Bariatric surgery in Calgary Canada
Bariatric surgery in Calgary section, includes general infrmation about Bariatric surgery Procedure, Bariatric surgery Calgary Local News, Bariatric surgery Calgary Surgeon Locator and other Bariatric surgery related material.
Bariatric surgery Procedure
Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
The term “bariatrics” refers to "weight medicine". Bariatrics generally deals with pharmacotherapy of obesity and with obesity surgery.
Overweight and obesity are strongly related to medical problems in today’s world. There are many health effects of obesity, such as heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, and others.
In addition to medical concerns regarding obesity, appearance (look) has a major relevance to weight and obesity.
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes.
Before someone can become a candidate for bariatric surgery, certain criteria must be met. The basic criteria are:
[1] An understanding of the operation and the lifestyle changes the patient will need to make;
[2] A body mass index (BMI) of 40 or more, which is about 45 kg (100 pounds) overweight for men and 35 kg (80 pounds) for women; or
[3] A BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).
Risks involved
Past studies found that 10 to 20 percent of bariatric surgery patients had complications while they were in the hospital. In 2006, federal researchers found that 39.6 percent of patients had complications within 180 days of surgery. The most common complications are:
[1] A composite of gastrointestinal symptoms including vomiting, diarrhea, dysphagia, and reflux (20%)
[2] Anastomotic leaking (at the surgical connections between the stomach and the intestine) (12%);
[3] Abdominal hernia (7%)
[4] Infections (6%).
About 7% of patients were re-admitted to the hospital within 6 months to treat complications specific to the bariatric procedure.
The in-hospital death rate in adults undergoing obesity surgery in 2003 was 0.2%.
Laparoscopic surgery has become an important addition to this field of surgery, and demand soars, amidst scientific and ethical questions.
Surgical procedures in bariatrics
There are a number of surgical options available to treat obesity, each with their advantages and pitfalls. In general, weight reduction can be accomplished, but one must consider operative risk (including mortality) and side effects. Usually, these procedures can be carried out safely.
The surgical procedures can be grouped in three main categories:
[1] Predominantly malabsorptive procedures: although also reducing stomach size, these operations are based mainly on diversion and bypass.
[2] Predominantly restrictive procedures: a surgery that primarily reduces stomach size: Vertical Banded Gastroplasty (Mason procedure, stomach stapling); Adjustable gastric band (or "Lap Band"); Sleeve gastrectomy.
[3] Mixed procedures: applying both techniques simultaneously: gastric bypass surgery, like Roux-en-Y gastric bypass; Sleeve gastrectomy with Duodenal Switch Implantable Gastric Stimulation.
Biliopancreatic diversion
A complex operation, also known as biliopancreatic diversion (BPD), or Scopinaro procedure.
This surgery is rare now because of problems with malnourishment. It has been replaced with the Duodenal Switch, also known as the BPD/DS. Part of the stomach is re-sected, creating a smaller stomach (however after a few months the patient can eat a completely free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. This results in around 2% of patients severe malabsorption and nutritional deficiency that requires restoration on the normal absorption.
The malabsorptive element of BPD is so potent that those who undergo the procedure must take vitamin and mineral supplements above and beyond that of the normal population. Those that do not run the risk of deficiency diseases such as anemia and osteoporosis.
Because gallstones are a common complication of rapid weight loss following any type of weight loss surgery, some surgeons may remove the gall bladder as a preventative measure during BPD. Others prefer to prescribe medication to reduce the risk of post-operative gallstones.
Far fewer surgeons perform BPD compared to other weight loss surgeries, in part because of the need for long-term nutritional follow-up and monitoring of BPD patients.
Vertical Banded Gastroplasty
a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.
The same effect can be created using a silicone band, which can be adjusted by addition or removal of saline through a port placed just under the skin. This operation can be performed laparoscopically, and is commonly referred to as a "lap band."
Adjustable Gastric Banding
The first lower pressure, wider, one-piece adjustable gastric band called the MIDband® was introduced in 2000. Unlike many of the early bands this was designed specifically for laparoscopic insertion.
Other Bariatric surgery Procedures
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More Calgary info...
Calgary By bus
Greyhound, [6]. The main terminal is located an unpleasant 1 km walk west of the edge of Downtown. However, there is excellent access from the station to the downtown C-Train stations via Calgary Transit.
Red Arrow, [7]. Provides service to several Alberta cities, including Edmonton, with a somewhat more accessible bus stop on 9th Ave at 1st St SE. -
Calgary By car
This is essentially the prairies; crossing the vast expanses in the comfort of your own vehicle is the main method of transportation. Calgary is just over an hour's drive East of Banff (on the Transcanada highway, #1), and about 3 hours South of Edmonton on highway #2. From the USA side, use the I-15 Fwy. Calgary is about 200 miles (320 km) north of the border. It is likely that you will want to rent a car to explore Calgary and its surroundings.
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Plastic Surgery News...
- As reported in this week's issue of New Scientist magazine, research by Rice University professor of political science John Alford indicates that what is on one's mind about politics may be influenced by how people are wired genetically.
- According to PharmaLive, the FDA has approved abatacept (Orencia®) for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in paediatric patients aged six years and above. It may be used as monotherapy or concomitantly with methotrexate (MTX), but should not be used concomitantly with tumour necrosis factor (TNF) antagonists or other biological therapy (e.g. anakinra).
This approval is based on the AWAKEN trial, which included 190 patients aged 6-17 years with moderately to severely active polyarticular JIA who had an inadequate response to one or more disease-modifying anti-rheumatic drugs (DMARDs). The first part was a 4-month, open-label lead-in phase in which patients received IV abatacept (10 mg/kg; maximum 1,000 mg) on Days 1, 15, 29 and every month thereafter. Those who achieved an ACR Pedi 30 response entered Period B - a six-month, double-blind phase involving randomisation to remain on abatacept (n=60) or to receive placebo (n=62) for six months. The primary endpoint of the study was time to occurrence of disease flare.
The main findings were as follows:
• In the lead-in phase, abatacept treatment resulted in a consistent improvement in ACR Pedi 30 across all JIA subtypes (oligoarticular extended - 59.3%; polyarticular-RF positive - 68.4%; polyarticular-RF negative - 64.3%; and systemic JIA with polyarticular course - 64.9%)
• The time to occurrence of disease flare was statistically significantly longer in patients treated with abatacept compared to patients treated with placebo compared with abatacept (p=0.0002) [no specific details given on magnitude of this difference]
• Patients treated with abatacept experienced fewer disease flares compared to placebo-treated patients (20% versus 53%, respectively, p<0.001)
• The risk of disease flare among patients continuing on abatacept was less than that for patients who withdrew from abatacept treatment (HR 0.31, 95% CI 0.16 to 0.59)
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