All surgeries have risks. The complications of bariatric surgery (of each procedure) should and will be described to you in detail by your surgeon at the initial consultation. All these procedures are considered MAJOR SURGERY. They require general anesthesia and a hospital stay.
The risk of surgery is related to three factors: ANESTHESIA, OPERATION and PATIENT.
ANESTHESIA today is very safe. The drugs used today are effective, fast-acting, and readily reversed. During the procedure, the body is monitored using modern and sophisticated equipment, which detect problems early.
OPERATIVE RISK depends largely on the expertise, skill, and experience of the surgeon.
PATIENT RISK FACTORS are the most influential in the development of complications.
These include diabetes, hypertension, smoking, sleep apnea, and obesity (the heavier the patient, the greater the chances of complications).
The role of the surgeon is to determine the risk factors, correct them if possible, and get the patient in the best possible shape before surgery. Sometimes surgery is too risky for a particular patient, and it is not recommended. The following is a list of the most serious complications:
This is obviously the most serious adverse outcome from this type of surgery. In experienced hands, it occurs in about 0.2% of the cases and is related to the above-described risk factors.
This is the most serious complication for Roux-en-Y patients and sometimes requires immediate re-operation. Fortunately, it only occurs in about 1% of first time bariatric surgeries. This percentage is almost tripled with second time surgeries for revisions and/or conversions.
- Sepsis and intra-abdominal abscess:
It occurs in about 1% to 2% of first time bariatric surgeries. Requires drainage and sometimes re-operation.
Due to post-surgery pain, patients do not inhale deeply enough, and as a result, the lungs do not function in normal capacity. This leads to a high temperature and pulmonary infection. Your doctor will ask you to perform respiratory therapy immediately following your surgery. It is very important that you comply with these respiratory exercises.
- Intra-abdominal bleeding:
It will require immediate re-operation to stop bleeding and will probably involve a blood transfusion.
- Deep vein thrombosis:
This is also due to a lack of activity after surgery. Blood clots may form in the lower extremities and travel up to the heart and clog it. For this reason, less than 24 hours after surgery, your surgeon will INSIST that you get out of bed and WALK. Also, during your first post op day, pumps will be placed on your legs to provide a gentle, rhythmic massage. Also a blood thinner will be given before and after surgery.
- Displacement and erosion of Band:
This only occurs in patients with LAP BANDING and will require an additional surgery to re-position, remove or change the Band.
These are the most common EARLY post-op complications. There are other complications that may occur that you should be aware of:
- STRICTURE or NARROWING of the bypass anastomosis:
In Gastric Bypass patients, sometimes the gastric outlet is too small. This will require an endoscopy and dilation of the outlet by a tiny balloon.
- Failure to lose weight or maintain weight:
It is imperative that you closely follow all the diet indications given to you by your doctor. Bariatric surgery is not a miracle cure-all for obesity. You (and your family) will need to make changes in your life and you must be committed to these changes. In the future, you may also need plastic surgery to correct any excessive skin or the shape of your body.
If you do not take vitamins, calcium and iron supplements or follow the recommended diet directions given to you by your doctor, you may experience malnutrition which is correlated with baldness, lack of energy, anemia, and other serious complications.
- Uncontrolled vomiting, nausea or reflux:
In Lap Band patients this sometimes indicates obstruction or too much Band pressure, and may require an endoscopy.