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Flashcards in Bariatric Surgery (Obesity) Deck (16)
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1
Q

What is only effective method of sustaining weight loss for individual with BMI>35?

A

Bariatric surgery

2
Q

Ideal bariatric surgery candidate

A
Failed other modalities
No endocrine cause of obesity
No alc/drugs
Knowledgeable about procedure
Motivated
3
Q

What are requirements regarding weight management before surgery

A

Pt must have history of multiple diet attempts

4
Q

Are adolescents acceptable for bariatric surgery?

A

Ya, but slower process.

Careful consideration, need consensus with patient and family

5
Q

What are surgical options?

A

Roux-en-Y: Combination malabsorptive and restrictive
Laparoscopic gastric banding: restrictive
Sleeve gastrectomy: restrictive

6
Q

Describe metabolic effects of bariatric surgery procedures:

A

Rewatch

7
Q

Describe adjustable gastric band operation timeline

A

Operation=30-45 minutes
Overnight hospital stay
Normal activity in 5-7days
Diet from liquid=>puree=>regular diet

8
Q

What are risks/complications of adjustable gastric band

A
Bleeding: PE, MI
Intestinal obstruction
hernias
Mechanical failure: slippage, migration, erosion
10-15% re-operative rate
9
Q

What are expected weight loss with adjustable gastric band?

A

20-30lb in first month
1-2lbs per week
average in 1 year=60lbs

10
Q

What is most freuently performed bariatric procedure?

A

Roux en Y

11
Q

Roux en Y timeline

A
Operation time: 1-3hr
Hospital stay: 2.5d
return to normal activity: 7-10d
Diet advancement from liquids to puree to regular diet
Not reversible
12
Q

What is expected weight loss in Roux en Y?

A

20-30lbs in first month

75-100lbs in first 6 months

13
Q

What are risks/complications related to Roux-en-Y?

A
Bleeding
intestinal obstruction
hernias
Leaks: .5-2%
Strictures: 3%
ulcers ,dumping syndrome, malnutrition
14
Q

Vertical Sleeve Gastrectomy Timeline

A

Operation time: 1-2hr
Hospital stay: 2.5d
Return to normal activity: 7d

Irreversible

15
Q

Risks/complications of vertical sleeve gastrectomy

A
Bleeding
Intestinal obstruction
hernias
Leaks/vistulas
Injury to spleen/splenectomy
Stricture
16
Q

What are mortality rates for each procedure?

What are causes? (2)

A

Adjustable gastric band: .1%
Roux-en-Y bypass: .5%
Vertical sleeve gastrectomy: .25%

Causes are PE and MI