Bariatric surgery in AT
Bariatric surgery in AT section, includes general infrmation about Bariatric surgery Procedure, Bariatric surgery AT Local News, Bariatric surgery AT Surgeon Locator and other Bariatric surgery related material.
Bariatric surgery Procedure
Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
The term “bariatrics” refers to "weight medicine". Bariatrics generally deals with pharmacotherapy of obesity and with obesity surgery.
Overweight and obesity are strongly related to medical problems in today’s world. There are many health effects of obesity, such as heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, and others.
In addition to medical concerns regarding obesity, appearance (look) has a major relevance to weight and obesity.
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes.
Before someone can become a candidate for bariatric surgery, certain criteria must be met. The basic criteria are:
[1] An understanding of the operation and the lifestyle changes the patient will need to make;
[2] A body mass index (BMI) of 40 or more, which is about 45 kg (100 pounds) overweight for men and 35 kg (80 pounds) for women; or
[3] A BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).
Risks involved
Past studies found that 10 to 20 percent of bariatric surgery patients had complications while they were in the hospital. In 2006, federal researchers found that 39.6 percent of patients had complications within 180 days of surgery. The most common complications are:
[1] A composite of gastrointestinal symptoms including vomiting, diarrhea, dysphagia, and reflux (20%)
[2] Anastomotic leaking (at the surgical connections between the stomach and the intestine) (12%);
[3] Abdominal hernia (7%)
[4] Infections (6%).
About 7% of patients were re-admitted to the hospital within 6 months to treat complications specific to the bariatric procedure.
The in-hospital death rate in adults undergoing obesity surgery in 2003 was 0.2%.
Laparoscopic surgery has become an important addition to this field of surgery, and demand soars, amidst scientific and ethical questions.
Surgical procedures in bariatrics
There are a number of surgical options available to treat obesity, each with their advantages and pitfalls. In general, weight reduction can be accomplished, but one must consider operative risk (including mortality) and side effects. Usually, these procedures can be carried out safely.
The surgical procedures can be grouped in three main categories:
[1] Predominantly malabsorptive procedures: although also reducing stomach size, these operations are based mainly on diversion and bypass.
[2] Predominantly restrictive procedures: a surgery that primarily reduces stomach size: Vertical Banded Gastroplasty (Mason procedure, stomach stapling); Adjustable gastric band (or "Lap Band"); Sleeve gastrectomy.
[3] Mixed procedures: applying both techniques simultaneously: gastric bypass surgery, like Roux-en-Y gastric bypass; Sleeve gastrectomy with Duodenal Switch Implantable Gastric Stimulation.
Biliopancreatic diversion
A complex operation, also known as biliopancreatic diversion (BPD), or Scopinaro procedure.
This surgery is rare now because of problems with malnourishment. It has been replaced with the Duodenal Switch, also known as the BPD/DS. Part of the stomach is re-sected, creating a smaller stomach (however after a few months the patient can eat a completely free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. This results in around 2% of patients severe malabsorption and nutritional deficiency that requires restoration on the normal absorption.
The malabsorptive element of BPD is so potent that those who undergo the procedure must take vitamin and mineral supplements above and beyond that of the normal population. Those that do not run the risk of deficiency diseases such as anemia and osteoporosis.
Because gallstones are a common complication of rapid weight loss following any type of weight loss surgery, some surgeons may remove the gall bladder as a preventative measure during BPD. Others prefer to prescribe medication to reduce the risk of post-operative gallstones.
Far fewer surgeons perform BPD compared to other weight loss surgeries, in part because of the need for long-term nutritional follow-up and monitoring of BPD patients.
Vertical Banded Gastroplasty
a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.
The same effect can be created using a silicone band, which can be adjusted by addition or removal of saline through a port placed just under the skin. This operation can be performed laparoscopically, and is commonly referred to as a "lap band."
Adjustable Gastric Banding
The first lower pressure, wider, one-piece adjustable gastric band called the MIDband® was introduced in 2000. Unlike many of the early bands this was designed specifically for laparoscopic insertion.
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Austria History Once the center of power for the large Austro-Hungarian Empire, Austria was reduced to a small republic after its defeat in World War I. Following annexation by Nazi Germany in 1938 and subsequent occupation by the victorious Allies in 1945, Austria's status remained unclear for a decade. A State Treaty signed in 1955 ended the occupation, recognized Austria's independence, and forbade unification with Germany. A constitutional law of that same year declared the country's "perpetual neutrality" as a condition for Soviet military withdrawal. This neutrality, once ingrained as part of the Austrian cultural identity, has been called into question since the Soviet collapse of 1991 and Austria's entry into the European Union in 1995. A prosperous country, Austria entered the European Monetary Union in 1999.
Austria Electricity Electricity is supplied at 220 to 230V 50Hz. Outlets are the European standard CEE-7/7 "Schukostecker" or "Schuko" or the compatible, but non-grounded, CEE-7/16 "Europlug" types. Generally speaking, U.S. and Canadian travelers should pack an adapter and a converter for these outlets if they plan to use North American electrical equipment in Austria.
Plastic Surgery News...
- U. S. Charge d'Affaires, Steven J. White, announced that the United States will provide an additional $1.2 million (Rs. 4.7 crores) for victims of last year's floods in Bihar. This support is in addition to the $1.05 million (Rs. 4.1 crores) the United States provided in September 2007.
- According to review published by the Cochrane Collaboration, there is no good evidence for or against the effectiveness of over-the-counter (OTC) medicines in acute cough.
Researchers performed a systematic review to assess the effects of oral OTC cough preparations for the management of acute cough. The review included data from 25 randomised controlled trials (RCTs) (17 in adults and 8 in children) comparing oral OTC cough preparations with placebo in a total of 616 children and 2876 adults suffering from acute cough in the ambulatory settings.
The systematic review described the available evidence, and also concluded that although there is no good evidence for the effectiveness of OTC preparations for acute cough, the results of this review have to be interpreted with caution because study designs, populations, interventions and outcomes varied markedly between studies, limiting the generalisability of the results.
[Note: The U.S. Food and Drug Administration (FDA) had also recently issued a Public Health Advisory for parents and caregivers, recommending that over-the-counter (OTC) cough and cold products should not be used to treat infants and children less than 2 years of age because serious and potentially life-threatening side effects can occur from such use – see link above for full details]