The "Con" argument for bariatric surgery

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A debate for one of my senior level classes. Each person was given a side of a topic to defend and put sources into APA format.

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  • Clear = free of caffiene, carbonation, and alcohol, low-calorie and low-sugar Full liquid = high protein, low calorie, low sugar Soft food = moist, diced, chopped, pureed, Solid food = eating speed and amount
  • Laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, Roux-en-Y gastric bypass.
  • The "Con" argument for bariatric surgery

    1. 1. THE CONS OF BARIATRIC SURGERY By Anna Yancey
    2. 2. Bariatric Surgery Overview  There are 3 basic concepts for bariatric surgery (Saber, 2013)  Gastric restriction (lapband)  Gastric restriction with mild malabsorption (gastric bypass)  A combination of mild gastric restriction and malabsorption (duodenal switch)  All are medical procedures used for weight loss
    3. 3. Gastric Restriction (lap-band)  Reduces the size of the stomach by using an adjustable band. (fda.gov)
    4. 4. Gastric Restriction Complications  Regurgitation of ingested food  Slip of the ring  Gastric erosion  Local pain  Infection of the fluid inside the ring  Dilation of subcutaneous capsule  Lack of absorption of nutrients
    5. 5. Gastric Restriction Complications  Nearly 50 percent of patients required removal of their bands (Mercola, 2012)  60 percent needed to undergo additional surgery (Mercola, 2012)  One American clinical study that included a 3-year follow-up reported a staggering 88 percent of gastric banding patients experienced one or more adverse events, ranging from mild to severe. (Mercola, 2012)
    6. 6. Gastric restriction with mild malabsorption (bypass)  The size of the stomach is reduced by almost 90% and is directly connected to the middle part of the small intestine  Shortens the path of the food so less of it is absorbed
    7. 7. Gastric Bypass (San Diego, Gastric bypass)
    8. 8. Gastric bypass complications  Anastomatic leakage  Anastomatic stricture  Ulceration of anastomosis  Gastric dumpling syndrome  Lack of absorption of nutrients
    9. 9. Combination of gastric restriction and malabsorption (duodenal switch)  More than 85% of the stomach is removed and by passes most of the length of the intestines, minimizing food absorption.
    10. 10. Duodenal Switch (LAPSF, 2013)
    11. 11. Duodenal switch complications  Chronic diarrhea  Anemia, protein deficiency  Osteoporosis  Abdominal pain
    12. 12. Post-Operative Diet  Clear liquids (1-2 days)  Full liquid (2-3 weeks)  Soft food (4 weeks-few months)  Solid foods (Isom, 2012)
    13. 13. Bariatric Surgery Statistics  About 20 percent of people who opt for weight-loss surgery require further procedures for complications (Klein, 2013)  30 percent deal with complications relating to malnutrition, like anemia or osteoporosis, since the intestines are absorbing fewer nutrients. (Klein, 2013)
    14. 14. Bariatric Surgery Statistics  As many as 20 percent of people will gain a significant amount of weight back (Klein, 2013)  Weight regain might be related to technical failures of the surgery and should be reassessed by the bariatric surgeon (Birch, Christiansen, Cottreau, Karmali, Sharma, Stadnyk & Stokfossa, 2010)
    15. 15. Cost of Bariatric Surgery  Cost varies between clinic and surgeons  Follow ups are routinely scheduled  Surgeon visits are scheduled every month for LAGB patients for band fills and every 3 months RYGB and LSG patients (Birch, Christiansen, Cottreau, Karmali, Sharma, Stadnyk & Stokfossa, 2010)
    16. 16. Costs of Bariatric Surgery  From 2004-2005 the cost of a laparoscopic pre- surgery was $1,591.86  Time of surgery was $14,468.50  Total = $16,060.36 with healthcare only paying 14% on average.  $13,811.90 is out of pocket (Buchwald, Buessing, Cremieux, Ghosh, Shikora & Yang, 2008)
    17. 17. Costs of Bariatric Surgery  Open pre-surgery cost 2004-2005 was $2,246.30  Time of surgery $19,900.61  Total $22,146.91 with healthcare paying 14% on average.  $19,046.34 out of pocket (Buchwald, Buessing, Cremieux, Ghosh, Shikora & Yang, 2008)
    18. 18. Post Surgery Costs  Laparoscopic costs 1-2 months after surgery $859.40  Open surgery costs 1-2 months after surgery $1,881.62 (Buchwald, Buessing, Cremieux, Ghosh, Shikora & Yang, 2008)
    19. 19. Conclusion  Multiple post-op complications  Diet restrictions  Residual weight gain  Not-cost effective  Healthcare/Insurance
    20. 20. Works Cited Saber, A. (2013). Bariatric surgery. Retrieved from http:/emedicine.medscape.com/article/197081-overview. (2013, September 6). LAP-BAND® Adjustable Gastric Banding System [Web Graphic]. Retrieved from http:/www.fda.gov.medicaldevicesproductsandmedicalprocedures/deviceap provalsandclearances/recently-approveddevices/ucm248133.htm Mercola, J. (2012, November 17). Why weight loss surgery is not a sound treatment choice for type 2 diabetes. Retrieved from http://articles.mercola.com/sites/articles/archive/2012/11/17/weight-loss- surgery.aspx
    21. 21. Works Cited (2013). Vertical gastrectomy with duodenal switch [Web Graphic]. Retrieved from https://www.lapsf.com/duodenal-switch-weight-loss-surgery.php San Diego, U. (Designer). (2010). Gastric bypass [Web Graphic]. Retrieved from http://health.ucsd.edu/specialties/surgery/bariatric/weight-loss- surgery/Pages/comparison-chart.aspx Klein, S. (2013, January 09). Weight loss surgery side effects: Procedure's not-so-glamorous side highlighted by al roker's embarrassing story. Huffington Post. Retrieved from http://www.huffingtonpost.com/2013/01/09/weight-loss-surgery-side-effects- al-roker_n_2441223.html Birch, D., Christiansen, S., Cottreau, D., Karmali, S., Sharma, A., Stadnyk, J., & Stokfossa, C. (2010). Bariatric surgery: a primer. Manuscript submitted for publication, College of Family Physicians of Canada, , Available from
    22. 22. Works Cited Buchwald, H., Buessing, M., Cremieux, P., Ghosh, A., Shikora, S., & Yang, H. (2008). A study on the economic impact of bariatric surgery. The American Journal of Managed Care, 14(9), doi: Ebscohost Isom, K. (2012). Standardizing the evolution of the postoperative bariatric diet. Diabetes Spectrum, 25(4), 222-228. Retrieved from http://search.proquest.com.ulm.idm.oclc.org/docview/1237613913

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