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Obesity is a condition that affects over 30% of adults in the United States and is associated with comorbidities such as type 2 diabetes mellitus, heart disease, and cancer. For individuals with clinically severe obesity, defined as having a body mass index above 40 kg/m², lifestyle interventions may produce insufficient weight reduction. Weight loss surgery, such as Roux-en-Y gastric bypass (RYGB) , has proved to be the most effective clinical intervention for facilitating massive and immediate weight loss in clinically obese patients.In RYGB, the stomach is first divided into a small gastric pouch and a distal gastric remnant, which remains attached to the duodenum. Next, the jejunum is transected and its lower section is connected to the newly created gastric pouch to form the alimentary limb. This connection is typically created with surgical staples. The formation of the alimentary limb allows ingested food to bypass the region composed of the distal gastric remnant, the duodenum, and the upper jejunum; collectively termed the biliopancreatic limb. Finally, the lumen of the upper jejunum is reconnected to the lumen of the lower jejunum to allow enzymes and compounds to flow freely from the biliopancreatic limb into the alimentary limb.
Figure 1 RYGB surgically divides the digestive tract into the alimentary limb and the biliopancreatic limb, which then merge into the common limb.RYGB facilitates weight loss by reducing the functional volume of the stomach and altering intestinal anatomy to induce nutrient malabsorption. However, the procedure is associated with several complications, such as steatorrhea, or fatty stools, due to disruption of lipid digestion. Animal studies also suggest that RYGB promotes the growth of weight loss-inducing gut bacteria. Researchers have found that transplanting gut microbiota of obese postoperative RYGB mice into nonoperated, obese mice lacking gut flora may reproduce the therapeutic effects of RYGB in transplant-recipient mice.
Adapted from Bächler T, Le roux CW, Bueter M. How do patients' clinical phenotype and the physiological mechanisms of the operations impact the choice of bariatric procedure?. Clin Exp Gastroenterol. 2016;9:181-9.
-A staple line leak is an unanticipated opening of surgical staples at an incision. In RYGB, a staple line leak at the junction of the biliopancreatic limb and the alimentary limb would cause gastrointestinal tract contents to enter:

Question

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Obesity is a condition that affects over 30% of adults in the United States and is associated with comorbidities such as type 2 diabetes mellitus, heart disease, and cancer. For individuals with clinically severe obesity, defined as having a body mass index above 40 kg/m², lifestyle interventions may produce insufficient weight reduction. Weight loss surgery, such as Roux-en-Y gastric bypass (RYGB) , has proved to be the most effective clinical intervention for facilitating massive and immediate weight loss in clinically obese patients.In RYGB, the stomach is first divided into a small gastric pouch and a distal gastric remnant, which remains attached to the duodenum. Next, the jejunum is transected and its lower section is connected to the newly created gastric pouch to form the alimentary limb. This connection is typically created with surgical staples. The formation of the alimentary limb allows ingested food to bypass the region composed of the distal gastric remnant, the duodenum, and the upper jejunum; collectively termed the biliopancreatic limb. Finally, the lumen of the upper jejunum is reconnected to the lumen of the lower jejunum to allow enzymes and compounds to flow freely from the biliopancreatic limb into the alimentary limb.

Figure 1 RYGB surgically divides the digestive tract into the alimentary limb and the biliopancreatic limb, which then merge into the common limb.RYGB facilitates weight loss by reducing the functional volume of the stomach and altering intestinal anatomy to induce nutrient malabsorption. However, the procedure is associated with several complications, such as steatorrhea, or fatty stools, due to disruption of lipid digestion. Animal studies also suggest that RYGB promotes the growth of weight loss-inducing gut bacteria. Researchers have found that transplanting gut microbiota of obese postoperative RYGB mice into nonoperated, obese mice lacking gut flora may reproduce the therapeutic effects of RYGB in transplant-recipient mice.
Adapted from Bächler T, Le roux CW, Bueter M. How do patients' clinical phenotype and the physiological mechanisms of the operations impact the choice of bariatric procedure?. Clin Exp Gastroenterol. 2016;9:181-9.
-A staple line leak is an unanticipated opening of surgical staples at an incision. In RYGB, a staple line leak at the junction of the biliopancreatic limb and the alimentary limb would cause gastrointestinal tract contents to enter:

Quizplus · Accepted Answer

11ecba2d_0fa4_4092_a3bf_6d7a123de294_MD0008_00 The peritoneum is composed of two tissue membranes that line the abdomen: the parietal layer, which lines the abdominal wall, and the visceral layer, which covers the abdominal organs. The peritoneal cavity is a potential space (ie, an area between two adjacent structures that may press together) between the parietal and visceral layers of the peritoneum. The peritoneal cavity is found within the abdomen and contains organs such as the liver, stomach, and intestines. Based on the given scenario, a staple line leak at the junction of the biliopancreatic limb and the alimentary limb would allow gastrointestinal (GI) tract contents to enter the peritoneal cavity. (Choice A) Contents of the GI tract would not leak into the perineum, as the perineum is the area between the anus and the scrotum (in males) or vulva (in females). (Choice B) The peritoneum is a tissue membrane and is therefore not a space/cavity into which GI contents may enter. (Choice D) The pleural cavity is a thin, fluid-filled space between membranes of the lungs and would not be affected by a staple line leak in the postoperative RYGB GI tract. Educational objective: The peritoneum is composed of two membranes that line the abdomen: the parietal layer, which lines the abdominal wall, and the visceral layer, which covers the abdominal organs. The peritoneal cavity is a potential space between the parietal and visceral layers of the peritoneum.

Passage Obesity Is a Condition That Affects Over 30% of Adults