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.

1. THE CONS OF
BARIATRIC SURGERY
By Anna Yancey

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. Gastric Restriction (lap-band)
 Reduces the size of the stomach by using an
adjustable band. (fda.gov)

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. 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. 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. Gastric Bypass
(San Diego, Gastric bypass)

8. Gastric bypass complications
 Anastomatic leakage
 Anastomatic stricture
 Ulceration of anastomosis
 Gastric dumpling syndrome
 Lack of absorption of nutrients

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. Duodenal Switch
(LAPSF, 2013)

11. Duodenal switch complications
 Chronic diarrhea
 Anemia, protein deficiency
 Osteoporosis
 Abdominal pain

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. 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. 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. 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. 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. 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. 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. Conclusion
 Multiple post-op complications
 Diet restrictions
 Residual weight gain
 Not-cost effective
 Healthcare/Insurance

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. 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. 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