Risks, Complications, and adverse situations you should know
With
all surgical procedures there are risks involved. When you decide to
have surgery performed on you, you should know the risks. Discuss the
possible risks and complications in detail with your surgeon. Only then
will you be able to make an informed decision.
Am I candidate for Lap Band Surgery?
What are the general risks?
Placing
the Lap Band
not only involves some of the risks that all major surgeries
have, but also the same risks that all obese patients have during surgery.
You should know that one of the risks is death and may occur at any
time during the surgery or as a result thereof. Although it is an extremely
rare complication, death may occur even with all possible precautions.
Another
risk is perforation of the stomach wall during or after the surgery.
In this case, the surgeon would be obligated to do another surgery to
fix the problem. A clinical study done in the US showed that gastric
perforation occurs only in 1% of patients that have the Lap Band surgery
done. No deaths during, or immediately after, the surgery were reported.
Age, as well as excessive weight, increases the risks of surgery. Some
diseases, whether caused by obesity or not, may also increase risks
and complications. Not only do medications and methods that are used
during the surgery increase risks, but also the body’s response to
a foreign object.
What are the advantages of the Lap Band System?
Results
of past surgeries show that the Lap Band System may have fewer risks
than other surgeries used to treat obesity. Patients may experience
complications after the surgery, and
some may have to be hospitalized; however, none have been serious.
A
study done in the US, followed for 3 years, showed that 88% of the 299
patients that were researched had one or more adverse events, ranging
from mild and moderate to severe. The most common complications were:
nausea and vomiting (51%), gastroesophageal reflux and regurgitation
(34%), slippage of the band or dilation of the pouch (24%), and obstruction
of the stoma (14%).
In
the same study, 25% of patients had to have their LAP-BAND System removed,
of which two-thirds were removed after the adverse effects arose.
Esophageal
dilation or poor esophageal function occured in 11% of patients; however,
long-term effects of this problem are unknown.
Constipation,
diarrhea, and difficulty swallowing occurred in 9% of patients, and
in another 9% of patients a second surgery was necessary to correct
the initial problem of the LAP-BAND System. In 9% of patients an additional
procedure was necessary to correct a bent access port or a leak.
To
decrease slippage of the band, surgical techniques have been improved.
Surgeons with more laparoscopic experience report fewer complications.
Some
adverse effects may occur that are not considered to be serious. They
occur in less than 1% of patients. These adverse effects include esophagitis
(inflammation of the esophagus), gastritis (inflammation of the stomach),
hiatal hernia (upward protrusion of the stomach), abdominal pain, incisional
hernias, infection, dehydration, diarrhea, constipation, flatulence,
dyspepsia (abdominal discomfort), belching (stomach producing gas, usually
with a characteristic sound), bloating, esophageal spasms, blood vomiting,
fatigue, fever, chest pain, pain at the incision site, irritation of
the skin, slow healing process, edema, parasthesias (tingling sensations),
dysmenorrhea (painful menstruation), hypochromic anemia, band leakage,
cholecystitis, esophageal ulcers, shifting of the reservoir, pain at
the entry site, lesion of the spleen, and infection of the wound.
Make
sure to ask your doctor about all of these possible complications. If
there is any term that you do not understand, ask him to explain it
to you.
How much weight will
I lose with the Lap Band?
Is there a possibility that
the Lap Band System may have to be removed?
Although
the Lap Band System is a long-term implant, it may be removed or replaced
at any moment. For example, the device may be removed to manage any
adverse reaction that exists and persists. The device will also have
to be removed, repositioned, or replaced if you are losing more weight
than what you and your doctor had planned for you to lose.
Laparoscopic surgery also has its
own problems and risks:
- Kidney or spleen damage
- Damaging of important
blood vessels
- Problems related to
the lungs
- Thrombosis (blood clots)
- Rupturing of the wound
- Perforation of the stomach
or esophagus during the surgery
Laparoscopic
surgery is not always possible. The surgeon may have to perform an open
surgery due to some of the reasons previously mentioned. This has occurred
in about 5% of the cases studied in the United States.
Additionally,
certain problems exist which are directly related to the LAP-BAND System:
- Spontaneous deflation
of the band (the leak may originate in the band, the reservoir, or in
the tube by which the band and the reservoir are connected)
- Slippage of the LAP-BAND
- Slippage of the stomach
- Enlargement of the pouch
- Blockage of the stoma
- Weakening of the gastric
band
Obstruction of the stoma may be
caused by:
- Food
- Swelling
- Improper placement of
the band
- Excessive inflation
of the band
- Slippage of the band
or the stomach
- Enlargement of the pouch
Reports have
indicated that the esophagus has stretched or dilated in several patients,
which may be caused by:
- Improper placement of
the band
- Improper adjustment
of the band (too tight)
- Obstruction of the stoma
- Excessive eating
- Excessive vomiting
Patients with
a weaker esophagus have an increased risk of esophageal stretching or
dilation. Passing food through a weak esophagus should be avoided. If
you have difficulty swallowing, ask your surgeon to evaluate the problem.
Losing
weight with the Lap Band System is typically slower and more gradually
than with other weight-loss surgeries. The band should not be tightened
to soon in order to try to accelerate weight loss, since this could
cause enlargement of the pouch or of the esophagus.
It is possible
that an infection could weaken the band. Although it rarely occurs,
it may happen just after the surgery or years later.
Learn
to use your gastric band like a tool that helps you to reduce the amount
of food you ingest.
What is going to be my diet afetr Lap Band Surgery
Some
complications with the Lap Band System not only minimize weight loss,
but also cause regaining of the weight lost.
Some patients
have more nausea and vomiting than others. If vomiting persists you
should consult your surgeon. Rapid weight loss may lead to:
- Malnutrition
- Anemia
- Gallstones
- And other complications
If
any complication occurs, you will need to stay in the hospital longer,
or return to the hospital immediately. Minor complications may happen,
but will have a very small impact on your recovery time.
If
you already suffer from complications like diabetes, hiatal hernia,
severe and chronic inflammation of the lower part of the esophagus,
emotional or psychological problems, you may experience major complications.
You
are also at greater risk for complications if you have had a surgery
in the same area before. Open surgery and inexperienced surgeons will
increase your risks.
No
autoimmune diseases or disruptions of connective tissue have been reported
as a result of the LAP-BAND System, although they have been reported
with other silicon devices. These problems may include sclerosis and
systemic lupus erythematosus.
No
clinical evidence exists that supports a relationship between disrupted
connective tissue and silicon implants. However, studies are being continued
to evaluate the possibility of a relationship between the two. If autoimmune
symptoms arise after the gastric band has been placed, you will need
treatment. The gastric band may have to be removed. If at the present
time you have autoimmune symptoms, the LAP-BAND System is not suitable
for you.
How is the LAP-BAND System placed?
Removing the LAP-BAND
If the Lap Band has been placed laparoscopically, it can also be removed
laparoscopically. At times, an open surgery may be necessary to remove
the band. A study in the United States showed that 60% of LAP-BAND Systems
were removed laparoscopically.
Surgeons
report that after a gastric band is removed, the stomach returns to
its normal state.
At
the present time there are no existing reasons suggesting that the band
should be replaced or removed at any moment, unless a complication occurs
or the patient has reached the desired weight loss.
Removing
the device requires surgery, one which has all the risks and possible
complications that any other surgery has. Risks for complications increase
with every additional surgery or procedure that has to be done.
Risks, possible complications, and adverse situations of the lap band procedure you should know
Before and after Lap Band Surgery, What to expect
Lap Band Surgery Frequently Asked Questions (FAQ)<
