Bariatric surgery is a medically supervised weight loss procedure particularly designed for patients who suffer from obesity or morbid obesity. There are four main types of bariatric surgery, gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch, which limit food intake and, in some cases, alter the digestive systemic normal function. Given the advancements made in the field, weight loss surgery is currently conducted using minimally invasive techniques.
Surgery is often the last resource after the failure of other options such as diet and exercise, pre-packed meals or pharmacotherapy. The most appropriate method is a decision made by both the physician and patient, taking into consideration comorbidities, Body Mass Index and other personal characteristics. The main benefit of surgery is the quicker, easier weight loss, however, patients need to also make behavioral changes in their diet and activity levels as well.
Bariatric surgery is not new — surgical weight loss procedures were developed in the 1970s and have been constantly evolving since that time. Contemporary procedures are now considered to be quite safe, however, there are also a series of risks and potential complications that need to be considered by a patient before making a decision, as different bariatric surgical procedures carry different levels of risk.
Risks Associated with Bariatric Surgery Procedure
Bariatric surgery includes possible health risks, starting with adverse reactions to general anesthesia. Post operation, excessive bleeding, infection and blood clots may also occur as part of surgery complications, similarly to lung or breathing problems. There is the possibility of leaks in the gastrointestinal system. In the case of adjustable gastric banding, additional surgeries may be needed to adjust, reposition or remove the band, however, these are usually minimally invasive and minor.
In addition, there is the rare, but existent, probability of death. The study “Bariatric Surgery: Risks and Rewards,” published in 2008, revealed that weight loss surgeries are safe and that their benefits are more significant than their risks. Regarding mortality, the investigators demonstrated that the rates for sleeve gastrectomy is 0.1%, for adjustable gastric band is 0.1%, for gastric bypass is 0.5%, while for biliopancreatic diversion with duodenal switch is 1.1%.
Long-term Complications Related to Bariatric Surgery
In addition to the risks associated with the procedure itself, there are other complications that may compromise a patients’ health in the long-term. Bowel obstruction and dumping syndrome may be developed as a consequent of the alterations in the digestive system. Gallstones, hernias and ulcers are also risks that can result from the procedure. In addition, low blood sugar (hypoglycemia) and malnutrition may be consequences of bariatric surgery.
In the study “Risks and benefits of bariatric surgery: Current evidence,” investigators from the Cleveland Clinic analysed the current scene about risks and complications from bariatric surgery and concluded that the emergence of new technology is altering not only surgical procedures, but also the methods to respond to these problems. The researchers note the importance of endoluminal approaches, a technique that is being studied and may help decrease the risk associated with bariatric surgery.
What’s the Safest Bariatric Surgical Procedure?
Gastric banding is regarded as the safest weight loss procedure, due to its minimal invasiveness and the fact that the stomach is not altered through survey, but is made smaller through the use of a band that wraps around the organ. In procedures such as sleeve gastrectomy, if the seam created by removing 90% of the stomach leaks, that leakage can cause sepsis, organ failure and death. In gastric banding, however, these grave risks are not present, since no incision is made.