General Risks Of Weight Loss Surgery

 

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In general, weight loss surgery is a standard and safe procedure carried out by highly qualified and experienced surgeons. But because not everyone can lose weight through diet and exercise alone, surgery is available for patients with more complex cases of morbid obesity.

The bariatric surgery complications below might deter some from getting a procedure. However, not having surgery when you are morbidly can be much worse. Obesity dramatically increases your risk of a variety of chronic life threatening conditions. In contrast, most of the complications associated with bariatric surgery are easily managed or reversed, especially in Australia where our health care system is very developed. Weight loss surgery has been performed for more than 40 years now and these are the reasons that most physicians believe the risk of a surgical operation is justified for patients who have had trouble losing weight through other means.

In many cases, weight loss surgery may be life saving.

Each of the different procedures do have risks associated with them, just like all surgeries do. If complications take place during a laparoscopic (key-hole) or minimally invasive operation, your doctor might decide to perform open surgery. Not everyone is an appropriate surgical candidate for open surgery, so your doctor will need to determine if you are just in case this may happen.

In some cases, patients may be susceptible to some other additional risks involved with surgery depending on a number of factors like your age and current state of health. The skill, experience and care of the surgeon also plays a factor.

Requirements

Typically bariatric surgery is reserved for patients who are morbidly obese and have a Body Mass Index (BMI) of 40kg/m2 at least or 35kg/m2 but also have at least one condition which is worsening their health. It is only considered for use in adult patients who are morbidly obese who have failed other weight reduction alternatives that are more conservative, including behaviour modification, exercise and supervised diet programs.

Like with any other kind of surgery, there are long term and operative risks and complications that weight loss surgical procedures are associated with that you should discuss with your doctor. Weight loss surgery is in no way to be considered cosmetic surgery because it is an advanced medical procedure. It is also not to be confused with the removal of fat tissue by suction (liposuction) or excision.

Minor Complications

One of the most frequent post-surgical complications is the onset of a bacterial infection. This happens in about 1 in 20 patients. Most of the time it is not serious and can be treated with antibiotics. It is also possible that a patient can suffer from mild internal bleeding following the surgery or a problematic blood clot. These events are rare and require a follow-up procedure to solve.

Gallstones can be a longer-term complication for those undergoing bariatric surgery. These usually occur somewhere around the 10 month mark after the procedure and a simple endoscopic procedure can be used to remove the stone.

Food intolerances can develop in people who have had gastric band weight loss surgeries. This happens when there are certain foods that you used to be able to eat with no problems all that of the sudden result in discomfort following ingestion. It is still unclear exactly why these reactions develop. The best way of avoiding these symptoms is to stay away from the foods that trigger them. If the problems are particularly problematic, a surgeon can remove the gastric band which generally fixes the problem.

Some other minor complications may take up to 7 days of extra hospital stay in order to fix and they include injury to the spleen, infection of the wound, respiratory issues or any other minor ailments.

The complications above do not cover all of the potential risks involved with the surgery, and it is definitely worth talking with your surgeon first to get the whole picture.

Major Complications

Complications of the following may take a week or more of extra hospital stay after your initial surgery in order to fix:

  • Small Bowel Obstruction
  • Wound Seroma
  • Renal problems
  • Neurologic issues
  • Deep Vein Thrombosis (DVT)
  • Gastrointestinal bleeding (bleeding in the gut)
  • Evisceration, Dehiscence
  • Gastrointestinal leaks
  • Subphrenic Abscess
  • Pulmonary Embolism
  • Cardiac or Hepatic
  • There have also been reports of death after morbid obesity surgery

Gastric Banding Risks

The following risks are associated with Gastric Banding surgery.

Migration And Infection

An infection might develop either in the abdomen or port area. In some situations that might cause the band to migrate into your stomach.  Reoperation is usually necessary in this case. A majority of the complications that are associated with migrations happen due to there being too much fluid injected in the SAGB. Therefore, the balloon should be filled with a maximum of 9 fl of fluid, according to the manufacturer’s recommendations. In almost all cases of migration that have been reported, The fluid content in the balloon was over 11ml. This is 2ml over what the maximum recommended volume is. The migration rate can be kept low by not overfilling the system. This highlights the importance of choosing a highly skilled and experienced surgeon. In addition, a subclinical infection can cause migration. Although this is quite rare, it is very important to not allow anyone to inject liquid inside your port before having a swab that has been soaked in 5% chlorhexidine spirit applied to the skin for around ten minute prior to the injection. An infection can result if this skin preparation method is not used.

Leakage

Leakage coming from the connecting tube that is in between the port and balloon or from the SAGB might require reoperation. This balloon is made out of fragile material. Also the leakage might take place either years following the surgery or shortly after. In the case of leakage, usually it is easy to replace the SAGB with a new one. These days the complication is rare. However, it is important for you to be aware that it is a potential risk that the band over the long term might need to be replaced.

Pouch Dilatation And Band Slippage

If the band slips or the pouch becomes to enlarged the patient may need an a reoperation.

Silicone Band Punctures And Port Dislocation

  • The injection port might become dislocated.
  • There is always a risk of the silicone tube being punctured when injected in the port.

However, if either of the two above should happen, they can both be corrected easily from a small operation performed under local anaesthesia.

Other Complications

Ask your surgeon for more detail information if other complications have taken place. There isn’t any guarantee that you won’t have any problems with the SAGB for the remainder of your life. However, the SAGB has been used since 1987 in clinics around the world.

There is always a risk that reoperation will be needed, even when none of the complications mentioned above take place. What you need to understand is that the potential for reoperation is a vital part of managing morbid obesity overall. Reoperations are considered to be a technical measure that is necessary at times.

Like with any surgical procedure that uses general anaesthesia, of course there are risk of complications, include even death. For more comprehensive information, ask your doctor.

Potential Minor Side Effects of Weight Loss Surgery & General Advice

Vomiting

After food intake, patients might feel pain or vomit. This might be caused from poor eating behavior or through narrowing of the SAGB after the balloon has been injected with fluid. When you eat calmly and slowly, you will start to learn to listen for the signals that your stomach is giving you. Vomiting on a regular basis is a definite warning sign. In these cases, the amount of liquid might be adjusted for your SAGB.

Nutrients

During the rapid weight reduction phase, it is advised to take vitamin supplements. It is recommend to take a liquid vitamin mixture that contains multivitamins, especially the vitamin B complex, for the initial 6 months after surgery at least.

Family Planning

The period of time in between surgery and weight stabilisation is characterised as a period of starvation. During starvation it isn’t recommended to become pregnant, even though with regards to food the fetus has priority instead of the mother. If you do get pregnant, it is recommend that you remove all of the fluid from out of the balloon. Before you become pregnant, you should wait for your weight to stabilise first. More on weight loss surgery and pregnancy here.

Medicine

Before tablets are taken, they need to be crushed or broken into small pieces. This is a matter that patient should consult with their doctors about.

Constipation

Following surgery, numerous patients feel constipated. It is mainly due to the fact that reduced food intake results in less feces and therefore fewer bowel movements. If it becomes necessary to take a laxative, it is recommended to avoid bulking agents and use a liquid laxative like lactulose instead.

GP Check-Ups

Following surgery you need to have regular check-ups performed. In general, the check-ups will occur on a monthly basis. But visits will become less frequent fairly soon. Over the initial 18 months after surgery, the SAGB will be filed gradually via the injection port. During this period of time, your well-being and weight loss will both be monitored. After your weight has become stable, you will only need check-ups when you have a problem or on a yearly basis.

Exercise

It is important for you to change your physical activity level in addition to your eating habits. It is usually recommended for patients to start to slowly exercise. As weight is lost, it will gradually become easier to perform physical activities.