Lap Band and Gastric Bypass Surgery in Las Vegas – FAQs
Is Dr.Umbach Board Certified?
What other certifications or professional memberships does Dr. Umbach have?
Does Dr. Umbach perform the majority of cases open or laparascopically?
What types of bariatric procedures has Dr. Umbach performed?
What is Dr. Umbach's mortality rate?
What complications of surgery do you come across most often? Is your rate of complications greater or less than the national average?
Which bariatric procedure is best for me? Why? What are the risks involved?
If I want to have bariatric surgery, how long do I have to wait?
What can I do before the appointment to speed up the process?
How long will I be in surgery?
What is the length of my anticipated stay?
How long will it be before I can return to presurgery levels of activity?
How will my eating habits change?
Do you have information about bariatric surgery costs and payment options?
Can you provide me with the name of an insurance expert who can assist me in
qualifying for surgery?
What is the typical excess weight loss and improvement of associated health
conditions for your other patients?
Do you have patients who are willing to share their experiences, both positive and negative?
What information can you give me to help family and friends better understand this surgery?
What do you expect from me if I decide to choose a surgical solution?
Does the program have established guidelines in patient selection?
Does your program offer evaluation and treament for co-morbid conditions,
such as type 2 diabetes and sleep apnea?
Is there a dedicated facility and staff for my care?
Does the program offer registered dieticians?
Are the radiologists and anesthesiologists in the program board certified?
Will you work with my primary care physicians to ensure total wellness?
Will you work with me to get insurance approval?
If I am denied by my insurance company, do you offer any financing options?
Does your program offer support groups following surgery?
Can I have reconstructive surgery here after my weight loss? if not, can you
recommend a surgeon?
Do you offer accommondations and travel assistence for out-of-town patients?
Does the program offer translation services for non-english speaking patients?
Patient Financing For Bariatric Surgery Click Here For More Info
IS DR.UMBACH BOARD CERTIFIED?
Dr. Umbach is an American medical school graduate, board certified by the American Board of Surgery, and a Fellow in the American College of Surgeons.
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WHAT OTHER CERTIFICATIONS OR PROFESSIONAL MEMBERSHIPS DOES DR. UMBACH HAVE?
In 2002, Dr. Umbach completed a prestigious fellowship in Advanced Minimally Invasive Surgery at the University of Southern California. Since then he has dedicated himself to helping Las Vegas weight loss surgery patients and is an active member of the American Society of Metabolic and Bariatric Surgery.
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DOES DR. UMBACH PERFORM THE MAJORITY OF CASES OPEN OR LAPAROSCOPICALLY?
Given Dr. Umbach's extensive training and experience with operating laparoscopically on patients, nearly all operations are safely started and completed laparoscopically. Laparoscopic surgery benefits patients because of less wound infections, less pain, and quicker recovery, and faster hospital discharge.
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WHAT TYPES OF BARIATRIC PROCEDURES HAS DR. UMBACH PERFORMED?
Dr. Umbach has a vast experience, more than 500 cases, with the two most popular bariatric procedures: the gastric bypass and the Lap Band. As a result, he has successfully dealt with a wide variety of complex cases, including revision bariatric surgery of gastric bypass performed elsewhere. In addition, Dr. Umbach performs Stomaphyx in Las Vegas, Nevada.
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WHAT IS DR. UMBACH'S MORTALITY RATE?
Dr. Umbach's mortality rate of 0.2% is significantly less than the national average for the gastric bypass which is 0.5%. In addition, his mortality rate is 0 for gastric banding, which has a national mortality rate of 0.1%.
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WHAT COMPLICATIONS OF SURGERY DO YOU COME ACROSS MOST OFTEN? IS YOUR RATE OF COMPLICATIONS GREATER OR LESS THAN THE NATIONAL AVERAGE?
The types of complications vary based on the weight loss operation performed. Most commonly, gastric bypass patients can suffer from nausea, particularly early after surgery. This always resolves with time. While gastric banding patients have more problems with the port or band itself. These are typically easily correctable. Fortunately, major surgical complications, such as blood clots or intestinal leakage, are rarer and much less than the national average. Dr. Umbach feels vary strongly that proper preparation for surgery, both mentally and physically, greatly helps limit surgical complications.
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WHICH BARIATRIC PROCEDURE IS BEST FOR ME? WHY? WHAT ARE THE RISKS INVOLVED?
Pick the bariatric procedure that you understand and feel the most comfortable with. After learning more about weight loss surgery by reading websites such as this one, attending informational seminars and meeting with Dr. Umbach, it will become obvious which procedure is best. Any and every operation entails some risks, including the risk of death. For a detailed list of those risks please refer to the procedures section of this website. Remarkable, the risks of poor health and medical problems stemming from morbid obesity outweighs the surgical risks from weight loss surgery itself.
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IF I WANT TO HAVE BARIATRIC SURGERY, HOW LONG DO I HAVE TO WAIT?
Appointments for tests can be scheduled fairly quickly. Although the amount of time between the first consultation and the date of surgery depends on several factors, some patients wait a few months. These factors depend on completing certain steps, which include insurance approval, any pre-operative education (including seminars), medical evaluation, and pre-operation work-up.
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WHAT CAN I DO BEFORE THE APPOINTMENT TO SPEED UP THE PROCESS?
Choose a primary care physician if you don't have one already, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current. For example, women may have a Pap smear, and if older than 40 years of age, a mammogram. For men, this may include a Prostate Specific Antigen test (PSA). Results of diagnostic and routine screening for co-morbid conditions such as type 2 diabetes and high cholesterol can be necessary for documentation of medical necessity.
- Make a list of all the diets you have tried (a diet history) and take it to your doctor.
- Keep track of every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Make note of other weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts.
- Take any relevant medical data to your appointment with the bariatric surgeon, including reports of special tests (echocardiogram, sleep study, etc.), or a hospital discharge summary if you have been in the hospital for weight-related health problems.
- Take a list of your medications, including dosage and schedule.
- Quit smoking. Surgical patients who use tobacco products are at a greater surgical risk. Talk to a doctor for help with this.
- Gather all of the information (diet records, medical records, medical tests) your insurance company may require. This reduces the chance of being turned down because you failed to provide necessary information. Letters from your personal physician and professionals supporting the medical necessity of treatment are particularly valuable. When several physicians report the same findings, it may confirm a medical necessity for surgery.
- When you send your letter, call your insurance carrier regularly to ask about the status of your request. Your employer or human relations office also may be able to help you work through any issues. Be sure to write down dates and the names of people you speak with and keep notes about the conversations. When possible, get them to fax you copies of the policies they are quoting.
- Make sure your primary care physician is documenting your weight loss efforts and your weight in your medical records at every visit.
What is the process for application for insurance coverage?
Since every insurance policy is unique, it's important that you thoroughly understand your certificate of coverage to know exactly what is and isn't covered through your plan.
To qualify for insurance coverage, many insurers require patients to have a history of medically supervised weight loss efforts.
Dr. Umbach will prepare a letter to obtain preauthorization from your insurance company. The goal of this letter is to establish the medical necessity of bariatric surgery and gain approval for the procedure. The following information is generally included in the preauthorization letter:
- Your height, weight, and Body Mass Index, and any documentation you might have as to how long you have been overweight.
- Simply describing your condition as morbid obesity is not enough. A full description of all your obesity-related health conditions, including records of treatment, a history of medications taken, and documentation of how these conditions affect your everyday life, is necessary.
- A detailed report of how your excess weight affects daily activities, such as walking, tying your shoes, or maintaining personal hygiene.
- A detailed history of the results of your dieting efforts, including medically and non-medically supervised programs, medical records, and records you may have kept of payments to and meetings you've attended with commercial weight loss programs.
- A history of exercise programs, including receipts for gym memberships.
- Ask your doctor to include clinical information about how effective bariatric surgery can be, particularly the control or loss of obesity-related health conditions.
Normally, your insurance provider will respond to your request within 30 days. You should schedule a follow-up if you have not heard from your insurance company in that amount of time.
At the end of this stage, with the help Blossom Bariatrics, you will know if you qualify for surgery.
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HOW LONG WILL I BE IN SURGERY?
The actually operating time for both the gastric bypass and the gastric banding are about an hour or less. However, because of all the preparation and processes that occur on the day of surgery you can expect to spend several hours in the operating room area, including pre-op area, operating room, and the post op recovery area.
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WHAT IS THE LENGTH OF MY ANTICIPATED STAY?
With advances in anesthesia and laparoscopic surgery, patients typically leave the hospital the next day after a gastric bypass. Gastric banding patients can leave the hospital on the day of the operation. Close contact with the surgeon is critical earlier on after surgery. Blossom Bariatrics will call patients after surgery and patients will return for their first post operative visit 2 weeks after surgery.
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HOW LONG WILL IT BE BEFORE I CAN RETURN TO PRESURGERY LEVELS OF ACTIVITY?
Dr. Umbach encourages patients to return to normal activity quickly after surgery. There is no danger to you by performing normal light everyday activities, such as walking, cooking, and shopping. Most patients find it enjoyable to begin light exercise program soon after discharge from the hospital. In fact, an early return to activity is important for a safe and speedy recovery. One important point is that while taking narcotic pain medication, patients should not drive or operate machinery. Return to work is based upon your own personal recovery and the demands of your job. Patients often begin light office work Monday the week after surgery.
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HOW WILL MY EATING HABITS CHANGE?
Weight loss operations enable patients to develop a new and health relationship with food. As part of the preparation, you will attend classes and meet with a dietician. After surgery, patients have all the knowledge they need to eat a healthy protein based diet. Importantly, patients can and should eat a wide variety of foods. At a restaurant, people will not know that you have had weight loss surgery.
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DO YOU HAVE INFORMATION ABOUT BARIATRIC SURGERY COSTS AND PAYMENT OPTIONS?
Costs for weight loss surgery are impossible to quote exactly ahead of time. Rough estimates include the costs for the hospitalization, anesthesiologist and surgeon. For cash pay patients the gastric bypass costs about $21,000 and the gastric banding about $16,000. For those patients without any insurance coverage, Dr. Umbach understands this is a large investment in your health and has finance plans available in his office.
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CAN YOU PROVIDE ME WITH THE NAME OF AN INSURANCE EXPERT WHO CAN ASSIST ME IN QUALIFYING FOR SURGERY?
Obtaining insurance coverage for weight loss surgery can be very difficult and frustating. For example, some patients actually change jobs and or careers to gain proper coverage. Basically, either you have the insurance benefit or do not. Patients are no longer able to obtain coverage based on “medical necessity”. For those patients with proper insurance coverage, Blossom Bariatrics will help guide you through the entire authorization process.
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WHAT IS THE TYPICAL EXCESS WEIGHT LOSS AND IMPROVEMENT OF ASSOCIATED HEALTH CONDITIONS FOR YOUR OTHER PATIENTS?
Through the results of many scientific studies and years of experience, it is known that the majority of patients will lose about 2/3rds of their excess body weight. So for a patient who is 120 pounds overweight, she can expect to lose 80 pounds and keep it off. Weight loss surgery generally cures or improves about 3/4s of a patient's medical problems. For a patient with diabetes, sleep apnea, and high cholesterol, there is 75% chance that the diabetes, sleep apnea, and/ or high cholesterol will resolve.
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DO YOU HAVE PATIENTS WHO ARE WILLING TO SHARE THEIR EXPERIENCES, BOTH POSITIVE AND NEGATIVE?
It is very important that patients research thoroughly all the pros and cons of weight loss operations. This should include talking with other patients, surfing the web, attending seminars, and meeting with your surgeon. Ask around and you will be surprised how many people you already know that have had weight loss surgery. Another fabulous resource for all weight loss patients is a website called ObesityHelp.com. Finally, our Bariatric Nurse Coordinator, Nakita, is in fact a very successful weight loss patient who is always willing to share her knowledge.
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WHAT INFORMATION CAN YOU GIVE ME TO HELP FAMILY AND FRIENDS BETTER UNDERSTAND THIS SURGERY?
Unfortunately, it can be hard for family and friends to understand weight loss surgery. Please share your entire journey through the weight loss surgery process with your family to help educate them. Dr. Umbach encourages patients to bring your support person to all meetings including the informational seminar, the evaluation with the surgeon and dietician, educational classes, and support groups. Friends will quickly learn that this is not the easy way out, it requires hard work and dedication.
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WHAT DO YOU EXPECT FROM ME IF I DECIDE TO CHOOSE A SURGICAL SOLUTION?
Just as patients have many expectations of their weight loss operation, Dr. Umbach has similar expectations of his patients. Successful patients attend classes, follow the program guidelines, change their lifestyle, loss weight before surgery, and attend support groups. Perhaps the most important expectation is that patients understand this is a lifelong change and they must follow up with their surgeon.
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DOES THE PROGRAM HAVE ESTABLISHED GUIDELINES IN PATIENT SELECTION?
Dr. Umbach's guidelines for bariatric patient selection match those developed by the National Institutes of Health back in 1991. Basically, patients can qualify for weight loss surgery when they are 75 pounds or more overweight. Additional criteria for selecting patients for surgery are similar to those needed for any major elective operation. In general, patient should be between the ages of 18 and 68, able to walk a block, have stable controlled medical problems, non-smoking, and be knowledgeable of the surgical risks.
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DOES YOUR PROGRAM OFFER EVALUATION AND TREAMENT FOR CO-MORBID CONDITIONS, SUCH AS TYPE 2 DIABETES AND SLEEP APNEA?
Morbid obesity is associated with many other medical conditions. At Desert Springs Hospital and Blossom Bariatrics, we offer sophisticated and comprehensive care for these co-morbidities, such as sleep apnea and diabetes mellitus. In addition, Dr. Umbach works closely with the referring primary care physician to optimize the associated medical conditions of his patients. The purpose of a thorough patient preparation is to make their weight loss surgery as safe as possible.
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IS THERE A DEDICATED FACILITY AND STAFF FOR MY CARE?
As a Center of Excellence Hospital, Desert Springs Hospital is dedicated at all levels to care for the bariatric patient. This commitment includes an exclusive Center of Excellence physician Medical Director, a Certified Bariatric Nurse Coordinator, specialized operating room facilities, exclusive bariatric patient rooms, and a dedicated nursing staff. In addition, Desert Springs Hospital has a sleep center and diabetic care center available for patients.
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DOES THE PROGRAM OFFER REGISTERED DIETICIANS?
Preparation for weight loss surgery involves multiple steps. After the initial informational seminar, patients meet directly with Dr. Umbach. At this comprehensive evaluation, each patient will receive an individualized list of tasks to complete. Patients will then meet with our registered dieticians for an hour evaluation. These same dieticians are available for additional visits as required by the patient's insurance company. Additional dietary education will include a 3 hour class covering the basics of nutrition and successful eating habits.
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ARE THE RADIOLOGISTS AND ANESTHESIOLOGISTS IN THE PROGRAM BOARD CERTIFIED?
Because Desert Springs hospital is a Center of Excellence and has a long history of performing weight loss surgery, all associatied physician specialists are board certified and very experienced in the needs of bariatric patients. In addition, Dr. Umbach uses a small number of anesthesiologists to further improve the quality of patient care.
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WILL YOU WORK WITH MY PRIMARY CARE PHYSICIANS TO ENSURE TOTAL WELLNESS?
A successful surgical weight loss program involves the patient's primary care physician during all phases of their journey. Blossom Bariatrics requires a referral from the patient's physician to start the process. Additional records from your doctor may be needed to complete the surgical evaluation. In return, Dr. Umbach's office will keep the primary care physician informed by sending copies of visits and reports.
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WILL YOU WORK WITH ME TO GET INSURANCE APPROVAL?
Dr. Umbach will work hard with each patient to obtain insurance approval. The insurance approval process culminates with submission for pre-authorization for the operation. Blossom Bariatrics sends an inch thick packet tailored to the specific requirements of the patient's insurance company for pre-authorization. This results a very high chance of approval the first time around with the insurance company.
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IF I AM DENIED BY MY INSURANCE COMPANY, DO YOU OFFER ANY FINANCING OPTIONS?
Because of a thorough preparation for insurance authorization, denials are rare. However, as a service to his patients, Dr. Umbach personally calls the medical director of the insurance company for each denial. This approach can typically results in reversal of the denial. If your insurance company denies your appeal you can consider hiring an insurance lawyer or insurance advocate, both of whom can be very helpful. The insurance lawyer or advocate should have an in-depth understanding of the appeals process, as well as any laws that apply, and how to go about responding to the insurance company. With some insurance carriers, the number of appeals that you can make is limited. So be sure to learn as much as possible about the appeals process ahead of time. As a last resort, patients can finance their operation through outside loan programs available at Blossom Bariatrics.
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DOES YOUR PROGRAM OFFER SUPPORT GROUPS FOLLOWING SURGERY?
One the most important habits for a successful patient is regular attendance at support groups. Though it is difficult to find the time to attend, patients always learn something at each support group meeting. Desert Springs Hospital will have regularly scheduled support groups for patients. Please refer to their web site for exact times and locations.
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CAN I HAVE RECONSTRUCTIVE SURGERY HERE AFTER MY WEIGHT LOSS? IF NOT, CAN YOU RECOMMEND A SURGEON?
Prospective patients frequently have many questions about the need for plastic surgery after major weight loss. However, the actual number of patients who eventually pursue plastic surgery is quite small. Most patients after becoming healthier and happier are satisfied with their new bodies. For those patients who still wish to have plastic surgery, Dr. Umbach can recommend a plastic surgeon.
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DO YOU OFFER ACCOMMONDATIONS AND TRAVEL ASSISTENCE FOR OUT-OF-TOWN PATIENTS?
One of the many reasons Dr. Umbach came to Las Vegas was to establish a concierge practice for patients from out of the area. As a major tourist destination, affordable flights and hotels are readily available. Please contact Blossom Bariatrics directly to make specific arrangements.
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DOES THE PROGRAM OFFER TRANSLATION SERVICES FOR NON-ENGLISH SPEAKING PATIENTS?
Blossom Bariatrics and Dr. Umbach are proud to offer their services in both English and Spanish. In addition, a full range of translation services is offered at Desert Springs Hospital.
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