Risks and Complications
Laparoscopic Gastric bypass and Laparoscopic sleeve gastrectomy are major operations. Just like any other surgical procedure, it is important for you to understand your risks and bariatric surgery complications. Potential risks and bariatric surgery complications are the same as for any clinically severe obese patient undergoing any other major abdominal operation. The level of bariatric surgery complications depends upon the degree of obesity and other conditions such as diabetes, heart and/or lung disease.
Obesity and these other conditions can increase bariatric surgery complications of both the surgery and anesthesia. Possible bariatric surgery complications include respiratory problems, infection, cardiac complications, leaks where intestine and stomach are sutured together, and blood clots in the deep veins of the legs. Rarely, death can result from heart attack or a blood clot to the lung, resulting from the body's response to surgery. Gastric bypass is NOT cosmetic surgery and bariatric surgery complications should be understood by all patients considering the procedure. This procedure is performed only to try to prevent major illness or premature death from the complications of clinically severe obesity.
- Respiratory problems are a potential bariatric surgery complication. If a patient has another condition involving the respiratory tract, a pulmonary evaluation with a lung specialist before surgery may be recommended. During the operation, special forms of anesthesia may be necessary to minimize effect on the lungs. Using an incentive spirometer every 1 to 2 hours after surgery will promote deep breathing and coughing to prevent lung complications. If you are able, you will be helped to sit up in a chair several hours after you wake up from surgery, which will also help your lungs.
- A leak or rupture where the intestine is joined to the stomach is another serious bariatric surgery complication and may require an immediate return to the operating room to be corrected. On the morning after surgery, you may have an x-ray test called a gastrograffin swallow, to make sure there is no leak. If a leak is detected, re-operation is required and additional drains are inserted. You will be given a feeding tube for nutritional formula to be passed into your intestinal tract below the leak, to allow the site to heal.
- Constipation is also a bariatric surgery complication. After surgery, you may be constipated. Remember that you will be eating less, and you will have fewer bowel movements. Many people report having a bowel movement every two to three days. You will get instructions about drinking more fluids, taking a stool softener, doing exercises, and adding fiber to your diet to help prevent constipation.
- Blood clotting in the leg veins and clots migrating to the lungs are a possibility and could be serious. The larger a person is, the more likely it will happen. Low dose injections of heparin, a blood thinner, are used to prevent clots from forming during times of maximum risk. Also, inflatable boots, elastic stockings and frequent walking after surgery help to decrease the risk of blood clots.
- Bleeding during or after the surgery is a complication. Doctors pay close attention to controlling bleeding throughout the operation, with special efforts paid to the spleen and other places where bleeding is more common. If bleeding occurs, blood transfusion, re-operation, and potentially removal of the spleen may be required.
- Vitamin deficiencies can occur after surgery but are surprisingly common prior to surgery. Between 30-50% if patients have vitamin D deficiency before operation. Taking the prescribed vitamin supplements and undergoing regular checkups with the surgical team is the best way to prevent serious neurologic, blood and muscle disorders resulting from vitamin deficiencies.
Other potential bariatric surgery complications may occur months or even years following surgery. Bowel obstruction can result from adhesions or from internal hernias which may require operative intervention. Vitamin deficiencies can occur particularly if you do not take the prescribed vitamins.
Consult with your physician to learn more about bariatric surgery complications.