Bariatric surgery

Question 1

benefits of bariatric surgery

Answer 1

sustained weight loss
symptom improvement (sleep apneoa, mobility, HTN, DM)

Question 2

indication for bariatric surgery

Answer 2

all criteria must be met:
- BMI ≥40 or ≥35 with significant co-morbidities that
could improve with weight loss
- failure of non-surgical management to lose weight for 6 months
- fit for surgery and anaesthesia
integrated program providing guidance on diet, physical activity etc.
- well-informed & motivated patient
(if BMI >50, surgery is 1st-line treatment)

Question 3

laparoscopic gastric banding

Answer 3

Inflatable silicone band around proximal stomach →
small pre-stomach pouch (limits food intake, slows digestion)
at 1 year 46% mean excess weight loss

Question 4

Roux-en-Y gastric bypass

Answer 4

Oesophagojejunostomy allows bypass of stomach,
duodenum and proximal jejunum.
Alters secretion of hormones influencing glucose
regulation and perception of hunger / satiety.
Greater wt. loss and lower reoperation rates

Question 5

complications of Roux-en-Y gastric bypass

Answer 5

Dumping syndrome
Wound infection
Hernias
Malabsorption
Diarrhoea
Mortality 0.5%