1. Sleeve & Band: Increased Risk of Esophageal Cancer Dr. Rutledge

2. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net Imagine; Your Post Op Pt Post Op Patient Visit" "Dr., I found out the operation that you performed on me may cause cancer." "You did not tell me this." Your answer?

3. Sleeve & Band, 30% Reflux (2yr FU), Leads to Esophageal Cancer Dr. Rutledge

4. 1. GE Reflux => Esophageal Cancer Survey 120 Bariatric Surgeons "GERD Increases Risk of Cancer of Esophagus. Longer GERD = More Risk." AGREE 100%

5. 2. Band and Sleeve => 30% GE Reflux "Sleeve gastrectomy produces an important decrease in LES pressure, which can cause reflux symptoms and esophagitis" Obes Surg. 2010 Mar;20(3):357-62. Epub 2009 Dec 15.Manometric changes of the lower esophageal sphincter after sleevegastrectomy in obese patients.Braghetto I,

6. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net All patients had a pre- and postop swallow 18% New-onset GERD on UGI GERD score questionnaire, 22% New-onset GERD symptoms despite receiving daily Anti-Acid therapy Surg Obes Relat Dis. 2011 Nov-Dec:Gastroesophageal reflux after sleeve gastrectomy in morbidly obese patients. Howard DD, Caban AM, Cendan JC, Ben-David K. Department of Surgery, Minimally Invasive, Gastroesophageal and Bariatric Surgery Service, University of Florida, Gainesville, Florida 32610, USA

7. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net

9. Survey Bariatric Surgical Experts

10. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net Band & Sleeve

11. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net Esophageal carcinoma after sleeve gastrectomy. Scheepers AF, Schoon EJ, Nienhuijs SW. Surg Obes Relat Dis. 2011 Jul-Aug; Esophageal adenocarcinoma after laparoscopic gastric band placement for obesity. Stauffer JA, Mathew J, Odell JA. Dis Esophagus. 2011 Jan; Adenocarcinoma of the lower esophagus after placement of a gastric band. Korswagen LA, Schrama JG, Bruins Slot W, Hunfeld MA. Obes Surg. 2009 Mar;

12. 3. Band Sleeve => Increased Risk of Esophageal Cancer 4. Surgeons Should Warn Their Patients: Risk of Esophageal Cancer after Band Sleeve

13. MGB / OA Consensus Conference Paris Oct 18-19, Email: DrR@CLOS.Net Best Practices What happens, When your sleeve patients find that They may be at increased risk for Esophageal Cancer Their surgeons could or should have known about it But Did Not Warn Them?