You must have the following information upon your consultation appointment
- Referral from GP
- Necessary blood test results
- Scans, images and any other relevant information
- Health fund card
- Medicare card
You will meet with Dr Kwon and this will allow him to evaluate your symptoms. As part of that consultation, he may request additional tests or procedures such as blood tests, imaging studies, or endoscopic examinations for diagnosis or treatment. A treatment plan may also be prescribed along with a follow-up plan of care. Sometimes, follow-up may be through your local doctor.
Frequently asked questions
Why am I being referred to a surgeon?
Your primary care physician may ask you to see a general or upper GI surgeon for many reasons.
General surgeons are experts in diagnosing and treating patients with symptoms arising from organs of the abdomen or gastrointestinal tract and abdominal wall such as hernias. Dr Kwon is accredited to perform both gastroscopy and colonoscopy, both diagnostic and therapeutic, such as removal of polyps.
Dr Kwon is sub-specialty trained oesophago-gastric surgeon with expertise in pathology involving the oesophagus, reflux disease, stomach including gastric cancer, and gallstone diseases. Dr Kwon has had extensive training and experience in both laparoscopic and radical gastric cancer surgery, involving extended lymph node dissection. He has a special interest in performing laparoscopic abdominal hernia repairs, using On-Q pain management system as well as Tackless mesh implantation, which aid in reduction of post-operative pain and enhancing recovery.
What can I expect at my initial consultation?
Your first visit will allow Dr Kwon to evaluate your symptoms. As part of that consultation, your gastroenterologist may request additional tests or procedures such as blood tests, imaging studies, or endoscopic examinations for diagnosis or treatment. A treatment plan may also be prescribed along with a follow-up plan of care.
What do I need to bring?
It is important that you bring the following items:
– Referral letter (referral letters addressed to other GI specialists are acceptable)
Health Summary (if not included in the referral letter)
– A list of all medications you are currently taking
– Recent blood work and x-rays (Barium swallow / meal, ultrasound, or CT scans of the abdomen or pelvis)
– Copies of past medical records
It helps to have your referral letters and previous relevant test results forwarded to Dr Kwon’s rooms ahead of your consultation – this will allow Dr Kwon to arrange other tests or obtain additional relevant information prior to the consultation or request.
Note: If medical records are to be sent by your doctor(s), please call us to verify that we have received them prior to your visit. Lack of these items can result in delays and/or additional appointments being scheduled.
Dr Kwon can receive correspondence from your doctor(s) via secure electronic channels including Argus and HealthLink.
What are the costs of consultation and procedures?
Initial consultation cost is $200 with medicare rebate of $75.05. Pensioner rate is $150.
Subsequent consultation cost is $150 with medicare rebate of $37.70. Pensioner rate is $100.
Please note Dr Kwon only works in the private sector.
1. For patients with eligible private health insurance.
All endoscopy (standard gastroscopy and colonoscopy including polypectomy) are “No Gap” with Dr Kwon, i.e. No out-of-pocket surgical or anaesthetic costs. Excess payable depends on your health fund policy.
NB. With HCF, there is no excess payable for Day Surgery procedures. With NIB, all payments are paid up front with 100% rebate afterwards.
All surgical procedures attract a maximum of $500 out-of-pocket expense for surgery. (Known Gap or Gap Cover). Smaller out-of-pocket expense applied for minor procedures. Additional Anaesthetic fee applies, maximum of $500 for most procedures.
NB. Slight variation applies for AHSA funds – please inquire.
2. For patients with Medicare only – No private health insurance.
All endoscopy procedures are bulk billed by Dr Kwon however attract an Anaesthetic fee (between $0 and $300). Private hospital admission fees range between $550 and $950.
Please inquire regarding other procedures.
Dr Kwon also performs minor procedures (excision of lipoma and skin lesions) under local anaesthetic in a dedicated procedure room (which avoids an anaesthetic fee), with out-of-pocket expense of ranging between $200 and $500.
What is Endoscopy (Gastroscopy and Colonoscopy)?
Upper Endoscopy/Gastroscopy Information
Gastroscopy is a procedure in which a flexible tube with a “video camera” at the tip is passed through the oesophagus, stomach and first part of the small bowel. It permits these areas to be inspected as well as specialised procedures such as biopsies, polypectomy, diathermy and dilations to be performed.
Dr Kwon uses the latest generation of scopes with Narrow Band Imaging and Magnification which allows close and detailed inspection of the tissues and targeted biopsies of abnormal areas.
Waiting time in the public system through Westmead or Auburn hospitals is based on clinical priority and is between 1-5 months.
Why is upper endoscopy done?
This test is performed to investigate symptoms such as bleeding, pain, nausea and difficulty swallowing to name a few. Other specialised techniques may be performed during the procedure. Biopsies are samples of tissue which may be performed for many reasons including looking for infection, testing that the small bowel is functioning well and diagnosing tissues which don’t look normal, including conditions such as coeliac disease and pre-cancerous and cancerous lesions. We can pass instruments through the endoscope to directly treat many abnormalities with little or no discomfort, for example; stretching a narrowed area, removing polyps or treating bleeding.
Preparation for the procedure
An empty stomach is essential for a safe examination, so you should have nothing to eat or drink, including water, for approximately 3-4 hours before the examination. We will tell you when to start fasting. Tell us in advance about any medications you take; you might need to adjust your usual dose for the examination, this is particularly important if you are diabetic. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease. Also, alert us if you require antibiotics prior to undergoing dental procedures, because you might need antibiotics prior to upper endoscopy as well.
During the procedure
Your procedure will be done under deep sedation with an anaesthetist. You will lie on your left side for the procedure. The endoscope doesn’t interfere with your breathing. You are unlikely to remember anything of the procedure.
After the procedure
You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat after you leave unless we instruct you otherwise. You must arrange for someone to accompany you home because the sedatives may affect your judgment and reflexes for the rest of the day. If you have sedation you must not drive until the next day.
Possible complications of upper endoscopy
Although complications can occur, they are extremely rare. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Other potential risks include a reaction to the sedative used, complications from heart or lung diseases, and perforation (a tear in the gastrointestinal tract lining). If you have a fever after the test, trouble swallowing or increasing throat, chest or abdominal pain, please contact us immediately.
How is the bowel prepared?
In order for us to get the best possible view and make the colonoscopy easier, your large bowel needs to be cleaned out of all waste material. You will be given a preparation kit which contains full instructions. Usually this involves a special diet for a day or two, consisting of no solid food, lots of clear fluids and laxatives the day before and day of the procedure. You need to have nothing to eat or drink for three to four hours before the procedure is done. However, you may have a sip of water with your regular medications. Take your regular medications on the day of the test.
Iron tablets should be stopped a week before the test. Aspirin can be continued. If you have diabetes or have heart valve disease or have a pacemaker implanted or are taking blood thinning tablets such as Warfarin or Clopidogrel it is important to discuss this with me before the colonoscopy is organized, as special arrangements may be necessary.
How is colonoscopy done?
Your colonoscopy will be done under deep sedation with an anaesthetist. The test is performed while you lie on your left side, although occasionally it may be necessary for you to lie on your back during the procedure. The instrument is inserted through the back passage. Most colonoscopies take between 20 and 45 minutes.
What is a polyp?
A polyp is a small growth attached to the bowel wall which over time can occasionally become a cancer. If polyps are found they will almost always be able to be removed at the time of the examination. Most polyps can be burnt off by placing a wire snare around the base and applying an electric current. If you have any questions please ask me before the colonoscopy. If necessary, small samples or biopsies of the bowel can be taken for analysis.
What happens after colonoscopy?
Following the procedure you will remain in the hospital recovery area for approximately two hours until the effect of the medication wears off. When you wake up you may feel a little bloated. This is due to the air that was inserted during the procedure. This will pass over the next hour or so. Very rarely, you may pass a small amount of blood. This is due to biopsies that have been taken and is of no concern. You may then go home. Because of the sedation given it is very important that you do not drive a car, travel on public transport alone, operate machinery, sign legal documents or drink alcohol on the same day.
Safety and risks
Serious complications of colonoscopy are rare, at less than one in a thousand examinations. However complications can occur and include the following: 1) Colonoscopy is considered to be the most accurate test of the colon. However, there is a risk that an abnormality may not be detected. 2) Intolerance of the bowel preparation: Some people develop dizziness, headaches or vomiting. 3) Reaction to the sedatives or anaesthetics. 4) Perforation (making a hole in the bowel). 5) Major bleeding from the bowel: This can occur as a result of polyps being removed. It is possible if these serious complications occur that you may require surgery or a blood transfusion. If you have any of the following symptoms in the hours or days after colonoscopy you should contact the hospital or my rooms immediately: severe abdominal pain, black tarry motions, persistent bleeding from the back passage, fever or other symptoms that cause you concern.
Have a question, referral or would like more information?
Please get in touch and we would be happy to assist with your enquiry.