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Bariatric Surgery Glossary

ABS

ABS

Also known as the American Board of Surgeons, they offer certification to surgeons who meet a specific set of standards of knowledge, training and education in bariatric surgery.

Absorption

Absorption

This is a portion of the digestive process where digested food is absorbed into the lower part of the small intestine into the bloodstream. This is where the body gets the nutrients and energy it needs in order to work properly.

Adipocytes

Adipocytes

They are cells that specialize in storing fat in the body. They are often found within the connective tissue in the body. These remain in the body even after significant weight loss. They may gain or lose fat content and if the body reaches its capacity for fat in the body, it will allow additional fat to be stored.

Adipose

Adipose

This means fatty or having to do with fat. This type of material is important to understand when one is seeking to lose a large amount of weight.

Adjustable Gastric Banding

Adjustable Gastric Banding

This bariatric surgical procedure is achieved with a band made of a special material that is placed around the upper portion of the stomach. During this placement, a small pouch is created along with a narrow passage for the rest of the stomach to remain in. This band can be tightened or loosened (adjusted) to change the size of the passageway for each patient. This can also be referred to as adjustable Lap band surgery.

Alimentary limb

Alimentary limb

This is used in a Roux-en-Y gastric bypass surgery as well as other weight loss surgeries that use the Roux-en-Y protocol. It is the length of the small intestine that extends from the gastric pouch made during surgery to the Y-junction. This junction leads to the common channel and is where ingested food travels from the pouch all the way to the distal intestine.

American Society for Metabolic Bariatric Surgery

American Society for Metabolic Bariatric Surgery

Also known as the ASMBS, this organization is dedicated to bariatric surgeries and obesity-related diseases. They hope to improve the public’s health and their members follow strict standards set in place in terms of education, training and knowledge of these topics.

Anastomosis

Anastomosis

This is a connection of two hollow organs or even parts of them during surgery. This process allows the lumina or cavities to open up to each other and flow continuously. This can occur when a part of the stomach or gastro and a portion of the small intestine or the jejunum provide an opening between the cavities for each other so that food flows freely.

Anesthesia

Anesthesia

Total or partial loss of sensation; often given to patients before surgery to allow them to use partial or total consciousness during a surgical procedure.

Band fill

Band fill

Also known as a LAP-BAND fill, this is a process where the adjustable gastric band installed in the body is adjusted. A doctor will decide on how many CCs a patient will receive at each visit after their surgery takes place. This will occur until the patient feels the most comfortable, whether by un-filling or adding more to the band.

Bariatrics

Bariatrics

This is a branch of medicine that deals specifically with the causes of, prevention and treatment of obesity.

Bariatric Surgeon

Bariatric Surgeon

This is a doctor that specializes in all diseases and illness related to obesity (having a body mass index of 30 or more).

Bariatric Surgery

Bariatric Surgery

Also known as weight loss surgery, this is a discipline of surgery that works with surgical procedures that can lead to weight loss. Generally these types of procedures restrict the patient’s ability to eat as well as the malabsorption of nutrients, or a combination of both.

Biliopancreatic diversion

Biliopancreatic diversion

This is a bariatric surgical operation that is considered a malabsorptive operation. It focuses on modest restrictions. During the procedure, the stomach is reduced to only 200-500 ml pouch. This is achieved after a portion of the distal portion of the stomach is removed. The small intestine is also divided into an alimentary limb and a biliopancreatic limb. Ultimately during this operation the intestinal tract is reconstructed to create a common channel for absorption of both fat and protein.

Body Contouring

Body Contouring

Also known as body shaping, body reshaping or a body lift, this is a group of plastic surgery procedures that can be performed after extreme massive weight loss. It is done to manage any hanging excess skin on the body. Doctors suggest that patients have reached a stable weight before this procedure is administered. Patients should also be in good health and not planning on conceiving after this procedure.

Body Lift Surgery

Body Lift Surgery

Body lift surgery works to both improve the shape and tone of underlying tissue in the body that supports the fat and skin. It is often done after extreme weight loss occurs.

Body Mass Index (BMI)

Body Mass Index (BMI)

This calculation determines the body mass index. This is achieved by multiplying the weight in pounds by 703 and dividing it by the squared number of the height in inches. What results is the body mass index with any number under 18.5 as underweight, normal from 18.5 to less than 25, overweight from 25 to less than 30, obese from 30 to less than 35, obesity class II from 35 to less than 40, obesity class III from 40 and above.

Bougie

Bougie

A bougie is a long tube that slides down the esophagus during surgery that a surgeon uses as a guide for measurement reasons when stapling a large part of the stomach and making a gastric sleeve.

Calcium

Calcium

The body needs this mineral in order to maintain strong bones and to function properly. Calcium is responsible for supporting the hardness and structure of the bones and the teeth. It is also needed for the muscles to move, nerves to carry messages to the brain and helps blood vessels to move blood throughout the body.

Calorie

Calorie

Calories mean energy for the body. 1 ounce of carbohydrates or protein contains 4 calories and 1 ounce of fat contains 9 calories. This is why low-calorie diets stay away from fats in order to decrease calorie intake and produce weight loss.

Cardiovascular

Cardiovascular

Having to do with the heart and blood vessels.

Certificate of Coverage

Certificate of Coverage

This is a document that a health insurance company provides that describes the policy and the requirements in term of eligibility, deductibles and other important variables associated with procedures, such as bariatric surgery.

Cholesterol

Cholesterol

Cholesterol is vital for normal body function. It is a lipid or fat that is produced by the liver. Too much of bad cholesterol in the body can be dangerous, so it’s important that cholesterol is tested periodically to ensure the body is functioning properly.

Ultimately, your blood cholesterol level influences the chance that one may get heart disease in the future as it is one of the major risk factors associated with the condition.

Clinically Severe Obesity

Clinically Severe Obesity

This is classified by a body mass index of over 40 or more or 100 pounds or more over an ideal body weight. This can be life-threatening and is also known as morbid obesity.

Co-Morbid

Co-Morbid

Related illnesses or disabling medical conditions that are related to clinically severe obesity or other obesity-related health conditions.

Colon

Colon

This organ begins at the large intestine that begins at the end of the small intestine and leads all the way into the end of the rectum.

Complications/Risks

Complications/Risks

This refers to any issues that may arise as a result of having bariatric surgical procedures. Surgeons will discuss these with patients prior to having a surgical procedure.

Contraindications

Contraindications

These refer to any symptom or situation that may be deemed inappropriate for an otherwise recommended treatment such as alcoholism or depression.

Criteria

Criteria

This determines what is right for a bariatric surgical procedure. Typically this is decided upon by an accrediting agency such as ABS or ASMBS.

Digestion

Digestion

This refers to the process where food is broken down by the stomach and upper small intestine into an easily absorbed form that continues down the tract to exit the body. Proper digestion is important for weight loss and optimal health.

Dilation

Dilation

This is the process in which a passage is opening or enlarging. This is also known as anastomosis (see definition above).

Disease

Disease

This is a process which can be hazardous to one’s health and must be treated in order for optimal health to occur.

Duodenum

Duodenum

This is the first 12 inches of the small intestine found immediately below the stomach. This is where both pancreatic fluids and bile flow into the duodenum through the liver and pancreas ducts.

Duodenal Switch Surgery

Duodenal Switch Surgery

Also known as biliopancreatic diversion with a duodenal switch, this weight loss procedure uses both malabsorptive and restrictive methods. The malabsorption in this surgery is more significant than gastric bypass. This procedure reduces the size of the stomach to a tube (sleeve) of just 100 to 150 mL. The duodenum (see definition above) is also divided where an alimentary and biliopancreatic limb are created. The alimentary one is brought up and connected to the duodenum and to the stomach tube while the biliopancreatic one is attached to the distal intestine to form a channel that flows freely to the colon.

Dumping Syndrome

Dumping Syndrome

This is a group of symptoms that result in the quick dumping of food directly into the small intestine. This is common in gastric bypass patients after their liquid diet that can be full of refined sugars (glucose). This can occur after a meal and can make a patient feel flushed, extremely weak, lightheaded or have diarrhea. Another form or delayed dumping can occur an hour or later after. Many believe this is directly related to hypoglycemia.

Gallbladder

Gallbladder

The gallbladder (biliary vesicle) is a small organ that sits just under the liver. The gallbladder stores bile produced by the liver before it is released into the small intestine.

Gastric

Gastric

Having to do with the stomach.

Gastric Balloon Surgery

Gastric Balloon Surgery

This surgery involved installing a balloon inside the stomach that will help to create short-term, rapid weight loss. This soft and expandable silicone balloon is placed with a camera that enters through the mouth travelling to the stomach. Once it is inserted into the stomach, it is filled with a sterile saline solution. This procedure does not give a patient much discomfort unlike some of the other bariatric surgery procedures. The balloon itself is fitted and is removed under mild sedative after 6-9 months.

Gastric Bypass Surgery

Gastric Bypass Surgery

This type of weight loss surgery involves stapling or dividing the stomach into a pouch to separate it away from the rest of the stomach. The intestine is also divided (attached to the pouch) and then is re-arranged into a Y-shape (roux-en-y). What results is the majority of the stomach and the upper part of the small intestine are both bypassed, which makes the patient feel full faster and leading to great weight loss.

Gastroesophageal reflux or GERD

Gastroesophageal reflux or GERD

This condition occurs when the stomach contents leak backwards from the stomach back into the esophagus. This can cause irritation, whether heartburn or other uncomfortable symptoms. This is especially common in obese patients.

Gastrointestinal

Gastrointestinal

Having to do with either the stomach or the intestine.

Gastrojejunostomy Anastomosis

Gastrojejunostomy Anastomosis

This surgical procedure occurs when anastomosis is created between the stomach and the jejunum loop. This is done in order to drain the stomach contents and to create a bypass for gastric contents. This can be done either open or laparoscopically.

Gastroplasty

Gastroplasty

Also known as stomach stapling or vertical banded gastroplasty, this weight loss operation is a restrictive procedure which reduces and limits the amount of food intake. This is different than gastric bypass which reducing the absorption of calories. It does not affect the normal digestive process and nutritional deficiencies are not common with this procedure unlike gastric bypass surgery.

Stomach stapling occurs when the upper part of the stomach is vertically stapled into a small pouch containing only 20-30 mL. At the lower end of this new pouch, a band or mesh is placed to prevent this outlet from getting any wider. This pouch helps to restrict the amount of food that can be eaten at one time because of the food’s ability to pass slowly into the rest of the stomach. This helps patients feel full longer.

Gastric Pouch

Gastric Pouch

This pouch is made in the uppermost portion of the stomach, but remains attached to the esophagus. It works to limit the amount of food that can be ingested. It is successful in weight loss as it helps with portion control.

Gastric Sleeve Surgery

Gastric Sleeve Surgery

Also known as sleeve gastrectomy, this surgical weight loss procedure works by reducing the size by about 25% of its original size. This is achieved by removing the large portion of the stomach creating a sleeve or tube-like piece. This procedure is typically done laparoscopically and is irreversible. It can also be done as a part of a two-stage gastric bypass surgery on extremely obese patients.

Gastric Sleeve Plication Surgery

Gastric Sleeve Plication Surgery

This restrictive surgical procedure folds the stomach in order to reduce its size. This procedure can be reversed or turned into another weight loss procedure, if needed. It helps to restrict the amount of food ingested versus gastric bypass which uses malabsorption to help patients lose weight.

Genetic

Genetic

Of relating to the genes or heredity; many experts believe that obesity can be genetic.

Ghrelin

Ghrelin

This gastrointestinal hormone or hunger hormone is found in the stomach. Experts have shown a role of this hormone in regulation of the appetite. It is especially important in those seeking to lose a large amount of weight.

Glucose

Glucose

This is an important energy source and is a carbohydrate. It is the most important simple sugar involved with metabolism. It is needed for all the cells and organs of the body including the muscles and the brain.

Heart Disease

Heart Disease

This describes a range of diseases which affect the heart including arrhythmias, heart infections or defects or blood vessel diseases. Obesity is a risk factor for this cardiovascular disease which can lead to increased risk of heart attack or stroke.

Hernia

Hernia

This is a weakness found in the abdominal wall that results in a bulge.

High Cholesterol

High Cholesterol

When there is a buildup on the walls of the arteries, they can become narrow and blood flow to the heart can be slowed or blocked. This condition greatly increases the risk of heart attack. Oftentimes the condition does not cause symptoms, so being checked regularly is important. If one is obese and has high cholesterol, they double their chance of heart disease.

Hyperosmolality

Hyperosmolality

This involves having highly concentrated things elements that can cause dumping syndrome symptoms in weight loss surgery patients.

Hypertension

Hypertension

Also known as high blood pressure, a poor diet or high-salt diet and lack of physical activity can contribute to this condition. These things also contribute to obesity in patients too.

Ileum

Ileum

This is approximately 10 feet of small intestine that handle absorption of foods, nutrients and minerals in the body.

Insulin

Insulin

This hormone is important in metabolism and using energy in the body from nutrients that have been ingested. Without proper insulin in the body, metabolism is slowed and weight gain can occur. Insulin is responsible for preventing fat utilization as energy in the body. When insulin is absent in the body, it begins to use fat instead as energy. Insulin is also responsible for controlling many body systems and to regulate amino acid uptake in body cells.

Insulin Resistance

Insulin Resistance

This is a medical condition where the body produces insulin, but doesn’t use it properly. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells. This can lead to prediabetes or Type II Diabetes. Most do not know they have it until they already have developed Type II Diabetes.

Jejunum

Jejunum

This is the 10 feet of the small intestine that is responsible for digestion.

Laparoscopy

Laparoscopy

This is an inside of the abdominal cavity using a laparoscope or tube that has a camera on its end. This often occurs while a patient is under anesthesia and allow for a clear visual field when exploring a patient’s internal organs and workings.

Laparoscopic Surgery

Laparoscopic Surgery

This is a surgical procedure that uses a tube (laparoscope) to perform a procedure. This is common for Gastric Bypass (Roux en Y gastric bypass) or Laparoscopic Adjustable Gastric Banding (LAP-BAND) surgeries.

Lower Body Lift

Lower Body Lift

This type of plastic surgical procedure involves an abdominoplasty as well as a thigh and butt lift. It requires a large incision around the waist in order to lift the lower body.

Malabsorptive Surgery

Malabsorptive Surgery

This type of weight loss surgery focuses on bypassing a portion of the small intestine. This organ is responsible for the absorption of nutrients. By bypassing, it helps patients lose weight. Procedures that use this type of process are gastric bypass surgery, and biliopancreatic diversion.

Metabolic Syndrome

Metabolic Syndrome

This is known as a group of risk factors that raise one’s risk of diabetes, stroke or heart disease. Metabolic refers to the biochemical process that is involved with the body’s normal functioning. Being overweight or obese greatly contributes to this as excess fat in the stomach area contributes to a greater risk factor for heart disease, especially in women.

Metabolism

Metabolism

This describes chemical reactions in the body that are involved with breaking down molecules for obtaining energy and the synthesis of compounds needed by cells. This is closely related to nutrition and the availability of nutrients in the body. This is closely related to weight gain and weight loss in the body.

Minimally Invasive

Minimally Invasive

This type of surgical procedure uses small incisions on the abdomen. This also can include a laparoscopic surgery with faster recovery, small scars and less pain.

Morbid

Morbid

This has to do with illness, disease and higher risk of death.

Morbid Obesity

Morbid Obesity

This is associated with being 100 pounds or more overweight. Others use a body mass index of 40 or above to classify this disease. Morbid contributes to the higher likelihood of comorbidities.

Mortality

Mortality

Having to do with death.

NIH Surgical Criteria

NIH Surgical Criteria

The National Institutes of Health (NIH) uses requirements that determine whether or not weight loss surgery is the right treatment option for the patient. These requirements include: 100 pounds or more above ideal body weight or a BMI of 40 or more or a BMI of 35 or more with one obesity-related medical condition.

Obesity

Obesity

This is known as having excessive weight or extra adipose tissue that can increase one’s risk of heart attack, diabetes and stroke.

Obstructions

Obstructions

These are referred to as the narrowing of anastomosis (see definition above) or a portion of the gastrointestinal (GI) tract that helps to slow down the normal passage of food or waste.

Pancreas

Pancreas

The pancreas is a glandular organ located deep in the abdomen, connected to the duodenum. The pancreas has two functions endocrine and exocrine. It’s endocrine function is to produce several important hormones, including insulin (that regulates blood sugar) into the bloodstream. It’s exocrine function is to produce pancreatic juice containing digestive enzymes to breaks down carbohydrates or starches, protein and fats in the small intestine.

Panniculectomy Surgery

Panniculectomy Surgery

This plastic surgery procedure involves surgically removing the pannus or excess skin and adipose tissue that looks like an apron over the genitals or thighs. This excess tissue can make hygiene difficult. This is different than an abdominoplasty because it only removes this apron of skin. No tightening of muscles occurs with this procedure.

Percent of Excess Weight Loss

Percent of Excess Weight Loss

This is the number that evaluates a patient’s weight loss over a specific period of time. This number is calculated by dividing weight loss by ideal weight and multiplying it by 100.

Port

Port

This is a medical appliance that is installed beneath the skin.

Post-Op Diet

Post-Op Diet

This is a specific diet that is followed after bariatric surgery. Depending on the surgery, there is a variety of stages most often starting with liquids, soft foods and later to solid foods.

Pouch

Pouch

This is a portion of the stomach that is created during a bariatric surgery procedure that will help limit food intake and promotes weight loss.

Pulmonary

Pulmonary

Having to do with the lungs.

Restrictive surgery

Restrictive surgery

During these procedures the capacity of stomach is decreased. A section of your stomach is removed, reduced or closed, which limits the amount of food it can hold and causes an individual to feel full faster.  This procedure does not interfere with the normal absorption (digestion) of food.

Examples of Restrictive Procedures: Gastric Banding, Gastric Plication, Gastric Sleeve, etc.

Revisional Surgery

Revisional Surgery

This surgical procedure is done on patients who have already had a bariatric surgery before. This often occurs in patients who either had complications from that surgery or didn’t have significant weight loss from their first surgery. Most of these surgeries are performed laparoscopically. Revisional surgeries can happen as a result of adjustable gastric banding, roux-en-y gastric bypass or sleeve gastrectomy (gastric sleeve) surgeries.

Roux-En-Y Gastric Bypass

Roux-En-Y Gastric Bypass

Sleeve Gastrectomy Surgery

Sleeve Gastrectomy Surgery

Staples

Staples

These are surgically sterile medical devices that connect tissues.

Strictures

Strictures

This refers to the narrowing of a section of the intestine that is often related to ulcers or scars.

Tummy Tuck

Tummy Tuck

This is a plastic surgery procedure that flattens the abdomen and removes any excess fat or skin by tightening the muscles in the abdominal wall.

Type 2 Diabetes

Type 2 Diabetes

This medical condition is often caused by an abnormal level of sugar or glucose in the blood. Also known as hyperglycemia, if one has this disease their body does not use insulin properly (insulin resistance). Obesity is a leading cause of developing Type 2 Diabetes in adults.

Vertical Banded Gastroplasty

Vertical Banded Gastroplasty

This restrictive surgical operation also known as stomach staples uses both a band and staples in order to create a small pouch in the stomach. At the bottom of this pouch, there is a one centimeter hole where the pouch contents can flow freely into the rest of the stomach and gastrointestinal tract. Stomach stapling is often used in order to manage obesity. This pouch helps to limit the amount of food that a patient can eat at one time.

Vertical Sleeve Gastrectomy

Vertical Sleeve Gastrectomy