WHAT ARE THE SIDE EFFECTS OF BARIATRIC SURGERY
Understanding how Bariatric surgery works can help in preventing the disadvantages of bariatric surgery. Perception about side effects of bariatric surgery is over discussed amongst the public at large than actual.
Laparoscopic sleeve gastrostomy i.e.; surgery in which a small part of the stomach is removed outside the body, decreasing the stomach remnant volume to 150-200 ml is the most common surgery done worldwide.
SHORT TERM RISKS OF BARIATRIC SURGERY
- The overall risk is less than 0.3 percent a summary of the possibilities are mentioned below
- There is a Possibility of leak through staple line which may require emergency re-surgery or stenting, some may need nutrition through saline (TPN)till the leak is cured.
- Bleeding – May require blood products or surgery but this generally stops on its own
- Possibility of wound infection in the postoperative period, which may need repeated dressing/ re-surgery/prolonged antibiotics. The cost for the hospitalization may escalate if any complication/delayed recovery occurs. This risk in bariatric surgery is as present in any other Surgery.
- Not so common side effect of bariatric surgery is the possibility of Deep Vein Thrombosis, pulmonary thromboembolism, cardiac ischemia/infarction, cardiac arrhythmia, Renal failure, pulmonary infections, etc in the perioperative or postoperative period.
- To prevent leak and bleeding a good Surgical technique is necessary, for deep vein thrombosis prevention anti-DVT Stollings and Pumps as well as drugs to prevent the same are used routinely.
LONG TERM RISKS OF BARIATRIC SURGERY
- Possibility of GERD because of reflux of acid in food pipe which may require antacids or any endoscopic or surgical intervention.
- Possibility of surgery for skin laxity, which can be prevented by regular intake of supplements, some require abdominoplasty later on
- Gall bladder stones due to rapid weight loss which may require Cholecystectomy, to prevent gallstones some medicines do help
- Possibility of weight regain if the dietary and exercise instructions are not followed
Females in the reproductive age group are advised to avoid pregnancy for at least 1 year post surgery and advised to use dual contraceptives till then as per Gynecologist opinion.
It is important that the patient is treated by the well qualified and experienced Bariatric surgery team of Surgeons, Physician, Endocrinologist, Pulmonologist, dietician, Physiotherapist, and Nursing staff so to avoid the complications. Thorough investigations of the patient are necessary before the surgery as many times a few diseases which are not evident like Hyperuricemia, Prediabetes or diabetes, etc. are diagnosed in these checkups. There is a need to follow up at regular intervals even after the primary surgery/treatment is over.
Side effects of bariatric surgery are minimal to the health risks which are associated with obesity. The cost of investigations for obesity-associated diseases like Diabetes, Hypertension, etc., annual amount spent on medications, hospital admissions one requires in a lifetime especially in diabetics to manage complications and number of days lost at work all put together is tremendous compared to a less than 0.3% overall risk in undergoing the surgery. One should choose this surgery with complete knowledge.