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Risk of surgery

Important Considerations

Bariatric surgery should not be considered until you and Dr. Tom Umbach have looked at all other options. If you are considering bariatric surgery, these are some of the points that must be discussed with your doctor:

  1. Bariatric surgery is not cosmetic surgery and should not be thought of in any way as cosmetic surgery
  2. Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
  3. The client and doctor should discuss the benefits and risks together.
  4. The client must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
  5. Problems after surgery may require more operations to correct them.

Complications of Bariatric Surgery

As with any surgery, there are immediate and long-term complications and risks. Your healthcare team can speak with you further about the benefits and risks. Possible risks can include, but are not limited to:

  • Bleeding*
  • Complications due to anesthesia and medications
  • Deep vein thrombosis
  • Dehiscence (separation of areas that are stitched or stapled together)
  • Infections
  • Leaks from staple lines
  • Marginal ulcers
  • Pulmonary problems
  • Spleen injury*
  • Stenosis (narrowing of a passage, such as a valve)
  • Death

*To control operative bleeding, removal of the spleen may be necessary.

According to the According to the ASMBS (American Society of Metabolic & Bariatric Surgery) 2004 Consensus Statement, the operative morbidity (complications) associated with Roux-en-Y Gastric Bypass in the hands of skilled surgeon is roughly 5% and the operative mortality (death) is roughly 0.5%. For Laparoscopic Adjustable Gastric Banding, the same consensus statement reported that, in the hands of a skilled surgeon, the operative morbidity is approximately 5% and operative mortality is approximately 0.1%.

Risks of the Gastric Bypass

Because the duodenum and other sections of the small intestine are bypassed, poor absorption of iron and calcium can cause low total body iron and a greater chance of having iron-deficiency anemia. Gastric bypass surgery cclients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids should be aware of the chance of iron-deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the possibility of increased bone calcium loss. By taking a multivitamin and calcium supplements, clients can maintain a healthy level of minerals and vitamins.

Bypassing the duodenum can cause metabolic bone disease in some clients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hipbones. Eating foods rich in nutrients and taking vitamins can help clients avoid this.

Chronic anemia due to vitamin B12 deficiency may occur. The problem can be managed with vitamin B12 pills or injections.

A condition known as dumping syndrome can occur from eating to much sugar or large amounts of food. While it isn’t considered a serious health risk, the results can be very unpleasant. Symptoms can include vomiting, nausea, weakness, sweating, faintness, and, on occasion, diarrhea. Some clients are unable to eat sugary foods after surgery. Some clients find this further helps their weight loss.

The bypassed portion of the stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are problems such as ulcers, bleeding, or malignancy.

Gastric Bypass a permanent, nonreversible procedure, and the procedure could result in death.

Risks of the Adjustable Gastric Banding

  • The access port may leak or twist, which can require revision bariatric surgery to correct the problem.
  • Surgery may not provide the necessary feeling of satisfaction that one has had enough to eat.
  • Dumping syndrome, which provide important warning signs, does not occur.
  • Band may erode into the stomach wall.
  • Band may move or slip.
  • Weight loss is slower than that following the Roux-en-Y bypass surgery.
  • The procedure could result in death.

Possible Side Effects

  • Vomiting
  • Dumping syndrome
  • Nutritional deficiencies
  • Gallstones
  • Need to avoid pregnancy temporarily
  • Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas and dizziness

Why Would I Have an Open Procedure

Some clients are not suitable candidates for laparoscopic or minimally invasive procedures. The following are reasons why you may have an open procedure, or that may lead your surgeon to switch during the procedure from laparoscopic to open:

  • Prior abdominal surgery that has caused dense scar tissue
  • Inability to see organs
  • Bleeding problems during the operation

The decision to perform the open procedure is made by your surgeon either before or during the actual operation and is based on client safety.