Bariatric Surgery Risks

Do I Qualify? | Bariatric Surgery | Lap Band | Realize Band | Gastric Bypass | Health Benefits | StomaphyX |
Risks | Choosing a Procedure | BMI

Our approach to patient care has resulted in zero mortality to date and a complication rate that is lower than the national average. These surgical results stand out as some of the best in the nation.

The risks of bariatric surgery are not insignificant and must be weighed against the health benefits of losing weight and becoming free from obesity and its related problems. It is important for you to understand that the risks of surgery are low and that the majority of patients have no complications.

To prevent long-term risks, continued medical surveillance with your weight loss team is recommended for the rest of your life.

According to the American Society for Metabolic and Bariatric Surgery 2004 Consensus Statement, the operative morbidity (complications) associated with gastric bypass in the hands of a skilled surgeon is roughly 5 percent and the operative mortality (death) is roughly 0.5 percent (1 in 200).  For the Lap Band the same consensus statement reported that in the hands of skilled surgeons, the operative morbidity is approximately 5 percent and operative mortality is approximately 0.1 percent (1 in 1,000).

However, as with any surgery, there may be 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
• Pain
• Infection
• Pneumonia
• Complications due to anesthesia and medications
• Deep vein thrombosis
• Pulmonary embolism
• Heart attack
• Death

Risks are associated with any type of surgery, including abdominal surgery.  These risks are greater for individuals who suffer from obesity.  Your weight, age and medical history play a significant role in determining your specific risks. Your surgeon can inform you about your specific risks for bariatric surgery.

Additional Risks Associated with the Lap Band

• Migration of implant (band erosion or band slippage)
• Tubing-related complications (tube kinking or leak)
• Band leak
• Infection

Additional Risks Associated with Gastric Bypass

• Leaks from staple lines
• Ulcers
• Dumping syndrome, an unpleasant side effect that may include vomiting, nausea, weakness, sweating, faintness, and diarrhea
• Stenosis (narrowing of a passage, such as a valve)

Compare Mortality Rates

Procedure	Mortality Rate	Occurs In…
Gastric banding	0.1%	1 out of every 1,000 people
Gastric bypass	0.5%	1 out of every 200 people
Hip fracture repair	3.3 to 8.2%	6 out of every 200 people

Side Effects:

Certain side-effects are seen with weight-loss operations simply because of the amount of weight loss in such a short period of time. These are seen also in people who have had successful weight loss without surgery.

Dumping Syndrome (Gastric Bypass patients only)
The "dumping syndrome" in which food moves too quickly through the small intestine can cause nausea, weakness, sweating, faintness, and sometimes diarrhea after eating. There can also be an inability to eat sweets without severe weakness and sweating causing patients to lie down to let the symptoms pass. “Dumping syndrome” is a good side effect because it encourages patients not to eat sweets. Dairy intolerance, constipation, headache, hair loss and depression are other possible side effects.

Transient Hair Loss (Gastric Bypass or Lap Band)
Hair loss and thinning is a common side-effect which may occur during the first 6 months. Although it is alarming, it will not lead to baldness and is reversible. Once your weight stabilizes and you take in more protein, the hair will grow back. Hair treatments and permanents should be avoided. Be sure to take in an adequate amount of protein. Most patients report that their hair returns fuller and thicker than before.

Nausea or Vomiting (Gastric Bypass or Lap Band)
Since the new stomach pouch is smaller, it will not be able to hold as much food. If you get full but continue to eat more or eat quickly without chewing thoroughly, chances are an episode of vomiting will result. These habits will change after several episodes of vomiting occur. You will have to "re-learn" your way of eating by eating slower, chewing food well and stopping when you feel full.

Lactose Intolerance (Gastric Bypass patients only)
The enzyme needed to digest milk and other dairy products (lactase) does not reach food in the usual fashion and may not be able to fully digest milk. Undigested milk can lead to gas, cramping and diarrhea. You may need to avoid dairy products and eat foods which do not contain lactose (i.e. soy milk, lactaid).

Hernia (Gastric Bypass or Lap Band)
Hernias are weaknesses in wounds and lead to a sometimes-painful bulge that tends to enlarge with time. This continues to be a problem when the gastric bypass is done using an incision. The risk of a wound hernia occurring is 1-2% with laparoscopic surgery or 10-20% greater with open surgery. If a wound hernia occurs, another operation is required to repair it. We typically wait one year until maximum weight loss has occurred before repair.

Gallstones (Gastric Bypass or Lap Band)
Up to one-third of obese patients who have bariatric surgery may develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones increases. Additional surgery to remove the gallbladder may be necessary. Some patients may have their gallbladder removed at the time of the obesity surgery if they have gallstones.

Vitamin and mineral deficiencies (Gastric Bypass patients only)
These can be prevented by taking vitamins, minerals, and having careful follow up with your primary care physician and a nutritionist. Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus. Most patients are required to take daily multivitamins and calcium with vitamin D. Some patients may require vitamin B12 or iron supplements as well.