Surgical Management of Obesity

Question 0

What are the 2 general types of bariatric surgical procedures?

Answer 0

(1) restrictive

(2) malabsorptive

Question 1

What is tried before considering bariatric surgery?

Answer 1

Medically-supervised weight loss (diet, exercise, etc.).

Question 2

What bariatric surgical procedures are restrictive?

Answer 2

(1) vertical stapling

(2) gastric banding / LapBand

Question 3

What bariatric surgical procedures are malabsorptive?

Answer 3

(1) gastric bypass

(2) duodenal switch / biliopancreatic diversion

Question 4

How does the LapBand lead to weight loss?

Answer 4

It effectively creates a smaller stomach pouch, leading to an earlier feeling of fullness.

Question 5

What is done in a Roux-en-Y gastric bypass?

Answer 5

(1) The connection between the esophagus and stomach is severed and sealed.
(2) The proximal small intestine (near the juncture between the duodenum and jejunum) is severed and joined to the esophagus.
(3) The duodenal portion of the GI tract containing the stomach is joined to the small bowel distal to the esophagus.

Question 6

What is done in a duodenal switch operation?

Answer 6

(1) Typically, the stomach is partially resected.
(2) The duodenum is severed between the pylorus and biliary duct and the small bowel is severed again distally.
(3) The portion of the small bowel that is connected to the large intestines is connected to the stomach.
(4) An opening is made in the distal small bowel and end of the free piece of small bowel is connected at this opening.

Question 7

Besides weight loss, what conditions does bariatric surgery improve?

Answer 7

(1) Type 2 diabetes, improvement that is not entirely related to weight loss.
(2) Cancer incidence in women.