Risks and Complications of Gastric Bypass Surgery


Surgery should not be considered until you and your family doctor have evaluated all other options. As with all surgeries, there are risks associated with the laparoscopic or open gastric bypass procedure. Though nearly every gastric bypass surgery performed by Hope Bariatrics is started as a laparoscopic operation, your doctor may choose to convert to open surgery. Your family doctor and surgeon must determine if you are an appropriate surgical candidate.

 

Indication

Weight loss surgery is typically reserved as a treatment for those individuals 100 pounds or more overweight (Body Mass Index [BMI] of 40 or higher) who have not responded to other less invasive therapies such as diet, exercise, medications, etc.

In certain circumstances, less morbidly obese patients (with BMIs between 35 and 40) may be considered for surgery (patients with high-risk co-morbid conditions and obesity-induced physical problems that are interfering with quality of life).

 

 

Important Considerations

The proper approach to weight-loss surgery requires discussion and careful consideration of a patient’s individual risks and benefits. Here are some things to consider regarding the decision to have gastric bypass surgery:

  1. Bariatric 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 (this is NOT liposuction surgery).
  3. Gastric bypass surgery is an “elective” surgery; that is, the patient is choosing to have it and the pre-operative process should involve an assessment of the risk and benefit to the patient.
  4. Gastric bypass surgery should not be thought of as reversible.
  5. The success of weight loss surgery is dependent upon long-term lifestyle changes in diet and exercise.
  6. Problems may arise after surgery that may require re-operations.

Success of surgical treatment must begin with expert surgical care, nutrition education and patient commitment to following the program guidelines.

 

Complications and Risks

As with any major surgery, there are possible short and long-term complications and risks. Gastric bypass surgery does involve some risk, the surgeons of Hope Bariatrics have very low complication rates but you must be aware of possible risks including but are not limited to:

Each patient has more than one opportunity to discuss surgical risk with the surgeon before gastric bypass; every effort is made by the Hope Bariatric team to minimize each patient’s risk.

The LAP-BAND® Adjustable Gastric Banding System Procedure

The LAP-BAND® System is usually placed laparoscopically while you are under general anesthesia. While you may be in the operating room for two to three hours, the surgery itself typically takes about an hour. First, the surgeon makes a few very small incisions in the abdominal wall and secures "ports" in these incisions to accommodate long, thin surgical instruments. A narrow camera is also passed through one of these ports so that the surgeon can view the operative site on a nearby video monitor. A small tunnel is made behind the top of the stomach to let the LAP-BAND® System device through and allow it to be wrapped around the upper part of the stomach, like a wristwatch. The LAP-BAND® System is then locked securely in a ring around the stomach. This creates your new, smaller stomach pouch. Also, to help hold the LAP-BAND® System in place, stomach tissue is folded over it and stitched together. The rest of the lower stomach will stay in its normal position. Then, the small access port, which is used for LAP-BAND® System adjustments, is fixed just underneath the skin. The access port is used by the surgeon to inject saline (sterile salt water) into the LAP-BAND® when you have an adjustment. The LAP-BAND® System is usually left empty for the first 4 to 6 weeks after surgery

How It Works
The LAP-BAND® Adjustable Gastric Banding System is a simple yet advanced gastric banding system that helps you gradually lose and control your weight by reducing the amount of food that your stomach can hold at one time. Allergan is the pioneer of adjustable gastric banding in the United States - this is a constantly evolving technology, involving a great deal of research and development.
The name "LAP-BAND" comes from the minimally invasive surgical technique used (laparoscopy) and the silicone gastric band placed around the top of the upper part of your stomach. The LAP-BAND® System works by helping you control your food intake and supporting long term, sustainable weight loss.

The LAP-BAND AP® System

The latest generation of the LAP-BAND® System - the LAP-BAND AP® System - is the most advanced adjustable gastric banding system approved by the FDA and was built on a proven heritage of effective laparoscopic adjustable gastric banding technology.
The LAP-BAND AP® System uses patented Omniform™ technology—soft, precurved, individual sections—and introduces a 360 degree inflation area. Omniform™ technology is designed to minimize the potential for leaks due to unwanted creases or folds (crease-fold failure). At the same time, the 360 degree inflation area evenly distributes pressure for complete coverage of stomach anatomy. The
LAP-BAND AP® System also has the highest available fill volume so your surgeon has the flexibility to offer more precise adjustments.
The LAP-BAND AP® System was designed to extend the proven performance of the LAP-BAND® System.

The LAP-BAND® System Advantages at a Glance

Minimally Invasive Surgery

Fewer Risks and Side Effects

Adjustable

Effective Long Term Weight Loss

Reversible

Risks, complications, and adverse events

All surgical procedures have risks. When you decide on a procedure, you should know what those risks are. Talk with your surgeon in detail about all the risks and complications that might arise. Then you will have the information you need to make the right decision for you.
Using the LAP-BAND® System includes the same risks that come with all major surgeries. There are also added risks in any operation for patients who are seriously overweight. You should know that death is one of the risks. It can occur any time during the operation. It can also occur as a result of the operation. Death can occur despite all the precautions that are taken. There is a risk of gastric perforation (a tear in the stomach wall) during or after the procedure that might lead to the need for another surgery. In a U.S. clinical study this happened in 1% of the patients. There were no deaths during or immediately after surgery in the U.S. study. Your age can increase your risk from surgery. So can excess weight. Certain diseases, whether they were caused by obesity or not, can increase your risk from surgery. There are also risks that come with the medications and the methods used in the surgical procedure. You also have risks that come from how your body responds to any foreign object implanted in it. Published results from past surgeries, however, indicate that LAP-BAND® System surgery may have fewer risks than other surgical treatments for obesity.
Patients can experience complications after surgery.  They may include but not limited to:  nausea and vomiting, regurgitation, band slippage, stomach-band outlet blockage, infection, port leakage, band erosion. Surgical techniques have evolved to reduce slippage. Surgeons with more laparoscopic experience and more experience with these procedures report fewer complications.
Talk to your doctor about all of the following risks and complications:

The LAP-BAND® System is a long-term implant, but it may have to be removed or replaced at any time. For instance, the device may need to be removed to manage any adverse reactions you might have. The device may also need to be removed, repositioned or replaced if you aren't losing as much weight as you and your doctor feel you should be losing.
It is possible you may not lose much weight or any weight at all. You could also have complications related to obesity.
If any complications occur, you may need to stay in the hospital longer. You may also need to return to the hospital later. A number of less serious complications can also occur. These may have little effect on how long it takes you to recover from surgery.
Anti-inflammatory drugs that may irritate the stomach, such as aspirin and NSAIDs, should be used with caution.


PATIENT TESTIMONIAL
Had gastric bypass surgery with Dr. Wilcox at Sewickley Hospital in July, 2003.

Pre-surgery BMI: 49.5

I have lost over 100 lbs.
 

- Barb



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