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Weight Loss Surgery Risks
FIND OUT IF
BARIATRIC SURGERY IS RIGHT FOR YOU
Statistics once showed that 1 in 300 died from gastric
bypass surgery, but recent statistics indicate the procedure
has become much safer due to better methods of performing
both roux-en-y and laparoscopic gastric bypass. People who
suffer from morbid obesity can have other serious medical
conditions which are related to or caused by being
overweight.
The higher your BMI is, the more likely it is that other
medical problems will exist. Other medical problems can
increase the risk of complications from gastric bypass
surgery and the recovery period after gastric bypass
surgery. Another risk factor is age, although this increases
the need for surgery there is generally a higher risk. Any
medical procedure that involves humans and reactions to
stress, trauma, drugs, and other causes, unpredictable
negative results can and will occur. This surgery should be
considered only after many attempts with other diet control
and exercise have failed. Diet and exercise will be required
before and after this surgery.
Statistical data associated with this gastric bypass
surgical procedure include: failure to lose weight (about
10%), some complication of surgery (10% - 15%), serious,
life-threatening complication (about 2% - 3%), and even
death (less than 1%). On the other hand, the risks
associated with morbid obesity far outweigh the risks
associated with surgery.
For example, studies prove that the individual who is 100%
over ideal weight has a risk of mortality that is ten times
that of a slender counterpart (meaning that an obese
individual's chance of dying is ten times as great in any
given year). There is no question that the potential
benefits of surgery outweigh the risks.
Since gastric bypass surgical procedures result in some loss
of absorptive function, the long-term consequences of
potential nutrient deficiencies must be recognized and
adequate monitoring must be performed, particularly with
regard to vitamin B12, folate, and iron. Some patients may
develop other gastrointestinal symptoms such as "dumping
syndrome" or gallstones.
Occasionally, patients may have postoperative mood changes
or their pre-surgical depression symptoms may not be
improved by the achieved weight loss. Thus, surveillance
should include monitoring of indices of inadequate nutrition
and modification of any preoperative disorders. The table
below illustrates some of the complications that can occur
following gastric bypass surgery.
Recommendation: Gastric bypass surgery is an option
for carefully selected patients with clinically severe
obesity (BMI 40 or 35 with comorbid conditions) when less
invasive methods of weight loss have failed and the patient
is at high risk for obesity-associated morbidity or
mortality. Evidence Category B.
After gastric bypass surgery, an occasional patient may have
a complication relating to the staple line or the outlet of
the pouch. For example, there might be leakage, perforation,
or bleeding where some staples are dislodged by
overstretching of the pouch. Other possible complications
are formation of an ulcer or stricture or failure of the
staple line to heal properly. These kinds of problems might
make additional surgery necessary. Though all precautions
are taken to prevent them, complications occasionally occur.
For the first month or so, the patient may experience nausea
and vomiting until he or she becomes accustomed to the new
small stomach. Afterwards, patients enjoy a feeling of
satisfaction with small amounts of food.
About one out of twenty-five patients may need to be
readmitted to the hospital because of vomiting. In the first
few weeks after surgery, vomiting may be caused by swelling
at the operative site. Later, there is a possibility that
vomiting might be caused by formation of a stricture, by
scarring of the outlet of the stomach pouch, or by
obstruction of the pouch outlet by a lump of poorly chewed
food, tablet, or other foreign body. In most cases these
complications can easily be corrected, without additional
formal surgery.
Because of the limitation of food intake, supplemental
vitamins must be taken. Vitamin supplementation will always
be necessary to minimize the risk of anemia, weakness,
muscular un-coordination, and clinical depression. During
the first few weeks following surgery, a liquid or chewable
vitamin is advised. Afterwards, any good multivitamin
preparation containing adequate amounts of the B-complex
vitamins and minerals is sufficient.
There is some evidence that babies may be born with
congenital abnormalities when there is rapid weight loss
during pregnancy. Therefore, pregnancy should be avoided
until weight has stabilized. Once weight has stabilized,
there are no contraindications to pregnancy.
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