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Sleeve Gastrectomy

Sleeve Gastronomy is also known as gastric sleeve surgery, or “sleeve,”procedure. During this procedure, the left side of the stomach is removed, leaving a stomach roughly the size and shape of a banana. Through 5 key-hole sized incisions, roughly 80% of the stomach is removed making patients feel full quicker and thus giving them better portion control. The segment of the stomach which is removed also houses hormone producing cells (Ghrelin- also known as a hunger hormone) which trigger hunger and therefore, once that portion of stomach is removed, hunger levels/cravings also tend to diminish. Sleeve gastrectomy also markedly improves most obesity-related comorbidities such as diabetes, sleep apnea, hypertension and hyperlipidemia.

  • Benefits To Patients

    1. Reduction of hunger.
      1. The hunger inducing hormone ghrelin is reduced by removing a portion of the stomach largely responsible for its production.
    2. Shorter operating time compared to gastric bypass.
    3. Does not re-route intestines.
      1. Reduces the risk of nutrient deficiencies.
    4. Less daily vitamins are needed after surgery compared to gastric bypass.
    5. No dumping syndrome.
    6. No adjustments are needed. The Lap Band requires regular adjustments (doctor visits).
    7. Weight loss occurs over 18 months.
      1. Gastric bypass weight loss is very quick. The majority of weight loss occurs in the first year.
      2. Lap Band is gradual and requires major lifestyle changes for success. The majority of weight loss occurs over 3 years.
  • Disadvantages

    • The procedure is irreversible
    • Possibility of leakage resulting in inflammation and infection
    • Does not always produce the expected weight loss. It is possible to regain lost weight with the intake of foods with a high calorie content
    • The gastric sleeve can stretch causing weight to be regained.
  • Who it's for?

    In general, gastric sleeve and other weight-loss surgery could be an option for you if:

    • Efforts to lose weight with diet and exercise have been unsuccessful
    • Your body mass index (BMI) is 40 or higher (extreme obesity)
    • Your BMI is 35 to 39.9 (obesity) and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea

    In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.

  • Surgery Day

    Here is what you can expect during the surgery day:

    • Gastric sleeve surgery is a very straightforward procedure with low complication rates. When serious complications do happen, they usually occur the first few days after surgery.
    • You’ll likely be scheduled for an early morning surgery, but this will depend on Dr’s schedule and hospital availability.
    • Prior to surgery you will have followed your two week pre-op diet.
    • You can’t eat anything after midnight the night before the surgery. Don’t cheat, because your surgery might be canceled.

Get in the best shape in your life.

Even if you’re as little as 30 pounds overweight,
one of our procedures can be a healthy way to reduce weight, keep it off, and aid in avoiding future health issues.

Lap Band

Gastric Banding also known as the LAP-BAND was approved in 2001 by the FDA. The silicone band is placed around the upper part of the stomach. It has an inflatable balloon that cinches around the stomach and allows patients to be less hungry and to eat less at each meal. The band is inflated with saline using a needle that goes thru the skin into the band port. The port is secured under the skin so that nothing is visible. Percent of excess weight loss at five years is 50-55%. Follow-up is crucial with the band as adjustments are usually necessary the first year and sometimes in the second year as well.

 

Complications may include infection, bleeding, gastric prolapse or band slippage and band/tubing problems. Reoperation may be necessary to address some of these complications. In Dr. Terushkin’s hands, these complications are decreased and less than the national average, but they still can occur. New York Lap Band patients can count on top bariatric surgeon Dr. Terushkin’s extensive experience. Dr. Terushkin has performed numerous adjustable gastric banding surgeries.

 

During adjustable gastric band surgery, a band made of silicone is placed around the upper part of the stomach. The band is placed by using laparoscopic techniques, making a few small keyhole incisions in the stomach and guiding the instruments with a camera. The gastric band can be adjusted through an access port placed just below the skin. The access port is connected to the band by a thin tube to allow for adjustments. Patients typically lose 40-50 percent of their excess weight. Diabetes is resolved in 50-60 percent of patients.

  • Before Surgery

    1. Educate yourself on what to expect and have all your questions answered by the doctor before the surgery. Knowledge can help your recovery.
    2. Make sure your family and friends know what to expect. Your will need a support system and your immediate family will be the most important support to you.
    3. Have a supply of foods you will need in the days/weeks immediately after the surgery.
    4. Lean out your diet to get your body ready for eating a smaller volume of food and a lower calorie diet.
    5. Plan to have people help with cleaning, laundry and other day-to-day tasks, while you fully recover.
    6. Compile recipes so you are prepared to cook for you and your family after weight loss surgery. Doing research ahead of time helps ease the transition.
    7. Prepare yourself mentally for all the changes that are going to happen in your life, especially your relationship with food.
  • After Surgery

    1. Stick to your doctor’s instructions.
    2. Have a good support group.
    3. Avoid sugars, fats, alcohol, and soda.
    4. Exercise
    5. Adjust your eating habits and listen to your body for clues on when you are hungry or some foods don’t agree with you anymore.
    6. Keep an eye on your body. If you notice anything out of the ordinary like a fever, bleeding, or excessive pain, call your doctor immediately.
    7. Stay hydrated. It’s important to drink between 1.5 to 2 liters of water each day (roughly 6 to 8 cups). Try not to drink 40 minutes before each meal and 20 to 30 minutes after.
    8. Always go to your follow up appointments.
    9. Stay positive.

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You’ve put off losing the weight for some time now. Let us help you reach your desired weight. Contact us today to see what procedure would best help you reach your weight loss goals.

Gastric Bypass

An established operation that has been used to treat obesity for more than 40 years, the gastric bypass entails creating a small stomach pouch and bypassing three to five feet of intestine. Obese patients typically lose 50-75 percent of their excess weight. Type 2 diabetes is resolved in 80 percent of patients.

  • Gastric Balloons

    Gastric balloons (also called intragastric or stomach balloons) are temporary, removable devices that are placed in the stomach by endoscopy (through the mouth) and can remain for up to six months. Patients with a BMI above 30 are eligible for gastric balloons.

    Balloons help to achieve weight loss by taking up space in the stomach, thereby restricting food intake.

  • Benefits of Gastric Balloons

    May be considered a middle ground between medications and surgery. They offer the following advantages:

    • No medications
    • No surgery
    • Less expensive than surgical options
    • Devices are temporary and procedures are reversible
    • Available to patients who may not be eligible for weight loss surgery

Keep The Weight Off

A healthy lifestyle is within your reach.

Intragastric Balloon

An intragastric balloon is a newer kind of weight-loss procedure. A saline-filled silicone balloon is placed in your stomach, which helps you lose weight by limiting how much you can eat. It also makes you feel fuller faster. This procedure is an option if you’re overweight or obese, and diet and exercise haven’t worked for you.

 

Like other weight-loss procedures, an intragastric balloon requires commitment to a healthier lifestyle. You need to make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of the intragastric balloon procedure.

  • Why It’s Done?

    The placement of an intragastric balloon helps you lose weight. Weight loss can lower your risk of potentially serious weight-related health problems, such as:

    • Heart disease and stroke
    • High blood pressure
    • Sleep apnea
    • Type 2 diabetes

    An intragastric balloon and other weight-loss procedures or surgeries are typically done only after you’ve tried to lose weight by improving your diet and exercise habits.

  • Who it's for?

    An intragastric balloon may be an option for you if:

    • Your body mass index (BMI) is between 30 and 40.
    • You’re willing to commit to healthy lifestyle changes and regular medical follow-up, as well as to participate in behavioral therapy.
    • You have not had any previous stomach or esophageal surgery.

    Intragastric balloons aren’t the right choice for everyone who is overweight. A screening process will help your doctor see if the procedure might be beneficial for you.

    The cost for placing and removing the gastric balloon is not usually covered by health insurance. Check with your health insurance plan or your regional Medicare or Medicaid office to find out if your policy covers the intragastric balloon and insertion procedure.

Love Your New Life

Overcome the health issue that is holding you back from fully enjoying life.

Hernia Surgery

A hernia is a weakness or opening in the abdominal wall, which often results in soft tissue such as fat or intestine protruding through the abdominal muscles causing pain and bulging. A hernia occurs when a section of the abdominal wall becomes strained and allows internal tissues to push up against or through the weakened area. Hernia can be extremely painful, diminish an individual’s quality of life, and will not go away on their own. However, there are treatment options available, and through advances in modern surgical techniques, hernia repair can now be performed using minimally invasive procedures. Dr. Terushkin is experienced in many different types of hernia repair, and can tailor an individual treatment plan to restore a patient’s health quickly and efficiently. Our high level of care is designed to ensure you have the best surgical experience possible, and our minimally invasive techniques can help you return to your normal activities with less downtime than traditional methods. If you are considering hernia surgery in the New York area, contact our office to schedule an appointment.

  • Types of Hernia?

    • Umbilical Hernia
    • Ventral Hernia
    • Inguinal/groin Hernia
    • Femoral Hernia
    • Incisional hernia
    • Recurrent Hernia
    • Hiatal Hernia

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Gallbladder Surgery

The gallbladder is a small, pear-shaped organ positioned under the liver in the upper right portion of the abdomen. Its main purpose is to collect bile, a digestive agent that is produced by the liver. Stones may form in the gallbladder and block the outlet of the gallbladder, causing pain. Sometimes the stones may move into the bile duct, causing jaundice or an inflammation of the pancreas (pancreatitis). Patients who have severe symptoms from gallstones (usually diagnosed on an ultrasound) usually have their gallbladder removed. Symptoms may include sharp abdominal pain, vomiting, and indigestion. Gallbladder pain may start after a meal and it may be a severe, steady pain. If left untreated, symptoms may worsen.

 

Sometimes gallbladder problems can be managed with medication or adjustments in diet. However, when severe obstruction of the gallbladder occurs, removal is the only option. If surgery is recommended, Dr. Terushkin will determine if laparoscopic surgery is appropriate for you.

  • What Preparation is Required for Laparoscopic Gallbladder Removal?

    • The following includes typical events that may occur prior to laparoscopic surgery; however, since each patient and surgeon is unique, what will actually occur may be different:
    • Preoperative preparation includes blood work, medical evaluation, and an EKG depending on your age and medical condition.
    • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
    • It is recommended that you shower the night before or morning of the operation. Your surgeon may also want you to use an antibiotic soap.
    • After midnight the night before the operation, you should not eat or drink anything. You may take medications that your surgeon has told you are permissible to take with a sip of water the
      morning of surgery.
    • Drugs such as blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E may need to be stopped temporarily for several days to a week prior to surgery.
    • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
    • Quit smoking and arrange for any help you may need at home.
    • Do not shave your abdomen before surgery.

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