Bariatric Surgery Procedures & Techniques Flashcards

After sleeve gastrectomy, staple-line leaks most commonly occur at which location?

Answer: Proximal staple line near the angle of His

Most sleeve leaks occur at the proximal staple line near the angle of His, where pressure is high and blood supply is poorer.

Which postoperative finding is often the earliest warning sign of an anastomotic or staple-line leak?

Answer: Persistent tachycardia above 120 beats per minute

Sustained tachycardia is often the earliest and most sensitive sign of a leak in bariatric patients, even before fever or peritoneal signs.

Which pair of risk factors most strongly increases the risk of a marginal ulcer after RYGB?

Answer: Smoking and NSAID use

Smoking and NSAIDs are the main modifiable risk factors for marginal ulcers at the gastrojejunostomy.

A patient develops severe, medication-refractory GERD after sleeve gastrectomy. What is the most common surgical revision?

Answer: Conversion to Roux-en-Y gastric bypass

Converting to RYGB diverts acid and bile away from the esophagus and is the standard revision for refractory reflux after a sleeve.

What is the first-line treatment for a gastrojejunostomy stricture after RYGB?

Answer: Endoscopic balloon dilation

Most anastomotic strictures respond well to one or more endoscopic balloon dilations.

Candy cane syndrome after RYGB refers to which problem?

Answer: An overly long blind end of the Roux limb at the gastrojejunostomy

An excessively long blind afferent end of the Roux limb fills with food and causes pain, nausea, and regurgitation.

If a hiatal hernia is found during sleeve gastrectomy, what is the generally recommended approach?

Answer: Repair it during the same operation (cruroplasty)

Repairing a hiatal hernia during the sleeve is recommended to reduce postoperative reflux and the risk of sleeve migration.