Over a hundred thousand foreign tourists visit Turkey for obesity operations. The majority of the demand for these operations originates from Europe and the Middle East. In Turkey, obesity is a major public health issue and leads to various health problems such as heart failure and diabetes. Severe obesity, defined as 5% of the population, is on the rise. It is difficult to calculate the increase in obesity that has spread in Turkey in recent years, due to the increase in the number of obese people and obesity surgery.
The sub-products of obesity surgery in Turkey are increasing in addition to these operations. However, one of them is more remarkable compared to other surgeries. This surgery is called “sleeve gastrectomy.” Turkey has gained considerable importance, especially in the Middle East and the Gulf countries. In recent years, “gastric sleeve” has become the most demanded and widespread obesity surgery in Turkey. The spread of sleeve gastrectomy in Turkey has now reached the majority of foreign tourists’ requests. Many foreign tourists are now starting to focus on weight loss instead of vacation.
Gastric sleeve, also known as laparoscopic sleeve gastrectomy, is one of the methods used in the surgical treatment of obesity and is the most common surgical treatment method. This surgical method can also be applied to patients with a body mass index (BMI) of 35 or higher, accompanied by diseases due to obesity, and not over 5 points of comorbidity. It is a restrictive type of operation. The structure of the stomach is changed by making a tube-shaped stomach with an approximate volume of 100-150 ml. In the surgery performed and managed with a video laparoscope, a significant part of the stomach is removed sideways with the stapler device.
Before the operation, the patient is requested to go through a nutrition program and provide detailed information to the doctor about their eating habits. Small meals should be consumed after the battery is inserted so as not to overstretch the stomach, and the calorie intake of the meal should be carefully planned by considering the nutritional values. The desired weight should be reached within 12-18 months of the operation.
The purpose of sleeve gastrectomy is to reduce the amount of food that can be kept in the stomach and speed up the process of reaching the feeling of saturation. At the same time, a hormone called “hunger hormone” that stimulates appetite is produced in the largest removed part of the stomach. The removal of the largest part of the stomach also aims to ensure that after the surgery, the desire for very sweet, high-fat foods and the desire to eat a large amount of food are reduced. The first stage of these operations is to reduce the craving for high-calorie foods. In this surgery, the muscles related to the digestion and normal absorption of the stomach are not damaged. The operation is performed using devices closed via 5 different small incisions in the abdomen, and the stomach is changed in an hour and a half with devices advancing through these incisions. In the operation, 70-80% of the stomach is removed, and about 100-200 ml of the volume of the tube-shaped stomach is left.
Medical Tourism in Turkey
Over the recent years, Turkey has become an increasingly popular country for foreign travelers seeking a number of medical services such as dental correction, eye surgery, plastic surgery, aesthetic procedures, organ transplantation, spine disorder treatment, cancer treatment, and obesity treatment. The increasing number of international healthcare accreditations, international hospital chains opening branches in Turkey, reduction of waiting periods for treatment, and the expanding collaborations with international insurance companies assist this increasing trend. The Ministry of Health in Turkey reports that a total of 1,046,340 patients from 144 countries benefited from healthcare services provided in Turkey during 2020. A total of 287,705 of these were inpatient treatments. Liposuction, tummy tuck, rhinoplasty, breast augmentation, eyelid and face lift surgeries, dental and eye treatments, as well as IVF applications were at the top of the list of preferences for the international visitors who traveled to Turkey in 2021.
The fact is that Turkey has become one of the leading countries in the field of medical tourism, both for tourism preferences and for its healthcare infrastructure. The number of international hospitals, healthcare personnel, and the development of medical infrastructure such as the establishment of health accreditation and the international medical travel agencies has made Turkey a popular medical tourism destination. Turkey stands out from the rest of the world with its success and experience in health tourism. With the implementation of secure therapeutic protocols, safe tourism certificates, and safe living certificates for individual stays, Turkey is a country that meets all the conditions of providing safe healthcare services.
Overview of Medical Tourism
Medical tourism is seeking effective and value-for-money health services worldwide. High costs, long waiting times for treatment, the search for more advanced technology, and the development of globalization are the main driving forces in medical tourism. Being one of the leading industries in medical tourism, health tourism includes a wide range of possibilities such as general health, plastic and reconstructive surgery, thermal therapy, wellness, oral and dental health, hair transplantation, and organ transplantation. It can be beneficial for those who are not satisfied with the services provided in their country, those who do not receive treatment in a socially and privately satisfactory way, those who experience a better quality of service in terms of outcome, cost, and time, and the same service in another country. This treatment process, called medical travel, medical tourism, health tourism, or transnational migration, has increased rapidly in recent years with the spread of information technologies, deregulation, the transformation of healthcare into a global industry, and cost differentials. Small countries, developing countries, or countries with lower health costs are entering the international health industry by taking a greater market share. As a result, countries such as Cuba, Thailand, Hungary, Turkey, Singapore, Costa Rica, Jordan, India, Puerto Rico, Dubai, Malaysia, South Korea, Taiwan, Lithuania, Estonia, Finland, Ukraine, and Mexico have become popular destinations for international healthcare. Energy generation in the health sector has become a legitimate and significant branch of tourism. With mediating companies or institutions in hospital selection and location, ticket, accommodation, and transfer reservation organizations, planned treatment tours are made safely and comfortably.
Choosing Turkey for Gastric Sleeve Surgery
It is very important to choose an experienced and successful clinic for a healthy, risk-free gastric sleeve operation. You can reach the necessary information by researching the reviews of other patients who have been operated on or by your friends’ recommendations. Turkey has the best budget-friendly and successful clinics and accomplished surgeons in the field of bariatric surgery. It is the best destination for affordable and quality health care services, including gastric sleeve surgery. Gastric sleeve operations in Turkey are popular among tourists traveling from many countries for treatment. The main reasons for this are that Turkey varies with its beautiful climate, and there are many places to visit and rich opportunities to have a vacation during the recovery period. Turkish people are also famous for their hospitality and positive attitudes to life. In Turkey, all surgical and post-surgery services are provided to patients in 4-5 star first-class hotels, international patient departments of full-service hospitals, and clinics through medical tourism agencies. You can rest in the luxurious and calm hospital rooms until you recover and return home. High-quality treatments and luxurious services will provide a comfortable rehabilitation process. The most important development for the patients is that most of the doctors speak English or the language that the patient can speak throughout Turkey.
Advantages of Choosing Turkey
Affordable Prices Turkey is an ideal destination for gastric sleeve surgery. Even though the gastric sleeve price in Turkey is much more affordable than in other countries, the quality is neither negatively affected nor is the latest technology put aside. Thus, patients renew their lives while having a more affordable and cost-effective process. Gastric sleeve prices in Turkey are arranged to include every detail, such as transportation, hospital processes, and experienced staff. In short, a pleasant and healthy journey is offered. The privilege of getting more for less is real.
Experienced Staff Turkey is one of the few countries that successfully realizes the number one step of obesity surgeries. With plenty of education and experience, excellent weight loss surgery in Turkey is carried out without any errors by the experienced staff. Thanks to the growing health tourism and the contributions of the staff who are experts in their fields, Turkey offers an impeccable deal.
Laws and Permissions One of the most important privileges is that it is completed meticulously by following the laws and permissions in Turkey. It is conducted under strict hygiene conditions with national and international accreditations. Furthermore, because the drugs are purchased from certified pharmaceutical companies, long-lasting results are achieved without any problems in terms of healthy content.
Preparing for Gastric Sleeve Surgery
Rapid weight loss after gastric sleeve surgery creates a risk of developing gallstones. To prevent gallstone formation after gastric sleeve surgery, gallbladder removal can be included during the operation. Gallstone formation roughly doubles after rapid weight loss. The formation of gallstones after rapid weight loss occurs within the first two months at the latest. The size of the stomach is increased by this procedure. The stomach volume remaining after food consumption is 3 to 4 times that of the consumed meal. This situation provides an advantage for both weight loss rates and the permanent feeling of satiety. After gastric sleeve surgery, rapid weight loss is achieved.
Before undergoing gastric sleeve surgery, patients should have a certain preoperative preparation. Patient preparation is started at least 10 to 14 days in advance. Advanced preparation allows the liquid diet period to be shorter. Following preoperative preparation, thanks to an approximately 10-day liquid diet period, the liver is metabolically improved by reducing the weight by 5 to 6 kg, and the risk of complications decreases. Rapid weight loss before the operation is directly related to the patient’s follow-up and compliance. Completing the necessary psychological and physical preparations and having the postoperative period conform to the nutrition program is the patient’s investment in himself. It is very important for patients not to approach the operation as only “surgery” and to approach the entire treatment program consciously.
Pre-Operative Evaluation
The multidisciplinary team is important during sleeve gastrectomy evaluation. Dieticians providing nutritional therapy to patients who will undergo sleeve gastrectomy help patients achieve better post-operative outcomes. It is also important for patients to follow pre-operative programs and develop healthy feeding habits. An experienced psychiatrist can evaluate whether there are psychiatric problems in patients that cause obesity and can help patients achieve better post-operative outcomes. An anesthesiologist evaluates the suitability of patients for anesthesia. Pulmonary doctors assess obesity syndrome, sleep apnea, and lung diseases. Endocrinologists and internal medicine specialists evaluate patients for obesity-related morbidity such as diabetes, hypertension, and heart diseases. Vascular surgeons observe the presence of peripheral and deep venous thrombosis as well as atherosclerotic diseases. Diabetologists monitor complications due to obesity such as type 2 diabetes and heart diseases and recommend the best algorithm to follow after sleeve gastrectomy operation. Other surgeons, specialized in different areas of surgery, reevaluate patients from the perspective of obesity and address the missing aspects of sleeve gastrectomy evaluation and operation. These specialized surgeons may include those interested in metabolic surgery, pulmonary surgeons, vascular surgeons, dermatologists, and cardiologists. Additionally, general surgeons with experience in bariatric and metabolic surgery perform the operations. An interdisciplinary approach is essential, and these detailed evaluations help identify the best algorithm to be used and the best candidates for sleeve gastrectomy operation.
The Gastric Sleeve Procedure
The gastric sleeve operation is the most frequently applied method in obesity surgery in recent years. The operation is performed laparoscopically under general anesthesia and takes 60-90 minutes on average. The operation involves filling the stomach with gas by inflating the abdomen, thus enabling the surgeon to see the stomach easily. Thereafter, approximately 85% of the stomach is cut longitudinally, and the stomach is converted into a tube-shaped organ by removing the curve. Little or no impact occurs in the discharge of food from the stomach because the angle-shaped valve of the stomach is maintained. The left-hand side of the stomach and the junction point of the esophagus with the stomach are supported with two layers of sutures to ensure that the stomach remains tubular. The main purpose of these sutures is to reduce the risk of leakage during the healing process. When there is a risk, the outer surface of the reorganized stomach is smeared with liquid, and the stomach is suctioned to control whether there is a leak. After the leakage control is completed, the stomach is emptied, air is removed, and staple sutures are applied to strengthen the incision line. After the operation, the incisions are closed, and the dressing is performed.
Surgical Technique
Two types of techniques can be used in a VSG application. The most common method is called laparoscopic surgery. In the post-surgical period, fewer painkillers are taken, which provides faster healing and a quicker return to daily activities. The other method is the open technique; the patient needs to stay in the hospital for a longer time because of the greater risk of hospital contamination compared to laparoscopic surgery. Though laparoscopic surgery is rapid and allows the patient to improve quickly, enough space on the patient’s body is necessary to be able to insert the camera and the surgical equipment. Patients with specific heart and lung diseases have a high rate of hospital infection, but open surgery is often preferred. In this method, applied under general anesthesia, a special device is inserted into the surgery area through small holes opened along the thin intestinal area of the abdomen. Subsequently, an ink-dyed and thin-striped camera and other surgical equipment are inserted into the gastric cavity for volume reduction. Postoperatively, patients start to feed orally from the first day and continue their lives with their daily vitamins and minerals. Appetite suppressants are prescribed for a year. As a result of the VSG application, the patient loses about 70% of the excess weight, depending on compliance with the diet list drawn up. Approximately 75% of complaints of type 2 diabetes completely resolve. More successful results are obtained after VSG applications performed by experienced teams.
Recovery and Post-Operative Care
You wake up after gastric sleeve surgery; it’s time to go home! Many patients feel good enough to go straight home from the medical center on the same day as the surgery, but you should plan to take at least 5 to 7 days off work. Returning to work earlier than this may result in delayed healing, longer hospital stays, and additional time off work. You should be able to move around and get out of the house for short walks after 24 to 48 hours. But take it easy – this is the most important time for healing, so for the first week at least, no exercise apart from strolling around indoors. You should avoid heavy lifting or anything that could put strain on your healing tummy muscles for 6 weeks.
Even though you may feel well enough to go out and do things like go to the shops, you should try to relax and lay low until 3 days after the surgery to give your body the chance to start healing itself before you start being more active. You may return to light physical activity after 2 to 3 days, but strenuous physical activity should be avoided for at least 2 weeks. If you feel up to it, you may return to work after 1 to 2 weeks; be careful with heavy lifting and contact with others to prevent infection. You may travel and undergo moderate exercise for 6 weeks; you may start walking and cycling to a small extent, and you may do household chores. You may engage in light fitness activities such as golf or easier jogging for up to 3 months.
Hospital Stay and Discharge
The patients will spend 4 days in the hospital before they are discharged. In this time period, they will be fed orally and begin to adapt to the post-surgical eating routine and will have their training sessions with the hospital dietitian again. The reason why only 4 days are spent in the hospital for gastric sleeve surgery is that this surgery is a low-risk operation and problems can be solved quickly in the post-surgery period. However, this discharge time is decided as a result of considering both professional experience and the most accurate post-surgical procedures and safe discharge planning.
Following the patient’s discharge, they are advised to stay in the city for at least 7 to 10 days. Furthermore, patients are followed in their countries with both a 1-month later appointment and they are recommended to submit any tests they have undergone in terms of check-up. They are also recommended for annual checks after 1 year is completed. However, it is quite difficult to find a specialist on this subject other than in Turkey. The reason is that, despite it being quite popular throughout the world, there are similar issues in terms of finishing training in the field of gastric sleeve surgery. This is a subject that requires another profession and surgical disqualification. Apart from this reason, another problem is that it will not be possible to find many centers performing regular check-ups. For this reason, it would actually be more beneficial and accurate to consider the hospitalization time and to take a short vacation to follow medical advice and complete the diet and exercise list in the first days. In our view, patients are advised to leave the city after 7 to 10 days.
Cost of Gastric Sleeve Surgery in Turkey
To perform bariatric surgeries such as gastric sleeve, balloon, and others, our medical team uses the newest technological developments in the field of treating excessive obesity. Our hospital carries out gastric sleeve surgery successfully for patients from abroad and offers them reasonable costs while providing a wide array of superior-quality medical services. Are you tired of slimming diets and wish to live life more comfortably? Do you get exhausted with the problems that come with being overweight? Would you like to leave this year behind in terms of feeling fit and looking good? Then think of it this way: this is usually the year to carry out this surgery.
The price of the gastric sleeve procedure changes depending on the hospital or medical center, country, type of anesthesia to be applied, and other special criteria. If you are thinking about having gastric sleeve surgery, we would like to mention that the number of unhealthy people who travel to other countries to have this surgery is constantly increasing, as both medical and regional demands rise, consequently increasing prices as well. Due to its more economical prices compared to other Western countries and the success of its surgical operations in this field, Turkey is seen as one of the favorite options in terms of health tourism.
Factors Affecting the Cost
1. Factors Affecting the Cost: There are some factors that affect the cost of gastric sleeve surgery in Turkey. These factors include the city where the surgery will be performed, the hospital where the treatment will take place, the agreement with the hospital, and the equipment and drugs to be used. In Turkey, we have seen that surgeries are more common in some cities than in others. These cities are Istanbul, Ankara, Antalya, and Izmir. Istanbul, with its multicultural structure and developed health tourism infrastructure, is at the forefront in terms of the number of surgeries. To give a brief example for you to see the price difference, a patient in Ankara is expected to pay 2,500 USD in a state hospital, while in Istanbul, 3,560 USD is expected to be paid in a state hospital. However, in a private hospital in Ankara, this fee increases to 4,300 USD, while in Istanbul, the same hospital charges a fee of 6,200 USD. In order to break down the cost of bariatric sleeve surgery more accurately, the hospital and the surgeon must reach a clear agreement. The agreement should contain the details of what is included in the operation. Then both sides can fulfill their responsibilities more easily.
For example, affected value-added tax issues need to be agreed upon before price agreements are reached. Thus, while determining the budget of the patients coming to Turkey through price research, they should have an agreement with the state hospital or private hospital, or there may be confusion by talking with the surgeon about which hospital to choose or how the price will change. Similarly, make sure that the prices of the preoperative preparations to be performed in the hospital are clearly specified. No additional costs that arise later should cause confusion and annoyance. Titles such as drains, hoses, needles, bandages, and adhesives are not worth going back and forth on. Many obligations and events accumulate by considering surgical policy during the preparations and surgery journey. Prices are hidden in the detailed items that make up the surgery. These often disturb the patients and cause a loss of trust in the surgeon. Clear agreements should replace alternative payment options. Trust can be established between the two, and this trust will significantly affect the operation’s performance.
Success Rates and Complications
Complication Rates of Gastric Sleeve Surgery: Gastric sleeve surgeries are more favorable than many other obesity surgeries because the complications of these surgeries are very low. Leak and hemorrhage are the most uncomfortable but rare complications to experience after the surgery. Complications guaranteed as a result of defective anastomosis or stapler use are very minimally seen as a result of choosing experienced surgeons and high-quality devices and equipment. Complications seen after gastric sleeve surgery include bleeding, anesthesia-related complications, pain, blood clots in the legs, fluid buildup in the lungs, stenosis, hernia, gallstones, infection, and bleeding problems.
Bleeding can occur within the first 24 hours after surgery. Postoperative bleeding usually leads to three reasons: an arterial bleed, a leak, and gastric sleeve slippage. These complications can be inadvertent hazards due to poor surgical technique, lack of adequate experience for the surgeon, and deviation from technical rules. An arterial bleed, in particular, is a major cause of death from internal bleeding, and it is typically discovered before the patient gets home from the hospital. Most cases occur within the first 8 hours after the patient goes home. Gallstones can form during rapid weight loss and cause problems. All patients undergoing VSG were recommended dietary changes, supplementation with ursodiol, and regular monitoring for gallbladder disease. Gastric sleeve stenosis may also occur in patients after VSG and a previous laparoscopic adjustable gastric band. If the stenosis does not increase after admission, a stent can be surgically inserted, following which they can be fed a thick liquid diet for 1-2 weeks before returning to a standard diet.
Long-Term Success Rates
The average excess weight loss is 57-76%. This study disproved that the stomach would eventually regain its former size by dilating, with weight reaching its lowest level at the 24th or 36th month post-surgery. Almost 50%-66% of the patients could return to normal weight, and 13%-20% of the patients who did not lose a sufficient amount of weight could not reach their target weights. It has been proven that the complaint of hypoglycemia hours reduced in patients with insulin resistance, and the remaining symptoms are easily resolved in the presence of unconscious feeding behavior. In comparison, only approximately 34% of patients had decreases in leptin levels, and 14.7% of patients had an increase in ghrelin levels weeks after the operation.
In a study of over 2,000 patients who were operated on, the mortality rate was found to be less than 0.25%. Regression in some comorbid diseases occurred in nearly 90% of the patients. Major surgical complications, including vomiting, occurred at a rate of 13-16%. It is known that the quality of life is important in operation success and that the patient gains this aspect easily in a short period. Regarding the nutritional status, an improvement in the performance of nutrient intake, in wound healing time, and a reduction in the risk of infection may be achieved, especially in those with nutritional deficiencies. On the other hand, the risks and the results show that careful monitoring of patients for the development of psychiatric disturbances and habits about nutrition is also important. It has been observed that this health problem has a significant decrease in the risk of developing certain types of cancer because of this surgery. The time during which the patient may have their meals normalizes as there is a significant reduction in the symptoms experienced hours before the regular mealtime. It has been observed that this health problem has a significant decrease in the risk of developing certain types of cancer. Amelioration in comorbid diseases was more common after two to six months post-operation.
Patient Testimonials and Experiences
“You made my dream come true. I am grateful and in debt to every one of you.” I have achieved a lot since my stomach reduction surgery; I have to say, I feel liberated. In fact, I have taken the first step into my new life since you advised me to decide. I am now free of many obesity problems. For completeness, I have more stamina, my pain is gone, and last but not least, I like myself. Thank you. Thanks to the whole team, especially who provided information, carried out the operation very well, and has always been a positive support throughout the process, making time for every problem. Congratulations and thanks to everyone.
Gastric Sleeve Real-Life Stories
Kevin Arps, 29, Bariatric Sleeve “Throughout school, I played football, so I was carrying a bit more weight than I should have been during my late school years. As I left school, however, I kept putting weight on, and there’s no other way to describe it; I just let myself go. I wasn’t active at all; my job was sedentary, and my hobbies were all sedentary. There was no physical activity whatsoever, and that’s when I started to pile on the pounds. I woke up in my hotel room the day after the operation, just looking at my surroundings, and there wasn’t a thing on my bed, no fold – even where my man boobs should have folded over, there was nothing there. I was ecstatic. “For school, we were doing a production of the musical, and I had to wear tight sequins. As I stepped up onto the front of the stage, my top lifted up, and the principal said, ‘Kevin, I think it’s safe to say that Tom has never had a baby before.’ When it happened, some of the kids I hadn’t seen since last year’s pantomime said they hadn’t recognized me. “When I got home to Northallerton, I woke up in my hotel room the day after the operation, just looking at my surroundings, and there wasn’t a thing on my bed, no fold – even where my man boobs should have folded over, there was nothing there. I was ecstatic. I went into the bathroom to shower, and as I walked in, I saw that the mirror was steamed up. I couldn’t see myself, but I knew I had to feel awful; then I caught sight of myself on the shower tap, and I was gobsmacked at the difference that had happened in just two days.” Wyn Davies, 35, Bariatric Sleeve “I had been overweight since childhood, really. After my divorce, it got worse; it really affected me and my job. I got made redundant, at which point I took a job in London, some 200 miles away from home, and saw this as an opportunity to possibly start again.”
Conclusion and Future Trends
Sleeve gastrectomy is one of the most common types of bariatric surgery and the most preferred procedure globally. The efficacy of sleeve gastrectomy shows an increasing trend in these surgeries. A significant number of patients with a high BMI can achieve substantial weight loss after laparoscopic sleeve gastrectomy. Resection of the gastric fundus and the removal of related parts associated with ghrelin production are still under discussion. There are ongoing issues regarding the section of the stomach to be resected, the size and volume of the resected stomach, and the incidence and management of leaks and stenosis. Additional comorbidities should be treated before performing these surgeries. The patient should be evaluated by a multidisciplinary team, and patients selecting the operation should be motivated. In conclusion, gastric sleeve surgery can be safely performed using laparoscopic techniques, and a high percentage of weight reduction can be achieved through increased insulin sensitivity and hormonal changes. Furthermore, due to the lack of segmental malabsorption, two-phase nutrient absorption can be achieved. However, in the case of weight gain after surgery, the surgical options for remedial surgery may be more limited. In other words, achieving success in the first surgery is of increased importance for the patient, and thus a successful pattern of eating should be established. Additionally, all bariatric surgeries should be considered as a surgical platform, not an endpoint, and potential surgical outcomes are an integral part of the treatment strategy. Thorough information provided to patients helps in the implementation of results over the long term. Well-designed and prospective studies that provide a standard approach and accessibility for patients can enable this.
Emerging Technologies
In the current technological developments, when examining different surgical package equipment, staplers, trocars, harmonic scalpels, skin adhesives, ultra-thin staples, and 3D endoscopes for robotics applications, the energy systems used were comprehensive. These advanced technologies can change the surgeons’ tactics, reduce complications, extend the application areas of advanced procedures, accelerate the return of patients’ daily lives, reduce the pain component of surgery, and increase patient satisfaction. It can be stated that within the scope of different applications, the level of patient satisfaction, the point of view of the surgical team, and the component of technology for the protection of the patient’s physical, psychological, and social health play a guiding role. The experienced health team recognized that gastric surgery has increased its success, but it is not enough on its own; high-technology equipment increases the success rate gradually. The expert team, who see the same patients with diseases, can perform surgeries successfully with the help of technology, bear fewer complications, and guarantee fewer morbidities. High-quality health care, especially in obesity surgery, makes an important contribution. High expertise is a good parallel for the success of the procedures performed. The experience is at a high level, not the patient’s surgical experience, but the users of modern technology. Therefore, laparoscopic procedures provide a rapid and comfortable application, and the experiences of the expert staff and technological equipment are essential. This advanced equipment significantly reduces both the operation time and the discharge period; whereas, in terms of both ulcers and embolism, it has been demonstrated that reducing complaints increases safety and patient satisfaction.
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