Handling Complications

What Are Possible Bariatric Surgery Complications?

Some potential bariatric surgery complications that can occur after any abdominal operation (including but not unique to bariatric surgery) may include:

• Incisional pain
• Infections
• Bleeding
• Incisional hernias
• Blood clots in the legs (DVTs)
• Heart attacks
• Pneumonia
• Obstructions (difficulty with food moving through due to scar tissue)

At the BMCC we have specifically designed effective protocols and clinical pathways to prevent these complications*.

Other possible complications and considerations that are more specific to bariatric surgery may include:

• Leaks at surgical sites
• Ulcers (to combat this, avoid ulcer-causing substances: nicotine, caffeine, alcohol, drugs, and NSAIDS)
• Vitamin or protein malnutrition (you’ll need a lifelong commitment to vitamin/protein intake as directed)
• Excess skin
• Internal hernias
• Dumping syndrome (usually only with the bypass)
• Gallstones:
  • Gallstones can form after bariatric surgery. However, recent studies have shown that the risk of developing this problem after bariatric surgery is no higher than in the general population. Because of this, in most bariatric practices (including the BMCC) healthy gallbladders are not routinely removed at the time of bariatric surgery.
• Finally, weight regain is always a possibility with any surgery, so maintaining a strong commitment to the post-surgical pathway is critical.

Special considerations for each surgical option:

Surgical Option	Special considerations	Unique Planned Responses
LAP-BAND® Complications	-Internationally high removal rate (25-40% in first 5 years alone)	-Not a good surgical option for most patients
Gastric Sleeve Complications	-Increased reflux/heartburn	-Careful patient selection based on reflux severity -Hiatal Hernias are repaired at the time of surgery -Antacids are used when needed
Gastric Bypass Complications	-Slightly higher ulcer risk -Dumping syndrome -Nutrient deficiencies	-Eliminate ulcer-causing substances; use antacids -Avoid sugar-containing foods -Specific vitamin/protein protocol and testing
Loop Duodenal Switch (SADI-S) Complications	-Increased reflux (similar to sleeve) -Nutrient deficiencies -Loose or fatty stools (about 2 stools per day)	-Hiatal hernia repair, and antacids when indicated -Specific vitamin/protein protocol and testing -Avoid fatty foods

Dr. Long and your team at the BMCC are perfectionists who meticulously craft the details of your care before, during, and after surgery. Careful planning has yielded excellent results in our patients and minimizes your chances of experiencing the complications listed above*. However, most patients should realistically expect some excess skin after surgery.

How Often Do Bariatric Surgery Complications Happen?

Although bariatric surgery is more complex than minor abdominal operations, the good news is that in the right hands your surgery doesn’t need to carry significant additional risk of major complications*. It is very important that you choose a center that is fully accredited as a comprehensive MBSAQIP center, that you choose a very careful bariatric surgeon, and that you choose a practice with a comprehensive care team in place.

Dr. Long’s experience and careful planning have established his practice as an industry leader in bariatric surgery. The BMCC is a comprehensive MBSAQIP center that contributes several “best practices” to the national level and is recognized as a leader in bariatric surgical quality outcomes. As a result, our patients have done exceptionally well and lead the nation by achieving very low complication rates with superior weight loss*.

How Does the BMCC Handle Bariatric Surgery Complications?

At the BMCC, Dr. Long believes in handling bariatric surgery complications before they happen. Because of this, both Dr. Long and your team at the BMCC have developed extensive protocols (and education) before, during, and after surgery to prevent most complications*. He has also built models that identify additional risk differences in patients. The entire team works very hard to get to know each patient and understand how each individual patient factor may contribute to risk. With this clear understanding, additional safety planning ensures the lowest possible risk*.

Dr. Long is very transparent about how any additional health problems may translate into increased risk and what further steps will be needed to minimize this risk.  While careful planning, technical expertise, and thoughtful care can reduce your risk below national averages, it is also important to note that there is never zero risk with any operation. If rare complications were to arise, Dr. Long and the BMCC do an exceptional job of early recognition and aggressive management to minimize the impact and further optimize good outcomes*.

What Is Dumping Syndrome?

Dumping syndrome is a gastric bypass complication because it occurs when the stomach’s emptying valve has been bypassed. This means that foods rich in sugar or in carbohydrates (and very rarely deep fried/fatty foods) pass rapidly into the intestines before they are ready to receive this load. These sugary foods then draw a large amount of water into the intestines very rapidly, producing some or all of the following symptoms:

• Sudden watery diarrhea
• Cramping and abdominal pain
• Nausea and vomiting
• Sudden tiredness
• Heart palpitations
• Sweatiness
• Sudden dizziness (blood pressure may actually drop)

The good news is that for almost every patient, dumping syndrome is easy to control by avoiding the foods that cause it, avoiding liquids around the time of meals, and ensuring adequate fiber with meals. In fact, this is what every bypass patient should be doing anyway. In a very strange way, dumping syndrome can serve as a reminder to reinforce behaviors that will lead to better and more sustained weight loss as well as better long-term health*.