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including one pioneered by Dr. Saber, continue to offer more options for mini- mally invasive weight loss. These include laparoscopic sleeve gastrectomy, single incision laparoscopic bariatric surgery and robotic-assisted bariatric surgery. Sleeve Gastrectomy Laparoscopic sleeve gastrectomy THE HEALTH BENEFITS OF BARIATRIC SURGERY Obesity increases the risk of nearly every chronic disease, including the biggest killers: cancer, heart disease and diabetes. By giving patients a proven method for losing their excess weight, bariatric surgery improves not only patients' body image, confidence and energy, but also their longevity. "I can confidently tell all patients that problems like high blood pressure, diabetes and sleep apnea are going to be dramatically reduced, if not completely cured," says Dr. Khaitan. "I see patients after bariatric surgery go from taking large amounts of insulin and medicines for high blood pressure and wearing a CPAP machine at night, to just taking a daily multivitamin." Bariatric patients not only enjoy a reduced risk of deadly diseases, but typically also see improved quality of life with the reduction of other health problems such as fatigue, gastroin- testinal reflux, urinary incontinence and osteoarthritis pain. They report increased energy and mobility they never realized they had, according to Dr. Khaitan. While many patients have failed at long term weight loss with diet and exercise alone, weight loss surgery offers patients a greater than 90 percent success rate in losing the majority of their excess weight and keep- ing it off. Multiple ongoing post-operative educational and counseling programs help them maintain a healthier weight for a lifetime. "Patients who have had bariatric surgery tend to say that they have a whole new lease on life," says Dr. Khaitan. "I had a patient who recently ran her first 5K race. She did not realize she could run prior to her surgery! These kinds of successes are very gratifying from a physi- cian's standpoint." 36 | Cleveland-Akron-Canton MD NEWS n MDNEWS.COM n MARCH-APRIL 2012 involves removal of the lateral 90 percent of the stomach to restrict food intake and decrease appetite. According to Dr. Saber, the hormonal effects of sleeve gastrectomy can be more prominent than those of the most standard bariatric procedure, i.e. Roux-en-Y gastric bypass. He says there is also greater appetite suppression and excess weight loss with sleeve gastrectomy when compared with gastric bypass. A recent study reported a weight loss from sleeve gastrectomy of 69 percent excess body weight at 12 months compared to 60 percent after Roux en Y gastric bypass. (Karamanakos SN, Vagenas K, Kalfarentzos F, Alexandrides TK. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008 Mar;247(3):401-7.) "Sleeve gastrectomy has several advantages over current weight loss procedures," Dr. Saber explains. "Unlike gastric bypass, sleeve gastrectomy does not involve rerouting of the intestine or malabsorption, thus it does not affect absorption of food, vitamins or medica- tions. In addition, gastric sleeve does not have the risk of internal hernia, marginal ulcer or dumping syndrome." Sleeve gastrectomy is also different from adjustable gastric banding, even though both bariatric procedures involve stomach restriction. With gastric band- ing, the surgeon places a belt-like band around the stomach that is periodically tightened or loosened by the addition or subtraction of saline solution through a small access port below the skin. Sleeve gastrectomy does not require placement of a device nor adjustments. PHOTO © JOE SMITHBERGER, SMITHBERGER PHOTOGRAPHY, NORTH CANTON