Flashcards in Bariatric/MIS Deck (9)
management of a slipped gastric band?
immediately remove saline from the band and take pt to OR for removal (can strangulate the herniated stomach)
where is a gastric band placed?
proximal stomach, oriented medial to lateral in an inferior to superior position
what is a highly selective vagotomy?
removes only the innervation to the lesser curvature of the stomach and preserves the innervation to the pylorus (does not require a drainage procedure, low risk of dumping syndrome)
what is a truncal vagotomy?
severs both vagi as they course along the esophagus near the diaphragmatic hiatus, thus pylorus loses innervation so you need a drainage procedure and higher risk of dumping syndrome
where do the vagi nerves sit for truncal vagotomy?
LARP: left anterior, right posterior
what is the #1 MCC dysphagia following fundoplication?
what are the percentages of average Excess BW loss for:
1. gastric band
1. 50% (slower, pks at 2yrs)
2. 60% (faster pks 1.5yrs)
3. 75% (faster, pks 1.5yrs)
what is afferent loop syndrome and what are the risk factors for it? (technical) tx?
obstruction of the afferent limb (kinking, stricture, internal herniation) in B2 anastomoses
- risks: long afferent limb (30-40cm), antecolic anastomosis
- tx: convert to B1 or RNYGB, enteroenterostomy