Risk and Complications Bariatric Surgery
Like all surgical procedures, bariatric surgery carries potential risks and can result in unpredictable complications. Severe complications are rare. The relative risks and potential benefits need to be assessed on an individual basis and depend on factors such as your medical history and personal circumstances. This will be discussed with you by your doctor in detail prior to committing to any procedure. Some of the potential risks associated with bariatric surgery are outlined below.
These risks occur in the immediate post-operative period and require close monitoring.
Bleeding
Internal bleeding can occur due to blood vessel injury during surgery and external bleeding from the incision sites.
Infection
Infection at the surgical incision site and within the abdominal cavity due to leakage from an anastomosis (surgical connection between two organs) can occur. Signs of infection include redness, swelling, fever, discharge from the wound, or persistent pain.
Anastomotic Leak
Leakage from the newly created stomach pouch or bowel connections can lead to peritonitis, a life-threatening infection of the abdominal cavity. This would require immediate surgical intervention.
Blood Clots (Deep Vein Thrombosis – DVT & Pulmonary Embolism)
Due to prolonged immobility post-surgery blood clots are a risk.
Blood clots can form in the legs and may travel to the lungs (pulmonary embolism). Prevention includes early mobilisation, wearing compression stockings, and sometimes blood thinners.
Pulmonary Complications
Atelectasis (collapse of lung tissue) or pneumonia. This can occur in patients with sleep apnoea or obesity hypoventilation syndrome. Regular deep breathing exercises and post-operative respiratory physiotherapy can help.
Gastric/Abdominal Distension
Swelling of the stomach, bloating, or discomfort caused by the release of gas or air during surgery. This can be relieved by medications and avoiding swallowing air.
Adverse Reactions to Anaesthesia
This can include nausea and vomiting after surgery, allergic reactions to anaesthetic agents, heart attack or stroke, and airway complications, particularly for those with obesity and obstructive sleep apnoea.
Nutritional Deficiencies
Due to a reduced intake of food and reduced absorption of nutrients (especially in gastric bypass procedures). Common deficiencies include Vitamin B12, Iron, Vitamin D and Calcium, Folate and Protein. Management includes lifelong supplementation, routine blood tests, and dietary adjustments.
Dumping Syndrome (Primarily After Gastric Bypass)
This occurs when food moves too quickly from the stomach to the small intestine. Symptoms include nausea, vomiting, diarrhoea, dizziness, and weakness, typically after eating high-sugar or high- fat meals.
Gallstones
Rapid weight loss increases the risk of gallstone formation. Symptoms include pain in the upper right abdomen, nausea and vomiting. Gallbladder removal (cholecystectomy) may be necessary in severe cases.
Bowel Obstruction
This may occur due to scar tissue formation (adhesions), twisting, or internal hernias. Symptoms include severe abdominal pain, vomiting, inability to pass stools or gas. Treatment often requires surgical intervention.
Ulcers
Peptic ulcers can form at the surgical site, particularly after gastric bypass or sleeve gastrectomy. Symptoms include abdominal pain, nausea, vomiting, and indigestion. Medications to reduce stomach acid and avoiding nonsteroidal anti- inflammatory drugs (NSAIDs) may be advised.
Strictures/Stenosis
Narrowing of the connection between the stomach and intestine (or between the stomach and the oesophagus in sleeve gastrectomy patients). Symptoms include difficulty swallowing, vomiting, or regurgitation of food. Endoscopic dilation or surgical revision may be required.
Psychological Effects
Depression, anxiety, or feelings of body image dissatisfaction can occur, especially after significant weight loss. Eating disorders like binge eating or grazing may emerge, particularly if emotional eating was a factor pre-surgery. Behavioural support is included in each surgical support program at The BMI Clinic.
Excess Skin
Rapid weight loss can result in significant amounts of loose skin. Common areas include the abdomen, thighs, arms, and breasts.
Incisional Hernias
A hernia that develops at the site of the incision due to weakening of the abdominal wall. Surgery to repair the hernia is required.