Risks of Surgery

• Wound Infection – Wound infections are less likely to occur with laparoscopic surgery than with the traditional open incision. However, patients with diabetes are at higher risk for developing wound infections after any type of surgery, and obese patients require larger doses of antibiotics to prevent post-operative infection.
• Pneumonia – Obese patients require more aggressive post-operative respiratory care to prevent fluid build-up in the lungs that can lead to pneumonia. It is believed that because patients who have laparoscopic surgery feel better than patients who have open surgery, they can attend to their respiratory needs with more ease and decrease their risk of developing pneumonia.
• Deep-Vein Thrombosis/Pulmonary Embolism – Deep vein thrombosis (DVT) is when a clot forms, typically in the leg. If a piece of the clot comes loose and travels through the bloodstream to the artery that goes to the lungs, it’s called a pulmonary embolism (PE). A PE is the leading cause of death in the U.S. after weight-loss surgery and is best prevented by staying active and doing lots of walking after surgery. Because patients who have laparoscopic surgery generally experience less discomfort than those who have open surgery, they are more comfortable in doing the necessary walking and are, therefore, thought to be at less risk for this complication to occur.
• Bowel Obstruction – The most common reasons for bowel obstructions to occur after surgery are adhesions (internal scar tissue) or internal hernia (bowel twisting). There is less internal scar formation after laparoscopic surgery versus open surgery.
• Incisional Hernia – Hernias that form along the incision, requiring additional surgery to repair, are less common with laparoscopic surgery.
• Bleeding – In the hands of our surgeons, it is rare to require a blood transfusion during or after gastric bypass or banding surgery. We do not recommend that patients donate blood prior to surgery.
• Death – The national mortality rate for gastric bypass surgery is 1:200, or 1 in 200 patients, the same as the mortality rate for any major surgery on an obese patient. This rate varies tremendously, depending on choice of hospital and surgeon and individual patients’ medical conditions.

• Adverse Events – Placement of the gastric band is major surgery and, as with any surgery, death can occur. Possible causes include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and infection due to a foreign object having been implanted in the body. Overall mortality rates for band are unknown due to the relative newness of the procedure.
• Band slippage and erosion of the band into the stomach may occur. This requires additional surgery or other procedures to repair, and removal of the band is frequently necessary.
• Obstruction of the stomach, infection, or nausea and vomiting may occur. Re-operation with possible removal of the band may be required.
• Dilation of the stomach and esophagus above the band may occur. Surgical removal of the band is often necessary to treat this.
• Reoperation with or without band removal may be required if the patient develops a hiatal hernia due to band placement.
• Severe acid reflux can occur after band placement, which may require band removal.
• Port complications including twisting, infection, leakage, breakage may occur. This requires surgery to replace the port or entire band.
• Rapid weight loss may result in complications that can require additional surgery. Deflation of the band may help alleviate excessively rapid weight loss or esophageal dilation.
• Food limitations means that patients frequently are unable to consume steaks, chops and thick breads after band placement.

• Leak – This is due to impaired healing at the connection between the new small stomach and the small intestine. Diabetic patients are especially prone to slow healing, as are those suffering from sleep apnea. Re-operation is sometimes, but infrequently, necessary to repair a leak.
• Stricture – This is due to over-scarring at the connection between the stomach and small intestine. Too much scar prevents food from passing through appropriately. The treatment is dilation of the scarred area by endoscopy (a short, outpatient procedure where a videoscope is passed through the mouth) and the patient returns home the same day.
• Other Possible Side Effects – nausea/vomiting due to overeating, dumping syndrome (where a patient feels ill due to the body’s negative reaction to high sugar or high fat foods), decreased alcohol tolerance and increased alcohol absorption from a given drink, mild constipation.