Bariatric Surgery

Question 1

What is the “apple shape”?

Answer 1

More fat on waist
More visceral fat
Higher risk of weight-related problems

Question 2

What is the “pear shape”?

Answer 2

More fat below waist
Less visceral fat
Lower risk

Question 3

What are the options for bariatric surgery?

Answer 3

Restrictive
Malabsorptive
Combination

Question 4

What must we take into account for bariatric surgery?

Answer 4

MDT choice
Patients BMI/comorbidity
Patient + peers

Question 5

What are the advantages of Laparoscopic Adjustable Gastric Banding?

Answer 5

Relatively minor surgery
Reversible and adjustable
Low operative complication rate
Mortality 0.1%

Question 6

What are the disadvantages of Laparoscopic Adjustable Gastric Banding?

Answer 6

Requires an implanted medical device
Easier to ‘cheat’
Risk of prolapse or slippage
15% will require revisional surgery

Question 7

What are the disadvantages of Laparoscopic Sleeve Gastrectomy?

Answer 7

More invasive surgery
Long staple line (bleeding/leak)
Short pedigree
Mortality 0.4%

Question 8

What are the advantages of Laparoscopic Sleeve Gastrectomy?

Answer 8

Good medium term outcomes
No ‘dumping’ syndrome
No small bowel manipulation
No foreign body

Question 9

What are the advantages of Laparoscopic Gastric bypass?

Answer 9

Quick and dramatic weight loss

Pedigree

Question 10

What are the disadvantages of Laparoscopic Gastric bypass?

Answer 10

More invasive surgery
Malabsorptive component requires lifelong supplements
More complex if requires revision
Mortality 0.5%
Dumping syndrome