Moving Patients in the Right Direction

May 09, 2019 at 09:10 pm by Staff


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With a father and grandfather who were both physicians, Cesare Peraglie felt destined to pursue a career in medicine. As a child in south Texas, he shadowed his father, who was an OB-GYN, while he made his rounds or performed surgery.

"I got to see how doctors interacted with patients and talked with different types of people," he recalled.

"l learned that succeeding in medicine is all about establishing relationships and caring for your patients."

Finding a Calling

Peraglie went to medical school at Texas Tech, where he also performed his surgery residency. He thought about becoming an OB-GYN like his father, but that plan changed when a trauma surgery professor took him under his wing.

During his training, Peraglie completed bowel surgeries for trauma and cancer patients, and he took an interest in colon and rectal surgeries. At the time, minimally invasive surgery was an emerging field primarily used for gallbladder and appendix surgeries, but under the guidance of his mentor, he was able to experience laparoscopic colon surgery before it was recognized in the medical community.

"I cared for many patients recovering from large incisions after surgery," he said, "and I realized less-invasive techniques could provide better results."

Peraglie completed a fellowship in minimally invasive surgery in Kansas and another in colorectal surgery at Grant Medical/The Ohio State University. After completing these fellowships, he went into private practice in Las Vegas as a colorectal surgeon.

Expanding His Knowledge

While in Las Vegas, Peraglie operated on a woman whose daughter worked as a nurse for a bariatric surgeon.

Through that connection, he became interested in bariatric surgery and completed a year of training in that specialty.

In 2004, he was invited to Central Florida to train another surgeon and was ultimately offered a permanent position at a Polk County hospital in 2006. He recently joined the team at Poinciana Medical Center, where he serves as a colorectal and bariatric surgeon.

"Joining Poinciana was a 'ground-floor' opportunity," he asserts. "It's a newer facility in a growing area, and we're able to offer specialties not available before, which allows us to keep patients in their communities."

Previously, many patients had to drive to Celebration, Kissimmee or Orlando to receive specialized care, but this is no longer necessary, because Poinciana Medical Center offers a full spectrum of minimally invasive colorectal procedures.

"We often deal with misdiagnosed or mistreated issues, as well as complicated conditions such as inflammatory bowel disease," Peraglie explained. "It's important to have specialists who understand the nuances of this region of the body and have the experience to render appropriate diagnosis and care. We want to offer patients the best chance for a cure with good function, which will preserve their quality of life."

A New Lease on Life

Similar considerations also apply in bariatric surgery, where procedures require intervention and follow-up over time.

"Bariatric surgery is a surgical tool for patients; it doesn't necessarily cure them of obesity," he notes. "We're providing the jumpstart that encourages them to form healthy habits, make lifestyle changes and resolve medical issues -- all of which are critical for long-term success."

Someone who's severely overweight, notes Peraglie, may try to eat right and exercise, but they struggle because they have sleep apnea, chronic obstructive pulmonary disease or high blood pressure. "When you offer surgery, you start a cascade of beneficial effects, including loss of retained fluid, decreased joint pain, improved breathing and resolution of obesity-associated illnesses.

"They can bend down and tie their shoes, sit in a restaurant booth and play with their kids," he added. "It's truly life-changing."

Although he offers surgical options, Peraglie is one of a few surgeons in the country who perform mini-gastric bypass surgery (MGB/OAGB). He became interested in this procedure when he realized the advantages that it offered over other traditional procedures. "With the MGB/OAGB, we are able to offer patients one of the only procedures that is not only highly effective and durable but also easily reversible and revisable. Patients are typically in surgery an hour or less and the majority are able to go home the following morning," he said.

"We're able to induce remission in these comorbid conditions after addressing the hormonal effects of obesity," he explained. "Mini-gastric bypass surgery induces hormonal changes that act both on the pancreas and the intestine to naturally fight diabetes. Many of my patients can stop or reduce their diabetes medications quickly."

Peraglie has performed thousands of bariatric surgeries, both primary and revisional and has published on high-risk patients, including those who are morbidly obese and those over age 60. He is a current and longstanding member of numerous societies including the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).

Outside of work, Peraglie enjoys spending time with his wife, 10-year-old son and practicing Brazilian jiu-jitsu. He counts himself fortunate to have a career he loves -- and one that makes a tremendous difference in the lives of his patients.

"We're treating diseases that affect a person's lifespan," he said. "We're not only improving their life expectancy but giving them back the ability to perform everyday tasks. We're giving them a brand-new lease on life."