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Bariatric Surgery

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Kendall Valley

on 20 April 2015

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Transcript of Bariatric Surgery

History of Bariatric Surgery
Bariatric Surgery: surgical procedure for the express purpose of promoting major weight loss
Roux En Y Gastric Bypass
Drs Mason & Ito 1960's
Based on weight loss noted in ulcer surgery patients
Has been modified over the decades
Most commonly performed surgery for weight loss in the US
Now done laparoscopically
Limb of intestine connected to a very small stomach pouch
Jejunoileal Bypass (JIB)
Bariatric Surgery
restrictive procedures
malabsorptive procedures
Biliopancreatic Diversion (BPD) and Duodenal Switch (DS)
Malabsorbtive
U of M, 1954
Bypasses most of intestine while keeping stomach intact
Many severe problems, no longer a recommended surgery
(BPD) Dr. Scopinaro, Italy, 1976
controlled malabsorption
Delay digestive process
Reduce surface area of Intestine

Roux-En-Y Gastric Bypass
Gastroplasty
(stomach stapling)
Early 1970's
1st purely restrictive surgical procedure for the treatment of obesity
lead to gastric banding
Gastric Banding
1978-2001
Purely restrictive
Evolved with technology of appliances
LAPP Band approved by FDA 2001
Risks & Complications

RISKS & COMPLICATIONS
Vomiting and Dumping Syndrome
Nutritional deficiencies
Gallstone formation
Depression
Death
References
New Advances in Technology
References

"Types of Bariatric Surgery - Full Comparison." Bariatric Surgery Source. 30 Dec. 2011. Web. 13 Apr. 2015.


Infection
Blood clots
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/roux-en-y_gastric_bypass_weight-loss_surgery_135,65/

http://www.medscape.org/viewarticle/721429_5

https://weightloss.clevelandclinic.org/images/file/Risks%20and%20complications%20of%20bariatric%20surgery.pdf
E.Munsen
Process & Procedure
Post-care
Medications
Vitamins & Supplements
Diet
Exercise
Support Groups
Other Lifestyle Changes
pregnancy
returning to work
Long-Term
Endobarrier Endoluminal Liner
Gastric Plication
Maestro System
Primary Obesity Surgery Endolumenal (POSE) Procedure

Kendall, Claire, Trish, Christina, & Emily
DURING-
Anesthetic complications
AFTER-
LONG TERM-
DS modification by Dr. Hess 1986
DS vertical stomach cut
Most complicated surgery

Jejunoileal Bypass
Prescreening
https://asmbs.org/resources/story-of-obesity-surgery
http://www.haysmed.com/history-of-bariatric-surgery
http://www.slideshare.net/foregutsurgeon/history-of-bariatric-surgery
Trish Wagle
This operation can be performed in two different approaches the laproscopic technique (through 6 small incisions) or in rare instances, open technique (one vertical incision in the middle upper abdomen.
Advantages and Disadvantages of Laproscopic Approach
The
Advantages
of the Laproscopic Approach

>slightly shorter hospital stay
>less postoperative pain
>lower chance of developing an incisional hernia

The
Disadvantages
of the Laproscopic Approach
>longer operative time
>higher incidence of wound infection
>small bowel obstructions
Advantages and Disadvantages of Open Approach
The
Advantages
of the Open Approach
> One large incision may be a safer alternative some patients
>Reduces length of operative time
>Allows the surgeon to see the organs better
The
Disadvantages
of the Open Approach
>More postoperative pain
>Longer hospital stay for recovery
>Patient will have a larger scar right up the middle of the abdomnen.
Process and Procedures
for Roux En Y Bariatric Surgery
First Step
: Measuring the Stomach
Second Step
: Dividing the Stomach with the Stapler
Third Step
: Dividing the Intestines
Fourth Step
: Making the Connection
Roux En Y Bariatric Surgery is the most common way bariatric surgery is performed.
Roux En Y Bariatric Surgery
Endobarrier Endoluminal Liner
Gastric Plication
Maestro System (pacemaker)
-Required to attend approx. 9 meetings with various doctors & support groups.
-Approval by insurance
-Scare tactics of health conditions caused from morbid obesity.
-Appointments used to check the mental & emotional state of the patient
Prescreen:
-lose a significant amount of weight according to current weight.
-decide on a procedure & surgical plan
-Before surgery, plans in place for post care; nutrition & support group
Burton, Thomas M. "FDA Clears ‘Pacemaker for the Stomach’." The Wall Street Journal. N.p., 14 Jan. 2015. Web. 15 Apr. 2015. <http://www.wsj.com/articles/fda-approves-new-obesity-device-1421276434>.
EndoBarrier Placement in Stomach and Intestines. Digital image. Endobarrier® Implantation. North Eastern Weight Loss Surgery, n.d. Web. 15 Apr. 2015. <http://www.lapgastricband.com.au/endobarrier_australia.html>.
“Experimental Weight Loss Surgery: The 5 Most Promising Procedures." Bariatric Surgery Source. Ed. Gregg H. Jossart. N.p., 13 Oct. 2014. Web. 15 Apr. 2015. <http%3A%2F%2Fwww.bariatric-surgery-source.com%2Fexperimental-weight-loss-surgery.html>.
Fruit and Vegetables with Tape Measure. Digital image. Bariatric Follow-Up Care. Sutter Health Palo Alto Medical Foundation, n.d. Web. 15 Apr. 2015. <http://www.pamf.org/bariatric-surgery/services/follow-up-care/>.
Gastic Plication. Digital image. Laparoscopic Gastric Plication. Cleveland Clinic, 24 Nov. 2010. Web. 15 Apr. 2015. <https://weightloss.clevelandclinic.org/gastricplication.aspx>.
GI Dynamics' EndoBarrier Gastrointestinal Liner. Digital image. EndoBarrier Device Holds Promise for the Treatment of Type 2 Diabetes and Obesity. DiaTribe, 31 Oct. 2011. Web. 15 Apr. 2015. http://diatribe.org/endobarrier-device-holds-promise-treatment-type-2-diabetes-and-obesity>.
“Life After Bariatric Surgery." Patient Education. UCSF Medical Center, n.d. Web. 15 Apr. 2015. <http://www.ucsfhealth.org/education/life_after_bariatric_surgery/index.html>.
Man and Woman Running. Digital image. How Exercise Changes Our DNA. Center for Genetics and Society, n.d. Web. 19 Apr. 2015. <http://www.geneticsandsociety.org/img/pic/run.jpg>.
Scutti, Susan. Maestro System Implant. Digital image. EnteroMedics Implantable Appetite-Curbing Device Poised To Gain FDA Approval: A Cure For Obesity? Medical Daily, 23 June 2014. Web. 15 Apr. 2015. <http://www.medicaldaily.com/enteromedics-implantable-appetite-curbing-device-poised-gain-fda-approval-cure-obesity-289500>.



http://www.ellnerbariatric.com/your-education/gastric-bypass/surgery-step-by-step.html
https://my.clevelandclinic.org/ccmediaf//files/Bariatric_Surgery/schauerbest.pdf
https://asmbs.org/patients/bariatric-surgery-procedures
Christina Cook
-What causes such obesity?
All info about prescreening from my cousin/patient of baratric surgery, Melissa Anderson.

Kendall Valley
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