Obesity 5 Flashcards
why is bariatric surgery benficial?
Reduces mortality
Fewer cancer deaths
Fewer MI deaths
Surgery effective against diabetes and reduced medications taken, weight, and dyslipidemia
is laparoscopic bariatric surgery safe?
YES
qualifications for bariatric surgery
- BMI >40
- BMI >35 with comorbidity, T2DM, or hyperglycemia inadequately controlled
insurance requirements for surgery
- 6 months of visits and notes from doctor
- lab work up
- continued attempts to lose weight during the process
most popular bariatric surgery
sleeve gastrectomy
sleeve gastrectomy length or surgery and stay
1 hour
1-2 night stay
sleeve gastrectomy pros
- simple
- expected 55-70% weight loss
- reduces comorbidities
sleeve gastrectomy complications
- leaks
- reflux
- Barrett’s esophagus
- narrowing of sleeve
- bleeding
- GERD
gastric bypass lengths
2 hours
2 night stay
gastric bypass pros
- 52-68% weight loss
- effective for GERD and diabetes
- sustained long term weight loss and comorbidity resolution
gastric bypass cons
- restriction
- hormonal changes
- malabsorption (mainly in distal bypass)
gastric bypass risks
- mortality
- PE
- leak
- stricture
- ulcer
6. internal hernia - vitamin deficiencies
- osteoporosis
- dumping syndrome
duodenal switch pros
- 70% weight loss
- best improvement of DM and comorbidites
what is duodenal switch?
combination of sleeve and bypass
duodenal switch cons
- complex operation
- greater malabsorption
- short common channel
- greater risk of nutritional deficiencies and diarrhea
duodenal switch aka
SADS
SADI-S
SIPS
gastric band is the only option that is easily
reversible and adjustable
gastric band pros
- fast (<1 hour)
- 35-55% weight loss
- low overall risk