Taking obesity and metabolic health further, together.
Our diverse portfolio of innovative, high-quality products and reliable therapies means that when a patient comes to your ASC, you can choose the right product or therapy for the patient at the right time.
Below are products and services designed for bariatric procedures that are available to assist your ASC.
The sleeve gastrectomy (SG) procedure was first published as an initial stage of biliopancreatic diversion (BPD) with a duodenal switch (BPD-DS).1 SG was considered as a standalone procedure after it was noted that a number of patients that had undergone this initial stage of BPD had lost sufficient weight that further surgery was not required.1 In SG a section of the stomach is removed to leave a sleeve-like tube. The reduced stomach size results in earlier onset of satiety and reduced caloric intake. Data suggest that resolution of co-morbidities is independent of weight loss, and therefore that the metabolic effects of SG are crucial in improving long-term outcomes.2
Roux-en-Y gastric bypass (RYGB) is the most common choice in bariatric surgery.1,3,4,5,6 During the RYGB procedure, the size of stomach is reduced by stapling across the upper section and then the proximal and distal sections of the stomach are physically separated. This part of the operation reduces the amount of food that can be ingested at meal times. The new stomach pouch is then attached directly to the small intestine via a Roux limb. By bypassing the majority of the stomach and parts of the small intestine, digestion and nutrient absorption are reduced.7-8 This bypass also results in food entering the jejunum almost immediately after ingestion, which can lead to symptoms including pain and nausea.7-8 So called dumping syndrome is usually linked to ingestion of energy-dense foods and it has become an expected and desired part of the behavior modification after surgery, as it may help deter patients from consuming unhealthy foods.7
Adjustable gastric banding is the least invasive bariatric procedure and is more commonly performed in older patients or those with lower severity obesity.2 The procedure is generally carried out using laparoscopic techniques and is unique as a bariatric procedure in that it can be easily reversed. In this procedure, a band is placed around the upper part of the stomach and connected to an access port positioned just beneath the skin. By adding or removing saline solution via the port, the band can be inflated or deflated to decrease or increase, respectively, the rate at which food passes into the rest of the stomach. Decreasing the rate of passage results in a faster onset of satiety and reduced caloric intake, and changes in gut hormones also result in improved outcomes.2
Randomized controlled trials suggest compared to routine care, titrating anesthetic depth during TIVA using processed electroencephalography (pEEG) can reduce the amount of IV anesthesia used.9 The BIS™ monitoring system offers meaningful information you need to individualize and optimize anesthetic dosage — for the best possible outcome.10View more information
The next generation McGRATH™ MAC video laryngoscope features enhanced optics and is durable for routine use — so your first attempt is your best. Add McGRATH™ to your ASC to make your first attempt your best.View more information
PATIENT ENGAGEMENT RESOURCES
TAKE A STAND AGAINST OBESITY
The most common adverse events experienced during clinical studies include pain at implant sites, new pain, lead migration, infection, technical or device problems, adverse change in bowel or voiding function, and undesirable stimulation or sensations. Any of these may require additional surgery or cause return of symptoms.
Medical necessity will dictate site of service for each individual patient. Physicians should confirm inpatient or outpatient admission criteria before selecting site of service.
Madura JA 2nd, Dibaise JK. Quick fix or long-term cure? Pros and cons of bariatric surgery. F1000 Med Rep. 2012;4:19.
Golomb I, Ben David M, Glass A, Kolitz T, Keidar A. Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy. JAMA Surg. 2015;150(11):1051-7.
Nguyen NT, Nguyen B, Gebhart A, Hohmann S. Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252-7.
Crémieux PY, Ledoux S, Clerici C, Cremieux F, Buessing M. The impact of bariatric surgery on comorbidities and medication use among obese patients. Obes Surg. 2010;20(7):861-70.
Hinojosa MW, Varela JE, Parikh D, Smith BR, Nguyen XM, Nguyen NT. National trends in use and outcome of laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2009;5(2):150-5.
Inabnet WB 3rd, Winegar DA, Sherif B, Sarr MG. Early outcomes of bariatric surgery in patients with metabolic syndrome: an analysis of the bariatric outcomes longitudinal database. J Am Coll Surg. 2012;214(4):550-6;
Banerjee A, Ding Y, Mikami DJ, Needleman BJ. The role of dumping syndrome in weight loss after gastric bypass surgery. Surg Endosc. 2013;27(5):1573-8.
Machella TE. The Mechanism of the Post-gastrectomy "Dumping" Syndrome. Ann Surg. 1949;130(2):145-59.
Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology. 1997;87(4):808–815.
Luginbühl M, Wüthrich S, Petersen-Felix S, Zbinden AM, Schnider TW. Different benefit of bispectral index (BIS) in desflurane and propofol anesthesia. Acta Anaesthesiol Scand. 2003;47(2):165–173.