Dietistic REPLICA ASL RIETI

Introduction to Bariatric and Metabolic Surgery Epidemiology of obesity and indications for surgery Role of the multidisciplinary team (surgeon, dietitian, psychologist, internist) Surgical Techniques in Bariatric Surgery Sleeve gastrectomy Roux-en-Y gastric bypass One-anastomosis gastric bypass Biliopancreatic diversion / duodenal switch Revisional bariatric surgery Physiological and Nutritional Implications Anatomical and physiological changes after bariatric surgery Impact on nutrient absorption and metabolism Hormonal changes and metabolic effects Perioperative Nutritional Management Preoperative assessment: malnutrition, micronutrient deficiencies, and preparation for surgery Postoperative diet progression: liquid, pureed, soft, and solid diet phases Long-term dietary guidelines and lifestyle modifications Complications and Nutritional Consequences Early surgical complications (leaks, bleeding, strictures) and their nutritional implications Late complications: dumping syndrome, marginal ulcers, internal hernias Micronutrient deficiencies (iron, vitamin B12, folate, calcium, vitamin D, trace elements) Protein-energy malnutrition Special Considerations Nutritional management during pregnancy after bariatric surgery Bariatric surgery in elderly patients Long-term follow-up and role of dietitians in patient care

The course aims to provide students with the fundamental knowledge of general surgery relevant to dietetic practice. At the end of the course, students will be able to: Understand the pathophysiological basis and surgical management of major diseases of the gastrointestinal tract, hepatopancreatobiliary system, endocrine organs, and abdominal wall. Recognize the role of nutrition in the perioperative management of surgical patients. Correlate surgical pathology with dietetic assessment and dietary interventions before and after surgery. Communicate effectively with the surgical team, demonstrating interdisciplinary awareness. Prerequisites The course requires prior knowledge of human anatomy, physiology, and general pathology, which are considered essential for the effective study and understanding of surgical diseases. Recommended background includes basic biochemistry and nutrition.

Instructor-provided lecture slides and additional materials are integral parts of the course.

The course will be delivered through frontal lectures supported by multimedia presentations and dedicated teaching materials. Clinical cases and examples of surgical images/videos will be presented to strengthen the connection between theoretical knowledge and professional practice. Student participation will be encouraged through guided discussion.

The final evaluation will consist of: Oral examination, aimed at assessing theoretical knowledge and its application through the discussion of clinical cases relevant to bariatric surgery and dietetic practice. Active participation in class discussions may be taken into consideration.

Bariatric Surgery: A Primer for Your Medical Practice – Buchwald H, et al. Handbook of Nutrition and Bariatric Surgery – Shikora SA, Blackburn GL. Clinical Practice Guidelines (IFSO, EASO, ASMBS, SICOB).