Faqs

If you are having a surgery, you probably have some questions about the procedure and what to expect. This page contains a list of some of the most common questions we receive, and we encourage you to browse the rest of this site for more information.

VNUS Closure Procedure

How does it work to treat superficial venous reflux?

Since valves can’t be repaired, the only alternative is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. The Closure procedure provides a less invasive alternative to vein stripping by simply closing the problem vein instead. Once the diseased vein is closed, other healthy veins take over and empty blood from your legs.

How is the closure procedure different from vein stripping?

During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein, after which a stripper tool is threaded through the saphenous vein and used to pull the vein out of your leg through a second incision just above your calf.

In the Closure procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special (Closure) catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping (i.e., that may result from the tearing of side branch veins while the saphenous vein is pulled out). Vein stripping is usually performed in an operating room, under a general anesthetic, while the Closure procedure is performed on an outpatient basis, typically using local or regional anesthesia.

Three randomized trials of the Closure procedure vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, the Closure procedure was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the Closure procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, Closure patients returned to work 7.7 days sooner than surgical patients. Patients treated with the Closure procedure had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.

How long does the closure procedure take?

The Closure procedure typically takes about 45 to 90 minutes, though patients normally spend 2 hours at the office due to normal pre- and post-treatment preparation.

Is the closure procedure painful?

Patients report feeling little, if any, pain during the closure procedure. Your physician will give you a local or regional anesthetic to numb the treatment area.

Will the procedure require any anesthesia?

The Closure procedure is be performed under local or regional anesthesia at our office by Dr. Bass.

How quickly after treatment can I return to normal activities?

Many patients can resume normal activities the following day. For a few weeks following the treatment, Dr. Bass may recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.

How soon after treatment will my symptoms improve?

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

Patients report minimal to no scarring, bruising, or swelling following the closure procedure.

Patients report minimal to no scarring, bruising, or swelling following the Closure procedure.

Are there any potential risks and complications associated with the closure procedure?

As with any surgery intervention, potential risks and complications exist with the Closure procedure. All patients should consult their doctors to determine if their conditions present any special risks. Dr. Bass

Is the closure procedure suitable for everyone?

Only a physician call tell you if the Closure procedure is a viable option for your vein problem. Experience has shown that many patients with superficial venous reflux disease can be treated with the Closure procedure.

Is age an important consideration for the closure procedure?

The most important step in determining whether or not the closure procedure is appropriate for you is a complete ultrasound examination by Dr. Bass. Age alone is not a factor in determining whether or not the Closure procedure is appropriate for you. The Closure procedure has been used to treat patients across a wide range of ages.

How effective is the closure procedure?

Published data suggests that two years after treatment, 90% of the treated veins remain closed and free from reflux, the underlying cause of varicose veins.

What happens to the treated vein left behind in the leg?

The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue. One study reported that 89% of treated veins are indistinguishable from other body tissue one year after the Closure procedure was performed.6

Is the closure treatment covered by my insurance?

Many insurance companies are paying for the closure

Hernia Repair Procedure

What is a Hernia ?

A hernia is a weakness or tear in the abdominal muscles that allows fatty tissue or an organ such as the intestines to protrude through the weak area. Hernias can occur in many places in the body, most often in the groin. Sometimes, a weak spot in the abdominal wall can even be present at birth.

What are symptoms of a hernia?

Each hernia is different, and the symptoms of a hernia can appear gradually or suddenly. Different people feel varying degrees of pain. Some people even feel that something has ruptured or given way. Other symptoms may include:
* Feelings of weakness, pressure, burning, or pain in the abdomen, groin, or scrotum
* A bulge or lump in the abdomen, groin, or scrotum that is easier to see when you cough and disappears when you lie down
* Pain when straining, lifting, or coughing

What causes hernias?

Many hernias begin as a congenital defect, a weakness in the abdominal wall that a person is born with. If you have a weak point in a muscle wall, pressure from extra body weight, coughing, heavy lifting, or from straining during bowel movements can force the muscle apart, allowing part of an internal organ (or some other part of the body) to push its way through. Once that happens, the defect (hernia) will continue to enlarge until it is repaired.

How does smoking affect a hernia?

Chronic coughing from the lung irritation caused by smoking can put you at increased risk for a hernia. It can also cause a hernia to recur. Heavy smokers also tend to develop abdominal hernias at a higher rate than non-smokers. That’s because exposure to nicotine can help weaken the abdominal wall.

Do hernias always require surgery?

Surgery is the only way to cure a hernia. A hernia will not go away on its own. The good news is that today, many types of surgical hernia repairs are available. However, your surgeon may not always recommend it, depending on your medical history. For more information, read Methods of Repair.

How do surgeons repair hernias?

Surgeons use several hernia repair techniques today. Dr. Bas doctor may suggest one or several techniques as options for treating your hernia. Understanding all of your options will help you to decide which surgical method is best for you.

What preparation is required for laparoscopic surgery?

Most hernia operations are performed on an outpatient basis, and therefore the you will probably go home on the same day that the operation is performed. Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition. After Dr. Bass reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery. It is recommended that you shower the night before or morning of the operation. If you have difficulties moving your bowels, an enema or similar preparation may be used after consulting with Dr. Bass. After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery. Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery. Diet medication or St. John

What should I expect after hernia surgery?

Following the operation, you will be transferred to the recovery room where you will be monitored for 1-2 hours until you are fully awake.
Once you are awake and able to walk, you will be sent home. With any hernia operation, you can expect some soreness mostly during the first 24 to 48 hours. You are encouraged to be up and about the day after surgery. Call and schedule a follow-up appointment within 1 weeks after your operation. Usually, you may lift up to 20lbs after soreness resolves.

What complications can occur with a hernia repair?

Any operation may be associated with complications. The primary complications of any operation are bleeding and infection, which are uncommon with laparoscopic hernia repair. There is a slight risk of injury to the urinary bladder, the intestines, blood vessels, nerves or the sperm tube going to the testicle. Any time a hernia is repaired it can come back. Difficulty urinating after hernia surgery sometimes occurs. If persistent it may require a catheter for 1 to 3 days.

Gallbladder Removal Procedure

What is a gallbladder?

The gallbladder is a storage tank for bile. Bile, created in the liver and stored in the gallbladder, is secreted into the intestine to help your body absorb fat in foods that you eat. The gallbladder is stimulated by a meal, and in turn squeezes to release extra bile to aid in digestion.

Who is most at risk for gallstones?

Women are more prone than men to get gallstones because pregnancy predisposes women to get stones. Some people with high cholesterol are also at risk.

Are gallstones dangerous?

Gallstones can be dangerous. But, while 20 million people in this country have gallstones, in most people they don

What are symptoms from gallstones?

Typical gallbladder symptoms include pain or discomfort in the upper abdomen after eating, often in the middle or just under the ribs on the right side. Sometimes the pain or discomfort can be felt in the back as well. Some patients have nausea or vomiting, and some patients only feel indigestion after eating, often accompanied by a

When should I see a surgeon for gallstones or gallbladder pain?

If you have any of the above symptoms and have been diagnosed with gallstones, you should be evaluated by Dr. Bass.

Do I need any special x-rays?

Most patients only need an ultrasound, an inexpensive test that has no radiation. Additional testing to diagnose gallstones is rarely needed but if it is necessary, Dr. Bass will order it.

Should I follow a special diet if I have gallstones?

If you are diagnosed with gallstones because you have symptoms from your gallbladder, you should be careful about your diet. Since the gallbladder helps with digestion of fats, it is important to avoid most fats until you have surgery. Limited data is emerging that suggests that Coconut oil stimulates the gallbladder less than other oils and may reduce the risk further attacks. Most physicians suggest going on a low fat diet prior to surgery.

What are my treatment options for gallstones?

While medications, lithotripsy and even Chinese herbs have been used in the past, Laparoscopic Surgery is the best treatment for patients with symptoms from gallstones.

What is laparoscopic gallbladder surgery?

Laparoscopic gallbladder surgery has been around for over 25 years now. It involves small (1/4

Is gallbladder surgery safe?

Yes, gallbladder surgery is safe. Most patients go home right after surgery. Less than 1 in 100 people have a complication (such as bile leaking from the liver area where the gallbladder was). This can easily be solved by a procedure performed by a gastroenterologist, called an ERCP. Sometimes people have an extra stone in the bile ducts that drain the liver, and this too can be taken care of with an ERCP. About 1 in 500 people need an additional operation to repair the ducts that drain the liver. This occurs most often with severely infected gallbladders, and is one of the reasons not to delay gallbladder surgery.

What should I expect on the day of my laparoscopic gallbladder surgery?

You will need to come to the hospital about 90 minutes before surgery. This allows plenty of time for parking and registration. Once you register, you will be taken to the surgical center where you will change into an appropriate gown for the operating room and an IV will be started. You will then meet with the nurses and the anesthesiologist. I will stop by to meet with you and whoever is with you and give you time to ask a few questions. Surgery time is about 1-1.5 hours, after which you will spend about 2 hours recovering.

What should I expect after my laparoscopic gallbladder surgery?

Most people can return to work about 1 week after their gallbladder surgery and resume normal exercise 4 weeks after surgery.

Since the gallbladder is important to the digestion of fats, it is important to stay on a low fat diet the first few weeks after surgery. Over time, the body will adjust and patients can typically eat whatever they want. However, fatty foods should slowly be added to the diet. If fats are added too quickly, patients may feel crampy abdominal pain, loose stools and gassiness.

What can I eat after gallbladder surgery?

Usually after about a week most can he eat about whatever they want. Most people’s bodies will adjust over this time so that they can digest any food, while a rare few will not.

While your body is adjusting, it is important to slowly add fats into the diet. This allows the body enough time to adjust to not having a gallbladder. Fats such as coconut oil, may be better tolerated immediately after gallbladder surgery. As you add fats into your diet, you will know what you can or cannot handle.

If you eat too much of a fat that your body cannot handle, you may experience gas cramps and diarreha. This is common after gallbladder surgery and should resolve over time.