Bariatric Surgery

Question 1

Indications for bariatric surgery:

People with BMI Of >** without co-morbidities

People with BMI of >** with co-morbidities

Fill in the gaps?

What is one benefit of bariatric surgery on diabetes Type II?

Answer 1

People with BMI Of >40 without co-morbidities
People with BMI of >35 with co-morbidities

It can induce remission of T2DM

Question 2

What are the 2 types of bariatric surgery?

Answer 2

Restrictive

Malabsorptive

Question 3

Restrictive:

Laparoscopic adjustable gastric band (LAGB):

What is it?

It is the safest option and is reversible.

What is the other type of restrictive surgery?

Answer 3

Band around the top of the stomach create a pre-stomach pouch which is essentially a new smaller stomach.

Vertical sleeve gastrectomy

Question 4

Malabsorptive:

Roux-Y-Gastric Bypass (RYGB):

Answer 4

A portion of the jejunum is attached to a small stomach pouch to allow food to bypass the distal stomach, duodenum and proximal jejunum.

Question 5

Before surgery:

What changes need to be made in a patient’s lifestyle before they can undertake bariatric surgery?

Answer 5

Work with a structured weight management program for 6 months to 1 year

Make sustainable life style changes

Confirm no major mental health problems

Stop smoking

Co-morbidities optimised

Patient keen and motivated

Prepared for a long term life style change

Question 6

The following improvements that bariatric surgery has on the patient

Answer 6

Improved mobility
Hypertension improved
Sleep apnoea resolved
Quality of life improved
Mental health benefits
Improved financial and social health

Question 7

Complications:

Peri-operative complications - what are they?

Long term:

What may occur? - 2

Answer 7

Infection, Bleeding, anaesthetic complications – people can die on the table

Nutritional deficiencies
Loose skin = aesthetic problems after weight loss

Question 8

Complications:

Dumping syndrome:

• What is it and why does it happen?
• What are some symptoms of dumping syndrome?
• How can patients manage this?

Answer 8

Dumping syndrome is a group of symptoms, such as diarrhea, nausea, and feeling light-headed or tired after a meal, that are caused by rapid gastric emptying. Rapid gastric emptying is a condition in which food moves too quickly from your stomach to your duodenum.

Avoiding sugary and fatty foods and drinks.

Avoiding drinking 30 mins, before and after and during eating.

Eating slowly and chewing food well.

Question 9

What must you remember to tell female patients after having their surgery?

Answer 9

They shouldn’t get pregnant in the next 2 yrs - so they need to use some form of contraception.