3_5ObesityBariatricSurgery Flashcards
What comorbid conditions show increased risk with increasing BMI (obesity)?
1) CV disease, 2) diabetes, 3) musculoskeletal disorders, 4) breast/colon/endometrial cancer, 5) sleep apnea
How does obesity cost the patient?
1) increased hospital stay lengths, 2) decreased QoL, 3) lower income, 4) social stigma, 5) decreased life expectancy
What is an example of an endoscopic procedure to induce weight loss?
intragastric balloon
What are the risks to sleeve gastrectomy?
1) infection, 2) leaking, 3) clots, 4) evidence relatively lacking
Sleeve gastrectomy is otherwise known as?
stapling
What are the risks to gastric banding?
1) slippage, 2) infection
How does gastric banding work?
inflatable (saline) band squeezes stomach into upper and lower pouch to cause slower emptying of the upper pouch
How much food is a gastric banding patient allowed per meal?
1/2 to 1 cup of soft/well-chewed food
What are 2 types of gastric bands?
LAPBAND and REALIZE
What causes dumpting syndrome?
eating refined sugar
What are the symptoms of dumping syndrome?
1) TACHYCARDIA, 2) nausea, diarrhea, 3) tremor
For which weight-loss surgery is dumping syndrome a risk?
RYGB
What are the risks in RYGB?
1) leaks, 2) N/V, 3) hernia, 4) obstruction, 5) deficiency
How does an RYGB work?
restrictive and malabsorptive technique bypasses most of stomach (15-50mL) and jejunum
How is RYGB performed?
laparoscopically or open
How is a BPD performed?
laparoscopically or open
What patients can get a BPD?
only if BMI > 60
What are the risks of BPD?
1) malnutrition, 2) steatorrhea, 3) intermittent diarrhea
Describe the length of stay and success rate associated with a BPD?
2-7 days in the hospital, 80% success with 10% morbidity
What surgical weight loss technique is most risky?
BPD
Which surgical weight-loss techniques are solely restrictive?
1) banding, 2) sleeve
Which surgical weight-loss techniques are solely malabsorptive?
BPD
Which surgical weight-loss techniques are both malabsorptive and restrictive?
RYGB
Why has surgical weight-loss increased exponentially since the 90’s?
1) more obesity = treatment failures, 2) laparoscopic, 3) celebrities, 4) CMS REIMBURSEMENT