Ophthalmic Procedures

Cataracts

What are cataracts?
Cataracts are clouding of your eyes' natural crystalline lens and can be the reason sharp objects become blurred, bright colors become dull or seeing at night is more difficult. The majority of cataracts are simply a result of the natural aging process but can also be caused by diabetes, medications or trauma to the eye. Cataracts are the leading cause of visual loss in adults age 55 and over.

What happens if cataracts go untreated?
Over time, the clouded area of your lens will become larger and denser. Eventually, your entire lens can be cloudy and cause blindness.

How are cataracts treated?
Cataracts can only be removed surgically--no medication or special diet will cure them. Using a small incision and a "no stitch" technique, the patient's cloudy lens is removed and replaced with an artificial lens implant. After treatment, some patients experience the best vision of their lives.

Is cataract surgery safe?
Yes, cataract removal is one of the safest and most effective surgical procedures. More than 3 million cataract surgeries are performed each year in the United States and the success rate of cataract surgery restoring sight is 95%.

Does cataract surgery hurt?
No, most people are surprised to find out how easy and pain-free cataract surgery is. Anesthetic drops numb the nerves in and around your eye so you should feel little to no discomfort. The procedure itself takes about 20 minutes and most patients are back to their normal activities the next day.

How soon will my vision improve?
When your cataracts are removed all the things you could not see clearly are bright, clear and vivid again. Most patients experience improved vision immediately, but your sight may continue to improve for several days or weeks.

Cataract Surgery Options

We offer patients some of the most advanced technologies for achieving the safest cataract surgery with the best possible vision outcome. Options include:

  • Laser Cataract Surgery
  • Specialized premium lens implants for eyeglass independence
  • ORA System® for the most accurate lens prescription
  • iStent® - implant placed during cataract sugery to control glaucoma

Read more about these options in Our Procedures and ask your ophthalmologist which options are best for you.

Lens Implants

What are lens implants?
Lens implants are clear, lightweight artificial lenses that replace your natural crystalline lenses during cataract surgery. They are also known as intraocular lenses (IOLs).

What kind of lens implants are available?
Many. Depending on your insurance coverage, vision correction preferences, activities and lifestyle, you and your ophthalmologist can discuss your options for either standard or premium IOLs.

How do standard IOLs differ from premium IOLs?
Standard IOLs have only one point of focus (called monofocus) and can usually provide clear distance vision after cataract surgery. Most patients will need glasses after surgery for reading and near vision tasks. Our patients receive Alcon brand standard IOLs.

Premium IOLs offer patients greater freedom from eyeglasses than standard IOLs. They are specially designed to allow patients distance, intermediate and near vision without glasses (in most cases). There are two types of premium lOLs, multifocal and toric.

What are multifocal IOLs?
Multifocal IOLs are premium lenses designed to replace cataracts and correct presbyopia (farsightedness) or myopia (nearsightedness) at the same time. The goal is to give you a full range of clear vision, near, far, and everywhere in between. Click on the links below for more information about our premium multifocal IOLs:

  • Crystalens®
  • nanoFLEX™
  • ReStor®
  • ReZoom®
  • Verisyse™

What are toric IOLs?: Toric IOLs are also known as astigmatism-correcting IOLs. These lenses are for patients with existing corneal astigmatism and can usually give you quality distance vision with less dependence on glasses. Click on the link below for more information about our premium toric IOLs:

  • AcrySof®.

Am I a good candidate for premium IOLs?
Possibly. Some patients with co-existing ophthalmic problems or other health conditions may not be good candidates. Please discuss your lens implant options with your ophthalmologist.

What do standard IOLs cost if I have commercial insurance or Medicare?
Both commercial insurers and Medicare cover the cost of standard cataract surgery with a standard lens. Patients will have individual co-pays or deductibles dictated by their specific insurer for their cataract surgery.

Does insurance cover the cost of a premium IOL?
Medicare and many insurance providers consider the implantation of these high-tech, "premium" or "upgrade" lenses as medically unnecessary. The patient is responsible for the additional out-of-pocket cost. Many believe that the exceptional vision outcome and the ability to be completely eyeglass-free is immeasurably valuable.

LenSx® Laser

The first laser cleared to treat cataracts The LenSx® Laser from Alcon is the first femtosecond laser cleared for use in cataract surgery - thus creating the category of laser refractive cataract surgery. This innovation allows eye surgeons to perform some of the most challenging steps in cataract surgery with the precision of advanced laser technology.
Cataracts are the leading cause of preventable blindness globally, and develop when the eye's lens, which primarily consists of water, becomes cloudy and prevents the passage of light to the retina which impairs and disrupts vision. Cataracts attribute to 48% of the world's blindness; however, they can be successfully corrected with cataract surgery, one of the five most cost-effective health interventions. LenSx® Laser Overiew and Benefits

The LenSx® Laser provides the surgeon with well-known benefits of femtosecond technology - micron level precision, accuracy and predictability. It is designed to perform many of the challenges of traditional, manually executed cataract surgery with computer precision. The LenSx Laser® uses focused femtosecond laser pulses to create incisions in the lens capsule, crystalline lens and the cornea. This results in treatments that are tailored to a surgeons's specifications and deliver a remarkable degree of accuracy.

Surgical Benefits:
* Enable surgeons to deliver a truly premium surgical experience for lens replacement
* Blade-free laser technology is an advanced alternative to manual cataract surgery * Automates some of the most difficult steps of cataract procedure
* Incisions made with image-guided software
* Allows for improved accuracy, predictability, reliability and reproducibility compared to traditional refractive cataract surgery

1. Helen Keller Internationa, Cataract Treatment, http://www.hki.org/preventing-blindness/cataract-treatment/, (Updated Not Available) [Accessed January 5, 2012]

2. World Health Organization, Prevention of Blindness and Visual Impairment, http://www.who.int/blindness/causes/priority/en/index.html, (Updated 2011) [Accessed Jaqnuary 5, 2012]

3. Nagy, ZZ. 1-year clinical experience with a new femtosecond laser for refractive cataract surgery. Paper presented at: Annual Meeting of the American Academy of Ophthalmology; October 24-27, 2009; San Francisco, CA." - LenSxLasers.com, http://www.lensxlasers.com/the-lensx-laser-difference.asp (Updated Not Available) [Accessed January 30, 2012]

4. Nagy Z, Takacs A, Filkorm T, Sarayba M. Initial clinical evaluation of an intraocular femtosecond laser in cataract surgery. J Refract Surg. 2009 Dec; 25(12):1053-60 To learn more, visit our LenSx® patient microsite by clicking the image to the left.

ORA System

ORA is a groundbreaking optiwave refractive analysis system that supports your ophthalmic surgeon's ability to bring more precise vision outcomes after cataract surgery.

How does ORA work?

ORA enables surgeons to measure the eye and refine outcomes during the procedure, rather than having to "wait and see" as with traditional cataract surgery. ORA calculates the prescription of the implantable lens real-time, during surgery, with a higher level of precision than via traditional, manual calculation.

What are the results?
Nearly 80 percent of ORA-guided patients are within 0.50 diopter of intended visual outcome post-op, compared to 60 percent with traditional cataract surgery. ORA is also proven to be particularly effective at reducing (by as much as two to five times) the need for a follow-up or enhancement procedure after cataract surgery.

Does insurance cover the cost of ORA?
Medicare and many insurance providers consider this precision tool as medically unnecessary. The patient is responsible for the additional out-of-pocket cost. Many who want a superior vision outcome feel it is an exceptional value.

Glaucoma

Glaucoma is the leading cause of blindness in the United States. It refers to a group of eye diseases, many of which are caused by increased pressure in the eye. This increased pressure damages the optic nerve, which can cause blindness.

Think of your eye as a sink and the faucet is always running and the drain is always open. When the drain becomes clogged, fluid cannot leave the eye as fast as it is produced, causing the fluid to back up and intraocular pressure (IOP) to build within the eye. When the IOP builds to a high level the optic nerve gets compressed and the nerve cells become damaged and eventually die. If the optic nerve is damaged it cannot send images to the brain; and if left untreated it can result in permanent visual loss. Early diagnosis and treatment of glaucoma can prevent this from happening.

NOTE: There are several types of glaucoma; the most common is open-angle glaucoma (described above). A rarer form is acute closed-angle glaucoma--it is a medical emergency and needs to be treated immediately or blindness can result in one to two days. If you are experiencing pain, nausea, vomiting, blurred vision or seeing halos around lights, call your ophthalmologist right away.

Who is at risk for developing glaucoma?
While anyone can develop glaucoma, there are a few conditions that put you at a greater risk:
  • 45 years and older
  • Family history
  • African descent
  • Hispanics
  • People with a thin central cornea
  • Very nearsighted (myopic)
  • Systemic health problems (diabetes, migraine headaches, poor circulation)
  • Prolonged cortisone or steroid use
  • IOP above the normal range
  • Severe eye injury
  • Low blood pressure

What are the symptoms of glaucoma?
Glaucoma is referred to as "the sneak thief of sight" because usually there are no symptoms until there is irreversible vision loss. You may see perfectly, read or drive without problems. It is crucial to have your eyes checked regularly by your ophthalmologist. Early detection and treatment is important in the prevention of unnecessary vision loss. Sixy-seven million people worldwide have glaucoma, but only half of those affected may realize they have it.

How is glaucoma detected?
Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. During your glaucoma evaluation, your ophthalmologist will measure your intraocular pressure, inspect the drainage angle of your eye, evaluate if there is any optic nerve damage and test the peripheral (side) vision of each eye. Photography of the optic nerve or other computerized imaging may be recommended. Some of these tests may not be necessary for everyone.

How is glaucoma treated?
Damage caused by glaucoma cannot be reversed. Eye drops, laser and/or eye surgery are used to help prevent further damage by lowering the existing IOP level. When non-surgical methods fail to decrease pressure, surgery may be required to create a new drainage channel. Filtration surgeries are designed to relieve eye pressure by removing tissue, inserting implants in the eye or a combination of both. Laser and eye surgery is typically performed as an outpatient procedure and the patient feels little to no discomfort.

iStent®

What is iStent®?
The iStent Trabecular Micro-Bypass stent is a new surgical therapy for mild-to-moderate open-angle glaucoma that is done in combination with cataract surgery. iStent is designed to improve aqueous outflow to safely lower intraocular pressure and may reduce the need for eyedrop medication (per your physician's advice).Is iStent right for me? If you are going to have cataract surgery and are currently taking one or more medications to lower your eye pressure, you may be a candidate for iStent. Talk to one of our ophthalmologist's (see Our Doctors) to find out if iStent is right for you.

How Does iStent work?
Glaucoma is normally associated with increased fluid pressure in the eye. The primary cause of elevated intraocular pressure (IOP) in patients with open-angle glaucoma is a blockage of the trabecular meshwork; a sponge-like tissue located near the cornea and iris through which aqueous humor passes to Schlemm’s canal and into the bloodstream. iStent:

• Creates a permanent opening in your trabecular meshwork
• Improves your eye's natural fluid outflow to safely lower IOP
• Works continuously to improve the outflow of fluid from your eyes
• Improves outflow with a single bypass


How big is iStent?
Tiny. It is the smallest medical device ever approved by the FDA.

Is the iStent procedure safe?
Yes. iStent is an FDA-approved device and it has a similar safety profile to cataract surgery.

Will I be able to feel or see iStent in my eye?
No. iStent is so small you will not be able to see or feel it after the procedure is done. However, your eyes will be sore and sensitive after cataract surgery. We will be giving you eye drop medicines to treat this.

Will I be able to stop using my glaucoma eye drop medicines?
Some patients are able to experience a reduction in their glaucoma medicines after receiving iStent, but this will be at the discretion of your physician. It is very important that you follow your physician's instructions until he or she can determine if it is safe to discontinue.

Will my insurance cover the iStent procedure?
iStent is covered by Medicare and many private insurance plans. If you are interested in the procedure, you should ask your doctor to see if your plan includes coverage for iStent.

Do you want to watch the iStent video?
Go to our YouTube channel to see a video that will help you clearly understand how the surgeon the implants the stent. To watch, click here.

CyPass® Micro-Stent

CyPass Micro-Stent is a way to manage glaucoma at the same time you undergo cataract surgery. It is a very small plastic tube placed just below the surface of the eye to help reduce eye pressure.

This is a way to increase the existing outflow of fluid in your eye by keeping one of the eye’s drainage pathways open. Now that the fluid has a place to go and isn’t building up, the pressure inside your eye (intraocular pressure) is reduced.

Making the decision to protect your vision is an important one, and you probably have a lot of questions. Here are some of the most common.

How is CyPass® Micro-Stent implanted?

CyPass® Micro-Stent will be implanted in your eye through the same incision used for your cataract surgery, just below the surface of your eye.

What steps do I need to take before surgery?

Your eye surgeon may ask you to stop taking certain medications for a few days before your surgery. Talk to your surgeon about any other recommendations.

What should I expect after surgery?

Your eye surgeon will give you eye drops to speed up the healing process and to prevent infection. You’ll recover at home after surgery. Typically, your eye surgeon will examine you the following day. Your eye pressure may fluctuate the first few days after surgery, but the specifics of surgery may be different for each individual. Be sure to ask your eye surgeon so you can fully understand what the recovery process is like.

Will I be able to see CyPass® Micro-Stent in my eye?

CyPass® Micro-Stent will be placed at the very outer edge of youth iris, which is the colored part of your eye, so you won’t be able to see it once it’s implanted.

Eyelid Surgery

As well as having healthy eyes, complete eye health includes having healthy eyelids. Some people have eyelids that are droopy, turn inward or outward, have excess skin or prolapsed fat pads which fall over the eyelashes. These conditions make lids appear puffy or heavy and can cause eye discomfort, limit vision and affect overall appearance. Fortunately, eyelid surgery can help.

What is eyelid surgery?
Eyelid surgery is the surgical intervention that restores the lid to its natural position.

Is it covered by my insurance?
When there is visual impairment involved, most insurance companies will pay for the procedure. Ask your ophthalmologist for more information.


Ptosis (upper eyelid drooping)
Ptosis can either be present at birth (congenital) or develop with age (involutional). For those with congenital ptosis, surgery is recommended in the preschool years to make it easier for your child to see. Ptosis that develops with age may limit your side or even your central vision. If it occurs in only one eye, it may create an uneven appearance. Eyelid surgery will often time lead to better vision and improved appearance.

Excess eyelid skin
Eyelid skin is the thinnest skin of the body and as a result, it tends to stretch with age. If the skin in the upper eyelid stretches, it may limit your side vision. If this occurs in your lower eyelid, "bags" tend to form. This excess skin can be removed surgically by a procedure called blepharoplasty. It will improve your side vision and other symptoms, as well as improve the overall appearance.

Ectropion (outward turning of the lower eyelid)
Ectropion is when the lower eyelid stretches with age and causes the skin to droop downward and turn outward. Eyelid burns or skin disease can also cause this problem. Ectropion can cause dryness of the eye, excessive tearing, redness, and sensitivity to light and wind. Surgery will help to improve these symptoms.

Entropion (inward turning of the lower eyelid)
Like ectropion, entropion occurs with age. Infection and scarring inside the eyelid are other common causes of entropion. When the skin turns inward, the eyelashes and skin rub against the eye, making it red, irritated, watery, sensitive to light and wind. If entropion is not treated, an infection may develop on the cornea. Surgery will help to protect the eye and improve these symptoms.

Gastrointestinal Endoscopy

Colorectal Cancer

What is colorectal cancer?
Colorectal cancer is a term used to refer to cancer that develops in the colon (large intestine) or the rectum. These cancers are sometimes referred to separately as colon cancer or rectal cancer, depending on where they start.

Abnormal growths in the colon or rectum
Most colorectal cancers develop slowly over several years. Before a cancer develops, a growth of tissue or tumor usually begins as a non-cancerous polyp on the inner lining of the colon or rectum. A tumor is abnormal tissue and can be benign (not cancer) or malignant (cancer). A polyp is a benign, non-cancerous tumor. Some polyps can change into cancer, but not all do. The chance of changing into a cancer depends upon the kind of polyp.

Adenomatous polyps (adenomas) - Adenomas are polyps that have the potential to change into cancer. Because of this, adenomas are called a pre-cancerous condition.

Hyperplastic and inflammatory polyps - In general, these are are not pre-cancerous. Some doctors think that some hyperplastic polyps can become pre-cancerous or might be a sign of having a greater risk of developing adenomas and cancer, particularly when these polyps grow in the ascending colon.

Dysplasia - Another kind of pre-cancerous condition is called dysplasia. Dysplasia is an area in the lining of the colon or rectum where the cells look abnormal (but not like true cancer cells) when seen under a microscope. These cells can change into cancer over time. Dysplasia is usually seen in people who have had diseases such as ulcerative colitis or Crohn’s disease for many years. Both ulcerative colitis and Crohn’s disease cause chronic inflammation of the colon.

Start and spread of colorectal cancer
If cancer forms within a polyp, it can eventually begin to grow into the wall of the colon or rectum. When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels. Lymph vessels are thin, tiny channels that carry away waste and fluid. They first drain into nearby lymph nodes, which are bean-shaped structures that help fight infections. Once cancer cells spread into blood or lymph vessels, they can travel to nearby lymph nodes or to distant parts of the body, such as the liver. Spread to distant parts of the body is called metastasis.

Types of cancer in the colon and rectum
Several types of cancer can start in the colon or rectum:

Adenocarcinomas - More than 95% of colorectal cancers are adenocarcinomas. These cancers start in cells that form glands that make mucus to lubricate the inside of the colon and rectum. When doctors speak of colorectal cancer, this type of cancer is almost always what they are referring to.

Carcinoid tumors - These less common tumors develop from specialized hormone-producing cells of the intestine.

Gastrointestinal stromal tumors (GISTs) - These less common tumors develop from specialized cells in the wall of the colon called the interstitial cells of Cajal. Some are benign (non-cancerous); others are malignant (cancerous). These tumors can be found anywhere in the digestive tract, but they are unusual in the colon.

Lymphomas -These are cancers of immune system cells that typically develop in lymph nodes, but they may also start in the colon, rectum, or other organs.

Sarcomas -These tumors can start in the blood vessels as well as muscle and connective tissue in the wall of the colon and rectum. Sarcomas of the colon or rectum are rare.

Symptoms of colorectal cancer may include:

  • Blood in the stool
  • Stomach aches, pains, or cramps that do not go away
  • Losing weight and you do not know why
  • Iron-deficiency anemia
  • Change in bowel habits (constipation and/or diarrhea)

Who is at risk for colorectal cancer?
  • Adults 50 years of age and older
  • People with family history of bowel disease, polyps, colorectal cancer
  • African Americans
  • People with a poor diet and/or low physical activity
  • People who smoke and/or drink alcohol excessively

How is colorectal cancer detected?
A screening colonoscopy is considered the gold standard for early colorectal cancer detection. Read more about the colonoscopy procedure here.

When should I start getting screened?
The American College of Gastroenterology recommends a colonoscopy screening beginning at age 50. African Americans should begin screening at age 45. Anyone with family history of colorectal cancer should begin screening 10 years before the age their relative was diagnosed.

To schedule your screening colonoscopy...
Dowload It Is Time For Your Screening Colonoscopy. This document includes our instructions for scheduling, fasting and preparing for the procedure.

IMPORTANT REMINDER:
This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

Source: American Cancer Society

Colonoscopy

How to schedule a screening colonoscopy:
You can call us directly to schedule a screening colonsocopy. For more information, dowload It Is Time For Your Screening Colonoscopy. This document includes complete instructions for scheduling, fasting and preparing for the procedure. Our gastroenterologists are listed here.

What is a screening colonoscopy?
A screening colonoscopy is a preventative colorectal cancer exam. A screening is performed on a patient with no current symptoms (bleeding, abdominal pain, etc.). If found, a polyp or any abnormal cel growth will be removed for preventative dianosis.

Your first screening colonoscopy is recommended at age 50 and every 10 years thereafter (with normal results). Screening colonoscopies are not needed after your 75th year. Your doctor will advise you on your individual screening schedule if it differs from the 10 year guideline (higher risk or negative results after a colonoscopy may require an earlier re-screen).

As of January 1, 2014, screening colonocopies are covered 100% for people insured under the Affordable Care Act | Obamacare.

What is a diagnostic colonoscopy?
A diagnostic colonoscopy is performed in order to explain a patient’s current complaints or symptoms, either as observed by the physician or reported to him/her by the patient.

Check with your insurance company to learn what portion of a diagnostic colonoscopy is covered.

Diagnostic colonoscopies are scheduled via one of our gastroenterologist's offices. If you are having irregular bowel movements, bleeding or any other complaints related to the lower digestive tract, you may need to consult with a gastroenterologist to determine if a diagnostic colonoscopy is recommended. If you need a gastroenterologist, find one here.

How is the procedure done?
A doctor inserts an endoscope (long, thin, flexible tube equipped with a tiny video camera) rectally to examine and photograph areas of the entire colon (large intestine). Your doctor will search for abnormal growths, polyps or colon cancers and will evaluate the colon for other sources of bleeding. It also allows for treatment such as removal of polyps or taking biopsies of unusual or bleeding tissue.

How long does the procedure take?
The actual procedure usually lasts about 20-30 minutes but can take longer if polyps are present, if the colon is long or twisted, or if excessive scar tissue exists. The extent of time required from check-in to check-out is approximately 2-3 hours.

Will it be painful and uncomfortable?
Quite the contrary. Patients receive sedation, usually propofol, via an IV line administered by an anesthesiologist/CRNA team. The sedative, also called twilight sleep, is a pleasant, relaxed state where you do not feel or remember anything. This allows the patient to experience a pain-free, comfortable procedure. By the time you start to wake up, the procedure has been long complete. The drugs used for sedation rarely result in nausea or vomiting.

Bowel Prep FAQs

It is extremely important that your colon be thoroughly cleaned before your colonoscopy so your doctor can see any abnormalities during the procedure.

Cleansing the colon before a colonoscopy is called bowel preparation, or "prep."
It involves taking medication that causes diarrhea for the purpose of emptying the colon. The medication is taken orally and comes in liquid or tablet form. You will also need to change your diet for a day or two before the colonoscopy. Many patients feel that the bowel prep is the most difficult part of a colonoscopy.

What are the types of bowel prep and how is my prep determined?
Several types of bowel prep medications are available. Your doctor will prescribe the type that is best for you. Your medical condition is the most important factor in deciding which type of bowel prep is prescribed. Tell your doctor if you:

  • Are pregnant or breast feeding
  • Have a history of bowel obstruction
  • Have high blood pressure
  • Have any heart, kidney or liver disease now or in the past
  • Have allergies to medicines
  • Have had difficulty with a bowel prep in the past

Other factors in determining the type of prep are: the time of the colonoscopy appointment; whether the prep is covered by your medical insurance; individual preferences such taste and amount of medication. If taste is important, our patients tell us that the Miralax/Gatorade prep is flavorless and most tolerable. Be sure to discuss the options available to you with your doctor.

What bowel preparation steps are involved before the colonoscopy?
You will need to carefully follow your doctor's instructions about the exact dose and timing of your prep. In general, here is what you can expect:

  • Changing your diet at least one day before your colonoscopy
  • Limiting your diet to clear broths, beverages and gelatin desserts
  • Not consuming dairy products or non-dairy creamers
  • Not consuming red or purple beverages, gelatins and popsicles
  • Drinking more fluids than you usually do to avoid dehydration
  • To follow carefully all the steps your doctor prescribes
  • To tell your doctor what medications you are taking

What medications interfere with bowel prep and/or colonoscopy?

Be sure to talk with your doctor about what you can and cannot take. Most medications can be continued, but these medications may interfere:

  • Aspirin products
  • Arthritis medications
  • Anticoagulants (blood thinners such as warfarin or heparin)
  • Clopidogrel
  • Insulin
  • Iron products

What are the common side effects of bowel prep?
The type and severity of side effects differ among patients. They also vary with the product used. Some patients have nausea, vomiting, bloating (swelling in the abdomen) or abdominal pain. A prep can cause kidney failure, heart failure or seizures, but this is rare. Your doctor will explain the possible side effects of the prep selected for you.

What if I forget to take the medication when I should or remember too late to finish the prep?
Call us and ask what to do if you are not able to complete the bowel prep as advised.


ColonoscopyAssist™

What is ColonoscopyAssist™?
ColonoscopyAssist™ is a program that helps uninsured and under-insured patients afford procedures to screen and diagnose colorectal cancer. They offer interest-free payment plans and grants for upper GI tract endoscopy, colonoscopy and post-colorectal cancer diagnosis support.

ColonoscopyAssist has grown to become one of the largest programs of its kind in North America. It is available in 59 cities throughout the country. Southgate Surgery Center was selected by ColonoscopyAssist as its primary surgical facility in Michigan.

Can I choose which doctor does my procedure at Southgate Surgery Center?
If you would like to, yes. When you request your appointment, just specify the name of the gastroenterologist you prefer--Rana Sabbagh, M.D., Sudarshan Singal, M.D. or Steven Watts, M.D.. Learn more about these physicians here.

What does the $950 flat rate for a colonoscopy include?
The $950 flat rate includes all costs related to the procedure. There are no hidden charges or fine print. The price includes:

  • Physician's fee
  • Southgate Surgery Center's facility fee, including nursing costs
  • Sedation costs
  • Removal of polyps and biopsies

Do I have to be paid-in-full before my procedure?
No. ColonoscopyAssist offers a zero-interest payment plan which is not normally offered to cash pay patients at hospitals or outpatient facilities.

Is my quality of care lessened if I use the ColonoscopyAsssist program?
No. Lower co-pays, exceptional care is our mission every day. As a ColonoscopyAssist patient, you will be treated with the same respect, compassion and courtesy as any other patient with insurance, including free transportation if needed.

Does ColonoscopyAssist have a website?
Yes. The site's address is: colonoscopyassist.com. You can find more information about the program, read patients reviews, learn about colon cancer, request an appointment and much more.

How do I request an appointment?
To request an appointment you may call (847) 986-8999 or make the request online via the following link: Online Appointment Request

Who will do my procedure?
One of our board-certified gastroenterologists credentialed with the ColonoscopyAssist program will provide your care. If you have a preference, include the physician's name on your online appointment request or let the operator know whom you prefer when you call. Our current ColonoscopyAssist providers are:

Sudarshan Singal, M.D.
Steven Watts, M.D.

Upper GI Endoscopy

What is upper GI endoscopy?
Upper GI endoscopy (also called gastroscopy, EGD or Esophagogastroduodenoscopy) is a procedure that allows a physician to view the esophagus, stomach and first part of the small bowel (duodenum) through an endoscope. The patient's throat is numbed and they are given mild sedation so there is no discomfort during the procedure.

Why would I need upper GI endoscopy?
It may be helpful in diagnosing ulcers, gastritis, growths, GERD, Barrett's Esophagus, causes of bleeding or pain and cancer. It may detect the presence of pylori, a type of bacteria that causes ulcers. A sample of tissue (biopsy) may be taken, foreign objects or growths can be removed, bleeding can be stopped and narrow areas (strictures) can be opened.

When should I have this procedure done?
If you are experiencing any of the following symptoms your doctor may recommend upper GI endoscopy:

  • Nausea
  • Vomiting
  • Heartburn
  • Chronic acid reflux
  • Difficulty or pain swallowing
  • Unexplained anemia
  • Upper gastrointestinal bleeding

NOTE: Symptoms such as a little heartburn may not seem like a big deal, but it is crucial to seek a doctor's advice. Something more severe could be going on, like damage to your stomach or esophagus which could turn into cancer.

How do I schedule endoscopy?
If your family doctor or primary care physician has told you that upper GI endoscopy is needed, you can call us to directly schedule it. Our gastroenterologists do not require an office visit prior to the procedure. If you need a gastroenterologist or prefer to see one first, find one at Our Doctors page: here.

Is this covered by insurance?
Many insurance plans and Medicare will cover endoscopy. Check with your plan to find out if it is covered for you. We accept most insurances.

What is gastresophageal reflux disease (GERD)?
GERD is a more serious form of gastroesophageal reflux (GER), also commonly referred to as acid reflux. GERD occurs when stomach contents rise into the esophagus, causing a burning sensation in the chest or throat called heartburn. Occasional GER is common, but when reflux is persistent and occurs more than twice a week, it is considered GERD and can eventually lead to more serious health problems.

GERD can occur in people of all ages and those experiencing symptoms should consult a physician. If left untreated, it can lead to complications such as a bleeding ulcer. Scars from the tissue damage can lead to strictures (narrowed areas of the esophagus) and this makes swallowing difficult. GERD may also cause hoarseness, chronic cough and conditions such as asthma.

What is Barrett's Esophagus?
Barrett's Esophagus is a condition in which there is an abnormal change in the cells of the tissue lining of the esophagus.

No signs or symptoms are associated with Barrett's Esophagus, but it is commonly found in people with gastroesophageal reflux disease (GERD). A small number of people with Barrett's Esophagus develop a rare but often deadly type of cancer of the esophagus.

While the average age of diagnosis is 50, determining when the problem started is usually difficult. Men are twice as likely to develop Barrett's Esophagus and Caucasian men are at a higher risk than men of other races. Since Barrett's Esophagus is more commonly seen in people with GERD, it is crucial to manage and improve symptoms of GERD if you are affected by it, which may lower the risk of developing Barrett's Esophagus.

Barrett's Esophagus can only be diagnosed by having an upper GI performed. Since it does not have any symptoms, it is recommended that adults 40 years and older that have had GERD for a number of years have an upper GI regularly to check for the condition.