Frequently Asked Questions

What should I expect during the appointment?

Dr. Choi will ask you detail questions regarding your symptoms, your usual diet, bowel and toilet habits. Be ready to talk about it and no need to feel embarrassed! She will of course need to examine the area where the problem is. If the problem is in the anorectal region, the exam usually involves at least visual inspection (looking at the area externally) and a digital rectal exam, during which Dr. Choi will insert a gloved lubricated finger into the anus and lower rectum to feel for any abnormality. Depending on the condition, visual inspection of the anal canal internally may be needed by insertion of an anoscope (a lighted small plastic instrument) into the anus. The exam may not be comfortable but should not be painful. If you have a very painful anal condition, the digital rectal exam and anoscopic exam is usually skipped. Do not worry if your anal area is not cleaned or if you have not moved your bowel. You do not need to prepare for the exam in any particular way. For female patients, menstruation does not affect the exam.

What types of procedure can Dr. Choi do in office?

In general, minor procedures that only require local anesthesia for pain control can be performed in our office. No sedation is given in the office, meaning you will be awake during the procedure. Some procedures commonly performed in office include rubber band ligation of internal hemorrhoids, incision and clot extraction from thrombosed external hemorrhoids, incision and drainage of abscesses, anoscopic exam, biopsy or excision of small anal lesions, wound care and minor wound debridement.

Where does Dr. Choi perform surgeries and procedures?

Dr. Choi may perform procedures at one of the following locations:

What determines if I should have surgery at a free-standing ambulatory surgery center (ASC) vs in hosptial?

While most outpatient surgery (also called ambulatory or same day surgery) can be done in either an ASC or hospital-owned outpatient surgery department, Dr. Choi will recommend you to have surgery in hospital if:

  • you have a medical condition that put you at higher risk for anesthesia or may require longer observation post anesthesia, such as severe heart disease, having a cardiac pacemaker, if you are on dialysis for renal failure, or have severe lung disease;

  • your procedure requires special equipment not available at ASC;

  • you require emergency surgery during late afternoon or night time (even though surgery is short and you may go home after 1-2 hours of recovery post-anesthesia).

Surgeries that require overnight or longer hospital stay (such as colon or rectal resection) will need to be done in the hospital.

Should I have outpatient surgery at ambulatory surgery center (ASC) or hospital?

The safety and quality of care at ASC is comparable to that in hospital. ASC in general are run more efficiently, have more flexibility in scheduling, and charge a lower cost compared to hospital for the same type of surgery. If you have a high deductible insurance plan, you can expect to pay lower out-of-pocket cost when you have surgery in ASC. However, ASC may not accept as many insurance plans as hospital does.

What are the risks of my procedure and how do I prepare for it?

Dr. Choi will explain the recommended procedure including its risks, benefits and alternatives in detail during your office visit. You will receive detail pre- and post-procedure instructions to help you prepare for it. We encourage our patients to message us on the Patient Portal for any questions or concerns. Anorectal procedures are typically low risk procedures, and you will find procedure description and risks in the linked education material on this website when you go to Conditions and Treatment, click into the specific topic and look under Helpful Links.

The American College of Surgeons has published excellent patient education materials that discuss specific risks and preparation for colectomy and colonoscopy, and a comprehensive guide on Preparing for your surgery.

How many bills should I expect if I need a procedure?

For minor procedures done in Dr Choi’s office, you will receive one bill from Dr. Choi for that particular day of office visit when the procedure is performed. You will be informed before the procedure if it is potentially not covered by your insurance. If a biopsy was performed and sent to a lab for pathology diagnosis, you will receive a separate bill from the pathology lab.

For procedures performed in ASC or hospital, you will typically receive at least 3 bills: one from Dr. Choi (for the procedure fee), one from the anesthesiologist (for the anesthesia fee), and one from the ASC or hospital (for the facility fee). Examples of additional bills you may receive include bill from pathology lab or pathologist if a biopsy or tumor resection was performed, and bill from other physicians who are involved in your care during your stay in the hospital (e.g you are seen by a cardiologist because you develop irregular heart rhythm after surgery).