Florham Park Surgery Center - Setting the Bar for Excellence in the Performance of Same Day Procedures

Printer-friendly version

Written by Iris Goldberg in the New Jersey Physician Magazine
As advancements in technology have allowed many procedures that formerly required a hospital stay to become significantly less invasive, we have seen a dramatic increase in the number of same day or ambulatory surgery centers (ASCs). These facilities, with fully equipped operating rooms, provide patients with the opportunity to have their procedure and return home later that day. Usually owned, at least in part by affiliated surgeons, the ASC has become a highly preferred alternative to a large hospital or medical center for the vast majority of minimally-invasive surgeries.

Located in Morris County, the Florham Park Surgery Center exemplifies the important features that patients and physicians alike, should prioritize when choosing an ASC. Accredited by the Accreditation Association for Ambulatory Healthcare (AAAHC), certified by Medicare and licensed by the NJ Department of Health, Florham Park Surgery Center is currently involved in the process of being scrutinized by the Surgical Review Corporation (SRC) to become the first ASC in New Jersey to be certified as a Center of Excellence for Bariatric Surgery.

The Florham Park Surgery Center offers same day procedures in the following specialties:

• Bariatric Surgery
• Colo-Rectal
• Ear, Nose & Throat
• General Surgery
• Gastrointestinal Surgery
• Obstetrics/Gynecology
• Ophthalmology
• Orthopedic Surgery
• Pain Management
• Plastic Surgery
• Podiatry
• Spine
• Urology

With more than 50 affiliated surgeons, the Florham Park Surgery Center occupies approximately 12, 500 square feet on the first floor of the newly and completely renovated, plush Florham Park Medical building which provides ADA compliant handicapped parking, wide corridors, a drive-up canopied entrance and discharge area with electronic doors and handicap-accessible restrooms. The facility itself maintains 3 operating rooms with state-of-the-art surgical equipment, 2 procedure rooms and a climate-controlled recovery room. The beautifully decorated waiting area, complete with large flat screen TV and plenty of snacks on hand is a comfortable environment for family and friends to pass the time.

The entire medical and administrative staff at the Florham Park Surgical Center understands that even elective same day surgical procedures can be anxiety-producing for patients. In order to help patients feel as relaxed as possible before, during and after surgery, a carefully structured system, designed specifically to offer the highest level of care, convenience and comfort to patients and their families is always in place at the Florham Park Surgery Center.

For example, upon arrival patients are presented with minimal paperwork during the registration process. Also, the surgical schedule is organized to ensure that procedures will be done on time in order to spare patients and families the unnecessary stress of a prolonged waiting period. In fact, from start to finish, the priority of the highly trained professionals at the Florham Park Surgery Center is to make each and every outpatient surgical experience a positive one.

In order to give bariatric patients the same specialized, individual care and to honor its mission to “identify and deliver world class bariatric care and education to everyone we can reach,” the Florham Park Surgery Center is unique in its efforts to purposefully cater to these patients before, during and after surgery.

For the comfort of bariatric patients and to help them achieve optimal results, the Florham Park Surgery Center works closely with its bariatric surgeons to provide the latest in technology and equipment. All of the operating room tables, stretchers and wheelchairs are weight rated and the waiting area is furnished with weight rated chairs and sofas for safety and comfort.

For pre-surgical bariatric patients the Florham Park Surgery Center provides support and valuable information through its association with “My Program for Life,” which is a popular resource for people struggling with obesity. Pre-surgical seminars are held to answer questions and give patients the facts they need about the procedure and what to expect afterwards. Even insurance concerns are addressed.

A crucial component of success for bariatric patients who have had gastric lap banding is Banding Centers of America, which provides the necessary follow-up care for post-banding patients and is located just steps from the Florham Park Surgery Center. There, patients can be monitored by a staff of skilled and caring bariatric professionals and can have their band adjustments, when necessary.

Gastric banding is a restrictive procedure that limits the quantity of food that can be ingested. Performed through small incisions, as an outpatient procedure in a same day facility such as the Florham Park Surgery Center, a band is placed around the upper part of the stomach. The resulting pouch or “new stomach” has a dramatically reduced functional capacity. The gastric band has a balloon from the inside that is adjustable and can reduce stoma size, thus producing a feeling of fullness after only a small amount of food has been ingested. Because patients feel satisfied much sooner, they eat less.

The band forms a 15cc-30cc pouch that is designed to be inflated or deflated at any time after the procedure. For as long as patients continue to keep the band, they must have periodic monitoring and band adjustments. These adjustments are accomplished by either adding or removing saline solution through an access port. The frequency and intervalof adjustments varies with each patient but generally averages four times yearly.

At Banding Centers of America’s state-of-the-art, outpatient facility, the adjustment procedure, which is virtually painless and produces no clinical side effects is performed by the surgeon or physician’s assistant (PA) and takes approximately 15 minutes. This is a vast improvement over the process experienced by some patients who relate undergoing prior adjustments in a hospital setting and spending three or four hours there.

Fluoroscopy is used at Banding Centers of America, to guide the process visually, allowing for accurate placement of the needle into the adjustment port. Further, fluoroscopy is an essential tool that allows visualization of the physical configuration of the band, tubing and port. It also enables the physician to evaluate the patient’s esophagus, pouch and stomach if he or she is experiencing any symptoms prior to adjustment.

The process of visualization under fluoroscopy, along with the physical sensation during the adjustment process, gives patients a good understanding of what is going on inside them, as far as the lap band is concerned. To ensure patients’ safety, Scatter-Ban® radiation barrier, which is a patented accessory, proven to offer significantly reduced exposure to scatter radiation is utilized for every adjustment procedure.

With a patient-driven, fluoroscopically guided method of band adjustments, it has been found that patients are able to experience the most successful weight loss. In a study conducted by the Department of Surgery at the Loyola University Medical Center in Illinois, weight loss results were compared for 248 patients with and without fluoroscopically guided adjustments. The data suggests that patient driven band adjustment results in superior weight loss and also, fluoroscopic guidance may optimize the result of each adjustment and minimize the incidence of adjustment-related complications.

Besides performing routine adjustments, sometimes the surgeons at Banding Centers of America see patients whose bands have slipped out of place. This could conceivably require another surgical procedure to correct. Timothy Herbert, a highly skilled radiology technician, is Director of Operations for Banding Centers of America and he is present during all band adjustments. Mr. Herbert shares that in 50% of cases, physicians at the Banding center are able to restore the band to its proper place, without the need for additional surgery.

The experienced bariatric professionals at Banding Centers of America realize that the lap band is merely a tool. Without band adjustments, continuous follow-up and a dedicated commitment on the part of the patient, successful, life-long maintenance of healthy weight cannot be achieved. In order to keep its patients on track, Banding Centers of America has created a tranquil, familial environment where patients feel comfortable and nurtured. The only facility of its kind in the state, Banding Centers of America provides follow-up care to patients throughout New Jersey, some of whom drive considerable distances to be treated there.

Patients are encouraged to call or drop by with any questions or concerns. For those with young children, a fully stocked play area is provided and staff members gladly supervise while mom or dad is having an adjustment or conferring with a physician or other member of the support team.

Some patients have gastric band surgery outside the United States, especially when cost is a factor. Often, they do not subsequently receive the routine monitoring and adjustments that are essential, not only for successful maintenance of weight loss but for also for preservation of health. While some physicians choose not to assume responsibility for the post-operative care of a surgery they did not personally perform, Banding Centers of America’s surgeons are happy to oversee the follow-up care of these patients. Actually, they will assume the care of any post- lap band surgery patient, regardless of where the procedure was performed or by whom.

It is without question that the most important component to an optimal result for bariatric patients is having a strong support system in place. Weight loss surgery involves a major change in lifestyle. Patients need to learn to have a completely different approach to food, with significant modifications to what and how they eat. Every meal and especially every social occasion present a challenge, especially early on. Bariatric patients must also incorporate a realistic exercise regimen and know how and when to make appropriate changes in that regimen as their weight reduces over time.

Besides caring for the physical needs of post-lab band patients, Banding Centers of America offers patients that all-important network of psychological support and nutritional counseling. Monthly cooking classes taught by dieticians and chefs who are trained in preparing appetizing foods that are bariatric-friendly, help patients make the transition to healthier eating.

Banding Centers of America works with area gyms to facilitate reduced-cost memberships with exercise programs designed especially for post-weight loss surgery patients. The Peer to Peer Support Group which gives post-surgery patients the opportunity to meet and share feelings, experiences, problems and tips for staying on track is a regular event at Banding Centers of America.

Like the Florham Park Surgery Center, Banding Centers of America works closely with “My Program for Life,” which presents patients with a guide to a happier, healthier life, helping them to take control of their obesity and regain good health. For example, the Health and Weight Loss Family Festival last summer with sponsors including physicians, dieticians and representatives from health clubs in the area, provided valuable tips and information on maintaining healthy weight, at no charge for all who attended.

To promote physical activity for patients after surgery, the Walking Club has become quite popular as well. The last event was a Walk for Liberty which was held on September 11, 2010 at Liberty State Park in Jersey City. Participants had the opportunity to get healthy exercise and to also commemorate a somber day in our country’s history. Many were so touched by the occasion they didn’t realize they had walked a total of six miles.

Coming up on January 19, 2011, “My Program for Life” and Saint Clare’s Health System will present a fun-filled Meatball Throwdown, featuring a bariatric-friendly cooking class and will include a meatball-making competition. The Florham Park Surgery Center and Banding Centers of America will be actively involved. Participants will learn how to create three or more different bariatric-friendly and delicious meatball recipes and will be able to judge their favorites.[This event already occurred. Click here for the winning meatball throwdown recipe

The staff at the Banding Centers of America is expertly trained to treat patients who struggle with their weight. These skilled professionals are in the best position to evaluate whether or not patients are, in fact, staying on course or perhaps not doing as well as they might. It has been rewarding, to say the least, for the physicians and the entire team to witness the many successes they have helped patients achieve.

One exciting success story is that of Brian Pelo, who is 38 years old and had a gastric lap band procedure performed at the Florham Park Surgery Center by bariatric surgeon, Michael Bilof, MD last June. In the six months since, Mr. Pelo has lost a total of 112 pounds. He reports that his surgery went quite well, with no problems or complications. “Everyone there made me feel very comfortable,” Mr. Pelo remembers. “It was actually a pleasant experience,” he adds.

Mr. Pelo is equally pleased with his follow-up care at Banding Centers of America. He has had a number of band adjustments that were quickly and easily accomplished, causing no discomfort whatsoever. At 233 pounds compared to 345 pounds on the day of his surgery, Mr. Pelo says his life has totally changed. “I am busy working all of the time now,” Mr. Pelo shares. “Before, I was so heavy, I didn’t want to leave the house,” he admits. He has learned a new way of eating and has left the bad habits behind. When asked how Banding Centers of America has helped, Mr. Pelo responds, “They’re always there for me.”

Patient C, who prefers to remain anonymous, is a 28 year old who had her lap band procedure done a little over a year ago in another state, where she was living at the time. She relates experiencing an uncomfortable feeling of tightness, even after adjustments until she came to New Jersey and began treatment with Dr. Bertha at Banding Centers of America.

“At the other place they didn’t use fluoroscopy to guide the adjustments so they really did not know how much to adjust,” she relates. Since being cared for by Dr. Bertha, her band is exactly how it should be and she is back on track and continuing to lose weight. It is important to note that without the guidance of fluoroscopy, adjustments cannot be precise and this could certainly compromise a patient’s success with the lap band.

Patient C is extremely thankful that Dr. Bertha agreed to supervise her care, even though he did not perform her surgery. She is also taking advantage of the support group at Banding Centers of America and has found the interaction with other bariatric patients to be quite helpful.

Certainly, no one enjoys the prospect of undergoing a surgical procedure. In many instances though, surgery is necessary to improve or preserve the quality of one’s life. When that surgical procedure can be performed without the need for a hospital stay, in an environment that is safe, comfortable, and pleases both patient and family, much of the anxiety can be avoided. The Florham Park Surgery Center dedicates itself to accomplishing this for each and every patient under its care.

For those who have had gastric lap band surgery the staff at Banding Centers of America makes certain that the follow-up band adjustments are painless, completely accurate and are done within fifteen minutes or so, rather than three or four hours. Also, patients receive all of the support and care they need to achieve their weight loss goals.

Both the Florham Park Surgery Center and Banding Centers of America are outpatient facilities providing patients with the care and treatment they require in an environment carefully created to ensure a safe and comfortable experience. Back home, just hours later, patients might be surprised to happily realize, “What a difference a day truly can make!”

Florham Park Surgery Center is located at 83 Hanover Road, Florham Park NJ 07932. (973) 805 9960 www.FlorhamParkSurgeryCenter.com

Banding Centers of America is located at 83 Hanover Road, Florham Park NJ 07932. (973) 805-9977 www.BandingCentersOfAmerica.com