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Laparoscopic Adjustable Gastric Band > LAGB Review - All Areas > Flashcards

LAGB Review - All Areas Flashcards

0
Q

What are the Dietary Advancement Phases after LAGB?

A 
Phases:
 - Clear Liquids due to inflammation from surgery 
      = 2 days - 1 week
 - Full/Pureed Liquids
      = 1 week to 4 weeks
 - Soft Foods
      = 2 - 4 weeks
 - Regular diet
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1
Q

What are the contraindications for LAGB?

A
  • Autoimmune Conditions
  • Lupus, Scleroderma
  • Chronic Steroid Use
  • Inflammatory Diseases of the GI Tract
    • Ulcers, Esophagitis, Crohns Disease
  • Severe Cardiopulmonary Disease
  • Portal Hypertension
  • Esophageal/Gastric Varices
  • Advanced Cirrhosis
  • Psychological Impairment
  • Active Addictions
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2
Q

What are the signs that a LAGB patient is in the Optimal Zone?

A
  • Early and prolonged satiety
  • Small meals satisfy
  • Satisfactory weight loss or maintenance
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3
Q

What are some common ways to prevent LABG complications, or reduce long term effects of complications?

A
  • Early recognition and treatment is essential
  • Peri-Operative anti-coagulation is important
  • Prevention of post-operative complications are the responsibility of the entire healthcare team
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4
Q

What is the most common cause of litigation with bariatric surgery?

A
  • Failure to recognize and/or treat complications.
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5
Q

LAGB dehydration is handled how?

A
  • Determine the reason and treat
  • Remember insensible fluid loss
    • eg. Hot weather and exercise = increased fluid loss
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6
Q

How is band prolapse/slippage diagnosed?

A
  • Diagnosis is usually confirmed with Barium Swallow
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7
Q

What is the first step with band slippage treatment?

A
  • Remove the fluid from the band
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8
Q

If the prolapse/slippage is a concentric dilation, is small and the symptoms improve, what is the treatment process for the patient?

A
  • Re-train the patient - Behavior modification and eating rules
  • Re-adjust the band slowly
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9
Q

If the prolapse/slippage is large, what are the treatment options?

A
  • Revision surgery
  • Band reposition
  • Band removal and replacement
  • Conversion to GB, Sleeves, DS
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10
Q

What are the signs and symptoms of an obstruction, in a LAGB patient?

A
  • Food and liquid intolerance
  • Substernal pain
  • Nausea/Vomiting
  • Reflux
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11
Q

How is an obstruction diagnosed, in a LAGB patient?

A
  • Diagnosis is by UGI and or EGD
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12
Q

What is the treatment for an obstruction in a LAGB patient?

A
  • Decompress the band and treat the cause
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13
Q

What types of foods may LAGB patients have difficulty with?

A
  • Doughy, sticky foods like bread, dried fruits
  • Pasta, Rice, chips
  • Raw vegetables - instruct patient to chew thoroughly, Use caution with stringy, fibrous vegetables like celery, pineapple, asparagus
  • Caution with nuts
  • Dry foods difficult to digest, and can form a bolus in the pouch
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14
Q

What are the signs and symptoms that a LAGB patient needs a fill?

A
  • Hungry
  • Eating big meals
  • Looking for food
  • Satiety that does no last beyond 2 hours
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15
Q

What are the signs and symptoms that a LAGB is Too Tight?

A
  • Reflux
  • Weight gain, maladaptive eating
  • Vomiting
  • Chest pain with food/fluids
  • Increased hunger
  • Increased saliva
16
Q

What is the treatment for a LAGB that is too tight?

A
  • Deflate the band according to tolerance and re-educate
17
Q

What are the potential nutritional deficiencies with LAGB patients?

A
  • Reduced micronutrient absorption =
    • B1 - Thiamin reduction due to eating less fortified breads and cereals
    • Folate - reduction due to eating less volume of fruits and vegetables
  • Reduced food intake and reduced volume also effect these nutrients
18
Q

What are the LABG Supplement Recommendations per ASMBS?

A
  • Multivitamin - 100% DV for at least 2/3 of nutrients - 1 per day
  • Calcium - 1500 mg/day - divided into 3 doses (no more than 500-600mg per dose at a time)
  • B-Complex - optional 1 per day
  • Iron - none additional
  • Vitamin D - no current recommendation
  • Protein - no current recommendation
19
Q

What are the signs and symptoms of a DVT?

A
  • Throbbing, aching, heavy sensation in the calf
  • Redness, swelling, warmth
  • Leg pain with activity
  • Homan’s sign is not reliable
20
Q

What is the treatment for a DVT?

A
  • Best Treatment is prevention
    • Compression stockings
    • Walking
  • Anticoagulants
21
Q

What are the signs and symptoms of a PE (Pulmonary Embolism)?

A
  • Shortness of breath
  • Chest Pain
  • Hypoxia
  • Anxiety
  • Tachycardia
22
Q

What do you do if you suspect a PE?

A
  • Immobilize the patient
  • Start supplemental O2
  • Call physician immediately
23
Q

What are the LAGB specific complications?

A
  • Death
  • Access Port and Tubing Problems
  • Port Infection
  • Wound Infection
  • Dehydration
  • Slippage/Prolapse/Pouch Dilation
  • Erosion
  • Perforation
  • Obstruction

Laparoscopic Adjustable Gastric Band (1 decks)

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