CBC Bariatric Surgery and Procedures 2 — Questions and Answers
Question 1: Which bariatric procedure involves removing approximately 80% of the stomach along the greater curvature, leaving a tubular pouch?
- Sleeve gastrectomy (Correct answer)
- Roux-en-Y gastric bypass
- Adjustable gastric banding
- Biliopancreatic diversion with duodenal switch
Correct answer: Sleeve gastrectomy
Sleeve gastrectomy removes about 80% of the stomach along the greater curvature, creating a banana-shaped tubular pouch.
Question 2: In Roux-en-Y gastric bypass, what is the approximate size of the newly created gastric pouch?
- About 15-30 mL (Correct answer)
- About 150-200 mL
- About 500 mL
- About 1 liter
Correct answer: About 15-30 mL
The Roux-en-Y gastric pouch is typically 15-30 mL, roughly the size of an egg, which sharply restricts intake.
Question 3: Which mechanism primarily explains why sleeve gastrectomy reduces hunger beyond simple restriction?
- Removal of the ghrelin-producing gastric fundus (Correct answer)
- Increased bile acid absorption in the colon
- Vagal nerve transection
- Slowed gastric emptying into the duodenum
Correct answer: Removal of the ghrelin-producing gastric fundus
The gastric fundus is the main site of ghrelin production, so its removal lowers levels of this hunger hormone.
Question 4: A patient with a BMI of 37 and type 2 diabetes asks whether they qualify for bariatric surgery under the 2022 ASMBS/IFSO guidelines. What is the most accurate response?
- Yes, surgery is recommended for BMI ≥35 regardless of comorbidities (Correct answer)
- No, surgery requires a BMI of at least 40
- Yes, but only after 10 years of failed dieting
- No, diabetes is a contraindication to surgery
Correct answer: Yes, surgery is recommended for BMI ≥35 regardless of comorbidities
The 2022 ASMBS/IFSO guidelines recommend bariatric surgery for BMI ≥35 regardless of comorbidities and consider it for BMI 30-34.9 with metabolic disease.
Question 5: Which bariatric procedure is fully reversible and involves no cutting or stapling of the stomach or intestines?
- Adjustable gastric banding (Correct answer)
- Sleeve gastrectomy
- Roux-en-Y gastric bypass
- Duodenal switch
Correct answer: Adjustable gastric banding
Adjustable gastric banding places a removable silicone band around the upper stomach without cutting or stapling, making it reversible.
Question 6: Which procedure combines a sleeve gastrectomy with a long intestinal bypass and produces the greatest average weight loss?
- Biliopancreatic diversion with duodenal switch (Correct answer)
- Roux-en-Y gastric bypass
- Adjustable gastric banding
- Intragastric balloon
Correct answer: Biliopancreatic diversion with duodenal switch
The duodenal switch pairs a sleeve gastrectomy with a substantial intestinal bypass, yielding the greatest weight loss but the highest malabsorption risk.
Question 7: Why is laparoscopic surgery generally preferred over open surgery for bariatric procedures?
- It reduces wound complications, pain, and recovery time (Correct answer)
- It eliminates the need for general anesthesia
- It allows more stomach tissue to be removed
- It guarantees no risk of internal bleeding
Correct answer: It reduces wound complications, pain, and recovery time
Laparoscopic approaches use small incisions, lowering wound complications, postoperative pain, and hospital stay compared with open surgery.
CBC Bariatric Surgery and Procedures 2
Which bariatric procedure involves removing approximately 80% of the stomach along the greater curvature, leaving a tubular pouch?