Bariatric surgery Flashcards
What is the primary mechanism of restrictive bariatric procedures?
Reducing stomach capacity to limit food intake without altering nutrient absorption
Name purely restrictive bariatric procedures
Gastric Balloon
Endoscopic Sleeve Gastroplasty
Adjustable Gastric Band (AGB)
Sleeve Gastrectomy (SG)
Name purely malabsorptive bariatric procedures
BPD/DS
SADI-S
How do malabsorptive procedures promote weight loss?
By rerouting or bypassing parts of the small intestine, reducing calorie and nutrient absorption
Which bariatric procedure combines both restrictive and malabsorptive elements?
Roux-en-Y gastric bypass (RYGB)
What hormonal changes occur after sleeve gastrectomy?
Decreased ghrelin levels, leading to reduced appetite
What are the NICE guideline criteria for bariatric surgery eligibility?
BMI ≥40 kg/m², or BMI ≥35 kg/m² with comorbidities;
Also consider for BMI 30–34.9 kg/m² with recent-onset type 2 diabetes
What is the recommended postoperative follow-up duration according to NICE?
A minimum of 2 years within the bariatric service
What are potential complications of malabsorptive procedures?
Nutritional deficiencies, requiring lifelong supplementation and monitoring
Why is sleeve gastrectomy (SG) considered more than just a restrictive procedure?
While primarily restrictive, SG also affects gut hormones (REDUCES GHRELIN! i.e. reducing hunger hormone), leading to appetite suppression and improved glucose metabolism.
What is the most common bariatric procedure?
Sleeve Gastrectomy (SG);
While primarily restrictive, SG also affects gut hormones, leading to appetite suppression and improved glucose metabolism.
Mechanism: Removal of ~75–85% of the stomach reduces ghrelin production, decreasing appetite.
Outcomes: Excess weight loss (EWL) of 60–70% over 2 years; improvement in comorbidities like type 2 diabetes.
Considerations: Lower complication rates compared to RYGB; potential for weight regain over time
