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A laparoscopic adjustable gastric band is a permanent, non-reversible surgical alteration of the stomach designed to treat obesity.
Answer: False
Explanation: The source states that gastric banding is considered the least invasive type of bariatric surgery and is completely reversible through another 'keyhole' laparoscopic operation, though adhesions and tissue scarring are inevitable.
An adjustable gastric band promotes weight loss by significantly increasing the rate at which the stomach empties, thus reducing calorie absorption.
Answer: False
Explanation: The adjustable gastric band promotes weight loss by creating a smaller stomach pouch and slowing food passage, leading to a feeling of fullness, but it does not affect the rate at which the stomach empties or directly reduce calorie absorption.
The gastric band creates a small pouch at the top of the stomach that holds approximately 1/2 cup of food, significantly less than a typical stomach's capacity.
Answer: True
Explanation: The gastric band creates a small pouch at the top of the stomach that holds approximately 1/2 cup (about 120 mL) of food, which is significantly smaller than the typical stomach's capacity of about 6 cups (about 1,440 mL).
Unlike Roux-en-Y gastric bypass, gastric banding involves cutting and re-routing a portion of the intestines.
Answer: False
Explanation: Unlike Roux-en-Y gastric bypass and other bariatric surgeries, gastric banding does not involve cutting or removing any part of the digestive system, meaning the intestines are not re-routed.
What is a common alternative name for a laparoscopic adjustable gastric band?
Answer: A band
Explanation: A laparoscopic adjustable gastric band is often referred to as a lap-band, A band, or LAGB.
How does an adjustable gastric band primarily promote a feeling of fullness?
Answer: By creating a smaller stomach pouch and slowing food passage
Explanation: The adjustable gastric band promotes a feeling of fullness by creating a smaller stomach pouch and slowing the passage of food, which leads to the release of peptide YY (PYY), a satiety hormone.
According to the American Society for Metabolic Bariatric Surgery, how does gastric banding compare to other bariatric surgeries in terms of invasiveness and reversibility?
Answer: It is considered the least invasive and completely reversible type of bariatric surgery.
Explanation: The American Society for Metabolic Bariatric Surgery considers gastric banding the least invasive type of bariatric surgery and completely reversible through another 'keyhole' laparoscopic operation.
What is the approximate capacity of the small pouch created by a gastric band at the top of the stomach?
Answer: 1/2 cup (about 120 mL)
Explanation: The gastric band creates a small pouch at the top of the stomach that holds approximately 1/2 cup (about 120 mL) of food.
How does gastric banding differ from Roux-en-Y gastric bypass (RNY) regarding the digestive system?
Answer: Gastric banding does not involve cutting or removing any part of the digestive system.
Explanation: Gastric banding differs from Roux-en-Y gastric bypass in that it does not involve cutting or removing any part of the digestive system, nor does it re-route the intestines.
Is gastric banding considered a completely reversible procedure?
Answer: It is removable, but not entirely reversible due to adhesions and scarring.
Explanation: Gastric banding is considered removable, requiring a laparoscopic procedure to take out the band. However, it is not entirely reversible, as adhesions and tissue scarring are inevitable, and weight regain is common after removal.
All patients are suitable for laparoscopic gastric banding, regardless of their medical history or obesity level.
Answer: False
Explanation: Not all patients are suitable for laparoscopic gastric banding; individuals with extreme obesity, a history of previous abdominal surgery, or complex medical problems may require an open surgical approach or may not be candidates at all.
Gastric banding surgery is generally indicated for individuals between 18 and 55 years of age, with no exceptions.
Answer: False
Explanation: While gastric banding surgery is generally indicated for individuals between 18 and 55 years of age, some doctors may perform the procedure outside this range, with some patients as young as 12.
Patients are typically considered for gastric banding only after a history of failure with medically supervised dietary therapy for about six months.
Answer: True
Explanation: Patients must typically have a history of failure with medically supervised dietary therapy, usually for about six months, before being considered for gastric banding.
Untreated endocrine diseases like hypothyroidism are not a contraindication for gastric banding surgery.
Answer: False
Explanation: Untreated endocrine diseases like hypothyroidism are considered a contraindication for gastric banding surgery, as they pose an unreasonable risk.
The cost of adjustable gastric-band surgery in the United States typically includes all preoperative care, testing, and potential complications.
Answer: False
Explanation: Most practices typically do not include the cost of preoperative care and testing or any potential complications that may arise in their quoted fees for gastric banding surgery.
For which patient population is adjustable gastric band surgery primarily designed?
Answer: Patients with a BMI of 40 or greater, or 35-40 with certain comorbidities
Explanation: Adjustable gastric band surgery is primarily designed for obese patients with a BMI of 40 or greater, or those with a BMI between 35 and 40 who have certain comorbidities that improve with weight loss.
What is a general Body Mass Index (BMI) criterion for gastric banding surgery?
Answer: A BMI above 40, or 30-40 with specific co-morbidities.
Explanation: Generally, gastric banding is indicated for individuals with a BMI above 40, or those with a BMI between 30 and 40 who have co-morbidities that could improve with weight loss.
Which of the following is a key contraindication for gastric banding surgery?
Answer: Untreated endocrine diseases like hypothyroidism.
Explanation: Untreated endocrine diseases like hypothyroidism are a key contraindication for gastric banding surgery, as they pose an unreasonable risk.
What special consideration is advised for patients with an adjustable gastric band who are considering pregnancy?
Answer: The band should ideally be deflated to ensure optimal nutritional condition.
Explanation: For patients with an adjustable gastric band considering pregnancy, it is advised that the band ideally be deflated to ensure optimal nutritional condition before or immediately after conception.
Laparoscopic surgery for gastric banding typically results in a longer hospital stay and more pain compared to traditional open surgical procedures.
Answer: False
Explanation: Laparoscopic surgery for gastric banding typically leads to a shorter hospital stay, faster recovery, smaller scars, and less pain compared to traditional open surgical procedures.
Band adjustments, or 'fills,' involve removing saline solution from the band to increase restriction and promote weight loss.
Answer: False
Explanation: Band adjustments, or 'fills,' involve introducing saline solution into the access port to inflate the band and increase restriction, thereby helping to control hunger and promote continued weight loss.
A standard hypodermic needle is recommended for gastric band adjustments to ensure proper inflation.
Answer: False
Explanation: A specialized non-coring needle is essential for gastric band adjustments to prevent damage to the port membrane and avoid leakage of the saline solution, ensuring the long-term functionality of the device.
Gastric band adjustments are typically performed without the aid of an X-ray fluoroscope, relying solely on patient symptoms.
Answer: False
Explanation: Gastric band adjustments are often performed using an X-ray fluoroscope, which allows the radiologist to visualize the band's placement, port, and tubing, and assess the level of restriction.
The first band adjustment is usually made immediately after surgery to ensure optimal restriction from day one.
Answer: False
Explanation: The first band adjustment is typically made between four and six weeks post-operatively, allowing the stomach time to heal, as an immediate fill could result in excessive restriction due to post-surgical swelling.
The recommended long-term diet for gastric banding patients emphasizes wet foods like soups and smoothies, as they pass through the band more easily.
Answer: False
Explanation: The recommended long-term diet for gastric banding patients emphasizes normal, healthy, solid foods that require ample chewing, while wet foods like soups and smoothies should be limited as they can pass quickly through the band, leading to higher caloric intake.
Which of the following is an advantage of performing gastric banding using laparoscopic surgery?
Answer: Normal nutrient absorption because no part of the stomach is stapled or removed
Explanation: An advantage of laparoscopic gastric banding is that no part of the stomach is stapled or removed, and intestines are not re-routed, allowing patients to absorb nutrients normally.
What is the initial step in the surgical insertion of an adjustable gastric band via laparoscopic surgery?
Answer: Introducing carbon dioxide gas into the abdomen
Explanation: The initial step in laparoscopic gastric banding involves making a small incision and then introducing carbon dioxide gas into the abdomen to create a working space for the surgeon.
What type of needle is essential for gastric band adjustments to prevent damage and leakage?
Answer: A specialized non-coring needle
Explanation: A specialized non-coring needle is essential for gastric band adjustments to prevent damage to the port membrane and leakage of the saline solution.
What is the typical volume range of saline solution that adjustable gastric bands can hold?
Answer: 4 to 12 cubic centimeters (cc)
Explanation: Adjustable gastric bands are designed to hold between 4 and 12 cubic centimeters (cc) of saline solution.
What tool is often used during gastric band adjustments to visualize the band's placement and assess restriction?
Answer: An X-ray fluoroscope
Explanation: An X-ray fluoroscope is often used during gastric band adjustments to visualize the band's placement, port, and tubing, and to assess the level of restriction as radio-opaque fluid passes through.
When is the first band adjustment typically made after surgery?
Answer: Between four and six weeks post-operatively.
Explanation: The first band adjustment is typically made between four and six weeks post-operatively, allowing the stomach time to heal and preventing excessive restriction due to swelling.
What type of foods should gastric banding patients limit in their long-term diet to maximize the band's effect?
Answer: Wet foods like soups and smoothies.
Explanation: Gastric banding patients should limit wet foods like soups, casseroles, and smoothies in their long-term diet, as these can pass quickly through the band, leading to higher caloric intake and undermining the band's effect.
Rapid weight loss after gastric banding can decrease fertility, making birth control less necessary.
Answer: False
Explanation: Rapid weight loss after gastric banding can increase fertility, making it highly advisable for patients to use effective birth control methods to prevent unwanted pregnancies.
Gastric band patients routinely require calcium supplements and Vitamin B12 injections due to malabsorption issues.
Answer: False
Explanation: Gastric band patients typically do not experience nutritional deficiencies or malabsorption of micronutrients, nor do they routinely require calcium supplements or Vitamin B12 injections, unlike patients who undergo procedures like RNY.
In the short term, patients undergoing adjustable gastric banding typically lose more weight than those who have RNY gastric bypass.
Answer: False
Explanation: In the short term (first 3.5 years), patients undergoing adjustable gastric banding typically lose less weight than those who have RNY gastric bypass, BPD, or DS surgeries, although this difference may decrease over time.
A key benefit of gastric banding is its higher mortality rate compared to Roux-en-Y gastric bypass.
Answer: False
Explanation: A key benefit of gastric banding is its lower mortality rate (1 in 1000) compared to Roux-en-Y gastric bypass (1 in 250).
A 2021 meta-analysis in The Lancet found that bariatric surgery was associated with a significant reduction in all-cause mortality for obese adults.
Answer: True
Explanation: A 2021 meta-analysis published in The Lancet found that bariatric surgery was associated with a significant reduction in all-cause mortality for obese adults, both with and without type 2 diabetes.
What is a common nutritional outcome for gastric band patients compared to those who undergo RNY surgery?
Answer: Gastric band patients typically do not experience nutritional deficiencies or malabsorption.
Explanation: Gastric band patients typically do not experience nutritional deficiencies or malabsorption of micronutrients, nor do they routinely require supplements, unlike patients who undergo RNY surgery.
What is the average weekly weight loss for a gastric banding patient?
Answer: 500 grams to 1 kilogram (1-2 pounds)
Explanation: The average gastric banding patient loses between 500 grams to 1 kilogram (1-2 pounds) per week consistently.
Which of the following is listed as a key benefit of gastric banding compared to other bariatric surgeries?
Answer: No malabsorption issues
Explanation: A key benefit of gastric banding compared to other bariatric surgeries is that it involves no malabsorption issues, as no part of the digestive system is cut or re-routed.
A systematic review of Laparoscopic Adjustable Gastric Banding (LAGB) concluded that it maintains low rates of what?
Answer: Short-term complications
Explanation: A systematic review concluded that Laparoscopic Adjustable Gastric Banding (LAGB) maintains low rates of short-term complications, while also producing significant excess weight loss and reducing obesity-related comorbidities.
According to a 2021 meta-analysis in The Lancet, what was the median life expectancy gain for obese adults with type 2 diabetes who underwent bariatric surgery?
Answer: 9.3 years
Explanation: A 2021 meta-analysis in The Lancet indicated a median life expectancy gain of 9.3 years for obese adults with type 2 diabetes who underwent bariatric surgery.
Productive Burping (PBing), the regurgitation of non-acidic swallowed food, is a normal and expected occurrence for banded patients.
Answer: False
Explanation: Productive Burping (PBing), the regurgitation of non-acidic swallowed food from the upper pouch, is a commonly reported occurrence but is not considered normal, and patients are advised to modify eating habits to avoid it.
Band erosion occurs when the band slowly migrates through the stomach wall from the outside to the inside, which can be silent but cause severe problems.
Answer: True
Explanation: Band erosion occurs when the band slowly migrates through the stomach wall from the outside to the inside, a process that can be silent but lead to severe complications.
A port 'flipping over' is a common issue with the gastric band's access port that typically resolves on its own without intervention.
Answer: False
Explanation: A port 'flipping over' is an issue with the gastric band's access port that makes it inaccessible and often requires a minor surgical procedure to correct, rather than resolving on its own.
What is 'Productive Burping (PBing)' in the context of gastric banding?
Answer: The regurgitation of non-acidic swallowed food from the upper pouch.
Explanation: Productive Burping (PBing) in the context of gastric banding refers to the regurgitation of non-acidic swallowed food from the upper pouch, which is not considered normal and indicates a need for dietary adjustments.
What is 'band slippage' as a potential complication of gastric banding?
Answer: The lower part of the stomach prolapsing through the band, enlarging the upper pouch.
Explanation: Band slippage is an unusual event where the lower part of the stomach prolapses through the band, which enlarges the upper pouch and can potentially cause an obstruction requiring urgent surgery.
Which of the following is a documented digestive adverse effect of gastric banding?
Answer: Stoma obstruction
Explanation: Stoma obstruction is a documented digestive adverse effect of gastric banding.
The FDA expanded its approval for adjustable gastric bands in 2011 to include patients with a BMI between 30 and 40, provided they have at least one weight-related medical condition and have failed other weight loss methods.
Answer: True
Explanation: In February 2011, the FDA expanded its approval for adjustable gastric bands to include patients with a BMI between 30 and 40, provided they also have at least one weight-related medical condition and have attempted other weight loss methods without success.
The Lap-Band System is the only adjustable gastric band currently approved by the FDA in the U.S. market, having obtained approval in 2001.
Answer: True
Explanation: The Lap-Band System is currently the only adjustable gastric band approved by the FDA in the U.S. market, having received approval in 2001.
The Realize Band received FDA approval in 2016 and is now the most widely used adjustable gastric band in the U.S.
Answer: False
Explanation: The Realize Band lost its FDA approval in 2016, and the Lap-Band System remains the only FDA-approved adjustable gastric band in the U.S. market.
The Midband, an adjustable gastric band used outside the U.S., is opaque to x-rays for easy location and adjustment.
Answer: True
Explanation: The Midband, an adjustable gastric band used outside of the United States, is opaque to x-rays, which facilitates its easy location and adjustment.
Wilkinson and Peloso were the first to place a non-adjustable band around the stomach in 1978, using a 2 cm Marlex mesh.
Answer: True
Explanation: In 1978, Wilkinson and Peloso were indeed the first to place a non-adjustable band, specifically a 2 cm Marlex mesh, around the upper part of the stomach using an open surgical procedure.
Silicone was identified as the preferred material for early gastric bands because it caused significantly more adhesions and tissue reactions than other materials.
Answer: False
Explanation: Silicone was identified as the preferred material for early gastric bands because it caused significantly fewer adhesions and tissue reactions compared to other materials, making it better tolerated.
Lubomyr Kuzmak is credited with reporting the clinical use of the 'adjustable silicone gastric band' (ASGB) via open surgery in 1986.
Answer: True
Explanation: Lubomyr Kuzmak, a Ukrainian surgeon, is credited with reporting the clinical use of the 'adjustable silicone gastric band' (ASGB) via open surgery in 1986.
The advent of surgical laparoscopy made the gastric band a less appealing option for obesity management due to its increased invasiveness.
Answer: False
Explanation: The advent of surgical laparoscopy transformed bariatric surgery by making the gastric band a more appealing option for obesity management due to its minimally invasive nature, leading to benefits like shorter hospital stays and faster recovery.
The first human laparoscopic implantation of the newly developed Lap-Band was performed in the United States in 1992.
Answer: False
Explanation: The first human laparoscopic implantation of the newly developed Lap-Band was performed on September 1, 1993, in Huy, Belgium, not in the United States in 1992.
A congressional investigation into lap-band safety was requested in 2012 due to concerns about patient deaths linked to specific clinics.
Answer: True
Explanation: In 2012, a congressional investigation into lap-band safety was requested by members of the U.S. Congress due to patient deaths that occurred after lap-band surgeries at clinics associated with the 1-800-GET-THIN advertising campaign.
Professor Chris Oliver had a LapBand that was successful and he never required further bariatric surgery.
Answer: False
Explanation: Professor Chris Oliver's LapBand ultimately failed, and he subsequently underwent gastric bypass surgery in 2020.
In what year did the FDA expand its approval for adjustable gastric bands to include patients with a BMI between 30 and 40 with weight-related medical conditions?
Answer: 2011
Explanation: The FDA expanded its approval for adjustable gastric bands in February 2011 to include patients with a BMI between 30 and 40, provided they have at least one weight-related medical condition.
Which adjustable gastric band is currently the only one approved by the FDA in the U.S. market?
Answer: The Lap-Band System
Explanation: The Lap-Band System is currently the only adjustable gastric band approved by the FDA in the U.S. market.
What is a distinguishing characteristic of the Midband, an adjustable gastric band used outside the United States?
Answer: It is opaque to x-rays for easy location and adjustment.
Explanation: The Midband, an adjustable gastric band used outside the United States, is opaque to x-rays, which allows for its easy location and adjustment.
What was the material used by Wilkinson and Peloso in 1978 for the first non-adjustable band around the stomach?
Answer: 2 cm Marlex mesh
Explanation: In 1978, Wilkinson and Peloso used a 2 cm Marlex mesh for the first non-adjustable band placed around the stomach.
Who is credited with reporting the clinical use of the 'adjustable silicone gastric band' (ASGB) via open surgery in 1986?
Answer: Lubomyr Kuzmak
Explanation: Lubomyr Kuzmak is credited with reporting the clinical use of the 'adjustable silicone gastric band' (ASGB) via open surgery in 1986.
Who was the first to apply an adjustable band using the laparoscopic approach in 1992?
Answer: Prof. Guy-Bernard Cadière
Explanation: Professor Guy-Bernard Cadière was the first to apply an adjustable band using the laparoscopic approach in 1992.
When and where was the first human laparoscopic implantation of the newly developed Lap-Band performed?
Answer: September 1, 1993, in Huy, Belgium
Explanation: The first human laparoscopic implantation of the newly developed Lap-Band was performed by Belachew and le Grand on September 1, 1993, in Huy, Belgium.
What prompted a congressional investigation into lap-band safety in 2012?
Answer: Patient deaths after lap-band surgeries at clinics associated with the 1-800-GET-THIN campaign.
Explanation: A congressional investigation into lap-band safety was prompted in 2012 by patient deaths that occurred after lap-band surgeries at clinics associated with the 1-800-GET-THIN advertising campaign in Southern California.