Weight Reduction Procedures
Risk of Surgery
Who Need Surgery
Choice of Procedures
Metabolic Surgery
Life after Surgery
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Risk of Surgery
Surgery for severe obese people require extra care because they are well known to be at a disadvantage,
when having surgery, and it posted extra challenge to both the anesthetist and surgeons. The risk of
weight reduction procedure is mainly related to the complication after abdominal surgery.
Important Considerations
Bariatric surgery should not be considered until you and your doctor have evaluated all other options.
The proper approach to bariatric surgery requires discussion and careful consideration of the following
with your doctor:
| 1. |
These weight loss
procedures are in no way to be considered as cosmetic surgery.
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| 2. |
The surgery does
not involve the removal of adipose tissue (fat) by suction or excision.
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| 3. |
A decision to
elect surgical treatment requires an assessment of the risk and benefit to the patient and the meticulous
performance of the appropriate surgical procedure.
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| 4. |
The suggested
weight loss surgical procedure may not be reversible.
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| 5. |
The success of
bariatric surgery is dependent upon long-term lifestyle changes in diet and exercise.
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| 6. |
Problems may
arise after surgery that may require reoperations.
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| 7. |
Success of
surgical weight loss treatment must begin with realistic goals and progress through the best possible use
of well-designed and tested operations.
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Possible complications
General Risks
All abdominal operations carry these risks:
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bleeding
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infection
in the incision
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potential
problems with the heart and/or lungs
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obstruction
(blockage) of the intestine caused by adhesions
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hernia
through the incision; rejection of suture materials
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blood
clots in the legs and lungs
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risks
associated with general anesthesia (these risks are not significantly greater in most morbidly obese patients than in normal-weight patients)
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Specific Risks associate with different procedure
Adjustable Gastric Banding:
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The risk
of complication immediately after surgery, including stomach injury, bleeding is around 3-5 percent.
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The risk
of widening of the esophagus and stomach pouch with heartburn and regurgitation symptoms: experienced
by 2-3 percent. This can be treated with transient band deflation
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The most
frequent temporary problem after recovery from surgery is intolerance of hard, dry, sticky food, which
may lodge at the band level
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A few
patients experience band slippage, causing stomach obstruction that requires repeat surgery
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Band
erosion through stomach wall is possible
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Problems
with device, including infection, leakage of fluid, tubing breaks, and port infection, can occur
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Sleeve Gastrectomy:
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The risk
of immediate complications after surgery – around 5-8 percent. This includes long suture-line leak,
bleeding, abscess, infection.
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The most
frequent problem is worsening of pre-existing reflux disease and transient postoperative nausea
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Since a
portion of the stomach is removed, the procedure cannot be reversed
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There is
a risk of stricture, or abnormal narrowing, of the stomach that might require dilatation with endoscope
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There is
a risk of insufficient weight loss in very obese patients, requiring second-stage procedure like gastric bypass to achieve adequate weight loss
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Laparoscopic
Sleeve Gastrectomy is considered investigational by some surgeons
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Gastric Bypass:
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The risk of
complications after surgery: 8-10 percent. This includes suture line leak, infection, bleeding, bowel
obstruction.
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The most
frequent problem during recovery is adjusting to new eating habits and intolerance of some foods,
which can cause nausea and vomiting. This is experienced by 10 percent of patients.
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The risk
of malnutrition, specifically protein malnutrition, vitamin deficiency, and dumping syndrome
(intolerance of sugars) exists, but is avoidable with proper education, follow-up and compliance of patients
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Some patients
can experience ulceration of remnant stomach associated with pain, and possible bleeding that might require
urgent therapy, or narrowing of stomach outlet which require dilatation with endoscope
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About 2 percent
of patients can have intestinal obstruction due to excessive scarring or internal hernia usually treated with surgery
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About 5 percent
of patients develop gallstones or gall bladder dysfunction requiring removal of the gall bladder
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