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Questions and Answers
What is benefit of bariatric surgery?
What is benefit of bariatric surgery?
Match the different types of bariatric surgeries with their descriptors. This is a brief overview between restrictive and Malabsorptive.
Match the different types of bariatric surgeries with their descriptors. This is a brief overview between restrictive and Malabsorptive.
Sleeve Gastrectomy = RESTRICTIVE. Reduces stomach reservoir, limits amount of food consumed. No manipulation of small intestines. Adjustable Gastric Banding = RESTRICTIVE. Reduces stomach reservoir, limits amount of food consumed. No manipulation of small intestines. Single Anastomosis Duodenal Switch = Malabsorptive. limits amount of nutrients absorbed by bypassing a portion of small intestines. Roux-en-Y Gastric Bypass = Malabsorptive. limits amount of nutrients absorbed by bypassing a portion of small intestines.
Match the CONTRAINDICATIONS with the bariatic surgery
Match the CONTRAINDICATIONS with the bariatic surgery
Barrett’s Esophagus, Severe GERD, Achalasia = Sleeve Gastrectomy (SG) Drug/ETOH addiction, Hx of gastric ulcers, Crohn’s disease, uncontrolled gout = Roux-en-y Gastric Bypass (RYGBP) Drug/ETOH addiction, Barrett’s, Crohn’s disease/ UC, AI disease = duodenal switch Severe GERD, Barrett’s Esophagus, Achalasia = Adjustable Gastric Banding
What is the currently most performed bariatric surgery in the USA
What is the currently most performed bariatric surgery in the USA
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Match the surgery procedure to the surgery name
Match the surgery procedure to the surgery name
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A patient presents with nausea, vomiting, diarrhea, and feel very ill after eating a high fat meal with a surgical history of Roux-en-y Gastric Bypass. What is this called?
A patient presents with nausea, vomiting, diarrhea, and feel very ill after eating a high fat meal with a surgical history of Roux-en-y Gastric Bypass. What is this called?
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Match the PROs for each bariatric surgery type!
Match the PROs for each bariatric surgery type!
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CONS of each type of bariatric surgery
CONS of each type of bariatric surgery
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What patient is optimally suited for specific bariatric surgery?
What patient is optimally suited for specific bariatric surgery?
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Barrier, Nexplanon, Depo-Provera, IUD recommended for 12-18 months for bariatric surgery (not OCP) as contraceptive.
Barrier, Nexplanon, Depo-Provera, IUD recommended for 12-18 months for bariatric surgery (not OCP) as contraceptive.
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After bariatric surgery, NSAIDS should be avoided for LIFE.
After bariatric surgery, NSAIDS should be avoided for LIFE.
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Accelerated pouch emptying, excess GLP1 production and excess insulin release leading to hypoglycemia that occurs after RYGB that is often marked by high variable post prandial glucose levels is called -
Accelerated pouch emptying, excess GLP1 production and excess insulin release leading to hypoglycemia that occurs after RYGB that is often marked by high variable post prandial glucose levels is called -
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Kidney and gallstones are NOT common metabolic post-bariatric surgery complications.
Kidney and gallstones are NOT common metabolic post-bariatric surgery complications.
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What are EARLY complications associated with bariatric surgery (<30 days)
What are EARLY complications associated with bariatric surgery (<30 days)
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When is small bowel obstruction most common to occur post-operative?
When is small bowel obstruction most common to occur post-operative?
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A patient c/o spitting up white foam 4-6 weeks after RYGBP. What is likely?
A patient c/o spitting up white foam 4-6 weeks after RYGBP. What is likely?
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Do not drink fluids ____ mins prior/after eating once you have had bariatric surgery.
Do not drink fluids ____ mins prior/after eating once you have had bariatric surgery.
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At what BMI equal to or greater (regardless of comorbidities), does a patient qualify for bariatric surgery?
At what BMI equal to or greater (regardless of comorbidities), does a patient qualify for bariatric surgery?
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Individuals with _______ disease and BMI of 30-34.9 qualify for bariatric surgery.
Individuals with _______ disease and BMI of 30-34.9 qualify for bariatric surgery.
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Individuals with _____ and BMI ≥30
Individuals with _____ and BMI ≥30
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Individuals with BMI of 30–34.9 who do not achieve substantial weight loss or comorbidity improvement using nonsurgical methods QUALIFY for bariatric surgery.
Individuals with BMI of 30–34.9 who do not achieve substantial weight loss or comorbidity improvement using nonsurgical methods QUALIFY for bariatric surgery.
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is roux-en-Y gastric bypass restrictive or malabsorptive?
is roux-en-Y gastric bypass restrictive or malabsorptive?
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Among bariatric procedures, which surgery has the highest risk for nutritional deficiencies and severe protein malnutrition
Among bariatric procedures, which surgery has the highest risk for nutritional deficiencies and severe protein malnutrition
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Study Notes
Benefits of Bariatric Surgery
- Bariatric surgery helps in weight loss and improves overall health
Types of Bariatric Surgeries
- Roux-en-Y Gastric Bypass: a restrictive and malabsorptive surgery
- Restrictive surgeries: reduce stomach capacity, limit food intake
- Malabsorptive surgeries: alter digestion, reduce nutrient absorption
- Other surgeries: Laparoscopic Adjustable Gastric Banding, Sleeve Gastrectomy, Biliopancreatic Diversion with Duodenal Switch
Contraindications for Bariatric Surgery
- Unstable psychological conditions
- Active substance abuse
- Untreated eating disorders
- Lack of commitment to lifestyle changes
Most Performed Bariatric Surgery in the USA
- Roux-en-Y Gastric Bypass
Surgery Procedures
- Roux-en-Y Gastric Bypass: creation of a small stomach pouch, attaching it to the small intestine
- Laparoscopic Adjustable Gastric Banding: placing an adjustable band around the stomach
- Sleeve Gastrectomy: removal of a portion of the stomach, forming a narrow sleeve
- Biliopancreatic Diversion with Duodenal Switch: rerouting of the small intestine, creating a bypass and sleeve-like structure
Patient Presentation
- Dumping syndrome: nausea, vomiting, diarrhea, and feeling ill after eating a high-fat meal, common in Roux-en-Y Gastric Bypass patients
Pros and Cons of Bariatric Surgeries
-
Roux-en-Y Gastric Bypass:
- Pros: high weight loss, improvement in comorbidities
- Cons: malnutrition, vitamin deficiencies, dumping syndrome
-
Laparoscopic Adjustable Gastric Banding:
- Pros: reversible, adjustable, minimal nutritional deficiencies
- Cons: lower weight loss, higher risk of complications
-
Sleeve Gastrectomy:
- Pros: high weight loss, minimal nutritional deficiencies
- Cons: irreversible, higher risk of complications
-
Biliopancreatic Diversion with Duodenal Switch:
- Pros: high weight loss, improvement in comorbidities
- Cons: high risk of malnutrition, vitamin deficiencies
Patient Selection
- Optimally suited patients: those with a BMI ≥40, or BMI ≥30 with comorbidities
- Contraception recommendations: Barrier, Nexplanon, Depo-Provera, IUD for 12-18 months
- NSAIDs avoidance: for life after bariatric surgery
Post-Bariatric Surgery Complications
- Early complications (less than 30 days): anastomotic leak, bleeding, infection
- Small bowel obstruction: most common 2-4 weeks post-operative
- Hypoglycemia: accelerated pouch emptying, excess GLP1 production, and excess insulin release
- Spitting up white foam: likely due to dumping syndrome
- Fluid intake: avoid drinking fluids 30 minutes prior/after eating after bariatric surgery
- Qualification for bariatric surgery: BMI ≥40, or BMI ≥30 with comorbidities
- Qualification exceptions: individuals with type 2 diabetes, BMI of 30-34.9, who do not achieve substantial weight loss or comorbidity improvement using nonsurgical methods
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