Sleeve Gastrectomy in Baltimore, Maryland

This sleeve gastrectomy procedure works in two ways. First, the new stomach holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The surgery also affects gut hormones that control hunger, satiety, and blood sugar control.

Perhaps the greatest advantage of the gastric sleeve lies in the fact that it does not involve any bypass of the intestinal tract avoiding the chance of intestinal obstruction. It also makes it a suitable form of surgery for patients who previously had bowel resection or are already suffering from Crohn’s disease and a variety of other conditions that would place them at high risk for surgery involving intestinal bypass.

For patients with a particularly high body mass index (typically 50+) many forms of weight loss surgery are either difficult to perform or present increased risk. As a result, vertical sleeve gastrectomy in Baltimore is sometimes performed as the first of a two-part weight loss procedure – Duodenal switch.

For obese patients with a relatively low body mass index the vertical sleeve gastrectomy can also prove a good choice, especially where existing conditions (such as anemia or Crohn’s disease) prevent them from having other forms of bariatric surgery. In addition, patients may choose this form of surgery if they are concerned about the long-term affects of bypass surgery.

• Low mortality rate (0.1%)
• Preservation of normal continuity of GI tract
• Depending on starting BMI, patients typically may achieve weight loss comparable to that of gastric bypass and exceeding adjustable gastric banding
• Reduced risk of nutritional deficiencies
• No risk of marginal ulcer or intestinal obstruction
• Possible in patients with contraindications to Gastric bypass or Duodenal switch.

• Potential for inadequate weight loss
• Patients with high preoperative BMI (>50) may need an additional procedure to achieve adequate weight loss
• Potential complications exist with long staple line, including leaks and infection
• Potential excessive narrowing of the sleeve with worsening or development of new reflux symptoms
• Puts you at risk of developing gallstones and gallbladder disease
• The sleeved smaller portion of the stomach may stretch.
• To minimize the potential side effects of procedure, patients must adhere to dietary recommendation, life-long vitamins and mineral supplementation and regular follow-up.

Morbidly obese patients prior to bariatric surgery suffer from a higher frequency of reflux symptoms compared to the general population. To minimize risk of significant GERD after bariatric surgery , we actively screen patients for symptoms of reflux and hiatal hernia. If detected, we repair it at the time of bariatric procedure. This approach minimizes risk of possible delayed surgery for this condition and greatly improve their quality of life after bariatric surgery.

Morbidly obese patients are known to have a higher frequency of Gallbladder disease both prior to and after bariatric surgery compared to the general population. Asymptomatic gall stones can cause acute inflammation with significant weight loss after bariatric surgery in 30-40% of patients. It is our policy to actively screen patients for gall bladder problems prior to surgery and if anything is detected (gall stones, chronic cholecystitis due to dyskinesia, cholesterol polyps), removal of the gall bladder at the time of main bariatric procedure might be recommended. Consequently, risk of repeat surgery for gall bladder surgery later on is avoided. If no problems with the gall bladder are detected, after bariatric surgery patients are treated with Ursodiol or Actigall for first six months after bariatric surgery to prevent problems with the gall bladder.