Laparoscopic Roux-en-Y gastric bypass or vertical sleeve gastrectomy: a weighty decision

Vertical curves provide the transition between two roadway grades, ensuring safety, comfort, and functionality. Calculating elevations at specific stations along the curve involves several systematic steps based on the curve's geometry and provided design parameters.The vertical curve is defined by its length, grades, Point of Vertical Intersection (P.V.I.) location, and P.V.I. elevation. The stations of the Point of Vertical Curvature (P.V.C.), where the curve begins, and the Point of Vertical...

Gastric motility is the coordinated contraction and relaxation of stomach muscles that convert ingested food into chyme, a semi-liquid substance ready for further digestion in the intestines. The process begins with the vagus nerve inducing the relaxation of the smooth muscles in the fundus and body of the stomach, allowing these regions to expand and accommodate up to approximately 1.5 liters of food and liquid.
Peristaltic Waves and Chyme Formation
Upon food entry, the stomach initiates...

Decision-making is a fundamental cognitive process that involves evaluating alternatives and selecting among them. This process can range from simple choices, such as deciding what to wear, to complex decisions, like choosing a major in college or a career path. The complexity of the decision often dictates the approach we use, which can be broadly categorized into two types: automatic and controlled decision-making.
Automatic decision-making is fast, intuitive, and relies on gut feelings...

Gastric emptying occurs when the stomach gradually releases chyme into the duodenum. When the stomach is distended, it triggers the release of gastrin, a hormone that promotes gastric acid secretion to aid in digestion. Additionally, stomach distension contributes to peristaltic waves that propel gastric contents toward the pyloric region. The gastroenteric reflex, on the other hand, primarily stimulates peristalsis in the intestines, facilitating the movement of contents further along the...

Vertical curves are parabolic transitions that connect different grades on highways and railroads, ensuring a smooth alignment between back and forward tangents. The back tangent represents the initial grade, while the forward tangent defines the subsequent grade. These curves can be symmetrical, with equal tangent lengths, or nonsymmetrical, with varying lengths. The key points defining a vertical curve include the Point of Vertical Intersection (P.V.I.), where the tangents meet; the Point of...

The gastric phase of digestion begins as soon as food enters the stomach. The incoming food bolus triggers neural and hormonal mechanisms, which last approximately 3 to 4 hours. During this phase, the stomach undergoes significant changes to prepare the food for further digestion and absorption.
When food enters the stomach, it stretches the stomach walls and activates stretch receptors. This triggers local reflexes of the enteric nervous system, mediated through the myenteric plexus. These...