9.2 bariatic surgicla procedures + stoma

bariatric surgery is recommended for:

• Adults with a BMI ≥ 40 kg/m² or those with a BMI ≥ 35 kg/m² with associated health conditions (e.g., type 2 diabetes, hypertension).

• Children and adolescents with severe obesity, but only in exceptional circumstances within specialist centers and after comprehensive assessment.

bariatic surgeries

• gastric bypass

• sleeve gastectomy

• addjustable gastric band

• biliopancreatic diversion and duodenal switch

gastric bypass

Reduces stomach size and reroutes part of the small intestine, limiting food intake and absorption.

sleeve gastrectomy

Removes a portion of the stomach to limit food intake.

adjustable gastric band

Places a band around the stomach to create a smaller upper pouch, limiting food intake.

Biliopancreatic Diversion with Duodenal Switch

• Combines stomach size reduction with significant malabsorption by rerouting intestines.

stomas

sugically created opening on the surface of the abdomen to divert the flow of bolidy waste, faeces/ urine

stomas are used in severla clinical conditions

bowel cancer

crohns disease

diverticulitis

types of stoma

colostomy

ileostomy

urostomy

colostomy

Diverts the large intestine (colon) to the abdominal surface. Commonly used for colon cancer, diverticulitis, or trauma.

ileosotmy

Diverts the small intestine (ileum) to the abdominal surface. Used for conditions like Crohn’s disease or ulcerative colitis.

urrostomy

Diverts urine from the urinary tract to the abdominal surface, often after bladder surgery.

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stoma bag is used to colelct waste after the surgical procedure to form the somta

stoma care nurses are specialised to support sotma patients with ongoing care, education and appliance use and psychologicla support

As part of preoperative and postoperative care stoma formation is discussed with patients as part of their treatment plan

including psychological preparation, physical care, and lifestyle adjustments.

It is important for the healthcare team to provide patients with proper stoma education,

including diet modifications, care of stoma appliances, and recognizing complications like infections or blockages.

ome of the common interventions for stoma cure nurses include: 

• Demonstrate how to clean the area and change the stoma appliance. Ensure the patient has a proper seal to avoid leaks.

• Patients may need to adjust their diet to avoid foods that cause excessive gas, blockages, or diarrhoea (especially in ileostomy patients).

• Encourage adequate hydration, especially for ileostomy patients, to prevent dehydration due to increased fluid loss.

Pharmacists may be involved in answering questions about how medicines may impact on a patient with a stoma.

• The absorption of certain medications, especially those absorbed in the colon, may be altered for patients with an ileostomy or colostomy.

•  Medicines such as loperamide may be used to thicken stool consistency for patients with ileostomies.

further reading