Frequently Asked Questions

This is a common concern, particularly for inguinal (groin) hernia repair. Robotic repair is performed in the “preperitoneal” space, which is away from the spermatic cord structures (vas deferens, blood vessels) that are important for fertility. The robotic approach provides magnified 3D visualization that allows Dr. Kakarla to clearly identify and protect these structures. The risk of injury to the vas deferens with robotic repair is extremely low. Sexual function is not affected by hernia surgery. You can resume sexual activity when comfortable, typically 1–2 weeks after surgery.

Elective hernia repair is generally deferred until after delivery and recovery (usually 3–6 months postpartum). The abdominal wall needs time to return to its baseline after pregnancy. Emergency repair would be performed at any time if the hernia becomes incarcerated or strangulated. If you have a hernia and are planning pregnancy, discuss timing with Dr. Kakarla — it may be better to repair before pregnancy to avoid complications during pregnancy.

Teenagers (16+) are generally treated the same way as adults with robotic inguinal hernia repair. Younger adolescents may have different considerations depending on their growth and development. Dr. Kakarla evaluates each patient individually. The recovery for younger patients is often faster. They should avoid sports and physical education for 4 weeks after surgery.

No. A truss or support belt can temporarily hold the hernia in place and reduce symptoms, but it does not repair the defect. Hernias do not heal on their own and tend to enlarge over time. Prolonged truss use can actually make the hernia harder to repair by causing scar tissue. Surgery is the only permanent fix.

Dr. Kakarla uses lightweight, macroporous synthetic mesh for most hernia repairs. This type of mesh has decades of safety data and significantly reduces recurrence compared to suture-only repairs. The mesh lawsuit advertisements you may have seen on TV primarily involve a specific type of mesh used for pelvic organ prolapse — a completely different product and procedure. The mesh used in hernia repair has an excellent safety record and is the standard of care endorsed by all major surgical societies.

It depends on the type of hernia and your overall health. For small inguinal hernias, surgery can proceed at any weight. For large ventral or incisional hernias, significant weight loss before surgery can improve outcomes and reduce recurrence risk. Dr. Kakarla will discuss this honestly at your consultation — if weight loss would meaningfully improve your surgical result, he’ll recommend it and help you with a timeline.

Yes. Gallbladder pain commonly radiates to the right shoulder blade or between the shoulder blades. This is called “referred pain” — the gallbladder and the shoulder share nerve pathways through the phrenic nerve. If you have upper abdominal pain that wraps around to your back, especially after fatty meals, gallbladder disease should be evaluated.

Yes, in most cases. A gallbladder attack that resolves means the gallstone passed or shifted, but the stones are still there. Approximately 70% of patients will have another attack within 2 years, and the next episode may be more severe or lead to complications (pancreatitis, bile duct obstruction, or gallbladder infection). Elective surgery when you’re healthy is much safer than emergency surgery during an acute attack.

Yes, significantly. Ambulatory surgery centers (like Gwinnett Surgery Center) typically cost 40–60% less than hospital-based outpatient surgery for the same procedure. The facility fee is lower, which directly reduces your out-of-pocket cost. Many outpatient procedures (inguinal hernia, gallbladder, anorectal, skin procedures) can be performed at the surgery center. Dr. Kakarla will recommend the appropriate facility based on your procedure and medical history.

The No Surprises Act (effective January 2022) protects patients from unexpected medical bills in many situations. If you receive care at an in-network facility, you are protected from surprise out-of-network bills from individual providers (such as anesthesiologists) who you did not choose. Our practice participates with most major insurance plans, and our surgical facilities are in-network with the same plans. We verify your benefits before scheduling so you know your estimated out-of-pocket cost in advance. If you have questions about specific charges, our billing team is available at (770) 962-9977.

Yes. Our office routinely completes FMLA (Family and Medical Leave Act) forms, short-term disability paperwork, and fitness-for-duty clearance letters. Please bring the forms to your pre-op or follow-up appointment. Standard processing takes 3–5 business days. There may be a small administrative fee for some forms.

No. Robotic surgery is billed using the same CPT codes as laparoscopic surgery. There is no additional charge to you for the use of the robot. Insurance companies cover robotic procedures the same way they cover laparoscopic procedures. The robot is a tool that improves surgical precision — not an upcharge.

No. The da Vinci robot is a tool controlled entirely by Dr. Kakarla. He sits at a console in the operating room and controls every movement of the robotic arms with his hands and feet. The robot translates his movements into precise micro-movements inside the body. Think of it like power steering in a car — it enhances the surgeon’s capabilities, but the surgeon is always in complete control.

The da Vinci system has multiple redundant safety features and is continuously monitored throughout every procedure. In the extremely unlikely event of a system issue, Dr. Kakarla can seamlessly convert to laparoscopic or open surgery. This is one reason why experience matters — Dr. Kakarla is trained in all three approaches and can adapt immediately.

ERAS stands for Enhanced Recovery After Surgery. It is an evidence-based approach to surgical care that includes: minimizing fasting time before surgery, using multimodal pain management to reduce opioid use, early mobilization (walking) after surgery, early feeding, and avoiding unnecessary drains and tubes. ERAS protocols have been shown to reduce complications, shorten hospital stays, and speed recovery. Dr. Kakarla follows ERAS principles for all procedures.