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Risks of Surgery

Possible Risks Associated with Bariatric Surgery

Bariatric surgery presents risks similar to those of any other abdominal surgery. These risks vary depending on the medical history of each patient, but some of the more common problems that can occur are listed below.

Potential Risks to the Lungs: Pulmonary Embolus, Atelectasis and Pneumonia

  • Deep Vein Thrombosis - The decreased activity and slowed blood flow caused by bariatric surgery (and associated with obesity) increases the chance of deep vein thrombosis, which is a blood clot in the legs. A pulmonary embolism occurs when a blood clot breaks off inside the vein and floats through to the lungs. Blood-thinning medications can help prevent clotting, and special compression stockings can help increase the speed of blood flow in the veins. Walking also helps prevent blood clots by improving circulation, and patients are encouraged to walk on a regular basis beginning the night following surgery.
  • Atelectasis - After bariatric surgery, the patient's breathing may not be enough to fully inflate the lungs. As a result, the tiny air passages in the lungs may not be able to stay open, resulting in  partial collapse. This condition is called atelectasis, and a program of walking and deep breathing and cough exercises is the best treatment. The patient is taught these exercises before surgery, and with the use of a CPAP machine
  • Pneumonia – A lung infection that can result from blockages in the lungs such as those caused by atelectasis, or from a build up of respiratory secretions. One means of preventing pneumonia is careful attention to the prevention of atelectasis.

Chance of Infection

Five to ten percent of bariatric surgery patients experience infection in the incision after the procedure. Obesity causes a very deep layer of fat beneath the skin, and this layer is susceptible to infection. In most cases, infection is not a serious problem. Although inconvenient, reopening the incision is usually sufficient treatment.

Abscess Formation

After a bariatric procedure, a pocket of fluid can develop. The presence of baceria can cause the fluidto become infected – this creates an abscess. An abscess is usually treated by surgically draining the fluid and introducing antibiotics.

Anastomotic Leak

During bariatric surgery, incisions are made between the bowel and stomach, and within the bowel itself. If a complete seal is not formed when closing these incisions, fluid can leak out of the bowel into the abdominal cavity. This is called an anastomotic leak, and can lead to a serious infection or abscess. A second surgical procedure may be required, depending on the size of the leak, but smaller leaks may be treated by inserting a drain into the infected area.. If this occurs, the patient will be unable to eat or drink for a period of time. An anastomotic leak usually results in a longer hospital stay, and the drain may create discomfort for the patient.

Infected Bladder

During surgery, a urinary catheter is put in place to manage urine build up, and is usually left in place for the first night after the procedure is completed. The presence of the catheter can lead to infections in the bladder, which are usually treated with antibiotics.

Hemorrhaging (Internal Bleeding)

In order to perform bariatric surgery it is necessary to cut blood vessels, which are then stitched back together to prevent bleeding. In some cases, a procedure called electrocautery is used to create a clot over the cut blood vessel. In some cases, the vessel will continue to bleed, either inside the abdomen or under the skin; in those instances, the bleeding is usually controlled with medication rather than additional surgery.

Anastomotic Stricture and Bowel Obstruction

  • Anastomotic Stricture
    Gastric bypass surgery reduces the size of the passage that allows food to leave the stomach. As healing progresses and scar tissue forms, this passage can become even smaller, and restrict the passage of food completely. This is called an anastomotic stricture. Five to ten percent of gastric bypass procedures result in this condition, and it is treated on an outpatient basis.
  • Bowel Obstruction
    Scars or adhesions may form as a result of any abdominal surgery. In some cases, a bowel obstruction occurs, which is a kink in the bowel at the location of the adhesion. In some cases, additional surgery is required to fix the problem.

Problems with Nutrition after Surgery

For patients who follow their doctor's instructions, difficulties with nutrition are rare after surgery. Most problems can be avoided with a healthy diet supplemented with the right vitamins and minerals. Patients will have access to the guidance of a dietician for further information. Below is a list of simple measures that patients should take to help ensure maximum comfort and proper nutrition following surgery.

  • Food Awareness
    In some cases, a condition called "dumping syndrome" may occur after bariatric surgery. This means that food is passed too quickly from the stomach to the intestines. Symptoms include lightheadedness, cramping and abdominal pain, rapid heart rate, profuse sweating, nausea and diarrhea. To prevent this problem, patients should avoid sweets and fried, fatty or greasy foods. In addition, patients should be careful not to eat too much at one meal, and should avoid drinking fluids with meals. Finally, patients are advised to avoid red meat for at least three months after surgery.
  • Preventing Anemia and Osteoporosis
    After bariatric surgery, patients must supplement their diets with a high-potency multivitamin and mineral supplement, since they will not be able to eat enough food to meet the recommended requirements. Daily intake of calcium, B12, and iron supplements are also encouraged to help maintain adequate levels, and to prevent osteoporosis and anemia.
  • Proper Protein Intake
    In order to maintain the health of tissues and organs after bariatric surgery, patients need a steady intake of protein. Because gastric bypass reduces the amount of food that can be eaten, starting each meal with additional protein-rich foods is recommended.
  • Pacing Yourself at Mealtime
    Following gastric bypass surgery, patients need to stop eating as soon as they feel full. Continuing to eat will result in nausea and vomiting. It takes time to learn new eating habits such as thorough chewing and eating slowly, and most patients experience some nausea and vomiting at first. A slower pace helps the patient learn to stop eating at the point of fullness, and even a single bite can make the difference.

To register for a free informational seminar or to make an appointment for a consultation with a Temple bariatric surgeon click here or call 1-800-Temple-Med (1-800-836-7536).

This page is intended to provide tips and guidelines only, and should not be taken as a definitive medical or dietary plan for patients of bariatric surgery. For detailed information about diet and nutrition specific to your needs, consult your doctor or dietitian.

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