Upper GI Surgery Flashcards
What are the side effects of laparoscopic hiatus hernia repair?
- Dysphagia
- Difficulty to belch and vomit
- Gas bloating
- Excess flatulence
- Diarrhoea
What is bariatric surgery?
Refers to all surgical procedures utilised to achieve reduction of excess weight
What are the three types of bariatric surgery?
Restrictive
Malabsorptive
Combination
Describe purpose of restrictive bariatric surgery
Decrease size of stomach leading to satiety with smaller volumes of food hat eventually leads to food intolerance and weight loss
Name types of restrictive bariatric surgery
- Synthetic gastric band
- Stapling
- Size reduction by ‘sleeve gastrectomy’
Describe purpose of malabsorptive bariatric surgery
Bypassing segments of bowel, which thereby cause malabsorption of nutrients
Describe purpose of combination bariatric surgery
Involves both aspects of restriction and malabsorption - such as Roux-en-Y bass (considered gold standard)
What is the process of Roux-en-Y surgery?
Creates stomach pouch out of small portion of the stomach and attaches in directly to the small intestine, bypassing a large part of the stomach and duodenum
What are the advantages of laparoscopic adjustable gastric banding?
- Minor surgery
- Reversible and adjustable
- Low operative complication rate
- Mortality 0.1%
What are the disadvantages of laparoscopic adjustable gastric banding?
- Requires implanted medical device
- Risk of prolapse or slippage
- 15% require revisional surgery
What are the advantages of a laparoscopic gastric bypass?
- Quick and dramatic weight loss
* Dumping syndrome
What are the disadvantages of a laparoscopic gastric bypass?
- More invasive surgery
- Malabsorption component requires lifelong supplements
- More complex if requires revision
- Mortality 0.5%
What is a laparoscopic sleeve gastrectomy?
Partial gastrectomy which results in the removal of the stomach, with the remainder looking like a ‘banana’
Reduced size inhibits distension of the stomach so that it becomes fuller sooner, thereby increasing the patients feeling of fullness and decreasing appetite
What are the advantages of a laparoscopic sleeve gastrectomy?
- Good medium-term outcomes
- No dumping syndrome
- No small bowel manipulation
- No foreign body
What are the disadvantages of a laparoscopic sleeve gastrectomy?
- More invasive surgery
- Long staple line
- Mortality 0.4%
