Weight Reduction Procedures

Risk of Surgery

Who Need Surgery

Choice of Procedures

Metabolic Surgery

Life after Surgery

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.
2. The surgery does not involve the removal of adipose tissue (fat) by suction or excision.
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.
4. The suggested weight loss surgical procedure may not be reversible.
5. The success of bariatric surgery is dependent upon long-term lifestyle changes in diet and exercise.
6. Problems may arise after surgery that may require reoperations.
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.


Possible complications

General Risks

All abdominal operations carry these risks:

bleeding

infection in the incision

potential problems with the heart and/or lungs

obstruction (blockage) of the intestine caused by adhesions

hernia through the incision; rejection of suture materials

blood clots in the legs and lungs

risks associated with general anesthesia (these risks are not significantly greater in most morbidly obese patients than in normal-weight patients)

Specific Risks associate with different procedure

Adjustable Gastric Banding:

The risk of complication immediately after surgery, including stomach injury, bleeding is around 3-5 percent.

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

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 infection, leakage of fluid, tubing breaks, and port infection, can occur

Sleeve Gastrectomy:

The risk of immediate complications after surgery – around 5-8 percent. This includes long suture-line leak, bleeding, abscess, 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

Gastric Bypass:

The risk of complications after surgery: 8-10 percent. This includes suture line leak, infection, bleeding, bowel obstruction.

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

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

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




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