30 North Union Road, Suite 104, Williamsville, NY 14221
Call Synergy Today! (716) 565-3990
  • About Synergy Bariatics

    Synergy Bariatrics is a caring team of professionals with a patient-centered approach to care. We promote patient education, regular check-ups, and the support of family and peers to take on the challenges of healthy eating, regular physical activity, and behavior change. Because of our experience with over 4000 patients, we have become experts in weight loss. Our talented providers can discuss all of your options and explain the mechanisms behind each surgery. Here at Synergy Bariatrics, we believe that when patients actively participate in their pre- and post-surgery treatment plan great results can be achieved and maintained.

    Inside Synergy Bariatrics

    • Our Surgeons and Providers

      Meet the caring and supportive Synergy Bariatrics team of surgeons and providers.

      more
    • Our Staff and Support Team

      Meet our amazing team of professionals who use a patient-centered approach.

      more
  • Synergy History and Mission

    To provide caring, patient centered medical and surgical care to our community, using proven therapeutic modalities while searching for answers to the causes of obesity and its related diseases.

    Synergy Bariatrics had its origins in the surgical practice of Dr. Joseph A. Caruana. After leaving full time academics for private practice in 1991, he specialized in surgery of the liver, biliary tract, stomach, and intestine.

    Because of increasing evidence that weight loss surgery, specifically gastric bypass, was beneficial to patients with serious obesity and encouraged to begin performing this surgery by patients and colleagues, he performed his first gastric bypass at Sisters of Charity Hospital in June, 2000. He has now performed over 4000 of these procedures and his published outcomes of safety and successful weight loss are among the best in the world.

    During the past decade, Synergy Bariatrics has been joined by Dr. Mark Cavaretta and a number of talented caring professionals, dedicated to the management of obesity and its related health issues.

    The mission of Synergy Bariatrics remains to provide caring, patient centered medical and surgical care to our community, using proven therapeutic modalities while searching for answers to the causes of obesity and its related diseases.

  • Our Surgeons and Providers

    • JOSEPH A. CARUANA, MD

      Joseph A. Caruana, MD is Medical Director of Synergy[...]

    • MARK CAVARETTA, MD

      Mark Cavaretta, MD is a bariatric surgeon, who joined[...]

    • NICOLE ROSSNEY, RPA-C

      Nicole Rossney graduated from D'Youville College in 2007[...]

    • MISTY DENNIS, RPA-C

      Misty Dennis graduated from D'Youville College in 2010[...]

    • ANN MARIE LICAUSI, LMSW

      Ann Marie LiCausi, LMSW, is an eating behavior specialist[...]

    • SCOTT V. MONTE, PHARM.D

      Dr. Scott Monte graduated from the University at Buffalo[...]


  • Our Surgeons and Providers

    JOSEPH A. CARUANA, MD

    Joseph A. Caruana, MD is Medical Director of Synergy Bariatrics and Chief, Bariatric Surgery at Sisters of Charity Hospital in Buffalo, New York. He is certified by the American Board of Surgery and is a Fellow of the American College of Surgeons. He is a member of the American Society for Metabolic and Bariatric Surgery and several other National and International surgical societies. Dr. Caruana has published over 40 articles in peer reviewed medical journals. He performs gastric bypass and laparoscopic vertical sleeve gastrectomy.

    MARK CAVARETTA, MD

    Mark Cavaretta, MD is a bariatric surgeon, who joined Synergy Bariatrics in 2010. A native of Western New York, he performed a fellowship in bariatric surgery at the Geisinger Health System in Danville, Pennsylvania after completing his surgical residency in New York City. He is eligible for the American Board of Surgery and a member of the American Society for Metabolic and Bariatric Surgery. Dr. Cavaretta performs laparoscopic gastric bypass, laparoscopic vertical sleeve gastrectomy, laparoscopic adjustable gastric banding.

    MARC MCCABE, RPA-C

    Marc McCabe graduated from D'Youville College in 1999 with his Bachelor of Science degree as a Physician Assistant. He joined the Synergy Bariatrics team in 1999 and currently serves as one of our Physician Assistants. His role in your care is to assist the surgeons with your surgery and to provide you follow-up medical care after your surgery.

    NICOLE ROSSNEY, RPA-C

    Nicole Rossney graduated from D'Youville College in 2007 with her Bachelor of Science and Master of Science degree as a Physician Assistant. She joined the Synergy Bariatrics team in 2010 and currently serves as one of our Physician Assistants. Her role in your care is to assist the surgeons with your surgery and to provide you follow-up medical care after your surgery.

    MISTY DENNIS, RPA-C

    Misty Dennis graduated from D'Youville College in 2010 with her Bachelor of Science and Master of Science degree as a Physician Assistant. She joined the Synergy Bariatrics team in 2011 and currently serves as one of our Physician Assistants. Her role in your care is to assist the surgeons with your surgery and to provide you follow-up medical care after your surgery.

  • Our Surgeons and Providers

    ANN MARIE LICAUSI, LMSW

    Ann Marie LiCausi, LMSW, is an eating behavior specialist and is Executive Director of the Eating Disorders Association of WNY. Ms. LiCausi provides patient education and counseling for prospective patients of Synergy Bariatrics, as well as for those needing assistance with life adjustments after surgery.
    Phone: 716-565-3991

    SCOTT V. MONTE, PHARM.D.

    Dr. Scott Monte graduated from the University at Buffalo School of Pharmacy and Pharmaceutical Sciences in 2006 with his Doctorate in Pharmacy. He joined the Synergy Bariatrics team in 2009 and currently serves as our clinical pharmacist. His role in your care is to review your medications before surgery and to help prepare you for the changes and requirements following surgery.
    Phone: 716-565-3990 ext. 119

  • Staff and Support Team

    • CYNTHIA LAWSON

      Cynthia joined the Synergy Bariatrics team in 2012[...]

    • LINDA BROUGH

      Linda joined the Synergy Bariatrics team in 2011[...]

    • MISSY BENKER

      Missy Benker joined the Synergy Bariatrics team in 2007[...]

    • GAIL CHRISTOPHER

      Gail Christopher jointed the Synergy Bariatrics team[...]

    • JACKIE DIAZ

      Jackie Diaz joined the Synergy Bariatrics team in 2009[...]

    • AMANDA MAYLE

      Amanda Mayle joined the Synergy Health & Fitness team in 2012[...]

  • Our Staff and Support Team

    CYNTHIA LAWSON

    Cynthia joined the Synergy Bariatrics team in 2012 and currently serves as the practice's switchboard operator and café attendant. Her role at the practice is to answer all incoming patient phone calls and help service your nutritional needs before and after surgery.

    KRYSTAL FLORET

    Krystal Floret joined the Synergy Bariatrics team in 2012 and currently serves as the practice's receptionist. Her role at the practice is to verify your insurance coverage, accept your co-pays and schedule appointments with the surgeons, physician assistants, or pharmacist.

    LINDA BROUGH

    Linda joined the Synergy Bariatrics team in 2011 and currently serves as the other new patient intake coordinator. Her role at the practice is to help you address any questions about the practice and insurance requirements to become a new patient. She can assist you with any questions or difficulties you may have with completing the InfoSurge educational seminar.

    MISSY BENKER

    Missy Benker joined the Synergy Bariatrics team in 2007 and currently serves as the practice's new patient coordinator. Her role at the practice is to review all your registration materials and help you schedule an initial visit with one of our surgeons.

    GAIL CHRISTOPHER

    Gail Christopher jointed the Synergy Bariatrics team in 2001 and currently serves as the practice's office manager and billing specialist. Her role at the practice is to oversee policies and procedures and to help assist you with any financial considerations surrounding the surgery or your follow-up care.

    JACKIE DIAZ

    Jackie Diaz joined the Synergy Bariatrics team in 2009 and currently serves as the practice's medical assistant and surgical scheduler. Her role at the practice is to help educate you on the practice and insurance requirements so that you safely and successfully reach surgery.

  • Our Staff and Support Team

    AMANDA MAYLE

    Amanda Mayle joined the Synergy Health & Fitness team in 2012 and currently serves as an administrative assistant to Ann Marie LiCausi, LMSW. Her role is to help with scheduling and coordination of all the services available through Synergy Health & Fitness.

  • Questions

    • Why Bariatric Surgery?

      A tool to help you when diet and exercise are not enough. It is well known that taking in fewer calories, making better food choices, and increasing the amount of daily exercise are cornerstones for losing weight.

      more
    • Am I Eligible For Surgery?

      Professional Criteria to be eligible for surgery. The criteria for surgery are based on your body mass index (BMI) and your history of attempts at sustaining weight loss through diet, exercise, or medicines.

      more
    • What Are My Options?

      There are (3) options for Bariatric Surgery, the Roux-en-Y gastric Bypass, Sleeve Gastrectomy, and Adjustable Gastric Banding. All three procedures are stand-alone and have their own profiles.

      more
    • What's Involved?

      There are six steps in the process to safely complete surgery. These steps can usually be completed in a 6-8 week period, but are very dependent on your comfort with the process and motivation to complete the requirements.

      more
  • Why Bariatric Surgery?

    A tool to help you when diet and exercise are not enough.

    It is well known that taking in fewer calories, making better food choices, and increasing the amount of daily exercise are cornerstones for losing weight and improving disease such as high blood pressure, high cholesterol, and diabetes. Through years of research trying to help people lose weight it has been repeatedly shown that many people can be successful losing weight for a short period of time, but even the most motivated will often regain or increase their weight from where they started. It is important to understand that the body has many ways of regulating body weight and that new research shows the body may try to counteract weight loss by altering certain hormones that help to regulate hunger, appetite, and metabolism. People undergoing Bariatric Surgery have a more proper hormone response to weight loss and therefore are able to lose a greater amount of weight and maintain the weight loss more commonly than people who try through traditional diet and exercise strategies alone.
    PDF: Weight Adaptations Article NEJM 2011

    Improving your chronic diseases and reducing the number of medications you need to take.

    It is common for people undergoing Bariatric Surgery to see an improvement in blood pressure, cholesterol, and type 2 diabetes. Below is a link to the summary of information and full article to a study published in the New England Journal of Medicine (2012) that shows the average change in blood pressure, cholesterol, blood sugar, and the reduced need for medicines following Gastric Bypass surgery. It was found that people undergoing Gastric Bypass or Gastric Sleeve surgery were able to achieve better control of their diabetes in comparison to people not having surgery. Remarkably, people undergoing surgery were able to accomplish diabetes control and maintain control of their blood pressure and cholesterol while significantly reducing their number of medications.
    PDF: Information Summary/Chart
    PDF: Full Article NEJM 2012

    Increasing your lifespan and your quality of life.

    In a study of approximately 10,000 obese people it was found that there were 40% less deaths over a 7-year follow-up period in people undergoing Gastric Bypass versus those that did not have surgery. In particular, the group of people that had Gastric Bypass had 56% fewer deaths from coronary artery disease (CAD), 60% less deaths from cancer, and 92% less deaths from diabetes. Research has also shown that people undergoing Gastric Bypass have a remarkable improvement in their quality of life and level of functioning. Most commonly, people that are motivated to continue with follow-up visits, lose the most weight, and actively participate in their treatment of other medical conditions have the greatest improvement in their quality of life.
    PDF: Long-term Mortality 2007
    PDF: Am J Medicine QOL 2009

  • Gastric Bypass Surgery Study Summary

     

    Before Surgery

    6-months after Surgery

    12-months after Surgery

    WEIGHT AND BODY MASS

    Weight

    235 lbs

    193 lbs

    170 lbs

    Body Mass Index

    37.0 kg/m2

    28.2 kg/m2

    26.8 kg/m2

    BLOOD PRESSURE

    Systolic Blood Pressure

    135 mmHg

    -

    132 mmHg

    Diastolic Blood Pressure

    82 mmHg

    -

    72 mmHg

    On Blood Pressure Medicines

    78%

    -

    33%

    CHOLESTEROL

    LDL (Bad Cholesterol)

    92 mg/dl

    -

    94 mg/dl

    HDL (Good Cholesterol)

    46 mg/dl

    -

    59 mg/dl

    Triglycerides

    167 mg/dl

    -

    95 mg/dl

    On Cholesterol Medicine

    86%

    -

    27%

    DIABETES

         

    Fasting Glucose

    193 mg/dl

    96 mg/dl

    99 mg/dl

    Hemoglobin A1C

    9.3%

    6.3%

    6.4%

    On Diabetes Medicine

    98%

    -

    22%

  • Am I Eligible for Surgery?

    Professional Criteria to be eligible for surgery.

    The criteria for surgery are based on your body mass index (BMI) and your history of attempts at sustaining weight loss through diet, exercise, or medicines. You must also be able to understand and be motivated to adhere with lifestyle changes that go along with the surgery.

    Calculate your BMI (Input Height, Weight to get BMI, http://www.nhlbisupport.com/bmi/)

    Criteria for Surgery
    Option 1   Option 2
    Age > 18   Body mass index of > 35
    Body mass index of > 40   With other chronic diseases such as high blood pressure, diabetes, and sleep apnea.
    A history of unsuccessful weight loss attempts through
    diet, exercise, or medication therapy
      A history of unsuccessful weight loss attempts through
    diet, exercise, or medication therapy

    It is very important that you have an understanding and motivation to work with our staff, follow-up regularly after surgery, and adhere to lifestyle changes we will teach you.

    The Synergy Bariatrics Surgeons will meet with you to assess your personal risks and benefits and to determine if surgery is a safe option based on your medical history

    INSURANCES ACCEPTED BY OUR OFFICE

    Blue Cross/Blue Shield RMSCO
    Independent Health Medicare & Medicaid
    Univera VA Healthcare (must have a referral from the VA)

    ***At this time Synergy Bariatrics does not participate with Humana***

    CASH PAYMENT OPTIONS

    Synergy Bariatrics provides a cash payment option for patients interested in any surgery.
    Please contact Gail Christopher at 565-3990 ext. 104

  • INSURANCES ACCEPTED BY OUR OFFICE

    Complete Listing Below

    Blue Cross/Blue Shield
    Community Blue                                
    Traditional Blue                                                                     
    Senior Blue
    BCBS PPO (verify that your policy has bariatric coverage)
    Blue Cross/Blue Shield Family Health Plus (valid insurance referrals are required)
    Community Care (valid insurance referrals are required)
    Healthy New York

    Independent Health
    Medisource (valid insurance referrals are required)                                       
    Family Health Plus (valid insurance referrals are required)   
    Encompass 65
    NOVA

    Univera
    Univera PPO                                      
    Univera PPS                                       
    Univera Family Health Plus
    Buffalo Community Health
    Univera Senior Choice (valid insurance referrals are required)

    RMSCO
    Medicare
    Medicaid
    VA Healthcare (must have a referral from the VA)

    ***At this time Synergy Bariatrics does not participate with Humana***

  • What Are My Options?

    There are (3) options for Bariatric Surgery, the Roux-en-Y gastric Bypass, Sleeve Gastrectomy, and Adjustable Gastric Banding. All three procedures are stand-alone and have their own profile for weight loss, improvement of chronic disease conditions, and risks. Below are three brief descriptions and accompanying video clips to help your understanding of the procedures. The Surgeons at Synergy Bariatrics will help guide you toward your final decision based on your medical history and potential risks of the different surgeries.

    Surgical Procedures

    • Roux-en-Y Gastric Bypass

      The Roux-en-Y gastric bypass is the GOLD Standard of Bariatric Surgery. During the Roux-en-Y gastric...

      video & more
    • The Sleeve Gastrectomy

      During the Sleeve Gastrectomy procedure the surgeon removes about 80% of the stomach leaving a small...

      video & more
    • The Adjustable Gastric Band

      During the Adjustable Gastric Band procedure the surgeon implants two devices: a silicone band and...

      video & more


    What to expect for weight loss

  • Surgical Options : Roux-en-Y Gastric Bypass

    The Roux-en-Y gastric bypass is the GOLD Standard of Bariatric Surgery. During the Roux-en-Y gastric bypass procedure a small upper stomach pouch is created (about the size of a golf ball), dividing it from the lower stomach. Food will only come into the smaller pouch and therefore it can be limiting to the volume of food that can be eaten. The small intestine is also divided so that food "bypasses" the lower stomach and first part of the small intestine. The shape of this change results in a "Y". The Roux-en-Y gastric bypass is the Bariatric Procedure with the longest history of success for weight loss and affects the body's metabolism leading to improvement in blood pressure, cholesterol, and type 2 diabetes.

  • Surgical Options : The Sleeve Gastrectomy

    During the Sleeve Gastrectomy procedure the surgeon removes about 80% of the stomach leaving a small, "sleeve shaped stomach". The Sleeve Gastrectomy differs from the Roux-en-Y gastric bypass in that no alterations are made to the small intestine and the stomach pouch is larger than Roux-en-Y gastric bypass (about the size of a banana). While the Sleeve Gastrectomy has not been performed as a stand-alone procedure for as long as the Roux-en-Y gastric bypass it has been shown to produce weight loss and have a similar metabolic effect on blood pressure, cholesterol, and type 2 diabetes that are remarkably similar to the Roux-en-Y gastric bypass.

  • Surgical Options : The Adjustable Gastric Band

    During the Adjustable Gastric Band procedure the surgeon implants two devices: a silicone band and an injection port. The silicone band is placed around the upper part of the stomach creating a small pouch that is still connected to the remaining chamber of the stomach. The injection port is attached to the abdominal wall, underneath the skin. Fluid is injected into the port to fill the band and create restriction. The fluid can be increased or lessened to an optimal point that helps to promote the sense of fullness. The Adjustable Gastric Band has been shown to help patients lose weight with resulting improvement in their blood pressure, cholesterol, and type 2 diabetes. It does not have a significant effect on metabolism.

  • Surgery - What to Expect

    Most commonly, people that are motivated to continue with follow-up visits, lose the most weight, and actively participate in their treatment of other medical conditions have the greatest improvement in their quality of life.

    Here are the expected results after the surgical procedures:

     Excess Body Weight Loss

     

    3-months

    6-months

    12-months

    18-months

    Roux-en-Y Gastric Bypass

    30-35%

    45-50%

    50-65%

    65-70%

    Sleeve Gastrectomy

    25-30%

    35-40%

    50-60%

    60-65%

    Gastric Band

    15%

    22%

    33%

    40%

    Excess Body Weight is the amount of weight over your ideal body weight. Your ideal body weight is based on your gender and height.  Please note that these are average responses and that you may see greater or lesser response.

  • How to get to surgery?

    There are six steps in the process to safely complete surgery. These steps can usually be completed in a 6-8 week period, but are very dependent on your comfort with the process and motivation to complete the requirements.

    Step 1: Educate yourself on the surgical options by attending or viewing an information seminar
    Option #1: Attend In-Person at Synergy Bariatrics (reserve a spot by calling 716-565-3990 x 109)

    Option #2: Click here to Complete the Seminar Online.

    Step 2: Complete your registration packet and send it to our office
    If you complete the information seminar in-person - the packet is mailed to you when you sign-up

    If you complete the information seminar on-line - you may print out the packet at the end after a quiz

    ***Please feel free to call 716-565-3990 x 109 should you have any problems printing the packet***

    Step 3: Come in for a visit with the surgeon and agree on your best option
    Once you have completed ALL parts of the registration packet our new patient coordinator, Melissa Benker, will call you to schedule an appointment. At your first visit you will meet with a number of our staff members including our bariatric nurse, medical assistant, surgical scheduler (Jackie Diaz), pharmacist (Dr. Scott Monte), and surgeon (Dr. Caruana or Dr. Cavaretta). The surgeon will discuss all of your options with you and help guide you toward the surgical option that is best for you.

    Step 4: Complete ALL health plan and Synergy Bariatrics practice requirements
    There are a number of health plan and practice requirements that must be completed before scheduling surgery. These include the following:

    • A completed primary care physician documentation form for bariatric surgery approval (this can be found in your registration packet)
    • A thyroid laboratory test known as a TSH (Independent Health members only)
    • A pre-surgical psychological evaluation from a provider specialized in bariatric surgery (a list of providers in your area can be found in your registration packet)
    • Visit a bariatric dietician OR attend a nutrition class at Synergy Bariatrics. (Dr. Caruana hosts regular FREE sessions)
    • Attend the Fundamentals Workshops (Provided by Ann Marie LiCausi at Synergy Bariatrics)
    • You MUST not be smoking cigarettes


    Step 5: Await authorization from your health insurance plan

    Once you have completed ALL health plan and practice requirements our Medical Assistant will submit your information to the health plan for approval. Health plan approval usually takes 5-7 days following submission.

    Step 6: Schedule a surgery date and complete ALL pre-surgery requirements
    Once you have received approval from the health plan our surgical scheduler, Jackie Diaz, will contact you to set-up a surgery date. At that time you will also receive information on the final educational requirements leading up to surgery.

    • Bariatric surgery essentials
    • Exercise requirements and timeline
    • Liver reduction diet (2-week high protein, low carb, no fat diet immediately before surgery)

     

  • Become a Patient Today!

    Step 1: Attend a no obligation, FREE information seminar

    Start Anytime: Click and Complete the Seminar On-line
    Schedule a Time to Attend In-Person: Contact 716-565-3990 x 103

    Step 2: Complete the registration packet and get it to our staff

    If you completed the seminar on-line you may print the packet out at the end after taking a quiz. If you are attending the seminar in-person it will be mailed to you when you sign-up!
    *Please contact 565-3990 if you have questions or need a registration packet mailed to you. 

    Step 3: Await our office to contact you for an appointment with one of our surgeons

    Once the registration packet has been received, our new patient coordinator, Melissa Benker will contact you to schedule an appointment with one of our surgeons.  In order for us to help you obtain a surgery date in the timeframe you desire, we highly recommend that you begin working on the health insurance plan and Synergy Bariatrics practice requirements for surgery approval.  These include:

    A completed primary care physician documentation form for bariatric surgery approval (this can be found in your registration packet)

    A thyroid laboratory test known as a TSH (Independent Health members only)

    A pre-surgical psychological evaluation from a provider specialized in bariatric surgery (a list of providers in your area can be found in your registration packet)

    Attend a nutrition class (Dr. Caruana hosts a FREE session at Synergy Bariatrics)

    Attend the Fundamentals Workshops at Synergy Bariatrics (716-565-3991)

    You MUST not be smoking cigarettes


    Our surgeons and staff are here to help you through all steps in the process before and after surgery.
    Please do not hesitate to contact us at 565-3990 with any questions.

  • Our Address

    Synergy Bariatrics
    30 North Union Road, Suite 104
    Williamsville, New York 14221

    Telephone: (716) 565-3990
    Fax: (716) 565-3988
    E-mail: cynthia@synergybariatrics.com

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