Management of Morbid Obesity 1st Edition by Harvey Sugerman 0824758560 9780824758561

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ISBN 10: 0824758560

ISBN 13: 9780824758561

Author: Harvey J. Sugerman

Edited by world-renowned bariatric surgeons, this comprehensive reference provides a clear overview of multidisciplinary approaches to bariatric surgery and clearly details the techniques and outcomes of commonly performed bariatric operations, potential complications associated with bariatric surgery, and practices in long-term follow-up and nutri

Management of Morbid Obesity 1st Table of contents:

1. Obesity: Pathogenetic Mechanisms

Introduction

Detection and Evaluation of Food

Processing of Nutrients

Nutrient Sensing

Hunger and Motivation

Surgical Treatment of Overeating

Conclusion

References

2. Epidemiology and Comorbidities of Morbid Obesity

Epidemiology

Trends in Oral Intake in the United States

Children

Socio-Economic Status

Social Consequences of Obesity

Comorbid Conditions

Neoplasia

Cardiovascular

Pulmonary

Endocrine

Gastrointestinal

Genitourinary

Musculoskeletal

Hematologic

Renal

Neurologic

Infectious / Immunologic

Dermatologic

Psychiatric

Social/Economic

Summary

References

3. Treating the Morbidly Obese Patient: A Lifestyle Approach to a Chronic Condition

Introduction

Lifestyle Modification

Dietary Changes

Physical Activity

Combining Behavior Modification and Pharmacotherapy

Surgery

Summary and Conclusions

References

4. Preoperative Evaluation and Intraoperative Care of the Obese

Introduction

Preoperative Evaluation

The Role of the Bariatric Surgeon

The Role of the Bariatrician

The Role of the Bariatric Nutritionist

The Role of the Bariatric Psychologist/Psychiatrist

Cardiovascular Evaluation

Obstructive Sleep Apnea (OSA)

Diabetes

Gastrointestinal Evaluation

Gastroesophageal Reflux Disease

Gallstone Disease

Non-Alcoholic Steatohepatitis

Deep Venous Thrombosis (DVT)

Revisional Bariatric Surgery

Intraoperative Care

Airway Management

Respiratory Mechanics

Intraoperative Physiologic Pulmonary and Hemodynamic Changes

Conclusion

Acknowledgment

References

5. Essentials of a Bariatric Surgery Program

Introduction

Overview of Etiology and Epidemiology of Morbid Obesity

Criteria For Selection of Patients For Bariatric Surgery

Components of a Bariatric Surgery Program

Personnel

Dietary Evaluation

Psychological Evaluation

Expert Consultants

Anesthesiology for Bariatric Surgery

Preoperative Workshops and Support Groups

The Preoperative Educational Workshop

Support Groups

Hospital Requirements

Bariatric Surgery Database

Bariatric Surgery Program Web Site

Conclusion

References

6. Nutrition and Roux-en-Y Gastric Bypass Surgery

Introduction

Pre-Surgical Nutrition Assessment and Management

Pre-Surgical Nutrition Education

Postoperative Diet Guidelines

Nutrient Absorption and Deficiency

Malabsorptive Procedures

Roux-En-Y (Rygb)

Protein Considerations

Vitamin B1 (Thiamine)

Vitamin B12 (Cobalamin)

Iron

Folate

Metabolic Bone Markers

Post-Surgical Nutrition Assessment

Nutrition and Surgical Complications

Conclusion

References

7. Laparoscopic Vertical Banded Gastroplasty

Introduction

Methods

Indications for Surgery

Patient Selection for Laparoscopic VBG

Operative Technique Wedge VBG

Postoperative Care

Results

Discussion

References

8. Physiology of Laparoscopy in the Morbidly Obese

Effects of Carbon Dioxide Absorption During Pneumoperitoneum

Effects of Increased Intra-Abdominal Pressure During Pneumoperitoneum

Hemodynamic Changes and Cardiac Function

Hepatic Function

Intraoperative Pulmonary Mechanics

Renal Function

Venous Stasis

Conclusions

References

9. The Pathophysiology of Severe Obesity and the Effects of Surgically Induced Weight Loss

Introduction

Central (Android) Vs. Peripheral (Gynoid) Fat Distribution

Hypertension

Cardiac Dysfunction and Dyslipidemia

Pulmonary Dysfunction

Diabetes

Venous Stasis Disease

Degenerative Joint Disease

Gastroesophageal Reflux and Asthma

Urinary Incontinence

Female Sexual Hormone Dysfunction

Pseudotumor Cerebri

Malignancy Risk With Obesity

Hernia Risk With Obesity

Infectious Problems Associated With Morbid Obesity

Nald/Nash

Quality of Life

Mortality

Conclusions

References

10. Techniques of Laparoscopic Gastric Bypass

Introduction

Materials and Methods: Laparoscopic Gastric Bypass Technique

Patient Positioning and Operating Room Set-up

Port Placement

Dissection and Creation of the Mesocolic Window

Creation of the Roux-en-Y

Creation of the Gastric Pouch

Creation of the Gastrojejunostomy

Closure of Mesenteric Defects

Postoperative Management

Discussion

References

11. Outcome of Laparoscopic Gastric Bypass

Introduction

Literature Review—Case Series

Literature Review—Prospective, Randomized Clinical Trials

Discussion

References

12. Changing Intestinal Absorption for Treating Obesity

Introduction

Development of Bariatric Surgery

Initial Malabsorptive Attempt (Intestinal Bypass)

Restrictive Phase

Gastroplasty

Gastric Bypass

Gastric Banding

Biliopancreatic Diversion Phase

Biliopancreatic Diversion

Beneficial Effects of Biliopancreatic Diversion

Weight Loss

Quality of Life

Comorbidities

Detrimental Effect of Biliopancreatic Diversion

Prevalence of Side Effects

Vitamin and Mineral Deficiencies

Risk of Protein Deficiencies

Change in Intestinal Flora

Conclusion

References

13. Laparoscopic Adjustable Silicone Gastric Banding

Introduction

Patient Selection

Operative Technique

Postoperative Management

Immediate

Long-Term: Band Adjustments

Office-Based Adjustments

Radiographic-Guided Adjustment

Complications

Gastric Prolapse

Erosion

Postoperative Obstruction

Results

Effect on Comorbidities

Conclusions

References

14. Outcomes of Laparoscopic Adjustable Gastric Banding

Introduction

The Benefits of Weight Loss

Bariatric Surgery Provides the Only Effective Option

What Is the Best Surgical Option?

Characteristics of the ideal Surgical Procedure

Laparoscopic Adjustable Gastric Banding

Introduction

Key Attributes of LAGB

Sources of Data

Outcomes

Safety

Efficacy

Discussion

Conclusions

References

15. Part II of Debate: Laparoscopic Roux-en-Y Gastric Bypass

Introduction

Roux-En-Y Gastric Bypass

Historical Perspective Comparisons with Restriction

Laparoscopic RYGB

Laparoscopic Adjustable Gastric Banding (Lagb)

International Studies

American Experience

Grade A Evidence

Band Adjustment

LAGB Conversion

Comorbidity Resolution

Conclusion

References

16. Complications of Laparoscopic Bariatric Surgery

Introduction

Leaks

Intestinal Obstruction From Internal Hernia

Bleeding

Stricture Formation

Pulmonary Embolism

Cholelithiasis

Marginal Ulcer

Incisional Hernia

Pressure-Related Complications: Rhabdomyolysis and Compartment Syndrome

Laparoscopic vs. Open Bariatric Surgery

Conclusion

References

17. Postoperative Follow-Up and Nutritional Management

Introduction

Commonly Performed Bariatric Procedures

The Significance of Long-Term Follow-Up

Nutritional Deficiencies

Protein-Calorie Malnutrition

Dehydration

Nausea and Vomiting

Vitamin Deficiencies

Iron

Folic Acid

Vitamin B12

Gastrointestinal Issues

Abdominal Pain

Gallbladder Disease

Intestinal Obstruction

Marginal Ulceration

Weight-Loss Failure

Conclusions

References

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