Michael Schweitzer, M.D., F.A.C.S
The Johns Hopkins Obesity Surgery Center The Johns Hopkins University School of Medicine and Health Systems
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Information Criteria Consultation Forms You Will Need!! Resume Insurance The Diet After Surgery Directions Video Links Home Page	Laparoscopic Sleeve Gastrectomy Originally it is part of the duodenal switch with biliopancreatic diversion operation where the lateral stomach is divided with staples and removed. This leaves the patients with a smaller stomach that is still connected in the normal anatomical way. The stomach that remains is larger than a gastric bypass pouch but much smaller than the normal human adult stomach, thereby causing restriction and possible decrease appetite due to gut hormones released by the removed fundus (unproven). The pylorus is preserved so most patients should not experience dumping. The operation has no malabsorption and in theory less nutritional deficiencies since there is no bypassed intestine. Currently there is no long-term data (>5years) and as with all restrictive operations (adjustable gastric band, vertical gastric banding, etc..) excess weight loss will most likely be significantly less than a combined restrictive with malabsortption procedure (gastric bypass, duodenal switch w/ bpd, etc..) . The operation may be used as a stage procedure to induce weight loss in a patient who is at a higher risk for complications if the entire gastric bypass or duodenal switch operation is done at the same time. The patient would then need a second operation in 3 to 6 months after hopefully significant weight loss caused there risks to decrease. The operation may also be an alternative for those who do not want an adjustable band or have less weight to lose and do not want the malabsorption component of a gastric bypass or duodenal switch. Advantages No malabsorption No adjustments (adjustable band patients must come back for injections) Fundus is removed (unlike adjustable band where food empties into the rest of the stomach) Can be changed to a gastric bypass or duodenal switch at a later date Preserves the pylorus (most patients should not get dumping) Disadvantages Stomach may stretch over time A large portion of stomach is removed (permanent) No long-term data to support it as a solo weight loss operation Risks* 1)Leak of stomach fluid from the staple line 2)Stricture 3)Ulcer 4)Stomach does not empty well, poor motility 5)Bleeding 6)Blood Clots 7)Heart attack and stroke (if at risk) 8)Anesthesia 9)Death *These are some of the risks, please discuss at your consultation and ask questions. In most cases the risks are low but this is major surgery. Corrective surgery(s) may be necessary if complications arise.