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Flashcards in Bariatric Surgery Deck (11)
1

Define morbid obesity:

BMI>40

or

BMI>35 with comorbid medical problem

2

What medical conditions are associated with morbid obesity?

  • sleep apnea
  • CAD
  • pulmonary dz
  • DM
  • venous stasis ulcers
  • arthritis
  • infections
  • sex hormone abnormalities
  • HTN
  • breast cancer
  • colon cancer

3

Indications for bariatric surgery?

BMI>35 with severe weight related comorbidity

BMI>40 even w/out comorbid condition

4

MOA of Gastric banding?

restrictive procedure

band wrapped around upper part of stomach=creation of smaller pouch

band can be inflated or deflated to affect restriction based on weight loss outcomes.

5

MOA of Roux-En-Y gastric bypass?

30mL pouch constructed and loop of jejunum is anastamosed

BOTH restrictive and malabsorptive procedure

Gold standard of bariatric procedures in USA

6

MOA of Biliopancreatic Diversion and Duodenal Switch?

malabsorptive

subtotal gastrectomy leaving a 200-400mL gastric remnant

not very restrictive

can be done open or laparoscopically

malabsorptive result can lead to debilitating diarrhea

7

MOA of sleeve gastrectomy?

majority of stomach on greater curve is removed, leaving "sleeve" of stomach on lesser curve

open or laparoscopic

 

8

Contraindications to bariatric surgery?

  • unstable angina
  • end stage pulmonary dz
  • cirrhosis
  • bad end organ dysfunction

9

Possible post op complications of bariatric surg?

  • gallstones
  • anastomotic leak
  • marginal ulcer
  • stenosis of pouch/anastamosis
  • malnutrition
  • incisional hernia
  • spleen injury
  • iron deficiency
  • B12 deficiency

10

Which operation works best overall?

gastric bypass: mean weight loss of 50% excess weight

11

Which bariatric operations are restrictive, which are malabsorptive, and which are both?

Restrictive: bands and sleeves

Malabsorptive: bypasses, diversions, and switches

Both: Roux-En-Y