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Bariatric surgery, which encompasses several modification procedures that lead to weight loss, proves to be a benefit for many. As obesity remains the second cause of premature death in the United States after smoking, bariatric procedures like gastric bypass surgery ultimately let people be more active and lower risks and illnesses associated with morbid obesity.
However, death rates and complications remain particularly high, especially for certain groups like the elderly, men, and those disabled by obesity. Specifically, one in 350 people die from the procedure and 40 percent of all who get gastric bypass surgery yearly experience complications of some kind.
Understanding Bariatric Surgery
Multiple procedures fall within the category of bariatric surgery: Roux-en-Y gastric bypass, vertical banded, adjustable gastric band, sleeve gastrectomy, gastric balloon, gastric placation, sleeve gastrectomy with duodenal switch, jejunoileal bypass, and endoluminal sleeve.
Out of these, gastric bypass remains the most popular bariatric surgery in the United States. Procedures may be open or less invasive with laparoscopic surgery. For this procedure, the stomach gets shortened and rerouted: A stapler makes a smaller pouch, which is then connected to the distal small intestine. The upper part of the small intestine then gets reattached.
Doctors typically tell patients the risks of mortality are one in 500 or one in 1,000. Hospital stays last from two to six days, and by three to five weeks after, a patient may resume ordinary activities.
Complications and Risks
Studies have shown that, on average, one in 50 patients dies 30 days after bariatric surgery, while three percent of patients under age 40 die in 13 years and 12 percent of all patients die in 15 years. 10 to 20 percent of all patients need a corrective operation, often to deal with abdominal hernias, gallstones, a leak, infection, or deep thrombophlebitis.
Risks and complications may arise from the following instances:
Lack of Experience: Studies have found that patients who undergo gastric bypass surgery with surgeons who have less experience (have performed the procedure less than 70 to 100 times) have a greater risk of complications. In certain cases, hospitals have allowed surgeons to perform gastric bypass after just going through a weekend seminar.
Greater Risks for Certain Demographics: A 2005 study of 16,155 Medicare patients published in the Journal of the American Medical Association shows certain groups have a greater mortality risk from bariatric surgery than others. In some cases, risks increase from the one in 500 statistic to one in 50. The risks tend to be greater for the elderly, men, people with hypertension or similar conditions, and people disabled by obesity.
Failure to Diagnose: Prior to a procedure, a physician may fail to properly screen a patient for gastric bypass surgery. Once the procedure is finished, medical professionals may fail to properly diagnose and treat leakage of gastric fluid, pulmonary embolism, or gastric bleeding.
After the procedure, patients may experience:
- Leaks: This occurs in the stomach to abdominal cavity or where the intestine is connected. Peritonitis or a blood clot has potential to result.
- Intra-abdominal abscess
- Bowel obstruction
- Major airway events
- Organ injuries
- Pulmonary embolism
- Gallstones (estimated for 33 percent of all cases)
- Vomiting and nausea: This may result when the connection narrows between the stomach and intestines.
- Iron, B12, calcium, or other nutritional deficiencies leading to anemia or osteoporosis.
- Dumping syndrome: With this condition, the food progresses too quickly through the stomach and intestines. Symptoms include nausea, weakness, sweating, feeling faint, and diarrhea after eating and are made worse by high-calorie or refined foods.
- Loose stomach staples: In recent years, the FDA has received reports concerning surgical staples and medical staplers from Ethicon and U.S. Surgical, whose products are used for all bariatric surgeries in the United States.
In spite of all risks, demand for bariatric surgery continues to grow. Yet, patients hoping to improve their condition find themselves dealing with life-altering complications.