Bariatric Surgical Procedures (Online Lecture) Flashcards
morbid obesity
more than two times ideal body weight or body mass index >40kg/m2 or more than 100 pounds greater than ideal body weight
medical management includes weight loss diet in conjunction with
behavior modification
first approach aimed at weight loss and then maintence, how do we do this?
setting goals for weight loss
improving diet
increasing physical activity
addressing barriers to change
self monitoring
need adequate rest
involved in plan
why do we need adequate rest
sleep loss increase coritsol which leads to weight gain
pharmacologic management includes medications that
inhibit reuptake of serotonin and norepinephrine
and/or prevent digestion of fats
when do we use pharmacologic
diet/lifestyle tried first
would we monitor the patient while on meds
yes
minimally invasive management
vagal blocking therapy
surgical management
roux en Y
gastric banding
sleeve gastrectomy
biliopancreatic diversion
vagal blocking therapy
pacemaker delivering pulses to block vagus nerve which decreases gastric contraction and emptying leading to feeling full, decreasing cravings which lead to less caloric intake
surgical management only preferable after
other measures have failed, insurance coverage varies widely can help treat comorbidities
preop care
- similar to any other abdominal surgical procedure
review of lab studies
ECG
lipid and liver panels
consent
NPO time period
12 hr and clear liquid 48 hr period before
vertical banded gastroplsty
vertical line of staples placed to create a small stomach pouch to which a band is connected to provide an outlet to the small intestine
circumgastric banding
limits size of stomach by placement of inflatable band around funds of stomach
this band can be inflated or deflated to change the size of stomach as the client looses weight
works by making initial stomach part smaller so patient gets fuller quicker and will consume less calories
gastric bypass
gastric resection combined with malabsorption surgery
clients stomach, duodenum and part of jejunum is bypassed so fewer calories are absorbed
banding malabsoption issues
no malabsorption issues compared to other procedures because the food is digested and absorbed as it would normally be
bilopancreatic diversion anatomy change
removal of part of the stomach
large portion of intestine is bypassed
bilopancreatic diversion action
reduce amount of food consumption = smaller stomach significant amount of bowel is bypassed which equals decreased absorption of calories and nutrients impact gut hormones that control hunger, fullness, and blood sugar control
bilopancreatic diversion often done for what patients
diabetic