Benefits and Risks
- Multiple studies have documented that severe obesity is associated with very high risks of health problems, early death, and cancer.
- The loss of as little as 10% of excess weight has been shown to reduce or eliminate the need for medications associated hypertension, diabetes and lipid disorders.
- In addition, patients may resume exercise and become more active.
- Sleep apnea and shortness of breath can be reduced or eliminated.
- Overall improved self-esteem and establishing a new healthier lifestyle can be the end result.
Surgery for severe obesity is a major operation in which complications can arise whether performed by a laparoscopic or open technique. Overall about 5-8% of patients have a risk of a complication related to the surgery, and 0.5% risk of death. Other than the known risks of anesthesia and any major abdominal surgery, the specific problems which have been reported include:
- Pulmonary Embolism.
- Bleeding or injury to the spleen
- GI tract obstruction secondary to adhesions, scarring, or strictures.
- Malnutrition or anemia
- Chronic vomiting or diarrhea.
- Infection secondary to leakage from the stomach or intestines.
Long term, 1-2% of patients have their surgery reversed due to side effects or dissatisfaction with the restriction on food intake. All patients are advised to take vitamin and mineral supplements to minimize nutritional or metabolic side effects. Because of the potential for nutritional problems, patients should undergo periodic assessments for life.
The principle causes of severe complications and death are blood clots and leakage from the GI tract. We have performed over 2000 laparoscopic bariatric surgeries and have had 5 deaths (0.25%). Three occurred from pulmonary emboli, one from leakage in which the patient refused to return to the hospital for treatment, and one from heart failure in a patient awaiting a heart transplant. Overall, we have had 5 patients (0.25%) develop leaks post-operatively.
Our average weight loss varies according to the procedure performed. The Gastric Bypass averages 75% excess weight loss with 90% of our patients maintaining this at 7 years post-op. The VBG and Lap-band average 50% excess weight loss and approximately half the patients maintain this at 5 years.