and surgical nurses who are available for surgery 24-hours-a-day, seven-days-a-week.
Meet our dedicated providers below:
David Kloss, M.D., FACS
Thomas Van Bruggen, M.D., FACS
Dr. Thomas Van Bruggen, M.D.
Patient-centered surgical care. The only way we know how to do it.
Experienced, dedicated and ready to provide you with the care you need close to home, below is a comprehensive list of procedures performed at Tri-County Health Care each year:
- Laparoscopic (Inguinal/Incisional/Ventral/Abdominal)
- Breast Biopsy, Minimally Invasive
- Sentinel Lymph Node Evaluation
- Axillary Lymph Node Dissection
- Thyroid Surgery
- Fine-Needle Aspiration Thyroid Biopsy
- Lesions/Masses with or without skin grafting
- Laparoscopic Cholecystectomy
- Open Cholecystectomy
- Open & Laparoscopic Liver Biopsy
- Evaluation for GastroEsophageal Reflux Disease (GERD)
- Open & Laparoscopic Nissen Fundoplication
- Cesarean Section
- Open & Laparoscopic Hysterectomy
- Open & Laparoscopic Ovarian Procedures
- Open & Laparoscopic Sterilizations
- Dilation and Curettage
- Endometrial Ablation Procedures
- Bladder Slings
- Cystocele Enterocele Repair
Gastrointestinal & Colorectal Surgery
- Open & Laparoscopic Gastrointestinal Resections
- Repair of Perforated Gastric Ulcers
- Repair of Perforated Bowel
- Open & Laparoscopic Colon Resections
- Abdominoperineal Resections (APR)
- Laparoscopic & Open Appendectomy
- Ano-Rectal procedures
- Fissures and Fistulas
- Pilonidal Cystectomy
- Upper Gastrointestinal Endoscopy
- Removal of Foreign Body of Esophagus
- Tonsillectomy & Adenoidectomy
- Cauterization of Post Op T/A Bleeding
- Incision & Drainage of Peritonsillar Abscess
- Pressure Equalization (PE) Tubes
- Percutaneous Endoscopic Gastrostomy (PEG)
- Gastrostomy Tubes
- Jejunostomy Tubes
- Wound Management/Debridement
- Minor and Major Limb Amputations (lower extremity)
- Complex Laceration Repairs
Venous Disease Management
- Varicose Vein Procedures
- EndoVenous Ablation Procedures
- Chest Tube Thoracostomy
Cardiac Pacemaker Insertion & Generator Changes
Surgical procedures are also performed at Tri-County by Orthopedists, Podiatrists, Urologists & ENT Specialists.
Visiting Surgical Specialists
Ears, Nose, Throat
Kurtis Waters, MD
Riverstone Professional Centre, Baxter
Harold Rodenbiker, MD
Fercho Eye Care, Fargo, ND
Benjamin Robertson, MD
Northern Orthopedics, Brainerd
Paul Thompson, MD
Northern Orthopedics, Brainerd
Greg Smith, MD
Fergus Falls Medical Group, Fergus Falls
James Andrews, MD
Heartland Orthopedic Specialists, Alexandria
Kevin McCann, DPM
St. Cloud Orthopedics, Sartell
Todd Greatens, MD
Internal Medicine and Pulmonology, Brainerd
Greg Parries, MD
Adult and Pediatric Urology, St. Cloud
Anesthesia services at Tri-County Health Care are provided by three certified registered nurse anesthetists (CRNAs), and coverage is provided for all scheduled procedures and a 24-hour on-call basis. Anesthesia care is provided to patients of all ages, from newborns to seniors. Surgical anesthesia services include general, spinal and epidural anesthesia; various regional blocks as well as monitored anesthesia care (MAC sedation).
In addition to surgical anesthesia, CRNAs provide:
- Resuscitation care in trauma and cardiac/respiratory codes
- MAC sedation for MRI/CT scans as needed (e.g., in case of claustrophobia)
- MAC sedation/analgesia for selected ER procedures (e.g., in pediatrics and dislocated joints)
- MAC sedation for upper GI endoscopy and colonoscopy
- Epidurals/Intrathecals for labor and delivery
- PICC Lines
- Consultative services for pain management
- Regional blocks for orthopedic cases
- IV starts
Anesthesia care is provided in a safe and modern environment with state-of-the-art anesthesia machines and monitors. The newer BIS monitor is also available for monitoring the depth of anesthesia to assist in preventing recall under anesthesia. Each CRNA is certified bi-annually by the Council on Recertification of Nurse Anesthetists and maintains certification in adult and pediatric advanced cardiac life support and neonatal resuscitation.
Meet Our Dedicated Staff:
Wendy Gravelle, CRNA
Joe Kreklau, CRNA
Keith Nelson, CRNA
Rachael Spear, CRNA
At Tri-County Health Care, we want to make your surgery event pleasant and worry-free as possible. Our staff is always here to answer your questions or concerns about your upcoming surgery. It is our hope that during the time you spend with us, you will sense our promise to provide the best possible care for you and your loved ones.
Call your insurance company for questions regarding your coverage. The phone number can be found on the back of your insurance card. If further assistance is needed, our prior authorization staff will be available to assist you.
Eating Before Surgery
The night before your surgery, eat a light (i.e. soup, toast or Jell-o) supper unless you have been told otherwise. Do not smoke, chew gum, eat or drink anything including coffee after midnight unless your nurse or doctor told you it was okay.
A nurse from the surgery department will call you prior to your surgery to review your medications and instruct you on which medications to TAKE the morning of your procedure and which medications to HOLD until after your procedure. Medications should be taken with a small sip of water. Do not take any ACE inhibitors, oral diabetics, herbal medications or vitamins. If you are on any anticoagulants, such as Warfarin/Coumadin, or taking any insulin, please follow your physician's recommendations for morning dosing. Please bring with you all current medicine bottles including insulin, accucheck machine, inhalers, vitamins, herbals and over-the-counter medications.
Take a shower or bath the night before or the morning of surgery with an antibacterial soap (Dial). Please do not apply lotions, powders or oils to your skin. Remove all colored nail polish, hairpins and jewelry. Pack lightly and wear loose-fitting, comfortable clothing.
What should I bring to the hospital?
All current medicine bottles including insulin, accucheck machine and inhalers, vitamins, herbals, and over-the-counter medications. If you wear contact lenses, bring their storage case. If you use items like a cane, crutches, a walker, wheelchair, C-PAP machine, or hearing aids, please bring them with you. You should also bring your Insurance cards and any Medicare/Medicaid numbers. Also, please inform us if you have completed an Advanced Medical Directive or "5 Wishes" documentation.
Please do not bring valuables such as jewelry, credit cards, checkbooks, excess clothing or more than $5 to the hospital with you. If any problems arise prior to your arrival for surgery, please call 218-631-7581 or 218-631-3510 and ask for the Surgery Department.
Day of Surgery
Tri-County Health Care is located at 415 Jefferson Street North in Wadena. You may park in the south parking lot. Valet service is available Monday-Friday from 9 a.m. - 4 p.m.
If weather prevents travel, please call 218-631-7557 or 218-631-3510 to postpone surgery.
What if I don't feel good?
If you become sick or don't feel well, such as a cold, fever, cough, runny nose, sore throat or vomiting the day before your surgery, please call 218-631-7557 or 218-631-3510. For your safety, it may be necessary to postpone your surgery.
What to Expect
Before surgery you will change into a patient gown and robe since the operating room is a germ-free area. You will be given a name band for your wrist, and information on what to expect during surgery. For patient safety, you will be asked to verify your name and date of birth before receiving medications or having procedures. Staff will also ask many questions about your health history.
Before surgery you will:
- Go to the restroom.
- Remove all dentures, partials or plates.
- Remove hearing aids, wigs, hairpieces, hair clips, man-made limbs, contact lenses, glasses and jewelry including body piercings.
Once in the Operating Room, you will be awake long enough to meet the Operating Room staff and visit with staff that will be caring for you. A staff member will wash your skin with special soap and may shave the skin. This is to prevent infection from the many germs in hair and skin.
Family & Friends
A close friend or family member may stay with you until you are taken to the Operating Room. Your family will be told the likely length of the waiting time. During surgery, your family is encouraged to wait in your private room until your surgeon talks to them post operatively. Please have them inform the nursing staff if they leave. Your doctor will want to find them and visit with them after your surgery.
There are several types of anesthesia to stop pain and feeling during surgery. Anesthesia staff and your surgeon will help you decide which type of anesthesia is best for you. The anesthesia staff will administer your anesthesia and remain at your side during surgery. Other staff, such as nurses and technicians, will be present during surgery to assist the surgeon.
Once surgery is done, you will be taken to the Recovery Room to be watched closely by specially trained nurses. Nurses will monitor your blood pressure, heart rate, breathing, and pain level until you are fully awake. Your family will be waiting for you in your room. After surgery, your mouth may feel very dry, but you will not be given any water until you are more awake or until your doctor orders it. Warm blankets will be available if you feel cool after surgery.
The area of your surgery, called an "incision" may hurt, which is normal after surgery. In order to keep you comfortable, your nurse will ask you often about your pain. Please tell your nurse if you are uncomfortable. Non-drug comfort measures and pain medication will be given as soon as possible. Depending on the procedure, you can expect to be discharged when discharge criteria are met. Your nurse will keep you and your support persons informed of your discharge plans. You will need to make arrangements for transportation home since you will not be allowed to drive. You will also need to make arrangements for a responsible adult to care for you at discharge.
At any time if you have questions or concerns regarding your surgery, please call 218-631-7557 or 218-631-3510.