"Achievement is The Best Evidence of Ability." - Anonymous
At Surgical Specialists of Western New England, PC we believe that fellowship training sets the standard for excellence in specialty surgery. Nowhere else in the practice of general surgery is this more evident than in its most rapidly growing subspecialty, Minimally Invasive Surgery.
The concept of Minimally Invasive Surgery incorporates a set of treatment principles that can benefit all patients, even those treated non-operatively or with traditional open surgery. Our advanced laparoendoscopic surgical techniques embrace these concepts to their fullest extent.
As the first fellowship-trained Minimally Invasive Surgeon in Berkshire County, Dr. Fanelli offers unique experience and skills that hold potential benefit for each and every patient facing surgery or endoscopy. Surgical Specialists of Western New England, PC is a subspecialty practice focused on areas of proven clinical expertise.
Dr. Fanelli has developed several nationally recognized surgical techniques which improve patient care and are less invasive than traditional surgery. His published techniques for the laparoscopic treatment of bile duct stones during gallbladder surgery preserves the "minimally invasive" advantage of laparoscopic surgery, even in this difficult situation. Please see Dr. Fanelli's curriculum vitae for a complete listing of his acheivements.
Dr. Fanelli has made a tradition of introducing many new procedures to Berkshire County, and most recently, established a comprehensive weight loss surgery program for our community. Dr. Fanelli has inspired other surgeons to learn new techniques as well, improving patient care in our region.
Continuity of care is central to excellence in treatment. As a specialist in Gastrointestinal Surgery, Dr. Fanelli is uniquely experienced and qualified to help patients manage conditions like gastroesophageal reflux (chronic heartburn, or GERD), gallbladder disease, bile duct stones, colonic polyps, colorectal cancer (intestinal) and gastric (stomach) cancer from initial diagnosis through definitive treatment. Dr. Fanelli believes in expert level care, and is pleased to offer his expertise in diagnosis and treatment to patients facing serious gastrointestinal and colorectal disease. A Personal Message Thank you for visiting the Surgical Specialists of Western New England, PC Internet site. We are pleased to provide information on health topics related to the practice of surgery, but please remember that no Internet site can take the place of an office consultation with your own physician in addressing specific evaluation and treatment needs. Use of this Internet site is for informational purposes only, and viewing this site does not constitute the establishment of a patient-physician relationship.
Please schedule a visit today so that we may review your diagnosis, and discuss treatment options with you and your family. If we can't be of service to you, we will try to refer you to a physician who might be able to help.
If you need additional information regarding any of the topics on this site, or seek assistance in sorting through information you've reviewed, consider scheduling an office visit to meet with me.
Sincerely,
Robert D. Fanelli, MD, FACS, FASGE
Assistant Professor of Surgery University of Massachusetts Medical School
Director of Surgical Endoscopy Berkshire Medical Center After-Hours Surgery Because Dr. Fanelli is a specialist in gastrointestinal surgery and endoscopy, he does not take general surgery or trauma call for the Emergency Department at Berkshire Medical Center. However, Dr. Fanelli is often available to evaluate and treat new and established patients, even after hours. He routinely receives call from regional emergency departments to see patients with specialty needs.
Dr. Fanelli is also pleased to see new patients at any time, who have an illness that requires his specialized expertise. If you need an emergency department visit, and would like to be seen by Dr. Fanelli, please ask your primary care provider or the emergency department staff physician to contact him at 413-442-2462. Bariatric Surgery The Berkshire Center for Weight Loss Surgery is here to serve the needs of our patients who are morbidly obese and suffer from the diseases associated with morbid obesity.
We offer free educational seminars monthly. These seminars are scheduled for the first Tuesday of each month at 7PM, and are held at Berkshire Hills Country Club. Call our office at 413-442-2462 to pre-register and to confirm the date and location, especially if we are experiencing severe weather.
The Berkshire Center for Weight Loss Surgery offers a series of operative interventions aimed at achieving substantial weight loss in individuals who are morbidly obese. Morbid obesity increases the risks of developing diabetes, heart disease, hypertension, and other serious health problems. Obesity can also be disabling, either psychologically or physically, and results in joint degeneration as well. Dr. Fanelli is pleased to have started this program for the community, and has enjoyed helping to launch the career of his colleague, Dr. Andrew B. Lederman, who also practices baraitric surgery.
Please remember that bariatric surgery is a serious intervention aimed at preserving the lives of patients at high risk for death and disability from their obesity. These procedures are not intended for casual weight loss for individuals who respond to traditional diet and exercise recommendations, or who do not meet the National Institutes of Health Consensus Panel definition of morbid obesity.
Planning for The Berkshire Center for Weight Loss Surgery began in 2002, and our first patient visits for bariatric surgery were scheduled in October 2004. We achieved certification by the American College of Surgeons Bariatric Surgery Center Network in May 2007, which is a distinction unique that verifies our high standards of excellence.
If you have attended an informational meeting about bariatric surgery and are ready to move forward, please call to make an appointment to see Dr. Fanelli at 413-442-2462.
Thank you for your interest in the Berkshire Center for Weight Loss Surgery, Berkshire County's only weight loss surgery program Common Procedures
Laparoscopic Lymph Node Biopsy/Dissection A minimally invasive approach to biopsy, or removal, of lymph nodes from within the abdomen or retroperitoneum (the deepest portion of the abdomen), which is useful in diagnosing lymphomas and other conditions and for assessing the success of therapy.
Laparoscopic Common Bile Duct Exploration A set of minimally invasive techniques allowing removal of gallstones that have passed from the gallbladder into the common bile duct, that preserve the benefits of laparoscopic gallbladder surgery while treating this complex problem.
Laparoscopic Endobiliary Stenting A minimally invasive surgical technique developed by Dr. Fanelli that allows laparoscopic placement of a stent when bile duct stones are identified, assuring successful outpatient removal after surgery.
Laparoscopic Cholecystectomy A minimally invasive procedure for gallbladder removal, using three or four one-quarter to one-half inch incisions. Patients often return home the day of surgery, and typically return to full activity within ten days.
Laparoscopic Nissen Fundoplication A minimally invasive surgical procedure used to treat significant GERD, that allows correction of hiatus hernias and restoration of more normal function in reflux patients.
Operative Hemorrhoidectomy Surgical therapy for symptomatic internal and external hemorrhoids that are not amenable to band ligation. Tissue fusion techniques and suture-less hemorrhoidectomy are typically performed. Also see Procedure for Prolapse and Hemorrhoids for information regarding the most revolutionary change in anorectal surgery in many years.
Non-operative Hemorrhoidectomy A variety of non-procedural and endoscopic therapies exist to provide symptomatic relief of hemorrhoidal discomfort. Band ligation is a very effective endoscopic means of treating hemorrhoids that avoids the discomfort and prolonged recovery of traditional surgery.
Resection of Colon and Rectal Malignancy Various operative procedures tailored for each patient's benefit, to remove intestinal cancer and regional lymph nodes. There are a number of minimally invasive techniques available.
Laparoscopic Inguinal Hernia Repair A minimally invasive approach to groin hernias that is highly successful and allows early return to unrestricted activity.
Laparoscopic Ventral Hernia Repair A minimally invasive approach to the repair of abdominal wall hernias and incisional hernias that often affords greater strength and fewer complications than traditional "open" surgery.
Laparoscopic Colectomy A minimally invasive approach to the resection, or removal, of a segment of the large intestine, for benign and malignant diseases. Surgical Specialists of Western New England, PC's physicians have been performing laparoscopic colon surgery since 1994, longer than most other surgeons in New England.
Laparoscopic Splenectomy A minimally invasive approach to the removal of the spleen, usually for blood-borne diseases such as Idiopathic Thrombocytopenic Purpura (ITP).
Colonoscopy A video examination of the large intestine useful in detecting, and removing, intestinal polyps, and for screening for colon and rectal cancer.
Esophagogastroduodenoscopy (EGD) A video examination of the upper GI tract, including the esophagus, stomach, and duodenum, the first segment of the small intestine. Useful in evaluating difficulty swallowing, reflux symptoms, and ulcer disease.
Surgical Management of Chronic Pain Syndromes Procedures such as cryoanalgesic nerve ablation, spinal cord stimulation, and placement of intrathecal infusion pump systems are performed in adults and children in concert with the pain specialists from the New England Pain Center.
Laparoscopic Heller Myotomy A minimally invasive surgical procedure that is highly effective in restoring swallowing ability for people affected by the esophageal motor disease achalasia.
Surgical Treatment for Rectal Prolapse Various operative and endoscopic procedures are offered for patients with rectal prolapse, including those performed from below without the need for abdominal surgery.
Laparoscopic Staging of Malignancy A minimally invasive method for evaluating lymph nodes, the liver, and abdominal cavity through direct observation, biopsy, and laparoscopic ultrasound imaging before embarking on major surgery. Useful in the evaluation of patients with pancreatic and gastric cancers, as well as lymphomas, recurrent colorectal cancer, and certain other conditions.
The Stretta Procedure Non-operative therapy for GERD involving the endoscopic delivery of radio frequency energy to enhance performance of the lower esophageal sphincter.
Endoscopic Retrograde Cholangiopancreatography (ERCP) A video examination of the bile ducts and pancreas, useful in removing gallstones from the bile ducts, and in evaluating pancreatic cancer and other diseases.
24-Hour Ambulatory pH Monitoring A diagnostic test to document the degree of esophageal acid exposure occuring in patients with gastroesophageal reflux disorder. Useful in linking GERD to asthma and other conditions, and for diagnosing GERD in unusual circumstances.
Esophageal Manometry A diagnostic test used to evaluate the muscular function of the esophagus in anticipation of endoscopic or surgical treatment for gastroesophageal reflux disorder.
Procedure for Prolapse and Hemorrhoids The Procedure for Prolapse and Hemorrhoids (PPH) is also known as the Stapled Hemorroidopexy, or Proctopexy. Current instrumentation now allows this nearly 20 year old procedure to be offered to many patients, with excellent results. Patients with prolapsing or protruding hemorrhoids, especially those without significant external hemorrhoids, are treated with minimal discomfort and minimal destruction of the natural protective hemorrhoidal cushions.
Enteryx for GERD Non-operative therapy for GERD involving the endoscopic injection of a biocompatible polymer to enhance performance of the lower esophageal sphincter.
nDo Plication Non-operative therapy for GERD involving the endoscopic placement of sutures to enhance performance of the lower esophageal sphincter.
Bariatric Surgery Bariatric surgery refers to a series of operative interventions aimed at achieving substantial weight loss in individuals who are morbidly obese. Morbid obesity increases the risks of developing diabetes, heart disease, hypertension, and other serious health problems. Obesity can also be disabling, either psychologically or physically, and results in joint degeneration as well.
Please remember that bariatric surgery is a serious intervention aimed at preserving the lives of patients at high risk for death and disability from their obesity. These procedures are not intended for casual weight loss for individuals who respond to traditional diet and exercise recommendations, or who do not meet the National Institutes of Health Consensus Panel definition of morbid obesity.
Additional information on weight loss surgery may be found at www.weight-loss-surgery.medem.com, our specialty web site.
Inguinal Hernia Surgery Laparoscopic surgery is done using one of two techniques, TAPP or TEPP. Most modern repairs are TEPP, meaning that they are performed between layers of the abdominal wall.
Anterior repairs are done through small incisions placed directly over the hernia bulge. The most common modern repairs are the Perfix Plug Hernioplasty, or Plug and Patch Repair, and the Kugel Hernia Repair. Each involves correcting the muscular defect with minimal tissue disruption.
Drs. Fanelli and Lederman have expertise in all aspects of inguinal hernia repair. They would be pleased to examine you, and review the appropriate options available for repair of your hernia.
Pre-Emptive Analgesia Pre-emptive analgesia is a technique for controlling postoperative pain, that begins pre-operatively. Drs. Fanelli and Lederman often prescribed specialized medications to begin the day prior to surgery, so that postoperative pain levels are minimal. A trend setting practice, Surgical Specialists of Western New England, PC was the first surgical practice in the region to institute routine use of pre-emptive analgesia.
Laparoscopic Roux-En-Y Gastric Bypass The Roux-en-Y Gastric Bypass is the gold standard in weight loss surgery. As an operation it has been refined over the past two decades to become the best surgical tool we have to help people lose weight. The gastric bypass involves creating a small gastric pouch out of the top of the stomach that is separated from the rest of the stomach. The pouch is then connected to a piece of intestine to give food a place to go. This accomplishes two things. First, you cannot eat very much, since the pouch is about the size of a golf ball. It means you feel full very quickly, and eat less. Also, the re-routing of the intestines means that you absorb less of the food you do eat (malabsorption). All this leads to an effective treatment for morbid obesity. The average person loses 2/3 of the excess weight within the first year. That means if you are 100 pounds overweight, you would lose 66 lbs at one year. Usually the weight loss doesn't stop there, but continues for the next year. After 3 years, weight loss tends to plateau, and patients may experience a small rebound, leveling off at approximately 55% of excess weight loss. We specialize in laparoscopic, or minimally invasive surgery, so we approach virtually all our gastric bypasses laparoscopically. This means 5 small holes, instead of one big incision. This is important, since the big incision of "open" surgery has a 20% rate of forming ventral hernias. Laparoscopic surgery also leads to faster recovery, less pain, and a shorter hospital stay.
Contact Us To arrange an office consultation with Dr. Fanelli, telephone the office staff at 413-442-2462 to schedule your visit.
If your health insurer requires a referral to see a specialist like Dr. Fanelli, please contact your primary care provider to be sure that your visit will be approved.
If you have had x-rays, labwork, or any prior related consultations performed, please be sure that copies of these reports are sent to our office well in advance of your visit.
Pick up any related x-rays where they were performed, and bring them with you when you see Dr. Fanelli, so that he may review these with you.
Since Dr. Fanelli strongly believes that all patients deserve a thorough personal evaluation by their surgeon, he does not perform new patient evaluations by e-mail, fax, or telephone.
Disclaimer The information and advice published or made available through the Surgical Specialists of Western New England, P.C. web site is not intended to replace the services of a physician, nor does it constitute a patient-physician relationship. The information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should consult a physician in all matters relating to your health. Surgical Specialists of Western New England, P.C. under no circumstances recommends particular treatment for specific individuals without an in-person consultation with one of our physicians.
All content on this web site should be assumed protected by copyright. All rights are reserved. Users are prohibited from modifying, copying, distributing, transmitting, displaying, publishing, selling, licensing, creating derivative works, or using any information available on or through the site for commercial or public purposes. Surgical Specialists of Western New England, P.C. is not responsible for any direct or indirect claim, loss or damage resulting from use of this web site and/or any web site(s) linked to/from it.
Employment Opportunities Employment Opportunities at Surgical Specialists of Western New England, PC.
There are currently no openings for employment at SSWNE, but check back in the future, or submit your resume online, by emailing info@sswen.com. Thank you for your interest.
Surgical Specialists of Western New England, PC is a progressive, rapidly growing surgical practice specializing in gastrointestinal, bariatric, and minimally invasive surgery and gastrointestinal endoscopy based in Pittsfield, MA. We currently seek a dynamic individual to fulfill a staff leadership role in our organization. Qualified candidates will have expertise in medical coding, billing, scheduling, and have experience managing and coordinating staff members. Salary is commensurate with qualifications and experience. Benefits include health insurance, 401(k), integrated profit sharing plan, and paid vacation, among others. This is a great opportunity for a billing supervisor who is ready to take on more responsibility as a practice manager. Significant coding and billing experience is required. Please send your resume and letter of introduction to employment@sswne.com or fax to 413-442-3101.
HIPAA - What is that? The Health Insurance Portability and Accountability Act of 1996 is commonly referred to as HIPAA (pronounced "Hippa"). This legislation provides specific benefits to patients regarding the privacy of their medical records and communications. Surgical Specialists of Western New England, PC is committed to respectful patient care and communications, and had effective policies in place even before HIPAA regulations were mandated. The documents used in informing patients about their rights under HIPAA regulations can be viewed in our offices during regular business hours, and are presented to patients seeking services at our office. Patients treated at the hospital are advised about HIPAA by hospital staff, and an agreement between Surgical Specialists of Western New England, PC and Berkshire Medical Center protects patient rights across the continuum of care.
If you have any questions about our HIPAA policies, please telephone the Surgical Specialists of Western New England, PC HIPAA Compliance Officer at 413-442-2462, and ask to speak with Jean.
If you'd like to view the Surgical Specialists of Western New England, PC HIPAA Privacy Notice and HIPAA Privacy Notice Acknowledgement, you'll find them on our Home Page under the Patient Education Resources heading, or on the page entitled Privacy Policy.
Hemorrhoidalpexy
Procedure Description: A method of suspending natural hemorrhoidal tissue
What To Expect: Patients typically experience less pain, an earlier return to work, and greater satisfaction with stapled proctopexy/hemorrhoidopexy compared with traditional operative hemorrhoidectomy. Natural hemorrhoidal cushions are resuspended with this technique, not surgically excised as is typically done during hemorrhoidectomy.
Preprocedure: Patients are evaluated in the outpatient office setting, and may undergo testing such as colonoscopy to accurately identify the problem and ensure colonic health. Prior to stapled proctopexy/hemorrhoidopexy, the patient will use two Fleet enemas to cleanse the rectum, or a more formal oral preparation. The procedure is performed on an outpatient basis using spinal or local anesthesia, with sedation.
Postprocedure: Following this procedure, patients may be given pain medication, an antibiotic, an antispasmotic, and often an antiinflamatory agent. Most patients return to work within one week, compared with three weeks for traditional hemorrhoid surgery. Bulk forming agents and stool lubricants are utilized after the procedure for one month to assist healing.
Meet the Office Staff
Meet the Surgical Specialists of Western New England office staff! Ro, Sue, Cheri, and Laurie are each an integral part of this practice.
When you call our office, you'll speak to a professional, who can assist you with appointments, scheduling your surgical or endoscopic procedure, and address any insurance or billing concerns.
Sue, a nurse with many years of experience caring for medical and surgical patients, leads our clinical team. She helps Dr. Fanelli with the evaluation and treatment of patients. Our clinical team is a valuable resource for patients, and all members are skilled to assist with virtually any clinical need.
Our office staff, Ro, Cheri, and Laurie, help patients with the registration process, appointment scheduling, and financial concerns. They are an important link with your primary care provider, and help coordinate the exchange of information between physician's offices and various hospital departments, enhancing our ability to care for you and your family members.
Everyone at Surgical Specialists of Western New England, PC is focused on providing effective, compassionate, and expert healthcare. Please let our wonderful staff know how they can help you.
Open Access Colonoscopy What is open Access colonoscopy?
Screening colonoscopy has been shown to identify polyps early so that they can be removed before they have the chance to become a cancer of the colon. Patients who undergo screening colonoscopy and have those polyps removed might be less likely to develop colon cancer, and if they do, might have it discovered at an earlier, more curable stage.
The term 'open access' means that patients who meet certain criteria can communicate with our office staff and schedule a screening colonoscopy without the need for an office visit first. Of course, anyone who wants to see Dr. Fanelli in the office for consultation is always welcome to call to schedule that visit.
Patients who are appropriate candidates for open access screening colonoscopy are those who are healthy and don't have heart disease, high blood pressure, diabetes, lung disease, or take blood thinning medications. Patients who have abdominal pain, rectal bleeding, vomiting of blood, nausea, or any other symptoms should be seen in the office before any procedure for complete consultation. Patients who are morbidly obese, have GERD, or who are allergic to common sedatives like Valium, Versed, Demerol, and Fentanyl should be seen in the office for consultation to plan their screening.
If you believe that you qualify for open access screening colonoscopy, please download our Open Access Colonoscopy form on the home page of this website, complete both sides of the form, and fax it, mail it, or drop it off at our office. If you have any questions, concerns, or simply want to see the doctor before the procedure, call us ... we'll schedule the consultation for you!
Patient - Centricity What is a problem specific patient focused practice? It is a medical or surgical specialty practice that seeks to assist patients completely from initial evaluation through definitive management of particular clinical problems by offering thorough knowledge of the disease process, expertise in its evaluation and treatment, and compassionate care to affected patients and families.
Dr. Fanelli chose to develop this type of comprehensive patient-centric practice because of his frustration in coordinating care for several family members.
Dr. Fanelli is the only surgeon in western New England focused on providing complete diagnostic and therapuetic care for patients based on their clinical problems. Furthermore, since Dr. Fanelli limits his practice to the areas of his clinical and scientific expertise, his patients enjoy the full benefit of this approach.
For example, individuals suffering from gastroesophageal reflux disorder (GERD) might typically be seen by their primary provider, refered to a gastroenterologist for medications or endoscopy, and then to another physician for physiologic evaluation. If endoscopic therapy is needed, the patient might be refered to yet another physician, and if surgery is required, another referal must be made. With so many physicians involved in their care, many patients find the experience cumbersome, tedious, expensive, and frustrating. Fragmented care can lead to incomplete evaluations, increased expenses, and decreased patient satisfaction, each of which detracts from the ultimate treatment outcome.
Dr. Fanelli eliminates this time-consuming, often flawed cycle by providing total care solutions for his patients. By focusing on specific problems, like GERD in this example, he has designed a care delivery mechanism that offers patients everything necessary for an accurate diagnosis, efficient evaluation, and effective treatment. By focusing on what patients need for specific health problems, he has thoughtfully built a practice that offers patients full spectrum care in the areas of his clinical interests and expertise.
Based on the initial office evaluation, Dr. Fanelli is often able to determine precisely what testing is necessary, and then personally perform or oversee that testing for the patient. As the only physician serving this community that is skilled and equipped for the physiologic analysis of the GI tract, Dr. Fanelli is able to offer testing that is not available elsewhere in the community. Whether the ultimate treatment requires medications, lifestyle changes, surgery, or advanced endoscopic techniques, Dr. Fanelli has unique expertise in each treatment method available.
Dr. Fanelli finds it easiest to explain the concept of the patient-focused practice by using the analogy of a store. Most surgical practices are like "variety stores." They offer many services, but the breadth of product offerings is shallow, and available expertise limited. A specialty surgical practice is more like a "specialty store." You can't find gum and light bulbs, or mops and paper towels next to the sophisticated specialty electronics items on display, but you can find all of the available options for a given need, and the expertise that is essential to impart significant knowledge to guide the consumer in making appropriate decisions.
Dr. Fanelli took this concept a step further in designing the weight loss surgery program for Surgical Specialists of Western New England, PC. He has assembled a multi-disciplinary team to help him care for morbidly obese patients who have decided to seek evaluation and potentially life-enhancing treatment.
The practice that Dr. Fanelli has crafted for patients since 1992 is highly specialized, and offers patients a uniquely complete and valuable experience.
From initial evaluation through definitive treatment and necessary long-term follow-up, Dr. Fanelli offers complete treatment solutions for patients. As a fellowship trained surgeon specializing in gastrointestinal surgery, GI and biliary endoscopy, and minimally invasive surgery, Dr. Fanelli is uniquely qualified to offer patient-focused care for gastrointestinal diseases like GERD, esophageal and swallowing disorders, gallbladder and bile duct stones, stomach ulcers and cancers, bowel obstruction, and colon cancer among others. Dr. Fanelli has formulated problem specific patient focused approaches to common surgical problems like hemorrhoids, groin hernias, and abdominal wall hernias as well, and is pleased to offer patients the most modern therapies available regionally and nationally.
Services at a Glance
General Surgery
Gastrointestinal Surgery
Gallbladder Surgery
Bariatric (Weight Loss) Surgery
Pancreatic and Hepatobiliary Surgery
Colon and Rectal Surgery
Cancer Surgery
Advanced Laparoscopic Surgery
Minimally Invasive Hernia Surgery
Gastrointestinal Endoscopy
Biliary Endoscopy
Gastrointestinal Physiology Studies
Evaluation, Medical, Endoscopic, and Surgical Therapy for GastroEsophageal Reflux Disorder (GERD)
