Bariatric Surgery Risks
There are risks with any major abdominal operation. Unfortunately, many of them are greater in people with morbid obesity.
Short Term Risks
The most common and important risks are listed below:
- wound infection
- thrombophlebitis (blood clots in the legs or lungs)
- leakage of the stomach, causing serious internal infection and even emergency reoperation
- heart attack
- breathing failure requiring ventilator support
Wound infections occur in about 2-10 percent of patients and are managed easily without permanent effects.
Usually, pneumonia and other breathing problems occur in smokers or in patients with pre-existing lung trouble.
Thrombophlebitis is common after major surgery, especially in obese patients. You will have special stockings put on in the operating room in an effort to prevent this complication.
Some patients also will receive low doses of a blood thinner, called heparin. If you have ever had a blood clot in your legs, you should tell us.
Major life-threatening complications, such as gastric leakage requiring an emergency operation are rare, occurring in about one percent of the cases. Death after operation should occur in less than one percent of cases.
We divide the long-term risks into two categories: technical problems and nutritional problems.
The most common technical problem is a hernia of the scar, called an incisional hernia. This occurs in more than 10 percent of patients and is an unavoidable occurrence after abdominal surgery in morbidly obese individuals.
The most serious technical problem is a disruption of the staples or tearing of the staples, which then allows food to pass through into the remaining stomach. This occurs in three percent to 5 percent of patients and unfortunately results in considerable weight gain.
Other technical problems include stretching of the stomach reservoir or the connection to the bypass intestine, which also result in weight gain.
Finally, a small percentage of patients have too small a reservoir or connection, resulting in occasional vomiting and/or restriction of the kinds of food one can consume. This problem is unusual, occurring in less than 5 percent of patients.
The nutritional risks of the operation result from the fact that iron, vitamin B12, and perhaps fat-soluble vitamins are not absorbed normally. You will be requested to supplement your diet for the rest of your life with a multivitamin plus iron pill and an extra strength vitamin B12 pill. We may ask you to take extra calcium.
If patients take their vitamin pills and eat a balanced diet, we believe that no easily detectable nutritional complications exist from this operation.