(VBG) involves partitioning the stomach into a small pouch in the upper portion along the lesser curvature of the stomach
adjustable gastric banding
(AGB) the stomach size is limited by an inflatable band placed around the fundus of the stomach; can be done using a Lap-Band system or realize band system.
verticle sleeve gastrectomy
about 85% of the stomach is removed leaving a sleeve shaped stomach, function is perserved, not reversable (restrictive)
surgeion will bypass various lengths of the small intestines so that less food is absorbed
combination of restrictive and malabsorptive surgery
combination of both restrictive and malabsorptive surgery, most common,
Advantages of vertical banded gastroplasty (VBG)
*no surgical anastomosis, *more normal anatomy and physiology of stomach maintained, *with lower risk of infection. (Restrictive)
Advantages of an Adjustable gastric banding
*food digestion occurs through normal process, *band can be adjusted to increase or decrease restriction, *surgery can be reversed *no dumping syndrome, *no malabsorption
Advantages of a vertical sleeve gastrectomy.
*function of stomach is conserved. *no bypass of intestine *avoids complications of anemia and vitamin deficiencies
Connection between two blood vessel
Which bariatric surgery has no surgical anastomosis?
vertical banded gastroplasty (VBG)
Majority of obese people *excess calorie intake for the body's metabolic demands
congential, chromosomal metabolic
(with malabsorptive procedures) Rapid emptying of chyme from surgically created residual stomach into small intestine
Expected outcomes for obsese patient that had bariatric surgery.
1. experience long-term weight loss 2. improvement of obesity-related co-morbidities 3. monitor for adverse side effect of surgical therapy 4. improved self-image 5. integrate healthy practices into daily routines
several disease processes present; more common with chronic illness
Name complications of VGB and RNY as regard to vomiting and pain.
uncontrolled vomiting and pain can result if too much intake,
Name compications of VGB and RNY with regards to nutritional deficits.
deficits in B12, calcium, iron and anemia
Name the gold standard of among bariatric procedures.
Roux-en-Y gastric bypass
Which bariatric procedure has tendency for dumping syndrome?
Roux-en-Y gastric bypass
Advantage of a Roux-en-Y gastric bypass (RYGB).
*better weight loss than restrictive procedures *lower incidencies of malnutrition and diarrhea *rapid improvement of weight related co-morbidities
In an Roux-en-Y or RNY gastric bypass how is the stomach stapled?
stapled completely horizontally with a small opening so food intake is limited
How musch of the stomach is removed in a sleeve gasttectomy?
85%; spares the sphincters so normal stomach mechanics and hunger hormones removed (ghrelin and leptin)
What is th typical gastric volume after surgery?
2oz at first then to 6oz
Criteria for bariatric surgery or WLS.
*morbidly obese BMI>40kg/m^2 *no serious endocrine problems *18+ years of age
Name two types of malabsorptive surgeries.
1. biliopancreatic diversion 2. biliopancreatic diversion with duodenal switch