Blog - Advanced Laparoscopic Associates
Advanced Laparoscopic Associates Sponsors Walk From Obesity Walkathon

Advanced Laparoscopic Associates Sponsors Walk From Obesity Walkathon

Advanced Laparoscopic Associates is proud to have sponsored the ASMBS Foundation’s Walk From Obesity event, held June 9 at Saddle River County Park in Saddle River, NJ. The event itself raised more than $9,000 for the ASMBS Foundation, and our ALA team was able to raise 205 percent of our goal, thanks to our generous donors and dedicated team members.

The ASMBS Foundation’s Walk From Obesity walkathon series is the only walkathon dedicated to raising awareness of the obesity epidemic currently affecting the United States. More than two-thirds of American adults are estimated to be overweight or obese, which can lead to dangerous health conditions such as:

  • Heart disease
  • Type 2 diabetes
  • Obstructive sleep apnea
  • Osteoarthritis

…and many more.

The ASMBS Foundation’s mission is to raise funds for obesity research and treatments, increase awareness of the dangers of obesity and improve access to care and treatment for obesity. ALA is dedicated to supporting this mission in any way we can, including participating in our local Walk From Obesity event.

The event took place in the beautiful 577-acre Saddle River County Park. Although the park’s path is an approximately 6-mile loop, the Walk From Obesity event was noncompetitive, meaning participants chose to walk as much or as little as they wanted.

ALA is proud of and grateful to all Walk From Obesity participants both for getting outside and getting healthy on a Sunday afternoon to provide awareness and raise funds for the ASMBS Foundation’s critical mission.

Dr. Trivedi Named 2019 Provider of the Year

Dr. Trivedi Named 2019 Provider of the Year

Please join Advanced Laparoscopic Associates in congratulating our own Dr. Amit Trivedi. Pascack Valley Medical Center named him 2019’s Provider of the Year during the facility’s National Hospital Week celebration on May 16.

Dr. Trivedi is chair of the Department of Surgery at Pascack Valley Medical Center. He has been instrumental in bringing the Senhance Robotic Surgical System to the medical center. Pascack Valley’s Senhance system—only the sixth in the United States—represents the future of laparoscopic and minimally invasive surgery.

This award, now in its third year, recognizes an outstanding physician who embodies all aspects of the hospital’s standards of performance and values. According to the medical center, Dr. Trivedi upholds its mission and vision every day and puts quality patient care as his top priority.

National Hospital Week is an opportunity for medical centers to recognize the outstanding staff—from physicians, nurses and other clinicians to administrators, operations staff and volunteers—who make a hospital run and change patients’ lives.

Advanced Laparoscopic Associates is proud to be represented by Dr. Trivedi and all of our dedicated clinical and administrative staff. Dr. Trivedi embodies our philosophies of patient-first care and relentless attention to the art and science of surgery.

Hernias and Surgical Mesh

Hernias and Surgical Mesh

If you have a hernia, which occurs when abdominal material pushes through a weak spot or hole in the surrounding muscle or connective tissue, you are far from alone. In fact, you are among an estimated five million Americans who have an abdominal hernia. This condition may be caused by straining or weakness in the area, but in the majority of patients, it has no known cause.

Once you’ve had a hernia, you’re more susceptible for another at the same site. The muscles or connective tissue is still weak. Surgeons have a solution, however—it’s called hernia repair, and it helps keep all your insides where they belong: on the inside.

Types of Hernias

There are various types of hernias, depending on their location. These include:

  • Inguinal hernia: Considered the most common type of abdominal hernia, it is caused when intestines push through a weak opening in the abdominal wall or groin area.
  • Femoral hernia: This is an uncommon type of hernia that results in a painful lump in the groin or inner thigh.
  • Umbilical hernia: A bulge at the belly button.
  • Incisional hernia: This type of hernia occurs on a healing surgical scar.
  • Epigastric hernia: This appears as a lump located between the belly button and sternum (upper chest).
  • Hiatal hernia: This type of hernia happens when the upper part of the stomach bulges through the large muscle (diaphragm) that separates the abdomen and the chest.

In some cases, there are no symptoms of a hernia. But when there are, these symptoms may include:

  • Bulge or swelling on either side of the pubic bone, made more obvious when coughing or straining
  • Pain in the pelvis, abdomen or testicle
  • Abdominal distension
  • A bulge in the abdomen or the belly button
  • For a hiatal hernia, heartburn or trouble swallowing

Hernia Repair

While millions of people have hernias, less than 15 percent of them seek medical treatment annually. However, an untreated hernia can lead to more serious conditions, which can even become life-threatening.

Often, patients fear surgery, but hernia surgery can be done as an outpatient procedure. Recovery depends on the size of the hernia but is usually minimal. The use of hernia mesh can strengthen the site of hernia and help prevent recurrence.

Patching the weak area of a hernia or closing up a hole with loosely woven flexible mesh is a stronger option than simply stitching the area. Since hernias have a high probability of recurrence, surgeons use hernia mesh to strengthen the repair and lessen the chances of that recurrence.

The advantage of the surgical mesh is that it allows the tension created by the repair to be spread across the abdominal wall, which in turn allows the patient to have normal movement after surgery.

In fact, 90 percent of the one million hernia repairs done annually in the U.S. use mesh. The mesh used for this surgery is usually the synthetic variety, made of polypropylene (petroleum) plastic. It is considered a permanent implant. 

Mesh Confusion

There has been some recent controversy due to the recall of surgical mesh by the Food and Drug Administration (FDA), but if you have or need a mesh implant, we are here to discuss the options with you.

Most of the mesh controversy stems from the use of transvaginal mesh. Surgical transvaginal mesh is used in urogynecologic repair of conditions such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Because these are different conditions in different areas of the body than hernias, using mesh in these repairs can lead to side effects and complications not seen in hernia repairs.

On April 16, 2019, the FDA ordered a halt to the sale and distribution of the two remaining companies that manufacturer transvaginal surgical mesh, stating that there is insufficient evidence to assure that probable benefits outweigh the probable risks in use of this mesh.

According to the FDA, any complications from mesh hernia repair have been associated with mesh products used in the past, which have been recalled and are no longer on the market. If you have had or will have a hernia repair using surgical mesh, this recall doesn’t pertain to abdominal wall hernias.

Conferring With Your Doctor

Like all surgical procedures, use of surgical mesh has some risks. That is why a qualified expert can help determine the best course of action for you, and the best surgical options. For certain hernias, and when the procedure is done correctly, experts say hernia mesh is very safe.

At Advanced Laparoscopic Associates, our experienced team of experts can help you determine the best treatments depending on your individual hernia condition. Request an appointment today with one of our team of qualified experts.

Advanced Laparoscopic Associates Surgeons Win Healthgrades Award

Advanced Laparoscopic Associates Surgeons Win Healthgrades Award

Please join us in congratulating the dedicated surgeons of The Bariatric Surgery Center at Hackensack Meridian Health Hackensack University Medical Center for earning a 5-star Bariatric Surgery Excellence Award from Healthgrades. The surgery center is staffed primarily by surgeons from Advanced Laparoscopic Associates, and our own Dr. Hans Schmidt is the chief of the bariatric program.

Healthgrades rates hospitals and hospital departments based on safety and clinical outcomes. The Bariatric Surgery Center received five stars, easily beating out the three-star national average. Its actual rate of complications was a mere 1.7 percent, more than 50 percent lower than the national average.

Advanced Laparoscopic Associates offers a wide range of bariatric and general surgery procedures. We specialize in—and are one of the only practices in the region to offer—advanced surgical and nonsurgical techniques such as LINX for gastroesophageal reflux disease and AspireAssist for weight loss. If you need surgery to correct a medical condition or are seeking bariatric surgery, request an appointment today.

Could This Weight Loss Surgery Be a Cure for Type 2 Diabetes?

Could This Weight Loss Surgery Be a Cure for Type 2 Diabetes?

Nearly 10 percent of Americans have a form of diabetes, a condition that affects the ability to regulate blood sugar. Add in the number of people with prediabetes—high blood sugar—and that number jumps to more than 100 million, or about one-third of the U.S. population.

There are two main types of diabetes:

  • Type 1: the immune system mistakenly destroys cells in the pancreas that produce insulin, which brings sugar from the bloodstream into the cells
  • Type 2: through repeated exposure (i.e., a diet high in sugar), the body becomes resistant and eventually immune to the effects of insulin

The outcome of both types of diabetes is that sugar remains in the bloodstream, where it can damage cells and blood vessels. Diabetes is associated with heart disease, kidney disease, liver disease and even vision and hearing problems. In addition, most people with type 2 diabetes are obese.

No Cure for Diabetes… or Is There?

Currently there is no cure for diabetes, but the condition can and does go into remission, which means that blood sugar is normal and there are no signs or symptoms of diabetes. However, because blood sugar fluctuates based on a number of factors, it’s possible the disease will come back.

But what if there really is a cure? Evidence is beginning to mount that a simple, safe, effective weight loss surgery procedure may also be a true cure. You’ve probably even heard of the procedure: gastric bypass.

What Is Gastric Bypass?

Roux-en-Y gastric bypass—or simply gastric bypass—was, until recently, the most popular bariatric surgery procedure in the U.S. (it has since been overtaken by vertical sleeve gastrectomy). It’s been performed since the 1960s, and its benefits for obesity are well-established.

Gastric bypass surgery has two parts. First, the stomach is sectioned off, creating a small pouch that can hold much less food than an unmodified stomach. Then, the intestines are rerouted to connect directly to that pouch, which bypasses part of the intestines. This reduces the number of calories the body absorbs. So, not only do people with gastric bypass eat less food due to a smaller stomach, they absorb fewer calories.

How Does Gastric Bypass Help Diabetes?

Gastric bypass is known to have a strong effect on type 2 diabetes. The American Society for Metabolic and Bariatric Surgery estimates that 80 percent of people who have gastric bypass will achieve complete type 2 diabetes remission. Other estimates are similar.

In fact, bariatric surgery is so promising for diabetes improvement that in 2016, an international group of diabetes authorities voted to include surgery as standard treatment for type 2 diabetes in clinical guidelines.

“This change is supported by documented clinical efficacy and by the evidence of an important role of the gut in metabolic regulation, which makes it an appropriate target for anti-diabetes interventions,” wrote Dr. Francesco Rubino, one of the authors of the consensus statement on clinical guidelines.

Dr. Rubino, a bariatric surgeon who practices in the U.K., was featured in a fascinating 6-minute video by The Economist, which you can view below.

In the video, Dr. Rubino stated that he believes that the section of the intestines that is bypassed in a gastric bypass procedure figure heavily into the development of diabetes. Bypassing this section of the intestines can change a large number of factors independent of weight loss, such as:

  • Bile metabolism
  • Glucose metabolism
  • Hormones
  • Intestinal flora (bacteria, etc.)

Dr. Rubino and others believe these changes can combine to permanently send diabetes into remission.

Who Is a Candidate?

The selection criteria for bariatric surgery to treat obesity are clear and simple. People who want weight loss surgery must have either:

  • A body mass index (BMI) of 40 or greater
  • A BMI of 35 or greater and co-morbid conditions related to obesity, such as diabetes, heart disease or obstructive sleep apnea

The 2015 guidelines (published in 2016) for surgery to treat diabetes are more complicated. In addition to BMI, bariatric surgeons must also take into consideration:

  • Heart disease risk
  • How long the person has had diabetes
  • How well the diabetes is controlled

If you are considering treatment for diabetes, request an appointment at Advanced Laparoscopic Associates. We can tell you if you meet the criteria for bariatric surgery, and we’ll give you options and advice on the best form of surgery to choose. We’ll be with you every step of the way, from consultation to postoperative follow-up and beyond.

Get SMART About Your Weight Loss Goals

Get SMART About Your Weight Loss Goals

Congratulations on your decision to take control of your weight! Maintaining a healthy body weight and body mass index (BMI) is essential to living a healthy life. Research strongly suggests that keeping to a healthy weight reduces the risks of heart disease, many types of cancer, diabetes, osteoarthritis and more, and may even help you live longer.

However, you probably know by now that losing weight isn’t as easy as it sounds. Sure, it’s simple: If you burn more calories than you consume, you’ll lose weight. But that doesn’t mean it’s easy.

We’re here to help. At Advanced Laparoscopic Associates, we’ve dedicated our professional careers to helping people live a healthy life. While we specialize in bariatric surgery, setting weight loss goals is good for all of our patients, whether they want to lose weight through surgery or through lifestyle changes. It’s time to get SMART about your weight loss goals.


Goals are great, but they need certain characteristics to be successful. Without these characteristics, you’re setting yourself up for failure. When setting goals, remember to be SMART about them.

SMART is an acronym that stands for:

  • Specific
  • Measurable
  • Attainable
  • Relevant
  • Time-based

Let’s take a weak goal—”I want to be healthier”—and make it SMART.

Specific. “I want to be healthier” is much too general. There’s no detail. “I want to lose weight” is a little more specific, but it still lacks enough actionable detail. Let’s start with one measurement. It can be pounds, or inches around the waist, or a percentage of your body mass index (BMI). For this example, we’ll start with fat loss. The goal becomes, “I want to lose 25 percent of my body fat.”

Measurable. This new goal is already measurable. However, percentage of fat loss can be one of the more difficult metrics to measure. Not everyone has access to a DXA scan, but most people do have bathroom scales. While it may not be as precise, let’s change the goal to something more readily measurable: “I want to lose 50 pounds.”

Attainable. You need to be able to see results and make progress toward your goal to avoid becoming overwhelmed and giving up. The current goal—losing 50 pounds—is attainable, but very ambitious and will take a long time to achieve. It’s better to break big goals into smaller chunks. Our goal becomes more attainable when we change it to, “I want to lose 10 pounds.”

Relevant. This is the “why” of your goal. Make sure your goal aligns with your values, and that you’re trying to meet it for the right reason. Let’s add some relevance to our goal: “I want to lose 10 pounds to cut my risk of heart disease.”

Time-based. Finally, giving yourself a deadline will spur you to action and help you focus. Make it short- or medium-term. It’s good to have long-term goals, but they should be broken down into short-term goals with timely deadlines.

“I want to lose 10 pounds in two months to cut my risk of heart disease” is now a SMART goal. It will require you to lose, on average, a little more than a pound a week, which is challenging but achievable. It is specific, has a defined metric for measurement and has a relevant reason for setting the goal.

Focus on Process, Not Outcome

Outcomes are not always fully within your control, but process is. Our goal of losing 10 pounds in two months is a SMART goal, but it’s outcome-oriented. It’s dependent on an external factor: a number on the scale.

Process goals are dependent on what you do. They are fully in your control. We can change our current SMART goal to be process-oriented by thinking about what it will take to achieve it.

Losing weight is a matter of burning more calories than you consume, so we can attack our weight loss from either side of the equation—consuming less or burning more. Let’s try consuming less.

One pound is equivalent to 3,500 calories. So, to lose a pound a week, you’ll need to consume 500 fewer calories than your total daily energy expenditure (TDEE), the approximate number of calories your body burns on a given day due to age, weight and activity level. You can figure your TDEE with any number of calculators; here’s one.

A 40-year-old sedentary woman’s daily TDEE is approximately 1,640 calories per day. That means her new, process-based SMART goal would become, “I will eat 1,140 calories a day for two months to bring my weight down and cut my heart disease risk.”

Get Help With Your Weight Loss Goals

If you want to lose weight but don’t know where to start, request an appointment at Advanced Laparoscopic Associates. We have a registered dietician on staff, Jennifer Blume, who can ensure you have the tools you need to meet your goals. We can tell you if you’re a good candidate for weight loss procedures, describe your options and help you get on a path toward a healthy, sustainable weight.

Rosie O’Donnell’s Weight Loss: Hear From Her Surgeon, Dr. Trivedi

Rosie O’Donnell’s Weight Loss: Hear From Her Surgeon, Dr. Trivedi

Actress and comedian Rosie O’Donnell almost lost her life from a heart attack in 2012. Having struggled with weight issues for much of her life, the former The View co-host knew she needed to make a change if she wanted to watch her children and foster children grow up. That’s why O’Donnell turned to one of the best in the business for weight loss surgery: Dr. Amit Trivedi of Advanced Laparoscopic Associates.

The Gastric Sleeve Procedure

Dr. Trivedi performed a gastric sleeve procedure on O’Donnell. The gastric sleeve, also known as sleeve gastrectomy or vertical sleeve gastrectomy, has overtaken the gastric bypass procedure as the most popular weight loss surgery in the U.S.

The sleeve gastrectomy is a laparoscopic procedure, which means that the incisions and tools used are very small, and the surgeon sees what he or she is doing with the aid of a camera called a laparoscope attached to a video monitor.

The procedure involves removing about 80 percent of the stomach so that the new stomach is approximately the size and shape of a banana. This does two things:

  • First, the stomach is smaller, so it holds less food. This means the patient typically consumes fewer calories, leading to weight loss.
  • Second, the portion of the stomach that is removed contains most of the cells that produce a hormone called ghrelin. Ghrelin signals to your brain that you’re hungry, so with the majority of the ghrelin-producing cells gone, the brain receives far fewer hunger signals.

“Without those hunger hormones, you don’t get those cravings, you don’t go looking for that large popcorn, and it makes diet and exercise work without a struggle,” Dr. Trivedi told Dr. Mehmet Oz when he and O’Donnell appeared on The Dr. Oz Show in 2015.

O’Donnell’s Weight Loss

Dr. Trivedi performed O’Donnell’s surgery in 2013. Two years later, she was down more than 50 pounds, according to reports. “I can’t even explain to you how different my life is and my brain is in terms of my relationship to food,” O’Donnell told Dr. Oz. “My body is not telling my brain that I’m hungry, so I’m actually not. I’m not thinking about food.”

Weight loss typically occurs quickly and lasts for years, according to the American Society for Metabolic and Bariatric Surgery. The procedure is minimally invasive, so recovery times are usually short. Combined with diet and exercise, a sleeve gastrectomy is an excellent solution for long-term weight loss and health enhancement. “It’s not a magic pill at all; it’s a tool that will help you,” O’Donnell said to Dr. Oz.

Weight Loss Surgery From the Experts

If you are interested in a bariatric surgery procedure with surgeon-to-the-stars Dr. Trivedi or any of the equally talented surgical team at Advanced Laparoscopic Associates, sign up for our next free informational seminar. You’ll learn how bariatric surgery can help you live your healthiest life.