gastric band adjustment
Post on 19-Oct-2014
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Gastric Band AdjustmentCase Study
31/10/2009
Done by: Shatha Jamal Al-MushaytPresented for: Dr. Abdullah Al-Huwaimel
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Patient information
Gender: Female Age: 29 years old Nationality: Saudi Professional diagnosis: Morbid Obesity Patient history: Gastric band surgery 5
years ago Exam type: Gastric Band Adjustment
she could not reach the required weight..(still obese)
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Contrast Media (CM)
Type: Barium sulfate -340 g
Preparation of CM: mixed with water Poured in a cup To be Swallowed by mouth
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Patient preparation
Patient had nothing by mouth for 4 hours before exam
No pregnancy the patient was free of any
object that may superimpose interested anatomic part under x-ray
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Procedure Equipment
Fluoroscopic unit Cotton pads Antiseptic fluid Needle & syringe Saline Pen marker Gastric band existed inside the
patient body
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Gastric Band System
Gastric band (silicone ring)
tube
access port
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How was Gastric band inserted by surgeon?
The band was inserted around the upper part of the stomach
The access port was placed just under the skin
The tube connect between them
>> See image
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Inserted Gastric Band
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Inserted Gastric Band
Inserted band forms a small stomach pouch less food is stored in the stomach, feel full sooner
Band size is controlled by Injection or withdrawn of Saline.
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Inserted Gastric Band
The inner surface of the band ring is a balloon-like
Injection to tighten the band Withdrawn to loose the band
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Procedure’s Steps
Patient was lying down on the x-ray table
Palin radiograph was taken: AP supine, KV: 96
Table then was tilted up to 44 degrees –fowler's position
(to prevent the normal reflux while CM drinking)
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- The radiologist located the access port under x-ray & marked it- he sterilized the place by antiseptic cotton pad and inserted the needle into the port
Procedure’s Steps
The needle
“Plain film of this case patient”
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Procedure’s Steps
the patient was instructed to collect the Barium sulfate in her mouth and swallow it at once
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Procedure’s Steps
In this case, Saline was injected by the syringe & needle to tight the band
Remember ! “she could not reach the required weight..(still obese) “
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Procedure’s Steps
The tight level depends on the patient’s comfort, displayed image and radiologist’s
opinion
End of the procedure
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Result(finding)
About 2 ml of saline was infused into the band
Re-evaluation after adjustment shows: Passage of contrast to the stomach
and Satisfaction of the patient
Dictating doctor, Dima JamjoomSigning and approving doctor, Al bager Naser Elbagir Nasir
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After Care
Since the patient was satisfied with the band size while swallowing, she could go home.
It was recommend to have a smooth meal the day of procedure
The following day, must be able to eat normally
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My Comment
Patient felt little pain while inserting the needle. So, I wondered why did they not use local anesthesia to numb the skin?!
The procedure wasinteresting.
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Morbid Obesity
Obesity is an abnormal accumulation of fat.
20-40% over the ideal weight mild obesity 40-100%moderate obesity 100% morbid obesity
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Morbid Obesity
Obesity considered morbid when it significantly increases the risk of obesity-related health conditions or serious diseases
It is considered serious “chronic” disease: symptoms occur slowly over long period of time
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Obesity In General
Is one of the most serious public health issues of the 21st century
Is a leading cause of death worldwide with increasing prevalence in adults and kids;
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Causes
Most commonly caused by a combination of:1. excessive dietary calories, 2. lack of physical activity
If a person eats more calories than he/she burns ,the person gains weight as the body stores the excess energy as fat
Other causes: A. genetic susceptibilityB. medical reasons. e.g. hypothyroidismC. psychiatric illness
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Symptoms & Obesity-Related Health Conditions
Major symptoms: Excessive weight gain & the large amounts of fatty
tissue
Obesity-Related Health Conditions: Hypertension Type II Diabetes Hypercholesterolemia Decreased fertility & pregnancy complications Gallstones Sleeping disorders etc.
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Treatment
Obesity is difficult to treat & weight may be regained.
Diet, exercises are primary treatments
Surgeries for sever cases
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Hope You Like It ! Thank You
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Reference
http://www.urmc.rochester.edu/hh/services-centers/bariatrics/morbid-obesity.cfm
http://medicaldictionary.thefreedictionary.com/Obesity%2c+morbid
http://en.wikipedia.org/wiki/Obesity#Causes
http://www.medicinenet.com/obesity_weight_loss/article.htm