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

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

Bariatric surgery

2

Ideal bariatric surgery candidate

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

3

What are requirements regarding weight management before surgery

Pt must have history of multiple diet attempts

4

Are adolescents acceptable for bariatric surgery?

Ya, but slower process.

Careful consideration, need consensus with patient and family

5

What are surgical options?

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

6

Describe metabolic effects of bariatric surgery procedures:

Rewatch

7

Describe adjustable gastric band operation timeline

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

8

What are risks/complications of adjustable gastric band

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

9

What are expected weight loss with adjustable gastric band?

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

10

What is most freuently performed bariatric procedure?

Roux en Y

11

Roux en Y timeline

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

What is expected weight loss in Roux en Y?

20-30lbs in first month
75-100lbs in first 6 months

13

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

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

14

Vertical Sleeve Gastrectomy Timeline

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

Irreversible

15

Risks/complications of vertical sleeve gastrectomy

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

16

What are mortality rates for each procedure?

What are causes? (2)

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

Causes are PE and MI