Risks of surgery
For all of our operations, there are the risks of the operation itself and the risks of the general anaesthetic. Modern anaesthetics are generally very safe but we arrange a thorough preoperative assessment where any potential risk factors are identified. Other specialists can be called in for opinions if required, and the consultant anaesthetists will meet you to discuss your anaesthetic beforehand. The hospital operating and anaesthetic facilities are state-of-the-art and all precautions are taken to reduce the risks.
Bleeding or leakage from a staple line or intestinal join may occur within the first 48 hours of surgery. One of the reasons for keeping you in hospital is to watch for these. Damage to your stomach, intestines or liver is possible during the operation and bleeding or perforation of the stomach or bowel may be the result. These problems are very rare but if they occur they are generally diagnosed and treated promptly. This may require a return to the operating theatre.
Most weight loss operation are done laparoscopically, i.e. using “keyhole” surgery, which avoids a large abdominal incision. However, there is a small risk that the laparoscopic operation will be converted to open surgery in the event of serious complications. Open surgery is associated with a longer hospital stay and longer post-operative recovery.
Another recognised risk of surgery is blood clots in the leg veins (Deep Vein Thrombosis, DVT). This can happen to anyone, but both obesity and laparoscopic surgery are independent risk factors. Every attempt is made to prevent this including by using injections to thin the blood, special stockings and calf pumps during the procedure. Getting you up out of bed and moving as quickly as possible after the operation is also important to keep the blood circulating. Due to all these measures, the risk of DVT is extremely low in our service, less than 1:200.
There are also long-term complications which may persist for, or arise after, months or years from the initial surgery. These are uncommon but include things such as:
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Slippage of a gastric band out of position, or erosion through the stomach wall
Once diagnosed the band may often be repositioned but sometimes requires complete removal -
Bowel obstruction
This is a rare problem that may occur after a gastric bypass. Because of the rearrangement of the intestines within the abdomen, the small intestine may kink and obstruct -
Stomach dilatation
Regardless of the operation done, if you regularly overeat the small stomach remnant can stretch and become less sensitive to the presence of food. This may lead to eating more and weight regain. Careful eating behaviour can prevent this -
Dumping Syndrome
This is nausea, bloating, abdominal cramps and perhaps diarrhoea after meals that may occur after a gastric bypass, again related to the rearrangement of the intestines within the abdomen. It can generally be prevented by eating appropriately and avoiding high calorie foods -
Weight regain
A little weight regain several years after surgery is quite common and can generally be controlled by attention to food choices, portion size and physical mobility. Massive weight regain is uncommon, and may be due to rare metabolic causes, but usually reflects a failure to make the right changes to lifestyle and eating behaviour following surgery -
Vitamin and other nutrient deficiencies
These are unusual but as you will be eating less, we recommend that you pay attention to the nutritional value of the food you put on your plate, and take a multivitamin supplement every day to prevent any future problems