Possible Complications of Bariatric Surgery

Bariatric surgery is not for the fainthearted. It is major surgery. Whether you have it in the U.S. or overseas, it is important to be aware of the risks. A federal government review of bariatric surgery in the United States reported that four of every 10 patients who undergo weightloss surgery develop complications within six months. This brings up the question of whether the risk is higher in other countries. In general, the answer is no. Hospitals and surgeons who do this sort of surgery adhere to uniform standards and procedures. However, there is one way that you can ensure that you will get the very highest standard of treatment: check if the hospital is certified by JCI (see Chapter 2). Also, make sure that the place you choose has performed many of the procedure you want. That is probably the best guarantee of success. The most common aftereffect of the operation is sagging skin. If you lose a few pounds, or lose weight gradually, the skin can adjust. But the skin cannot keep up with the dramatic weight loss that occurs after bariatric surgery. Skin that has been stretched for a long time may not contract completely. As Dr. Robert B. Nemerofsky, a surgeon in Secaucus, New Jersey, describes it: “If you stretch a rubber band out for a second, it snaps back. But if you stretch it out and hold it for a week, the rubber band will not contract back to its original size.” Therefore, many people who have bariatric surgery choose to undergo a second surgery after a couple of months to remove the excess skin. This is a much easier and simpler procedure. And if the weight is regained? The nowreduced skin simply stretches again to accommodate it, according to Dr. Jeffrey M. Kenkel, vice chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas. Postsurgical vomiting and diarrhea are also common. More worrisome are the risks of abdominal hernias, infections, pneumonia and respiratory failure, and the leaking of gastric juices caused by imperfect surgical connections between the stomach and the intestines. Recovery Is Not Necessarily Smooth and Easy Joanne Kayser, a 64yearold retired New Hampshire state employee, weighed 320 pounds in 2003 when she had decided to have weightloss surgery in Boston. She said, “The operation went well. It reduced my food intake. After the surgery, I lost 60 pounds.’’ Even better, her diabetes improved to the point that she no longer needed to take diabetes medications. Unfortunately, she developed complications during her recovery: “My incision did not heal for seven months. I could not exercise, and I stopped losing weight. The incision became infected, and I had to have surgery by a wound care specialist. In addition, after four months, I developed a hernia, a bulge in my tummy.’’ Her complications required further surgeries to resolve.