Bariatric surgery

Sleeve gastrectomy

Bariatric surgery procedure provides patients with excellent weight loss results

At 140 pounds overweight, Heather Modispaw was limited in the activities she could do. Simple things like walking her daughter to school or climbing the stairs at a football game left her out of breath and taking breaks every few minutes. She tried dieting. She tried exercising. Nothing worked. That’s when she decided to consult with physicians at the Johns Hopkins Center for Bariatric Surgery.

Bariatric surgeon Michael Schweitzer

Modispaw first met with Michael Schweitzer, M.D., in 2006 to have laparoscopic adjustable gastric banding, also known as the “lap band.” After losing 80 pounds, scar tissue caused complications and the band had to be removed. In early 2009, she met with Dr. Schweitzer again to discuss other options for weight loss surgery. Modispaw knew a lot of people who had great outcomes with gastric bypass surgery and sleeve gastrectomy. After reviewing the two procedures, she felt the sleeve gastrectomy was best for her.

“One of the benefits of the sleeve gastrectomy is that the gastrointestinal tract is left in place, so food continues on it natural course,” says Dr. Schweitzer. “There is no malabsorption (the body’s inability to absorb nutrients), so patients don’t experience the degree of vitamin deficiency like they do with gastric bypass.”Adds Modispaw, “After gastric bypass surgery, you have to take vitamins and other supplements for the rest of your life. That was something that I didn’t want to worry about.”

A Less Invasive Approach

The sleeve gastrectomy is a minimally invasive procedure where surgeons remove 85 percent of the stomach, creating a smaller, “sleeve-shaped” pouch. The surgeon makes several small incisions into the abdomen, and then inserts a laparoscope into one of the openings. This long tube with a camera and light attached allows the surgeon to view the stomach on a video monitor. Then, specialized surgical instruments are placed into the other incisions to dissect and remove part of the stomach.

The new, smaller stomach limits the amount of food that can be ingested at one time, so patients feel full faster. The fundus—the upper part of the stomach that produces the hunger hormone—also is removed during the procedure, significantly decreasing the patients’ appetite.

According to Dr. Schweitzer, sleeve gastrectomy is just beginning to emerge as a primary weight loss procedure of choice. Of the 320 bariatric surgeries performed at Johns Hopkins Bayview each year, more than 20 were sleeve gastrectomies in 2009. Dr. Schweitzer cautions, “Not all insurance companies cover this procedure, so we encourage our patients to check with their provider prior to scheduling a consultation with us.”

A sleeve gastrectomy can help patients lose anywhere from 40 to 60 percent of their excess body weight. Dr. Schweitzer says, “Any weight loss procedure should be viewed as an aid for weight loss and not as a quick fix. No matter what type of surgery you choose, it won’t force you to eat healthy and be more active. You have to be committed to a total lifestyle change.”

The Proof is in the Positive Results

Since her surgery in June 2009, Modispaw has lost more than 50 pounds and has seen significant improvements in her health. Prior to the sleeve gastrectomy, she had insulin dependent diabetes, high blood pressure, polycystic ovary syndrome (PCOS) and arthritis in her back. Now, she is no longer a diabetic, her blood pressure has decreased considerably and the PCOS has shown great improvement. While the arthritis in her back will never go away, Modispaw says that her pain is a lot more bearable since she lost weight.

Even though she is only able to eat about a half of a cup of food at any given time, Modispaw admits that she chooses to eat healthier foods. She’s also joined a gym, which has not only helped her lose weight, but gets her in shape so she can enjoy the simpler things in life.

“When you’re 320 pounds, you don’t have the motivation to do anything. You don’t even want to get off the couch,” Modispaw says. “Now, I look forward to walking my daughter to school every day. I feel like I’m starting a whole new chapter in my life!”

In addition to the sleeve gastrectomy, the Johns Hopkins Center for Bariatric Surgery offers the following surgical options for weight loss:

• Laparoscopic and Open Roux-en-Y Gastric Bypass

• Laparoscopic Adjustable Gastric Banding System

• Laparoscopic Duodenal Switch with Biliopancreatic Diversion

• Revision of previous bariatric surgery

To discuss a case or refer a patient call +1.443.287.6499.

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