Bariatric surgery procedures are either restrictive, which shrink the size of the stomach, or combined restrictive-malabsorptive, which also bypass part of the small intestine. Common procedures include gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass. Indications for bariatric surgery are a BMI over 40, or a BMI over 35 with comorbidities. Complications can include leaks, internal hernias, bleeding, ulcers, and nutritional deficiencies of vitamins and minerals.

1. Bariatric Surgery
Agarwal
MR 1/28/14

2. Bariatric Surgery
• Restrictive procedures
– Adjustable gastric banding
– Vertical banded gastroplasty
– Sleeve gastrectomy
• Combined restrictive-malabsorptive procedures
– Roux-en-Y gastric bypass
– Biliopancreatic diversion (BPD) with or without duodenal
switch
• Indications are:
– BMI > 40
– BMI > 35 and 1 or more comorbidities
– ? BMI 30 – 35 *
*O’Brien PE, Dixon JB, Laurie C, et al. 2006

5. Complications of Bariatric Surgery
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Anastomotic leak
Internal hernias
Gastrointestinal bleeding
Marginal ulceration
Stomal stenosis
Bowel obstruction
Staple line dehiscence

6. Nutritional Deficiencies
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Iron
Vitamin B12
Folic acid
Calcium
Vitamin D
Thiamine
Vitamin A
Vitamin E

7. References
• Clinical Practice Guidelines for the Perioperative Nutritional
Metabolic, and Nonsurgical Support of the Bariatric Surgery
Patient – 2013 Update: Cosponsored by American Association
of Clinical Endocrinologists, The Obesity Society, and
American Society for Metabolic & Bariatric Surgery. Surgery
for Obesity and Related Diseases 9 (2013) 159-191.