Resources

Frequently Asked Questions

Can I go off some of my medications after surgery?

As you lose weight, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have...Read More


How do I get a letter of necessity?

Some insurance requires this type of letter from either your surgeon or primary care provider before final approval for surgery. Many will just accept your surgeon’s consultation summary note. It is best to ask...Read More


Will I have to diet or exercise after the procedure?

No and Yes.

Most people think of a “diet” as a plan that leaves you hungry. That is not...Read More


Will I have to go on a diet before I have surgery?

Yes there is a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps...Read More


If I am self-pay but I have health insurance, will my insurance company pay the cost of post-operative complications?

Complications are often reported under a separate medical billing code. The insurance company may not cover these costs. Appeal is often very helpful, and direct contact with your hospital can make a big difference...Read More


If my insurance company will not pay for the surgery, are payment plans available?

There are loan programs available to cover the cost of health expenses such as metabolic and bariatric surgery. Appeals to insurance companies or directly to your employer may reverse a denial of coverage. Metabolic...Read More


Will I have to take vitamins and minerals after surgery? Will my insurance pay for these?

You will need to take a multivitamin for life. You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least yearly...Read More


Will I lose my hair after bariatric surgery?

Some hair loss is common between 3 and 6 months following surgery. The reasons for this are not totally understood. Even if you take all recommended supplements, hair loss will be noticed until the...Read More


Will I need to have plastic surgery? Does insurance pay for plastic surgery?

Most patients have some loose or sagging skin, but it is often more temporary than expected. You will have a lot of change between 6 and 18 months after surgery. Your individual appearance depends...Read More


When can I get pregnant after metabolic and bariatric surgery? Will the baby be healthy?

Most women are much more fertile after surgery, even with moderate pre-op weight loss. Birth control pills do NOT work as well in heavy patients. Birth control pills are not very reliable during...Read More


Can I have laparoscopic surgery if I have heart disease?

Yes, but you may need medical clearance from your cardiologist. Bariatric surgery leads to improvement in most problems related to heart disease including:
  • High Blood Pressure
  • Cholesterol
  • Lipid problems
  • Heart enlargement (dilated heart, or abnormal thickening)
  • Vascular (artery and vein) and coronary (heart artery) disease
During the screening process, be sure...Read More

Does type 2 diabetes make surgery riskier?

It can. Be sure to follow any instructions from your surgeon about managing your diabetes around the time of surgery. Almost everyone with Type 2 Diabetes sees big improvement or even complete remission after surgery. Some studies have even reported improvement of Type 1 Diabetes after bariatric procedures....Read More

Can I have laparoscopic surgery if I have had other abdominal surgery procedures in the past, or have a hernia, or have a stoma?

The general answer to this is yes. Make sure to tell your surgeon and anesthesiologist about all prior operations, especially those on your abdomen and pelvis. Many of us forget childhood operations. It is...Read More


When can I start exercising again after surgery?

Right away! You will take gentle, short walks even while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do...Read More


How long after metabolic and bariatric surgery will I have to be out from work?

After surgery, most patients return to work in one or two weeks. You may have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Your surgeon will give you clear instructions. Most jobs want...Read More

Are you one of the millions of Americans struggling to lose weight?

You’re not alone! Being overweight can take a heavy toll on your life—did you know that weight-related health problems can take up to 15 years off your life expectancy? Ask yourself what is it that you live for. Seeing your kids grow up? Perhaps seeing your grand kids...Read More


Has the da Vinci Surgical System been cleared by the FDA?

The FDA has approved this system you can view the brief HERE....Read More

Why is it called the da Vinci Surgical System?

The product is called the “da Vinci” after the much famed Italian Renaissance artist and mathematician. His at-the-time unparalleled anatomical accuracy and three-dimensionally detailed paintings brought his masterpieces to life. Similarly, the “da Vinci” Surgical System provides physicians with such enhanced detail and precision that the system can...Read More


Will robotic surgery make a surgeon unnecessary?

Despite the name “robotic surgery” the system is not a self-automated robot, it is a robot-assisted system that relies entirely upon the surgeon.

...Read More

What is Minimally Invasive Surgery (MIS)?

Minimally Invasive Surgery or MIS is a surgery procedure typically performed through tiny incisions or operating ports, rather than large incisions. This type of surgery typically results in potentially shorter recovery times, fewer complications, reduced hospitalization costs and overall reduced trauma to the patient. MIS has become the...Read More


What are the benefits of robotic-assisted surgery using the da Vinci compared against traditional methods of surgery?

The major benefits surgeons whom utilize the “da Vinci” Surgical System encounter as opposed to traditional methods are greater surgical precision, increased range of motion, improved dexterity, enhanced visualization and improved access. The major benefits for patients may include a shorter hospital stay, less pain, less risk of...Read More


When is surgery necessary?

Those with severe, chronic esophageal reflux may need surgery to correct the problem if other medical treatments are not relieving their symptoms. When left untreated, chronic gastroesophageal reflux can cause further complications including esophagitis, esophageal ulcers, bleeding, or scarring of the esophagus.

...Read More

How is anti-reflux treated?

Some patients do not respond well to medications or lifestyle changes while others are not comfortable following an on-going medication regimen. These patients, are candidates for a surgical procedure to correct their GERD symptoms. The most common surgical procedure for GERD is called a Nissen fundoplication, which involves...Read More


What is gastroesophageal reflux?

GERD, or Gastroesophageal reflux disease, is a digestive disorder that affects the muscular ring connecting the esophagus to the stomach, also known as the lower esophageal sphincter. Normally, the sphincter prevents food from creeping up into the esophagus from the stomach.

A patient diagnosed with GERD, presents...Read More


When should an Umbilical hernia be repaired?

In children, most umbilical hernias will go away on their own by age 3 or 4. This is why it may be recommended to wait until your child has reached this age to consider surgical repair. If, however, the defect is greater than 2cm in diameter, it will...Read More


What causes an umbilical hernia?

The abdominal organs are formed on the outside of a baby’s body during their development in the womb. These organs return to the abdominal cavity around the 10th week of gestation. If the wall of the abdomen fails to close around the abdominal organs, an umbilical hernia can...Read More


What are the symptoms of an umbilical hernia?

The most common symptoms associated with umbilical hernia are pain and a bulge. Usually symptoms are stable over time, but often the bulge can become larger or can involve entrapment of internal organs such as intestine. Anyone with a known umbilical hernia who develops persistent nausea and vomiting...Read More


What is an umbilical hernia?

An umbilical hernia is a protrusion, or abnormal bulge, that can be felt or seen over the belly button. This condition develops when a portion of the intestine protrudes through the muscle of the abdominal wall.

Umbilical hernias in children are caused by an opening in the...Read More


What are the risks of having surgery?

Femoral hernia repair has very few risks, however 1% of femoral hernia cases reported a return of their hernia after the operation. Complications of femoral hernia repair are extremely rare, however they can include the development of a lump under the incision site, difficulty passing urine, narrowing of...Read More


How is the surgery performed?

Femoral hernia repair can be performed one of two ways. It can be done through open surgery where one large cut is made in which the lump can be pushed back into the abdomen, or through laparoscopic surgery. This is a less invasive method where several small incisions...Read More


Why is surgery needed?

The operation pushes the bulge back into place and helps to strengthen the abdominal wall. Femoral hernia repair is a necessary procedure, since this type of hernia, if untreated, has a high risk of intestinal strangulation, which is a potentially life-threatening condition where a section of the intestine...Read More


What causes a femoral hernia?

A femoral hernia can occur when fatty tissue or part of an intestine, protrudes through into the groin area at the top of the inner thigh through a weak spot in the surrounding muscle wall of the abdomen and into the femoral canal.

Femoral hernias tend to...Read More


How is incisional hernia repair performed?

The procedure can be done in two different ways, either by a laparoscopic approach or by a conventional open repair. In a laparoscopic incisional herniorrhaphy, small incisions are made and a tube-like camera and instruments are used to place the mesh. In the conventional open repair procedure, the...Read More


How is an incisional hernia treated?

The surgical repair of an incisional hernia is largely dependent on reducing or eliminating the tension present at the surgical site. The method that is preferred by most hernia surgeons is a tension-free method and is used by most medical centers. This procedure involves the placement of a...Read More


What are the symptoms?

Pain is usually the first symptom a person will have with an incisional hernia, regardless of whether or not they have a bulge at the incision site or the abdomen. Once the bulge is present, it can increase in size and gradually cause more symptoms such as nausea...Read More


Who is at risk for incisional hernias?

Conditions that increase strain on the abdominal wall such as obesity, pregnancy, peritoneal dialysis, liver disease, chronic straining/lifting, chronic cough, or chronic difficulties with bowel movements or urination are risk factors for hernia formation. Also smoking, advanced age, malnutrition, poor metabolism, steroid medications, chemotherapy, and hematoma or infection...Read More


What causes an incisional hernia?

An incisional hernia is one that forms in a previous incision from prior surgery. The incidence of a hernia forming in a previous abdominal scar is about 20%, and is even higher in people who are obese or who are active smokers. The hernia defect itself can form...Read More


What complications can occur?

For laparoscopic hernia repair, primary complications associated with the operation are not common. There is a low risk of injury to blood vessels, nerves, the bladder, the intestines, nerves or the spermatic cord leading into the testicle. Your individual risk for these complications be reviewed with your surgeon...Read More


How is the Procedure Performed?

There are two general options for inguinal hernia repair: the open approach and the laparoscopic approach. The open approach requires a three to five inch incision in the groin area. The hernia defect is identified and repaired using a piece of surgical mesh. Local anesthetic and sedation as...Read More


What causes an Inguinal Hernia?

Everyone has natural weak point(s) in various areas of the abdominal wall due to their normal anatomy. One of these areas is in the groin (inguinal region). For children, hernia development can be congenital, but adults can develop this type of hernia as a result of strenuous activities,...Read More


What is hernia repair mesh?

Hernia repair meshes are generally similar to the material used to make mosquito nets. However, hernia meshes are highly developed materials engineered specifically for use as sterile medical devices used for abdominal wall reinforcement. Due to ongoing advances in technology, hernia meshes are an intense area of ongoing...Read More


Why should I have my hernia fixed?

If you suspect that you have an abdominal wall hernia, and it is causing you pain or discomfort, you should see your primary doctor for an exam and confirmation of the hernia. You can then request a referral to a hernia repair specialist, such as the surgeons at...Read More


How are abdominal wall hernias treated?

Abdominal wall hernias are treated with surgical repair, and depending on the size of the defect opening and other factors associated with your individual medical profile are often repaired with hernia mesh. These procedures are done either through an open incision or laparoscopically (through small incisions) depending on...Read More


How are abdominal wall hernias diagnosed?

Abdominal wall hernias are sometimes diagnosed by the patient who feels a bulge and is sometimes associated with pain. If this is the case, the hernia needs to be confirmed by a physician exam. Hernias can also be diagnosed on imaging studies such as CT scan. If you...Read More


What are the symptoms of an abdominal wall hernia?

Usually pain associated with a bulge are the first signs of an abdominal wall hernia. These can occur in the groin, at the bellybutton, or through a prior incision site from surgery, even years after the scar has healed.

...Read More

What causes an abdominal wall hernia?

A weakness in the layers of the abdominal wall is what is responsible for the formation of a hernia. This can be a natural weakness, for example those that commonly occur in the groin or belly button, or can develop at a weak point in a healed incision...Read More


What is an abdominal wall hernia?

An abdominal wall hernia is a defect, or abnormal opening, in the muscle or connective tissue layers that make up the abdominal wall. The abdominal wall is what keeps your internal organs inside and protected from the outside world. The abdominal wall extends from the bottom of the...Read More


When is hernia surgery necessary?

Patients who suffer the following conditions along with a hiatal hernia may be required to undergo surgical repair:
  • Gastroesophageal reflux or GERD with symptoms including regurgitation, difficulty swallowing, and/or heartburn that is no longer responsive to acid-blocking medications.
  • Strangulated hernia or obstruction - symptoms including the inability to have a bowel movement...Read More
  • How are hiatal hernias treated?

    Hernia surgery is not necessary when patients do not have any symptoms associated with their hiatal hernia. Although some mild symptoms such as bloating or stomach displeasure and heartburn can occur, there are ways a hiatal hernia may be treated through healthy lifestyle changes. These changes include maintaining...Read More


    How is a hiatal hernia diagnosed?

    A barium swallow study, which is a specific X-ray procedure, can enable the proper evaluation of the esophagus to correctly diagnose a hiatal hernia. Other ways to diagnose a hiatal hernia are by CT scan or esophagoscopy (EGD). The esophagoscopy is a procedure where an endoscope, a long-thin...Read More


    What are the symptoms of a hiatal hernia?

    It is not uncommon for people to have no symptoms associated with their hiatal hernia. When symptoms do occur, they normally consist of heartburn and gastroesophageal reflux. Other symptoms may include pain or discomfort in the stomach or upper abdomen, chest pain, a harsh or sour taste in...Read More


    What causes a hiatal hernia?

    There are many factors that can result in a hiatal hernia, but for most patients, the cause is unknown. It is possible that some people are simply born with a short esophagus or a large hiatus, or develop these conditions over time due to weakened tissue, or chronic...Read More


    What is a hiatal hernia?

    The diaphragm is a sheet of muscle that separates the abdomen from the chest cavity. It has an opening in the middle called the hiatus. The food pipe, or esophagus, runs through the hiatus in order for it to enter into the stomach. When the hiatus is enlarged,...Read More


    When Is Hiatal Hernia Surgery Necessary?

    If the hiatal hernia is in danger of becoming constricted or strangulated (so that the blood supply is cut off), surgery may be needed to reduce the hernia, meaning put it back where it belongs.

    ...Read More

    How Are Hiatal Hernias Treated?

    Most people do not experience any symptoms of their hiatal hernia so no treatment is necessary. However, the paraesophaeal hernia (when part of the stomach squeezes through the hiatus) can sometimes cause the stomach to be strangled, so hernia surgery is sometimes recommended. Other symptoms that may occur...Read More


    How Is a Hiatal Hernia Diagnosed?

    A hiatal hernia can be diagnosed with a specialized X-ray (using a barium swallow) that allows a doctor to see the esophagus or with endoscopy.

    ...Read More

    Who Is at Risk for Hiatal Hernia?

    Hiatal hernias occur more often in women, people who are overweight, and people older than 50.

    ...Read More

    What Causes a Hiatal Hernia?

    Most of the time, the cause is not known. A person may be born with a larger hiatal opening. Increased pressure in the abdomen such as from pregnancy, obesity, coughing, or straining during bowel movements may also play a role.

    ...Read More

    What Results Can I Expect from Endoscopic Sleeve Gastroplasty?

    Through the early trials of the endoscopic sleeve gastroplasty and published medical articles, the procedure has proven to yield great results for patients. A study published in the medical journal “Endoscopy” can be seen here. The initial findings show patients may expect to lose over 30% of their...Read More


    Who Qualifies for an Endoscopic Sleeve Gastroplasty?

    The endoscopic sleeve gastroplasty procedure is specifically designed with patients in mind whom are not morbidly obese, do not qualify for bariatric surgery, or whom are unable to undergo bariatric surgery. This is may include those with a body mass index of less than 40 with no comorbidities,...Read More


    What is Endoscopic Sleeve Gastroplasty?

    The endoscopic sleeve gastroplasty is a new, minimally invasive non-surgical procedure. It is a weight loss procedure offered to patients whom are not qualified candidates for bariatric surgery. The entire procedure is done through the mouth so there is no need for any incisions and as a result...Read More


    Will it be covered by insurance?

    Depending on the patient’s insurance plan, the procedure will be covered. If the plan does not qualify, there are cash pay options available. Further information can be provided upon request at your next appointment with Dr. Sadek.

    ...Read More

    What is the recovery process?

    At the conclusion of the procedure, patients usually return to their normal routine within 48 hours. It is important that patients follow the same diet and exercise regime from their original weight loss surgery after the finish of the outlet and pouch repair.

    ...Read More

    What are the side effects?

    As a result of the endoscopic procedure, patients typically feel little or no discomfort with minor side effects such as gas pain, nausea, sore throat, swollen tongue, and lip pain from the oral insertion of the endoscope.*

    ...Read More

    What are the benefits of the endoscopic procedure?

    At times open or laparoscopic revision surgery can be very difficult and even impossible due to scarring and adhesions from the original Weight Loss Surgery procedure. During the longer abdominal revision surgery, patients are three times more likely to develop complications during this than original WLS. In comparison...Read More


    Why would I regain weight after Weight Loss Surgery? (WLS)

    According to numerous studies, the majority of patients that undergo Weight Loss Surgery regain a significant amount of weight after the procedure. One common cause of this is the gradual stretching of the stomach or pouch outlet. Experts have proven that once the stomach and pouch begin to...Read More


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