Risks
Bleeding
As with any major surgery, bleeding can occur.
Rarely is there significant blood loss associated
with bariatric surgery. If bleeding occurs, a
blood transfusion would be necessary.
Deep Vein Thrombosis
Obesity and immobility (due to surgery) can cause
blood to pool in the lower extremities. When this
occurs, blood clots can form. This is prevented
by giving patients blood thinners, having patients
wear compression stockings, and ambulating.
Pulmonary Embolus
When a blood clot from the leg breaks loose and
travels to the lung, it is called a pulmonary
embolus. Like a deep venous thrombosis, it is
a risk of surgery of any type for the obese patient.
This is prevented by giving patients blood thinners
before and after surgery.
Wound Infection
Wound infection can occur after bariatric surgery.
Infections are prevented by giving intravenous
antibiotics at the time of surgery.
Anastomotic Leak
The anastamosis is the location where the stomach
and intestines are connected together during surgery.
There is a small risk of leakage at this connection.
If a leak were to occur, intestinal contents would
spill into the abdominal cavity. This can cause
infection. The JP drain remains in place for 10
days following surgery to help detect a leak.
If the drainage color changes in the drain to
green, the patient would undergo an x-ray to determine
if a leak is present.
Ulceration
Ulcers can occur in the stomach or small intestine
following surgery. These are prevented by taking
acid suppressing medication for three months following
surgery. If they occur, ulcers are treated with
medication and occasionally intravenous nutrition.
Erosion (LapBand)
The adjustable elastomer
band placed around the portion of the upper stomache
can cause breakdown of stomach tissue. Surgical
techniques are used that create an extra layer
of "padding" to the stomach to help prevent this
complication.
Pneumonia
Due to immobility around the time of surgery,
patients are at risk for developing pneumonia.
This is prevented by having the patients use an
incentive spirometer every hour while hospitalized
and ambulating. Ambulating helps to improve the
movement of mucus and secretions from the lungs.
Hernia
A hernia can occur after any abdominal surgery.
A hernia occurs when the intestine comes through
the weakened abdominal wall. The abdomen is weakened
due to the incision created at surgery. Having
the patient refrain from lifting greater than
10 to15 pounds for two months after surgery, and
refraining from strenuous activity for two to
three months following surgery can prevent hernias.
Dumping Syndrome
Dumping syndrome can occur following gastric bypass
surgery. This is a combination of diarrhea, sweating,
heart palpitations, nausea, and dizziness. This
occurs in some patients when sugars and carbohydrates
are consumed.
Nausea and Vomiting
Most patients experience some nausea and vomiting
in the first few weeks following surgery. This
improves as patients learn how to eat slowly,
do not drink and eat at the same time, and know
when to stop eating. If vomiting becomes persistent,
the patient needs to be evaluated for a stricture.
Stricture
Strictures can occur where the stomach and intestine
are attached. When some patients heal, this connection
scars down too small. If this occurs, patients
experience frequent nausea and vomiting. Treatment
of a stricture involves an endoscopy and dilation.
The dilation of the stricture is done by using
a balloon to stretch the opening. Occasionally
this must be done two to three times to keep the
stricture open.
Hair Loss
Some patients will experience some thinning of
the hair during the first six months after surgery.
This is due to lack of protein in their diet.
This will usually reverse itself after six months.
Nutritional Deficiencies
Due to the change in both the stomach and intestines
after surgery, patients are at risk for developing
nutritional deficiencies. It is imperative to
remain on the vitamin and mineral supplements
recommended by the nutritionist for life. Lab
work should be checked periodically following
surgery to ensure that nutritional deficiencies
have not occurred.
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