As with any surgery, there are operative and longterm complications and risks associated with weight loss surgical procedures that should be discussed with your doctor. Possible risks include, but are not limited to:
Any major surgery involves the potential for complications — adverse events which increase risk, hospital stay, and mortality. Some complications are common to all abdominal operations, while some are specific to bariatric surgery. A person who chooses to undergo bariatric surgery should know about these risks.
Due to poor circulation or underlying diabetes, many overweight people have difficulty healing wounds. Therefore, it is not surprising that between 1 and 5 percent of people develop wound infections at the site of surgery. The risk of wound infection is greatly reduced if surgery can be performed using a laparoscope ( a small instrument with a light on the end). In such a procedure, there are generally six very small incisions sites sites instead of one large one. As a
result hospitalization and recovery time are reduced. In general, a person’s size and whether or not he or she has had previous abdominal surgery are the deciding factors for determining if the laparoscopic approach van be used. The larger the person the less likely he or she will qualify for laparoscopic surgery. Laparoscopic surgery is much more technically demanding than the traditional procedure, but if you qualify for it, it definitely makes recovery quicker and less painful.
Infection of the incisions, or of the inside of the abdomen (peritonitis, abscess) may occur, due to release of bacteria from the bowel during the operat ion. Nosocomial infect ion, such as pneumonia, bladder or kidney infections, and
sepsis (bloodborne infection) are also possible. Effective short-term use of antibiotics, diligent respiratory therapy, and encouragement of activity within a few hours after surgery, can reduce the risks of infections.
Many blood vessels must be cut in order to divide the stomach and to move the bowel. Any of these may later begin bleeding, either into the abdomen (intra-abdominal hemorrhage), or into the bowel itself (gastrointestinal hemorrhage).
Transfusions may be needed, and re-operation is sometimes necessary. Use of blood thinners, to prevent venous thromboembolic disease, may actually increase the risk of hemorrhage slightly.
A hernia is an abnormal opening, either within the abdomen, or through the abdominal wall muscles.
An internal hernia may result from surgery, and rearrangement of the bowel, and is mainly significant as a cause of bowel obstruction. An incisional hernia occurs when a surgical incision does not heal well; the muscles of the abdomen separate and allow protrusion of a sac-like membrane, which may contain bowel or other abdominal contents, and which can be painful and unsightly.
The risk of abdominal wall hernia is markedly decreased in laparoscopic surgery.
Abdominal surgery always results in some scarring of the bowel, called adhesions. A hernia, either internal or through the abdominal wall, may also result. When bowel becomes trapped by adhesions or a hernia, it may become kinked and obstructed, sometimes many years after the original procedure. Usually an operation is necessary to correct this problem.
Any injury, such as a surgical operation, causes the body to increase the coagulation of the blood.
Simultaneously, activity may be reduced. There is an increased probability of formation of clots in the veins of the legs, or sometimes the pelvis, particularly in the morbidly obese patient. A clot which breaks free and floats to the lungs is called a pulmonary embolus, a very dangerous occurrence.
Commonly, blood thinners are administered before surgery, to reduce the probability of this type of complication.
After any abdominal surgery pneumonia is a risk.
This is because it hurts to take a deep breath. When a person fails to breathe deeply a portion of the lung may collapse, setting the stage for pneumonia. Approximately 0.1 percent of people undergoing the Roux-en-Y procedure develop
pneumonia. Simply breathing deeply following surgery reduces this risk. In order to facilitate deep breathing the hospital staff will tach you to use a handheld plastic device called an incentive spirometer. You will be instructed to inhale deeply with your mouth around the tube attached to the incentive spirometer. The more air you take into your lungs, the more you will move the little ball inside the spirometer.
Death occurs in about 0.5 percent (one in every two hundred) of people who undergo this procedure. While the risk is low, it is not zero.
This is about the same risk as any other major abdominal surgery. But this is elective surgery.
Making the big decision to have bariatric surgery may feel like taking a big risk. You are right, it is a big risk, but there are things you can do to reduce it. For example, quitting smoking, losing some weight, and developing an exercise program (even a little walking) before surgery can reduce your risk of major complications and death following surgery.