Role of Bariatric surgery in the management of Obesity Flashcards
Where do males tend to store their fat? What would a CT scan of their abdomen show?
Centrally.
CT would show more fat within the abdominal cavity around organs - this is visceral fat
Where do females tend to store their fat? What would a CT scan of their abdomen show?
Hips and thighs
More outwith abdominal cavity
Why is visceral fat so bad?
It is very unhealthy and leads to the development of metabolic syndromes
What are some associated diseases that can come about from metabolic syndrome? (8)
Heart disease Lipid problems Hypertension Type 2 diabetes Dementia Cancer Polysystic ovarian syndrome Non-alcoholic fatty liver disease
What is metabolic syndrome?
Combination of diabetes, hypertension and obesity.
See card
Bariatric surgery reduces the likelihood of having a stroke or MI
Which gender is less likely to develop cancer after having previously had bariatric surgery
Females
Is the cost of bariatric surgery effective?
Bariatric surgery is more cost effective than conventional controls.
What is gastric band surgery?
A low risk operation that involves putting a band around the upper part of the stomach at the gastro-oesophageal junction and this is connected to a port in the abdominal wall
Water is injected into the port to inflate the band and reduce the circumference of the stomach
The volume you can eat is much smaller. The Vagus fires to your brain to say you’re full. However, you can cheat this.
In Grampian, this surgery is less commonly carried out due to complications with the bands
Are gastric band’s commonly put in place nowadays?/
Not really as they cause a lot of problems. They seem to be taking more out than putting ones in
What are some problems with gastric bands? (2)
They can slip or become infected
What is a Laparoscopic sleeve gastrectomy
Takes 4/5 of the stomach away - restricts the amount of food / drink that you will be able to hold after surgery.
It switches off/suppresses your appetite - removes cells that produce a hunger-stimulating hormone
What is the hunger-stimulating hormone called that is lost after a sleeve gastrectomy
Ghrelin
What will a patient have to do to prepare for a sleeve gastrectomy
A 2 week liver shrinkage diet is essential to allow keyhole surgery to be performed safely and successfully
this means the lobe of the liver can be retracted to be able to see the stomach clearly
What is a Laparoscopic Gastric bypass
Reduces the size of your stomach by stapling across and dividing the top of your stomach - restricts the amount of food and drink which your smaller stomach and gastric pouch will be able to hold after surgery.
Also involves attaching a shortened part of the small bowel to this small pouch through which the calories and vitamins are normally absorbed from food.
Around 1-1.5m is missed out (bypass duodenum) of the enzyme digestion circuit. This combination of restriction and reduced absorption makes this one of the most effective weight loss operations available.
