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Center for Surgical Weight Loss

Bariatric Surgery at Care New England

Welcome to The Center for Surgical Weight Loss at Care New England. We understand that obesity can be a difficult disease to live with and a frustrating problem to treat. That's why we are committed to helping you along your journey to better health.

Kent Hospital is an MBSAQIP-Accredited Comprehensive Center. We offer a free video consultation, led by Dr. Jeannine Giovanni, director of bariatric surgery at Care New England. During the webinar, you can hear about your options, the risks, and the benefits of bariatric surgery, all from the comfort and privacy of your own home.

Watching the video consultation is the first step. We’ll then invite you to schedule an in-person consultation at Care New England’s Center for Surgical Weight Loss in Warwick, RI.

A New Lease on a Healthy Life
 
Center for Surgical Weight Loss

building-1227 Centerville Road, Suite 2
Warwick, RI 02886

   phone2(401) 736-3731

About Weight Loss Surgery

Do I qualify for surgery?

In order to qualify for surgery, you must meet criteria established by the National Institutes for Health. All surgeons in the United States who perform weight loss surgery must follow these guidelines, which include:

  1. BMI greater than 40 or greater than 35 with at least one major weight-related comorbidity.
  2. Age 18 years old or older.
  3. Demonstrated previous failed attempts at nonsurgical weight loss.
  4. No unstable psychiatric disorder.
  5. No active dependency on narcotic medications (ie. Oxycontin or methadone), alcohol, or illegal/recreational drugs.
  6. Must be committed to a healthier lifestyle and set realistic goals.
  7. Must be able to understand the risks and consent to the procedure willingly.
How does weight loss surgery work?

To understand how the surgery works, you need to understand the normal digestive process. The stomach stretches as it fills with food and it slowly releases a chemical ("hormone") into the blood stream to let the brain know what's going on. It can take at least 20 minutes before the brain realizes what's happening and makes us feel full. Eventually food exits the stomach and passes through the digestive tract. The nutrients and calories are broken down by digestive juices and absorbed into the body. The "waste" then reaches the colon which reabsorbs fluid and stores waste until it is evacuated.

Bariatric operations help patients lose and keep off weight through three important mechanisms:

  1. Restriction - This limits how much food you can eat and helps make you feel full.
  2. Malabsorption - This limits how calories and nutrients are taken up or absorbed into your body.
  3. Hormonal changes - Many of the hormones that make us feel hungry or are involved with blood sugar regulation and "cravings" lessen after surgery. This is one of the major ways diabetes is controlled or cured within days of gastric bypass surgery even before a person loses any weight.

The lap band works mainly by restricting food intake. The sleeve gastrectomy involves restriction and hormonal changes. The gastric bypass does all three.

History of weight loss surgery

Weight loss surgery has been around since the 1960s. The first gastric bypass surgery was performed by Dr. Edward Mason in 1966 at the University of Iowa. At the time, Dr. Mason was performing a lot of stomach surgeries for ulcers and cancers when he made the important observation that these patients then had a difficult time maintaining their weight. That's when he decided, "I'd take the undesirable effect of gastric resection, which was weight loss, and use it for a desirable effect, to treat obesity."

Bariatric surgery has evolved tremendously since that time. It is widely accepted now as the most successful long-term treatment for obesity and weight-related diseases. However, even today, there is no cure for obesity. Not even surgery. Surgery is a tool. It is very effective when a person is dedicated to a healthier lifestyle including better eating choices and increased physical exercise. That's also why there are choices. At Care New England, we offer three surgical treatments; the lap band, the sleeve gastrectomy and the roux-en-y gastric bypass (RYGB).

Free Video Consultation

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Our free video consultation is the first step towards easily finding the answers to your questions, all from the privacy of your own home. By participating in the free webinar, led by Dr. Jeannine Giovanni, director of bariatric surgery at Care New England, you’ll learn more about the considerations of surgical weight loss, get to know Care New England’s expert bariatric team, and take the first steps to start your journey to a healthier life.

Once you have watched the consultation video, you’ll have a basic understanding of the surgical weight loss process. Once completed you’ll be able to schedule an in-person consultation at Care New England’s Center for Surgical Weight Loss in Warwick, RI.

Procedures Offered

Lap Band

This device was approved for use in the U.S. by the Food and Drug Administration (FDA) in 2001. The band is made of solid silicone, like a belt, and is wrapped around the upper part of the stomach. The belt has an inner inflatable balloon that is adjusted by adding sterile water to the port. The port is placed under the skin. When the band is inflated, it squeezes the stomach, making it harder for food to pass from the small upper stomach pouch through to the rest of the stomach. Food is forced to slow down and, therefore, the small p

ouch stretches. This makes you feel full after eating very small portions. If the band is too tight, food will get stuck and cause vomiting. In that case, the fluid can be removed by the doctor to relax the band and allow food to pass easier. Digestion is normal and your anatomy is kept intact, which makes the procedure reversible.

Sleeve Gastrectomy

The "sleeve" is a procedure in which the majority of the stomach is stapled off and removed. This results in a long, slender stomach tube that doesn't stretch much. This procedure helps you eat small portions (4-8 ounces). It also has the added benefit of reducing hunger, partly due to the dramatic decrease in the hormone ghrelin which is primarily made in the part of the stomach that is removed. There may be other hormone changes that occur to help improve diabetes.

Roux-En-Y Gastric Bypass (RYGB)

This is still the most popular weight loss surgery in the U.S. With the bypass, nothing is removed but the anatomy is rearranged. First, a small one ounce stomach pouch is created. This is stapled and divided from the rest of the stomach and can only hold a few ounces of food. The remaining 95 percent of the stomach remains in place but no longer is able to receive food. This "bypassed" leftover stomach does not shrink, rot, or cause any problems. It still makes digestive juices.

Next, the small intestine is "rearranged." About two feet of small intestine is divided into three sections: the duodenum, jejunum, and ileum. The duodenum, where the majority of digestive juice is produced and nutrients are absorbed, is cut and connected to the jejunum three feet (100cm) down stream. The "free" or "cut" end is pulled up and connected to the pouch with a very small opening.

Now food enters the stomach pouch and squeezes through a small, button-sized opening to get into the intestine. The food travels three feet before it encounters the digestive juices produced by the bypassed stomach and duodenum. The overall effect is that patients eat small portions and calories do not absorb well (restriction plus malabsorption). In addition, because food bypasses the old stomach, 90 percent of diabetics are cured almost immediately after the operation.

  • What to Expect
  • FAQs
  • Recovery
  • Testimonials
  • Our Team

Contrary to popular belief, weight loss surgery is not the "easy way out." Surgery can successfully start you on the road to recovery, but it alone does not ensure long-term success. You must change your eating habits, exercise patterns, and relationship with food.

More than 80 percent of patients are able to lose and keep weight off long term. There is no amount of weight loss that is guaranteed. On average patients lose:

  • 40 percent excess weight with the band.
  • 50 to 60 percent excess weight with the sleeve.
  • 60 to 70 percent excess weight with the bypass.

These results are better in patients who participate in postoperative follow up with their surgeon, nutritionist, and support groups. Many, if not all, weight-related medical issues will resolve or improve after surgery.

These procedures are not without risks or side effects. You will learn about potential complications at the introductory seminar and from your doctor. It is important that you understand these risks so you can make an informed decision about surgery. We encourage you to learn as much as you can from us and through other resources. We invite and encourage questions from you.

The following is a list of potential complications:

For the Roux-En-Y Gastric Bypass and Sleeve Gastrectomy:

  • Bleeding.
  • Wound infection.
  • Leak from the staple line/peritonitis/sepsis.
  • Blood clots in the legs and/or lungs.
  • Stomach ulcers.
  • Narrowing of the pouch or "stricture" that must be later stretched open.
  • Hernia.
  • Intestinal blockage.
  • Vitamin or nutrient deficiencies.
  • Injuries to vital organs, nerves, or blood vessels.
  • Scar tissue.
  • Hair loss.
  • Excess skin.
  • Psychiatric problems and addiction.
  • Gallbladder disease requiring removal.
  • Kidney stones.
  • Dehydration.
  • Nausea or vomiting.
  • Inability to eat certain foods.
  • Dumping syndrome (occurs when the undigested contents of your stomach move too rapidly into your small bowel).
  • Acid reflux.
  • Death.
  • Failure to lose weight or weight regain.
  • Need for another operation to correct a problem.

For the Lap Band, all of the above complications apply, plus these:

  • Band slip.
  • Band erosion.
  • Band breakage.
  • Band infection.
  • Port problems.
  • Overstretching of the esophagus.
  • Excessive vomiting or heartburn.

Any one of these problems may require another operation, removal, revision, or conversion of the band to a different weight loss procedure.

You can help to reduce your risks of surgery with several measures:

  • Do not gain weight.
  • Try to lose weight before surgery.
  • Become physically active.
  • Stop smoking.
  • Stop birth control pills.
  • Follow the instructions of your physicians and nutritionist.

How long after metabolic and bariatric surgery will I have to be out from work?

After surgery, most patients return to work in one or two weeks. You will have low energy for a while after surgery and may need to have some half days, or work every other day for your first week back. Most jobs want you back in the workplace as soon as possible, even if you can’t perform ALL duties right away. Your safety and the safety of others are extremely important – low energy can be dangerous in some jobs.

You will be out of work for four weeks if your job is very physical and involves heavy lifting.

When can I start exercising again after surgery?

Right away! You will take gentle, short walks even while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. Walking is enough exercise for the first month as you are healing and your energy is returning. There is no restriction for any activity after four weeks. Build slowly over several weeks. If you swim, your wounds need to be healed over before you get back in the water. Wait until your incision sites are checked at your post-op appointment.

Can I have laparoscopic surgery if I have had other abdominal surgery procedures in the past, or have a hernia, or have a stoma?

The general answer to this is yes. Make sure to tell your surgeon and anesthesiologist about all prior operations, especially those on your abdomen and pelvis. Many of us forget childhood operations. It is best to avoid surprises! Although your surgery may be planned as laparoscopic, there is always a chance that the surgeon may have to make an open, larger incision.

Sometimes your surgeon may ask to see the operative report from complicated or unusual procedures, especially those on the esophagus, stomach, or bowels.

Does Type 2 Diabetes make surgery riskier?

It can. Be sure to follow any instructions from your surgeon about managing your diabetes around the time of surgery. Almost everyone with Type 2 Diabetes sees big improvement or even complete remission after surgery. Some studies have even reported improvement of Type 1 Diabetes after bariatric procedures. Do your best to control your blood sugars prior to surgery. It’s best to work with your primary care physician or diabetes specialist (i.e. endocrinologist).

Can I have laparoscopic surgery if I have heart disease?

Yes, but you will need medical clearance from your cardiologist. Bariatric surgery leads to improvement in most problems related to heart disease including:

  • High Blood Pressure.
  • Cholesterol.
  • Lipid problems.
  • Heart enlargement (dilated heart, or abnormal thickening).
  • Vascular (artery and vein) and coronary (heart artery) disease.

During the screening process, be sure to let your surgeon or nurse know about any heart conditions you have. Even those with atrial fibrillation, heart valve replacement, or previous stents or heart bypass surgery usually do very well. If you are on blood thinners of any type, expect special instructions just before and after surgery.

When can I get pregnant after metabolic and bariatric surgery? Will the baby be healthy?

Most women are much more fertile after surgery, even with moderate pre-op weight loss. Birth control pills do NOT work as well in heavy patients. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it! You should discuss a birth control plan with your gynecologist prior to surgery.

We recommend waiting 12-18 months after surgery before getting pregnant.

Many women who become pregnant after surgery are several years older than their friends were when having kids. Being older when pregnant does mean possible increased risks of certain problems. Down’s syndrome and spinal deformities are two examples. The good news is that, after surgery, there is much less risk of experiencing problems during pregnancy (gestational diabetes, eclampsia, macrosomia) and during childbirth. There are also fewer miscarriages and stillbirths than in heavy women who have not had surgery and weight loss.

Kids born after mom’s surgery are LESS at risk of being affected by obesity later, due to activation of certain genes during fetal growth (look up “epigenetics” – for more information). There is also less risk of needing a C section.

Will I need to have plastic surgery? Does insurance pay for plastic surgery?

Most patients have some loose or sagging skin, but it is often more temporary than expected. You will have a lot of change between six and 18 months after surgery. Your individual appearance depends upon several things, including how much weight you lose, your age, your genetics and whether or not you exercise or smoke. Generally, loose skin is well-hidden by clothing. Many patients wear compression garments, which can be found online, to help with appearance.

Some patients will choose to have plastic surgery to remove excess skin. Most surgeons recommend waiting at least 18 months, but you can be evaluated before that. Plastic surgery for removal of excess abdominal and breast skin is often covered by insurance for reasons of moisture, hygiene and rash issues.

Arms and other areas may not be covered if they are considered “purely” cosmetic by your insurer. Some of these “less invasive” operations can be done in the clinic, however – so they can be much more affordable!

Will I lose my hair after bariatric surgery?

Some hair loss is common between three and six months following surgery. The reasons for this are not totally understood. Even if you take all recommended supplements, hair loss will be noticed until the follicles come back. Hair loss is almost always temporary. Adequate intake of protein, vitamins and minerals will help to ensure hair re-growth, and avoid longer-term thinning. Some patients take a supplement called “Biotin”. There is no scientific evidence that this is effective nor are the side effects well known.

Will I have to take vitamins and minerals after surgery? Will my insurance pay for these?

You will need to take a multivitamin for life. You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs. You can pay for supplements out of a flex medical account. Generally, liquid or chewable vitamins are better absorbed. We do not recommend “gummy” vitamins.

If my insurance company will not pay for the surgery, are payment plans available?

Bariatric surgery will not be covered by your insurance carrier if you have an exclusion policy. This is true even if you medically qualify. Appeals are futile in this scenario.

There are loan programs available to cover the cost of health expenses such as metabolic and bariatric surgery. Appeals to insurance companies or directly to your employer may reverse a denial of coverage. Metabolic and Bariatric surgery is a health expense that you can deduct from your income tax.

If you are not able to qualify for a loan, the Obesity Action Coalition (OAC) produces a helpful guide titled “Working with Your Insurance Provider – A Guide to Seeking Weight-loss Surgery.” This guide can help you work with your provider and advocate for your surgery to be covered. You can view the OAC guide on their website.

Our staff can assist you with an out-of-pocket payment plan.

If I am self-pay but I have health insurance, will my insurance company pay the cost of post-operative complications?

Complications are often reported under a separate medical billing code. The insurance company may not cover these costs. Appeal is often very helpful, and direct contact with your hospital can make a big difference for final costs.

Will I have to go on a diet before I have surgery?

Yes. Most bariatric surgeons put their patients on a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.

Some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement. These diets are very different from the short-term diets, and usually are more about food education and showing a willingness to complete appointments and to learn.

Can I drink alcohol after surgery?

We do not advise any alcohol consumption for the first six months following surgery. Alcohol can be irritating to the stomach lining. It is also rapidly absorbed after bariatric surgery causing patients to become intoxicated with much smaller amounts. This can be very dangerous and possibly addictive. It is advisable that you do not drive, make important decisions, or conduct business after any consumption of alcohol. You should seek help from a medical professional if you or others suspect you may be developing a dependency on alcohol. Aside from addiction, alcohol is a form of sugar. Frequent or overconsumption can lead to excess calories and weight gain.

Will I have to diet or exercise after the procedure?

No and Yes.

Most people think of a “diet” as a plan that leaves you hungry. That is not the way people feel after surgery. Eventually, most patients get some form of appetite back six to 18 months after surgery. Your appetite is much weaker, and easier to satisfy than before.

This does not mean that you can eat whatever and whenever you want. Healthier food choices are important for best results, but most patients still enjoy tasty food, and even “treats.”

Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a “peak” every week of the year. Sometimes exercise is work, but if it becomes a punishing, never-ending battle, you will not keep going. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!

For many patients (and normal weight people, too) exercise is more important for regular stress control, and for appetite control, than simply burning off calories. As we age, inactivity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depends on doing weekly weight bearing (including walking) or muscle resistance (weights or similar) exercise.

I am unable to walk.

Almost everyone is able to find some activity to “count” as moderate exercise, even those who are partially paralyzed, or who have arthritis or joint replacement or spine pain. Special therapists may be needed to help find what works for you.

How do I get a letter of necessity?

Your surgeon’s office will submit a letter of medical necessity to the insurance company after you complete all the program requirements. Often the insurance company will require the surgeon’s consultation summary note that includes information pertaining to current weight, height, body mass index, the medical problems related to obesity, your past diet attempt history and why the physician feels it is medically necessary for you to have bariatric surgery. The insurance company will want to see documentation that you have been to the nutritionist and completed all the evaluations (medical, psychiatric, etc.) before they will authorize the procedure. Your surgery cannot be scheduled until the surgeon obtains this pre-authorization.

Do I need to stop any medication prior to surgery?

It is recommended that you stop all NSAIDs (i.e. ibuprofen, motrin, aleve, Naprosyn), aspirin products, Vitamin E, herbal supplements, and fish oil one to two weeks before your surgery. These medications can cause bleeding problems. Your doctor will instruct you when to stop any blood thinning medications such as Coumadin, Plavix, Eliquis or others. When you go to your preadmission testing appointment (“PAT”) you will be instructed which medications are ok to take on the day of surgery It is advised that you do not take any ACE inhibitors or “sartan” blood pressure medications the day before or day of your surgery. Make sure you have a complete and updated list of all your meds including prescription and over the counter meds at each visit with the doctor and when you are admitted to the hospital.

Can I go off some of my medications after surgery?

As you lose weight, you may be able to reduce or eliminate the need for many of the medications you take for high blood pressure, heart disease, arthritis, cholesterol, and diabetes. If you have a gastric bypass or sleeve gastrectomy, you may even be able to reduce the dosage or discontinue the use of your diabetes medications soon after your procedure.

We are glad you have chosen to have surgery with us. You can rest assured that we will provide the highest quality of care in a respectful, dignified manner. Your comfort and safety are our priority.

Surgery usually takes between one to three hours. You will meet the surgical team before going under anesthesia but will be completely asleep and continually monitored throughout your surgery. You will wake up from surgery in the recovery room where staff will monitor you carefully and make sure you are as comfortable as possible.

You will be allowed to drink water immediately. Most patients spend just a few hours in the recovery room. Your family and friends cannot come into the recovery area, but we will keep them updated about your condition. They may visit you when you arrive on the surgical floor. You will be up and walking within hours of your surgery. This helps you feel better, recover faster, and prevents life-threatening complications such as blood clots.

Lap band patients generally go home the day of their surgery. Sleeve and bypass patients spend one to three nights in the hospital. Everyone is followed closely by the surgical team made up of your surgeon, physician assistants, nurses, pharmacists, nutritionists, physical therapists, and medical specialists. All of these professionals have undergone training to understand your needs as a bariatric patient.

When you leave to go home, we will give you instructions about the diet plan, medications, and follow up. We will also review the signs and symptoms of potential complications. Know that you can always call your surgeon with any problem no matter how trivial it may seem.

Recovery

Recovery is different for everyone. You can expect some discomfort and we will give you medication to take as needed for pain and nausea. You may feel more tired than usual. It’s important to maintain a positive attitude and to keep your surgeon informed if there are any problems.

Lap band patients tend to recover quickly. Most patients take one to two weeks out of work. It is usually easier to eat and drink, but patients are advised to adhere to the strict dietary guidelines. These recommendations are crucial to avoid problems such as food getting stuck, retching, and vomiting. These actions can cause the band to slip or the sleeve/bypass to leak.

Bypass and sleeve patients tend to recover a little slower and usually need four weeks out of work.

Weight loss is rapid after the bypass and sleeve. The majority of patients lose most of their weight in the first six to 12 months. The band has to be adjusted often so weight loss tends to be slower (about one to two pounds per week). It’s important to remember that this process is a marathon not a sprint!

Follow Up

You will need to see the surgeon two weeks after your operation. Band patients will then be seen monthly to adjust the band. Sleeve and bypass patients will need to be seen in the office every three months for the first year, every six months the second year, and then every year for life. We will check your blood work at each visit to make sure you are not developing any vitamin deficiencies. We also suggest that you see the dietitian regularly. These visits are important to monitor your weight loss, medical conditions, and potential problems. They are also important to help you stay on track to achieve your weight loss goals.

Remember that this is the beginning of your journey to a healthier you. We know you can do it and are here to help before, during and after your surgery. Your success is our goal. Attend one our free informational seminars.

View our Next Steps Guide PDF

Marsha Fernandes and Jaime Lynne Rado

 

“When we heard how excited the staff in Kent’s Center of Surgical Weight Loss office was about the Walk from Obesity, we knew we had to be a part of it. From our very first appointment and throughout our journey, everyone has made us feel like we are part of the Care New England family. We don’t want to miss out on the opportunity to meet other members of our ‘family’ and learn about new ways to stay healthy.

We love to share our success stories as we want people to know that having weight loss surgery is nothing to be ashamed of. For us, it was one of the most positive, life changing decisions we made. We want to inspire others to walk their way to better health. Walking gives us the opportunity to spend time with each other and stay fit. It also helps us to be good role models for our kids, who we encourage to adopt a healthy lifestyle.”

 

Gina

 

“Having bariatric surgery has changed my outlook on life all together. I not only look different, but I feel healthier. I feel more energized and more importantly people always say to me how happy I look. I lose my mother in March, who was my biggest supporter, and I didn’t think I could finish this journey without her. But I found it in myself to do it and move closer to my goal.

What did I do once I hit my goal? I went to Disney World with my best friend. I rode a roller coaster and was not afraid if I would fit in the ride. I rode on an airplane and did not worry if I would have to ask for a seat belt extender.

This surgery has changed my life in so many ways and I could not have asked for a better surgeon or a better medical office than The Center for Surgical Weight Loss at Care New England.”

 

Susan

 
“Having weight loss surgery was the best thing I could have done! My main objective was to be able to really play with my grandchildren. Now instead of thinking "I can't because..." I think "Come on! What are we waiting for!"
 
 

Jane

 

“An outline for the stages I went through during the process with the hopes of motivating others:

SHAME. EMBARRASSMENT. DARKNESS.
SKEPTICISM. UNCERTAINNTY. DILEMA
THANKFUL. ACCOMPLISHED. ACHIEVEMENT.

Thank you to Dr. Giovanni and Jocelynn Cobb for saving my life.”

 

Luis

 

“All my life, I have never been lean, slim, or thin. Being naturally built bigger, I knew I would never be skinny. I felt I could lead an active lifestyle but – having surpassed 400 lbs. – the reality was that my weight prevented me from doing the many things my heart desired. Things like skydiving, riding a roller coaster, etc. were physically out of reach.

Since having gastric bypass surgery my life has improved dramatically in so many ways. When I get on an airplane I can put the table down in front of me and use only 1 seatbelt! I’ve checked off several of my life long goals. I have been indoor rock climbing, skydived, surfed, and I even summited Mount Kilimanjaro in Africa, which was a major bucket list item.

I am days away from my 2-year surgical anniversary (as of 2017) and I am the healthiest I have ever been in my adult life. I have very few food limitations and, while my portions are small, they are no longer freakishly small; for the most part I can eat just like anyone else. I am a happier person all around.

I now enjoy a much better quality of life and will forever be grateful. Thank you to Dr. Giovanni and her team for the expert care that to me back to what I deem to be a very full life!”

Giovanni_Jeannine
 
 
Jeannine Giovanni, MD

Jeannine Giovanni, MD, is the director of bariatric surgery for CNE. She is a board-certified general surgeon with advanced training in bariatric surgery. She did her surgery training at Boston Medical Center and completed a fellowship in bariatric surgery at Saint Francis Hospital in Hartford, CT. She has been practicing since 2005 and has performed more than 1,000 laparoscopic bariatric procedures including the lap band, roux-en-Y gastric bypass, and sleeve gastrectomy.

 
Tse_Lindsay
 
 
Lindsay M. Tse, DO, Minimally Invasive General and Bariatric Surgeon

Lindsay Tse, DO, is a board eligible Minimally Invasive General and Bariatric Surgeon at Care New England’s Kent Hospital. She completed her general surgery training at Hackensack University Medical Center in Hackensack New Jersey, where she served as the Chief Academic and Administrative Resident during her final year. She then completed her fellowship training in Minimally Invasive Surgery, Bariatric Surgery and Flexible Endoscopy at Houston Methodist Hospital in Houston, Texas. She has performed many complex laparoscopic intra- abdominal surgeries including advanced foregut procedures, fundoplications, hiatal hernia repairs, revisional bariatric surgery, roux en y gastric bypass, sleeve gastrectomy, common bile duct explorations, and esophageal surgeries. She received extensive training in advanced flexible endoscopy including stent placement, dilations, endoscopic mucosal resections and polypectomies. She also performs many minimally invasive general surgery procedures including cholecystectomy, appendectomy, hernia repair, and colon resections.

 
RESPONSIVEJocelynCobb
 
 
Jocelyn Cobb, PAC

Jocelyn Cobb, PAC, is a physician assistant and bariatric coordinator for the program. She graduated from Quinnipiac University in 2009 and has been working with Dr. Giovanni since 2011. She cares for patients postoperatively both in the hospital and office as well as assists in surgery. Hear from Jocelyn on what to expect and her advice for those considering weight loss surgery. Watch now.

 
RESPONSIVESherry-Peter
 
 
Sherry Peter

Sherry Peter is the office manager and program manager for The Center fir Surgical Weight Loss. Her role is to help patients coordinate their preoperative evaluations and to help obtain insurance approval for the procedures. 

 
sylvestre_jane
 
 
Jane Sylvestre, MS, RDN, LDN

Jane Sylvestre, MS, RDN, LDN is the bariatric nutrition specialist located on-site at the Center for Surgical Weight Loss. She graduated with her master’s in nutrition and food science in 1995 from Texas Women’s University. She is certified by the Academy of Nutrition and Dietics in adult weight management levels 1 and 2. Jane provides pre- and post-operative nutrition counseling and leads an array of programs that support long term weight-loss success.

 
piascik_daniel
 
 
Daniel Piascik, MHS, PAC

 

Daniel Piascik is a physician assistant with the bariatric and general surgery service. He graduated from Quinnipiac University in 2015 and has been a practicing PA in the state of Rhode Island throughout his PA career. He cares for patients both in the hospital and office as well as assists in surgery.