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A f ter participating in a seminar, patients meet one-on-one with their surgeon for a personalized discussion of their needs. "We discuss their medical conditions, body mass index and weight-loss goals," Dr. Barkan says. "The surgeon arrives at the best option along with the patient. The decision is ultimately the patient's, but we are there to guide them." Patient safety is of utmost consider- ation during these conferences, Dr. Hall says. For example, patients who are steroid-dependent due to a disease process are not candidates for gastric banding. Smokers are not considered for surgery unless they stop smoking for six weeks prior to their procedure. Dr. Brathwaite, with a high concern for patient safety, takes the rigorous approval process seriously. He has been known to cancel surgeries for patients who fa iled a preoperative nicotine screening test. In fact, Dr. Brathwaite helped New York state develop bariatric surgery guidelines, which later were adopted by other states and many insur- ance companies. Winthrop patients benefit from a meticulous screening process that is a national touchstone for patient safety. O nce a pat ient h a s de cide d on a procedure, a liaison helps him or her navigate the presurgical process. Depending on medical history, certain patients must meet with a vascular surgeon, cardiologist and pulmonolo- gist prior to surger y. Some patients will require other procedures, such as an inferior vena cava filter, before their surgery. A liaison helps make this complex round of appointments and clearances f low smoothly. Bariatric surger y is now a shorter p r o c e d u r e t h a n i n t h e p a s t . A t Winthrop-University Hospital, patients t y pica lly spend t wo night s in t he hospital following a sleeve or bypass procedure, and only a few hours follow- ing a laparoscopic banding procedure. Intensive education and care, including follow-up visits with their surgeons and participation in support groups, help patients maintain the exercise and nutritional patterns necessary for making bariatric surgery successful. Help for Patients with Swallowing Problems B e y o n d t h e p u r v i e w o f b a r- i a t r i c s u r g e r y , p h y s i c i a n s a t Winthrop-University Hospital use mini- mally invasive techniques for a variety of gastroenterological concerns. From the throat to the gut, small incisions benefit patients by producing excel- lent outcomes combined with faster recovery and less pain after surgery. Acha lasia, a disorder that ma kes swa llowing difficult due to lack of esophageal coordination, can lead to feeding problems, weight loss, acid ref lux and aspiration pneumonia. The esophagus can also become extremely dilated, necessitating its removal. "Though achalasia is of unknown etiology, we are certainly aware of its effects: The lower esophageal muscles narrow and cause a 'tra ffic jam' of food," Dr. Barkan says. "It's as if the food is being forced from a four-lane onto a one-lane highway." While other treatments, including Dr. Hall consults with a patient. KENETH HALL, MD A RECENT ADDITION to the team of highly skilled surgeons at Winthrop-University Hospital, Keneth Hall, MD, earned his medical degree at Howard University. During a surgical residency at Stony Brook University School of Medicine, he met Collin Brathwaite, MD, FACS, FASMBS, Chair of the Department of Surgery and Chief of the Division of Minimally Invasive Surgery and Bariatric Surgery at Winthrop-University Hospital. "Winthrop was the busiest surgical site I experienced during my training," Dr. Hall says. "Dr. Brathwaite took me under his wing, permitting me to scrub in on his cases." Dr. Hall became interested in minimally invasive and robotic surgery, and with the help of Winthrop-University Hospital, obtained special training in robotic surgery even before he completed his residency. Subsequently, he became Winthrop's first fel- low in minimally invasive and bariatric surgery and presented at national conferences on the subject. Today, he brings compassion and surgical excellence to his position as a full-time member of the minimally invasive and bariatric surgery team. M D N E W S . CO M ■ MD NEWS Long Island | 1 9