Bariatric surgical procedures include all except:
Correct Answer: Beal Transposition
Description: Ileal transposition Bariatric surgical procedures include: Veical banded gastroplasty Adjustable gastric banding Roux-en Y gastric bypass d. Biliopancreatic diversion e. Duodenal switch The surgical treatment of morbid obesity is known as bariatric surgery. Morbid obesity is defined as body mass index of 35 kg/m2 or more with obesity related comorbidity, or BMI of 40 kg/m2 or greater without comorbidity. Bariatric operations produce weight loss as a result of 2 factors. One is restriction of oral intake. The other is malabsorbtion of ingested food. Gastric restrictive procedures include Veical banded gastroplasty & Adjustable gastric banding. Malabsorbtive procedures include Biliopancreatic diversion, and Duodenal switch. Roux-en Y gastric bypass has features of both restriction and malabsorption. Veical Banded Gastroplasty This procedure has now largely been abandoned in or of other operations because of high rate of stenosis of the gastric outlet and poor long term weight loss.Adjustable Gastric Banding A silicone band is put around the proximal stomach to restrict the amount of solid food that can be ingested at one time. The adjustable nature of the band allows the amount of restriction to be increased or decreased, depending upon the patient's weight loss.Gastric band placement, unlike malabsorptive weight loss surgery (e.g. Roux-en-Y gastric bypass surgery (RNY), Biliopancreatic Diversion (BPD) and Duodenal Switch (DS)), does not cut or remove any pa of the digestive system. It is also usually easy to remove the band and reverse the surgery, requiring only a laparoscopic procedure. after which the stomach usually returns to its normal pre-banded state.Roux-en Y Gastric Bypass A gastric bypass first divides the stomach into a small upper pouch and a much larger, lower "remnant" pouch. Next the jejunum is divided and the lower pa of the small intestine is then attached to the new stomach pouch thus bypassing most of the stomach and the upper pa of small intestine. RYGB is thus both a gastric restrictive procedure and a mildly malabsorbtive procedure. Biliopancreatic Diversion BPD produces weight loss based primarily on malabsorption but it does have a mild restrictive component. Pa of the stomach is resected (Distal hemigastrectomy), creating a smaller stomach. The distal pa of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. The intestinal tract is reconstructed is a fashion to allow only a sho so-called common channel of the distal 50 cm of terminal ileum for absoption of fat and protein. Duodenal Switch This is a modification of the Biliopancreatic Diversion procedure developed to lessen the high incidence of marginal ulcers after BPD. The mechanism of weight loss is similar to that of BPD. The major difference between DS and BPD is the gastrectomy and the proximal anatomy. Instead of a distal hemigastrectomy, a
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