Role of Bariatric Surgery in the Management of Obesity and its Impact on Obesity Related Comorbidities

Question 1

What are some conditions that being obese increases your likelihood of developing?

Answer 1

• Heart disease / other CVS (atherosclerosis)
• Hypertension
• Type 2 diabetes
• Dementia
• Cancer
• Polycystic ovarian syndrome
• Non-alcoholic fatty liver disease

Question 2

How effective is bariatric surgery for overweight individuals on average?

Answer 2

• Pretty effective, graphs on slides show most subjects managing to maintain reduced weight after surgery
• Can even be effective in getting patients into remission from type 2 diabetes

Question 3

How does bariatric surgery affect patient mortality?

Answer 3

• Study in slides showed 24% decrease in mortality over 16 years in control vs. bariatric surgery population
• Decreases cancer related and MI related deaths

Question 4

What are some of the common types of bariatric surgery?

Answer 4

• Gastric banding
• Laparoscopic sleeve gastrectomy
• Laparoscopic gastric bypass

Question 5

Describe gastric band surgery

Answer 5

• Place a band near the top of the stomach, creates a small pouch that fills quickly so the patient feels full earlier and for longer
• Can adjust the size of the band by injecting / draining fluid from a tube connected to the band

Question 6

Describe laparoscopic sleeve gastrectomy

Answer 6

• Much of the stomach is removed from the greater curvature side, leaving a tube along the lesser curvature with significantly less volume
• Fills quicker, less food capacity

Question 7

Describe laparoscopic gastric bypass surgery

Answer 7

• Create a small pouch from the upper stomach and connect the small intestine to this pouch directly
• Bypasses most of the stomach and the duodenum

Question 8

What is an intra-gastric balloon?

Answer 8

• Device you can put into the stomach and then fill, makes you feel full by stimulating stomach stretch receptors
• No surgery required and removable
• Contraindications: large hiatus hernia, PUD (?), anticoagulation

Question 9

Survival rate and length of average hospital stay for bariatric surgery?

Answer 9

• Survival of 99.95% ish

- Avg. stay of 2.6 days

Question 10

What is the prioritization criteria used in Scotland for determining who gets bariatric surgery?

Answer 10

• Age 18-44
• BMI: 35-50
• Type 2 diabetes mellitus

Question 11

What can be an important post-surgical intervention for bariatric surgery patients?

Answer 11

• Vitamin supplementation

Question 12

What does the patient need to agree to / adhere to after bariatric surgery to ensure success?

Answer 12

• The adoption of a healthier lifestyle

- May include visits with dieticians / personal trainers