by Heather Paterson, BSc; and Kamran Zamanian, PhD

Ms. Paterson is Research Analyst, and Dr. Zamanian is Head of Research, iData Research Inc.

Introduction

Obesity is considered a prevalent and growing disease both in the US and globally by multiple leading health organizations, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). According to the CDC, over the past 20 years there has been a considerable increase in the incidence of obesity in the US. In 2007, more than 65 percent of US states had rates of obesity between 25 and 30 percent, and not a single state had levels less than 18 percent.[1] The use of the adjustable gastric band(AGB) to treat obesity in the US is showing a very healthy increase. Current devices are made of inert materials such as silicone and are implanted around the proximal stomach to decrease food intake. The mechanism of action is not completely understood, but “satiety,” rather than “restriction,” seems to be a common theme among successful patients. These devices are used to treat the disease of morbid obesity, with the goal of ameliorating medical comorbid conditions and prevention of obesity-related diseases. As the US continues to struggle with rapidly increasing obesity rates, the AGB market will increase through 2015.[2] Read the rest of this article »

Popularity: 1% [?]

Introduction

Retrograde intussusception, known in our bariatric office as RINT, is also called reverse intussusception or antiperistaltic intussusception. Retrograde describes the direction the bowel intussuscepts—from distalto proximal (Figure 1). The much more common is operistaltic or antegrade intussusception, where the bowel intussuscepts from proximal to distal, is seen in children and adults. Antegrade intussusception is usually associated with a lead point, such as a pyerspatch or small bowel tumor that gets dragged in the direction of normal peristalsis. RINT does not appear to have an anatomic lead point. RINT is unique to Roux-en-Y anatomy and almost exclusively involves the jejunojejunostomy or near vicinity regardless ofthe use of the Roux-en-Y, such as with gastric bypass or biliary reconstruction. The diagnosisis made on computed tomography (CT) scan (Figure 2) with the classic “target” sign at the jejunojejunostomy, along with symptoms of nausea, vomiting, and epigastric and periumbilical or abdominal pain on the left side made worse with eating. Read the rest of this article »

Popularity: 2% [?]

by Douglas Sutton, EdD, ARNP, NP-C; Deborah A. Raines, PhD, RN, ANEF; and Natalie Murphy, MSN, FNP-BC

Introduction

Weight reduction is the most obvious—and often most celebrated—outcome that results following bariatric surgery. As clinicians, we must be reminded that for our patients this physical metamorphosis has been many years in the making. While we often begin our assessment of the client by determining the number of days, months,or years postoperative a client is, we forget that the decision to seek information about bariatric surgery, and then to ultimately undergo a weight loss procedure, takes months and years for most people. This article focuses on both the presurgical decision-making period as well as the postsurgical experience of 14 patients who underwent Roux-en-Y gastric bypass surgery and shared their story as part of a larger, descriptive, qualitative study focused on women who chose to undergo a surgical weight loss intervention. While the change after surgery was captivating, dramatic, and life altering, this article will also focus on understanding the journey of change and its impact on those who undergo bariatric surgery. Read the rest of this article »

Popularity: unranked [?]

by Babatunde Ogunnaike, MD
Dr. Ogunnaike is Associate Professor and Chief of Anesthesia Services at Parkland Health and Hospital System, Southwestern Medical School, Dallas, Texas.

The success of bariatric perioperative care depends on a team of dedicated healthcare personnel working together toward optimal patient care. Important aspects of the bariatric surgery that are crucial to the success of the process are discussed in this article. Read the rest of this article »

Popularity: 2% [?]

Dr. Edward Mason reviews a new patient safety text…and offers some additional pearls of wisdom on the topic for Bariatric Times readers. Read the rest of this article »

Popularity: 1% [?]