Bariatric Surgery and Ostomies Flashcards
What is bariatric surgery?
Weight reduction surgery for the morbidly obese
What is morbid obesity?
- BMI > 40 (i.e. > 100 lbs over ideal body weight)
2. BMI > 35 with a medical problem related to morbid obesity
What is the BMI?
Body Mass Index
What is the formula for BMI?
Body weight in kg / (Height in m)^2
What medical conditions are associated with morbid obesity?
Sleep apnea, CAD, pulmonary disease, diabetes, venous stasis ulcers, arthritis, infections, sex hormone abnormalities, HTN, breast cancer, colon cancer
What are the current options for bariatric surgery?
Gastric bypass (malabsorptive) Vertical-banded gastroplasty
What is a gastric bypass?
Stapling off a small gastric pouch (restrictive), and a Roux-en-Y limb to gastric pouch (bypass)
How does gastric bypass work?
- Creates a small gastric reservoir
- Causes dumping symptoms when a patient eats too much food or high-calorie foods; food is dumped into the Roux-en-Y limb
- Bypass of small bowel by Roux-en-Y limb
Which bariatric surgery works best overall?
Gastric bypass
What are the possible post-operative complications after weight reduction surgery?
Gallstones (if gallbladder in situ), anastomotic leak, marginal ulcer, stenosis of pouch or anastomosis, malnutrition, incisional hernia, spleen injury, iron deficiency, B12 deficiency
What is the most common sign of an anastomotic leak after a gastric bypass?
Tachycardia
What is the incidence of anastomotic leak after bariatric surgery?
3%
What is the mortality rate of an anastomotic leak after bariatric surgery?
10%
What is a lap-band?
LAParoscopically placed BAND around the stomach with a subcutaneous port to adjust constriction.
Results in small gastric reservoir
What is a Petersen’s hernia?
Internal herniation of small bowel through the mesenteric defect from the Roux-en-Y limb after gastric bypass.