Procedures
Procedures
Operative, endoscopic, and diagnostic procedures explained step by step. What each one is, who it suits, and what recovery actually involves.
Metabolic
Procedures that treat metabolic disease by changing physiology, not just capacity.
- Laparoscopic Sleeve GastrectomySleeve gastrectomy narrows the stomach into a tube and removes the portion most responsible for hunger signaling. It is the most commonly performed metabolic operation and it treats disease, not appearance.
- Robotic SurgeryA robotic platform is a set of instruments the surgeon controls directly. It adds magnified three dimensional vision and wrists that move further than a human hand inside a small space. The surgeon makes every decision and every movement.
- Revisional Metabolic SurgeryRevisional metabolic surgery is a second operation after a previous bariatric procedure. It is considered for complications, for reflux that developed afterward, or when the metabolic response has faded. This page is a general explanation of the category.
Endoscopic
Performed through a flexible scope. No incisions in the abdominal wall.
- Endoscopic Sleeve Gastroplasty (ESG)Endoscopic sleeve gastroplasty reshapes the stomach from the inside using sutures placed through a flexible scope. There are no incisions and no tissue is removed. Few providers in Colorado offer it.
- Upper Endoscopy (EGD)Upper endoscopy is a direct look at the esophagus, stomach, and the beginning of the small intestine using a flexible camera. It answers questions that symptoms and imaging cannot.
- Diagnostic and Therapeutic EndoscopyEndoscopy is both a diagnostic and a treatment tool. Finding a narrowing and dilating it, or finding a lesion and sampling it, can happen in a single session when the plan allows for it.
Reflux Diagnostics
Measurement before treatment. These studies decide what the plan should be.
- Reflux Diagnostic EvaluationA reflux evaluation is a sequence of tests that answers three questions. Is acid reaching the esophagus, has it caused damage, and does the esophagus move normally. The answers decide the treatment.
- Bravo pH MonitoringBravo pH monitoring measures acid exposure in the esophagus using a small wireless capsule attached during endoscopy. There is no tube in the nose, and the recording usually runs 48 to 96 hours.
- Esophageal ManometryEsophageal manometry measures the strength and coordination of the muscle contractions that carry food to the stomach. It is the test that finds a motility disorder hiding behind reflux or swallowing symptoms.
- pH Impedance TestingpH impedance testing measures both acid and nonacid material moving up the esophagus. It is the study of choice when symptoms continue despite acid suppression, or when the main complaint is regurgitation or cough.
- Barium Swallow StudyA barium swallow is an x-ray study taken while you drink a contrast liquid. It shows the shape of the esophagus and stomach and how they move, which makes it useful for hiatal hernia, narrowing, and swallowing complaints.
General Surgery
Gallbladder, appendix, hernia, and repair at the hiatus.
- Gallbladder RemovalRemoving the gallbladder is the definitive treatment for symptomatic gallstone disease. It is performed through small incisions, and digestion continues without it.
- Hernia RepairHernia repair closes a defect in the abdominal wall and reinforces the area so it holds. Hernias of all kinds are repaired here, and the approach is chosen for the hernia rather than by habit.
- AppendectomyAppendectomy removes an inflamed appendix. It is usually urgent rather than elective, and it is most often performed laparoscopically through small incisions.
- Hiatal Hernia RepairHiatal hernia repair returns the stomach below the diaphragm and closes the enlarged opening it moved through. It is considered when the hernia is causing symptoms that testing has tied to it.
- Fundoplication for RefluxFundoplication is an antireflux operation in which the upper stomach is wrapped around the lower esophagus to reinforce the barrier between them. This page explains the procedure and when it is considered.