SURG - Bariatric Surg

Bariatric surgery aims to achieve significant weight loss and enhance overall health by addressing underlying conditions.

Roux-en-Y Gastric Bypass is a procedure that creates a small pouch in the stomach and connects it directly to the small intestine, restricting both food intake and nutrient absorption.

Restrictive surgeries focus on limiting food intake by reducing the size of the stomach, while malabsorptive surgeries alter digestion to decrease nutrient absorption.

Laparoscopic Adjustable Gastric Banding involves placing a band around the stomach to restrict its capacity and reduce food intake.

Sleeve Gastrectomy removes a portion of the stomach, creating a smaller, tube-like structure to limit the volume of food consumed.

Biliopancreatic Diversion with Duodenal Switch re-routes the small intestine to create a bypass and a sleeve-like structure, both restricting food intake and reducing nutrient absorption.

Unstable psychological conditions, active substance abuse, untreated eating disorders, and lack of commitment to lifestyle changes are all contraindications for bariatric surgery, as they can hinder successful outcomes and increase risks.

The most commonly performed bariatric surgery in the USA is the Roux-en-Y Gastric Bypass due to its proven effectiveness in weight loss and various health improvements.

Dumping syndrome is a common complication after Roux-en-Y Gastric Bypass, characterized by nausea, vomiting, diarrhea, and discomfort after consuming meals high in fat. It is caused by rapid emptying of the stomach, leading to an imbalance in digestion and nutrient absorption.

The Roux-en-Y Gastric Bypass is known for its high weight loss potential and significant improvement in related health issues, but it carries a risk of nutritional deficiencies, vitamin deficiencies, and dumping syndrome.

Laparoscopic Adjustable Gastric Banding offers the advantages of being reversible, adjustable, and causing fewer nutritional deficiencies compared to other surgeries, but it comes with a lower weight loss potential and higher risk of complications.

Sleeve Gastrectomy provides significant weight loss and minimal nutritional deficiencies, but it's irreversible and carries a higher risk of complications compared to other bariatric surgeries.

Biliopancreatic Diversion with Duodenal Switch leads to substantial weight loss and improvement in related health issues, but it poses the highest risk of malnutrition and vitamin deficiencies among the bariatric surgeries.

Patients with a BMI of 40 or higher, or a BMI of 30 or higher with comorbidities, are considered ideal candidates for bariatric surgery.

After bariatric surgery, barrier methods, Nexplanon, Depo-Provera, and IUDs are recommended for contraception for 12-18 months due to potential hormonal changes and complications related to surgery.

Patients undergoing bariatric surgery are advised to avoid NSAIDs (nonsteroidal anti-inflammatory drugs) for life due to potential gastrointestinal complications and increased risk of bleeding.

Early complications within 30 days of bariatric surgery often include anastomotic leaks, bleeding, and infection.

Small bowel obstruction is a common complication 2-4 weeks after bariatric surgery, typically caused by adhesions or kinks in the intestines.

Hypoglycemia can occur after bariatric surgery due to rapid pouch emptying, leading to elevated GLP1 and insulin levels, causing low blood sugar levels.

Spitting up white foam after bariatric surgery is often associated with dumping syndrome, indicating rapid passage of food into the small intestine before proper digestion.

For the best outcomes after bariatric surgery, it's crucial to avoid drinking fluids 30 minutes before and after meals to aid proper digestion and prevent complications.

Individuals with type 2 diabetes who do not achieve significant weight loss or improvement in their diabetes condition through non-surgical methods may qualify for bariatric surgery even if their BMI is between 30 and 34.9.