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Bariatrics

Possible Risks of Weight Loss Surgery

Up to 20 percent of patients who have any weight-loss surgery require follow-up operations to address complications or elect to have reconstructive or plastic surgery after their weight loss stabilizes. Some of the less common complications of weight-loss surgery include breakdown of the staple line and stretched stomach outlets.

Some patients do not achieve adequate weight loss, or regain some weight back, if they are not able to permanently change eating habits and lifestyle.

Risks Associated with Laparoscopic Gastric Banding

  • The risk of death after surgery: 0-0.1 percent
  • The risk of complication immediately after surgery, including stomach injury, bleeding, complications of anesthesia, heart attack, lung complication, blood clots in the legs and lungs, and wound infection: 3-5 percent
  • The risk of widening of the esophagus with heartburn and regurgitation symptoms: experienced by 2-3 percent. This can be treated with transient band deflation
  • The most frequent temporary problem after recovery from surgery is intolerance of hard, dry, sticky food, which may lodge at the band level
  • A few patients experience band slippage, causing stomach obstruction that requires repeat surgery
  • Band erosion through stomach wall is possible
  • Problems with device, including leakage of fluid, tubing breaks, and port infection, can occur

Risks Associated with Laparoscopic Gastric Bypass

  • The risk of death: 0-0.3 percent
  • The risk of complications after surgery: 8-10 percent. This includes suture line leak, bleeding, bowel obstruction, heart attack, lung complications, blood clots in the lung and legs, complications of anesthesia, and wound infection.
  • 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.
  • 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
  • About 2 percent of patients can experience marginal ulcer associated with pain, and possible bleeding that might require urgent therapy or surgery to stop bleeding
  • About 2 percent of patients can have intestinal obstruction due to excessive scarring or internal hernia usually treated with surgery
  • About 5 percent of patients develop gallstones or gall bladder dysfunction requiring removal of the gall bladder

Laparoscopic Sleeve Gastrectomy

  • The risk of death: 0-0.3 percent
  • The risk of immediate complications after surgery: 5-8 percent. This includes long suture-line leak, bleeding, abscess, heart attack, lung complications, anesthesia complication, blood clots in the lung and legs, and wound infection
  • The most frequent problem is worsening of pre-existing reflux disease and transient postoperative nausea
  • Since a portion of the stomach is removed, the procedure cannot be reversed
  • There is a risk of stricture, or abnormal narrowing, of the stomach that might require dilatation with endoscope
  • There is a risk of insufficient weight loss in very obese patients, requiring second-stage procedure like gastric bypass to achieve adequate weight loss
  • Laparoscopic Sleeve Gastrectomy is considered investigational by some surgeons and insurance companies

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