CSOWM - BARIATRIC SURGERY PROCEDURES & NUTRITION | ACTUAL EXAM QUESTIONS AND ANSWERS | LATEST UPDATE 2026/2027 | GRADED A+.

CSOWM - BARIATRIC SURGERY PROCEDURES & NUTRITION | ACTUAL EXAM QUESTIONS AND ANSWERS | LATEST UPDATE 2026/2027 | GRADED A+. One Anastomosis Gastric Bypass (OAGB) Disadvantages - <<<Answers>>>>- potential for malnutrition - bile reflux esophagitis - limited data >5 years to identify long term nutrition concerns Laparoscopic Adjustable Gastric Banded Plication (LAGBP) - <<<Answers>>>>combines LAGB with vertical SG - stomach below the band is plicated (rolled into itself and sewn together) Laparoscopic Adjustable Gastric Banded Plication (LAGBP) Advantages - <<<Answers>>>>- low morbidity - similar weight loss to VSG - reversible (since no resection) Bariatric and Metabolic Surgery Procedures - <<<Answers>>>>- Previously known as weight loss surgery - Impact the physiological regulation of body weight CSOWM - BARIATRIC SURGERY PROCEDURES & NUTRITION (ACTUAL 2025) QUESTIONS AND ANSWERS - - Improve morbidity and mortality rates among overweight/obese populations Examples: Sleeve Gastrectomy (SG), Roux-en-Y Gastric Bypass (RYGB), and Biliopancreatic Diversion (BPD/DS) Sleeve Gastrectomy (SG) - <<<Answers>>>>80% of stomach is removed (specifically the fundus, which significantly reduces ghrelin production) Sleeve Gastrectomy (SG) Advantages - <<<Answers>>>>- performed more quickly which means shorter anesthesia duration and lesser degree of post op systemic response - fewer complications - decreased risk of micro-nutritional problems - decreased risk of long term complications (obstructions, ulcers, dumping syndrome, hypoglycemia, etc) - can be revised/converted - allows access to both biliary & pancreatic duct (for upper GI/EGD) CSOWM - BARIATRIC SURGERY PROCEDURES & NUTRITION (ACTUAL 2025) QUESTIONS AND ANSWERS - favorable change in the gut microbiota. Sleeve Gastrectomy (SG) Disadvantages & Risks - <<<Answers>>>>- may exacerbate GERD due to preservation of acid producing cells - unknown long term data (10+ years) regarding durability of weight loss and comorbidity improvements - contraindicated in patients with severe GERD, lower esophageal sphincter incompetence, and Barrett's esophagus Combination Procedures - <<<Answers>>>>Gastric manipulation, causing some restriction and neural/hormonal changes Roux-en-Y Gastric Bypass (RYGB) - <<<Answers>>>>Step 1 Restriction: The surgeon separates the upper portion of the stomach from the lower portion. The upper portion (or the "pouch") is then connected to a limb of the small intestine, called the "Roux limb." The new stomach pouch restricts the amount of food you can eat, making you feel full after eating only a small amount of food. CSOWM - BARIATRIC SURGERY PROCEDURES & NUTRITION (ACTUAL 2025) QUESTIONS AND ANSWERS - Step 2 Malabsorption: The pouch is then connected to the middle of the small intestine (the jejunum) - the duodenum and part of the jejunum are bypassed. Roux-en-Y Gastric Bypass (RYGB) Mechanisms - <<<Answers>>>>Ghrelin Suppression - nutrient exposure to the intestine is sufficient for foodinduced ghrelin suppression - it may cause partial vagotomy Increases Satiety and Suppresses Appetite accelerates delivery of nutrients into the hindgut (cecum, large colon, small colon and the rectum) which increases the secretion of gut hormones (GLP-1, PPY, OXM, CCK) and bile acids Roux-en-Y Gastric Bypass (RYGB) Advantages - <<<Answers>>>>- more weight loss than the LAGB and SG - better comorbidity outcomes (CAD, T2DM, HTN, OSA, GERD, and cancer)