Clinicians from Kent Hospital have answered a range of questions about surgery and surgery services offered at Kent as part of our "Ask the Experts" campaign. Visit our YouTube Channel to view videos of our experts.
Does having hepatitis C mean you cannot have weight loss surgery?
Hepatitis C by itself is not a contraindication for surgery. However, if the patient has developed liver disease due to the Hepatitis, mainly Cirrhosis, then that patient should not have a laparoscopic adjustable gastric band. The degree of possible liver disease from the Hepatitis would need to be investigated with blood tests and x-rays.
How long will I typically have to wait after the gastric band surgery until I can return to work and resume other normal activities?
That depends upon what you do for work. Patients with a desk job can usually return to work in a few days to a week. People with jobs involving heavy lifting (for example construction) need to take 4 weeks off from work. This precaution is to prevent hernias from developing at the incision sites, not to protect the band. Any type of work or activity does not affect the band.
Michael Coburn, MD
What questions should I be asking before choosing a plastic surgeon to make sure he/she is qualified to operate on me?
The most important aspect to be considered when choosing a plastic surgeon is to make sure the doctor is board certified by the American Board of Plastic Surgery. Members of this board will have graduated from an accredited medical school and completed at least five years of additional training as a resident surgeon at an accredited program. This will include training in all areas of surgery with at least two years devoted to plastic surgery. There are many "boards and societies" available to plastic surgeons but this is the one that would require the most rigorous standards for qualification. Another area that could be investigated is through the state health department. Any sanctions against your surgeon would be recorded here. Word of mouth is also quite helpful. There are many board certified surgeons available in the community to choose from. If you know of someone who has had a positive experience with a particular surgeon, you might put this one on the top of your list.
John Issac, MD, Chief of Surgery
Nothing against the surgeons at Kent, but wouldn't I be better off going to a bigger hospital that does more surgical procedures and is likely to have the newest technology?
That's a good question. If you want to go strictly by size, Kent is the second largest hospital in the state. Everyone loves the latest gadgets - and we have most of them. But more important than the latest technology is the surgeon who's hand is on the end of the instrument. At Kent, all of the surgeons are fully trained and board certified. This should give a patient a level of comfort when meeting the surgeon for the first time. I have always felt that as long as your surgeon is well trained the most important aspect of the doctor patient relationship is the comfort and trust that is built by getting to know him or her over time. I believe this is one of the great advantages of a community hospital. If there is a procedure that a patient needs that isn't available at Kent, we know who the experts are and do not hesitate to make the referral. But this is not necessary nor an advantage for most procedures.
John Isaac, MD, Chief of Surgery
I am having out-patient carpal tunnel surgery on one hand next week. Approximately how long will the surgery and recovery room take, as I need to schedule a ride home?
For carpal tunnel surgery, the total time you will need to designate is approximately 2 and 1/2 to 3 hours counting preparation, surgery and recovery.
Denise Haskell, RN, Director of Surgical Services
What procedures are done to facilitate the regular flow of urine in males?
We have a complete urology program here at Kent with many surgeons who perform procedures related to urinary dysfunction. The cause of the dysfunction must first be determined based on symptoms and if needed, laboratory or other testing. Some of the procedures our surgeons perform are Cystoscopy and Ureteroscopy, by inserting a telescope through the urethra (urinary tube) into the bladder to assist with identifying possible causes and obstructions. Based on those findings, the surgeon may perform a Dilatation (opening or stretching) of the urethra, a Transurethral resection (removal) of a bladder tumor or prostate gland, or an open procedure for removal of tumors or other obstructions. Any procedure done is based on the patients symptoms and diagnosis and is discussed and explained to the patient in detail prior to surgery. The urinary dysfunction may also be caused by a muscle issue that may be treated with medication.
Denise Haskell, RN, Director of Surgical Services
What are the concerns around older people who require anesthesia as part of undergoing a surgical procedure?
The concerns we have with older people and their risk for surgery has more to do with the number and severity of the diseases they may have than how old they are. The longer you live, the more likely you will have developed a disease (stroke, heart attack, etc) that can increase your risk during a surgical procedure. A healthy 70 year old has a lower risk of complications than a 50 year old smoker with diabetes and high blood pressure. Older patients are more sensitive to some of our anesthetics and can take a little longer to wake up from general anesthesia and we adjust our anesthetic plans to take this into account. I hope that helps!
Jared Barlow, MD, Chief of Anesthesia
I am severely overweight but don't know if surgical weight loss is an option. Isn't the surgery dangerous?
No the surgery is not dangerous. It would be the same as laparascopic gallbladder surgery. It is not a dangerous or difficult procedure. The difficulty depends on the patients co-morbidities like high blood pressure, diabetes or lung disease. Those illnesses are considered and the patient is medically cleared for surgery. Obesity is based on body mass index, which is based on height and weight. There are many websites available to help calculate your BMI or your primary care physician can assist.
Michael Coburn, MD, Surgeon
My 80-year old mother just had her second hip surgery. Her doctor is suggesting in-home therapy instead of a nursing home. What is the best option?
In general there are several options and all are good and some may be better based on the specifics of each persons situation. Hip replacement surgery is an invasive procedure which causes trauma to the entire hip. In a person who is 80 years old the healing process may be longer then for a person who is in their 60s.
It has been my experience that in general patients of this age range seem to do best in either an Acute Rehab unit where they would get intensive OT and PT for up to 3 hours a day with the intent of that person returning home after a 7-10 day stay. If the person is slightly disabled a Skilled Nursing Faculty Nursing Home may be a better route if that person could not tolerate 3 hours of therapy a day.
Alan Dunn, Program Director, Rehabilitation Unit