Michael Schweitzer, M.D., F.A.C.S
The Johns Hopkins Obesity Surgery Center The Johns Hopkins University School of Medicine and Health Systems
.
Information Criteria Consultation Forms You Will Need!! Resume Insurance The Diet After Surgery Directions Video Links Home Page	The Laparoscopic method uses tiny incisions less than a 1/2 inch in size (most are 5mm and 12mm in size), instead of one long incision from the breast bone down close to the belly button. We also use specialized instruments and a fiberoptic scope that allows us to watch a video monitor while we perform the surgery. This results in less pain, better cosmesis, and faster recovery!!! The other significant advantage is less hernia and wound complications than the open method. The Laparoscopic Roux-en-Y Gastric Bypass is the most common bariatric surgery performed in the United States.  It involves stapling and dividing the stomach so that it is partitioned into a small upper pouch that is then connected the small intestine.  The small intestine, called the Roux limb (named after Caesar Roux, a surgeon in the late 1800’s) transports the food away from the distal stomach (which is most of the stomach).  The food then meets up with the intestine carrying the bile and pancreatic juices downstream from the first part of the digestive tract after the stomach. Please click here for more information. The Lap-Band or Adjustable Gastric Banding System is an FDA approved treatment for morbid obesity. This is a silicone band that is laparoscopically placed around your stomach thru 5 small incisions. It involves neither cutting of the stomach nor rearrangement of your intestines. In most cases in-hospital care should be approximately 23 hours or less. The band has an adjustable balloon that is filled over time.  This squeezes the top of the stomach and slows the emptying of food from the upper(small) to lower stomach. Please click here for more information. The Duodenal Switch is a hybrid operation that involves creating a small stomach (not as small as a gastric bypass) and a larger amount of bypassed intestine than the gastric bypass. It gives excellent weight loss that is sustained for the long run in most patients. The operation can be done laparoscopically. Please click here for more information.
	Laparoscopic Sleeve Gastrectomy is a 4^th operation that is the restrictive part of the duodenal switch with biliopancreatic diversion.  It does not involve any intestinal rearrangement.  It is a restrictive only operation that involves taking out the lateral part of the stomach.  It may be used as a 1^st step operation in high risk patients to induce weight loss before doing a completion duodenal switch or gastric bypass.  It is currently being considered a weight loss operation in lower BMI morbidly obese patients who do not want an adjustable band nor a malabsorptive operation.  Please click here for more information. The purpose of surgery is to alleviate or eliminate the medical problems caused from morbid obesity. All of these operations require lifelong dedication to eating healthy and exercise, however, unlike fad diets, these operations all have peer-reviewed articles showing sustained weight loss. The Benefits From Weight Loss Surgery!!!! The purpose of surgery is to prevent, alleviate or cure morbid obesity related diseases. It is not cosmetic surgery!!!! 1. A study at Johns Hopkins has shown that 63% of patients have liver disease from fat and inflammation before surgery. Most do not even know it. After gastric bypass 80% resolved. 2. Studies from the Medical College of Virginia showed after gastric bypass 95% of patients with Pseudotumor cerebri resolved; High blood pressure in 66% of patients, Type II diabetes resolved in 86%; Venous stasis ulcers resolved in 92%; Urinary stress incontinence in 75%. Sleep apnea improved in 93% to mild or resolved (67%). 3. An East Carolina University study showed type II diabetics died 3 times more with medical treatment than gastric bypass. Gastric bypass decreased cardiac deaths in this study. 4. A study from the University of Alabama showed improvements in lipid profiles specifically raised HDL (the good cholesterol) and lower triglycerides. 5. A study from the Alverado Hospital and Medical Center showed pregnant women who had previously undergone gastric bypass and compared them to morbidly obese women. They showed that gastric bypass lowered the complication rate of pregnancy over that of women who were morbidly obese. 6. A study from the Legacy Health system showed gastroesophageal reflux improved significantly in 12 patients who were studied extensively before and after gastric bypass. 7. A University of Pittsburgh study showed a 152 patients who underwent gastric bypass improved their gastroesophageal reflux symptoms, specifically heartburn improved 87% (preoperative) to 22% (postoperative). 8. A Canadian study compared 2 groups, 1035 bariatric surgery (gastric bypass) patients to 5746 morbid obese patients who did not have surgery. A maximum 5 years from the start of the study showed a death rate of 0.68% in the surgery group and a 6.17% in the control group (they did not have surgery). This translates to a 89% reduction in the relative risk of death. This study shows that OBESITY SURGERY SAVES LIVES!!!!! (published in the Annals of Surgery, vol 240, #3, Sept 2004). Michael Schweitzer, M.D., F.A.C.S. Associate Professor of Surgery The Johns Hopkins University School of Medicine Director of Minimally Invasive Bariatric Surgery Johns Hopkins Bayview Medical Center Department of Surgery 4940 Eastern Avenue Baltimore, MD 21224 Phone: 410-550-3345 email DrSchweitzer@yahoo.com web site www.smallscar.com
Johns Hopkins Bayview Medical Center | Johns Hopkins Medicine

© The medical information provided in this site is for education & information purposes only. The information provided is not a substitute for a professional medical opinion. If you have a medical problem, please contact your doctor or health care professional. Content copyright © 2000 Michael Schweitzer, M.D. All Rights Reserved. Republication or redistribution of any content is expressly prohibited without the prior written consent of Michael Schweitzer, M.D.