Frecuently Asked Questions Which are the risks of the surgery?
Without a doubt, this is one of the most frequent questions and perhaps the one that requires of a greater explanation. Making the decision of getting through an operation is very serious and important. It is our responsibility always to show the risks and advantages not only about the surgery, but also of stop being obese.
Evidently, the risk of surgery is associated with different factors, but the most important fact is related with the issue pertaining that greater weight or BMI, leads to greater risks .It is understood that if greater difficulty surgery is done, the risks also raise.
In general terms, the procedure with lowest risks is the gastric band placed by laparoscopic surgery and the one of the greatest is the duodenal switch. We will mention some of them.
Respiratory complications:
a.1)
Lung Thromboembolism: This is about the probability of clot formation that can travel through the blood stream causing an obstruction of it in some area of the lungs. Its presence causes chest pain, breathing difficulties and sometimes it is so severe that it can cause death. The way to diminish its appearance is by applying some types of anticoagulant in a preventive form even before surgery. To apply gradual compression systems on the legs with pneumatic hoses and, to make patients rise from the bed and walk in a fast form after the surgery. Any patient can have this risk, and in any type of surgery, nevertheless, the obese patients have greater probabilities of having it, for that reason, moving outside the bed is insisted at almost 6 to 8 hours after the surgery.
a.2)
Atelectasis- This complication means the obstruction of some lung segment, but by bronchial secretions. Habitually it is recommended to initiate lung strengthen therapy before the surgery and of course to stop smoking in the case of having the habit. In addition, this therapy is continued after the surgery and sometimes other measures like steaming and more. Sometimes the mucous tampon requires extraction through endoscope equipment, solving the problem completely. Furthermore, to smoke and to be obese increases the risk of this complication so, to rise and to walk quickly after the surgery, reduce the probability of its presentation.
Infection. - The risk of infection of the surgical wound goes related to the type of surgery. The laparoscopic approach has much less probability of infection, contrary to open surgeries. In the case of appearing, it might be necessary to open the wound partially or totally to carry out treatments and to control the event.
Bleeding. - Any surgery has the risk of presenting bled because cuts are being made in the tissues. Certainly, surgery is made with the necessary cares, using diverse mechanisms to avoid or to stop some bled, like stitches, electro-surgery, and diverse resources as coagulation-cuts with harmonic scalpel systems or even argon lasers. In spite of it, the probability of some remain bleeding can possibly appear after the surgery was concluded. In very few occasions a new surgery can be required to stop the new bled.
What happens if fistula appears? In the case of being under a surgery where resections of the stomach and anastomosis lines between the stomach or intestine were made, the risk of presenting fistula or leak is from 1 to 2%. This represents one of the most serious complications that can lead to the development of severe infections and to fatal ending.
If the presence of some leak is discovered in the first 3 to 4 days after the surgery, it would be necessary to reoperate and to carry out some procedure to correct the problem. Surely, the time within the hospital will extend and could need to receive some type of artificial feeding through some parenteral access.
If the leak or fistula appears after the 5th day, could only require to have the site well drained where it leaks and is possible not necessary to operate again but it would possibly make the stay within the hospital longer.
What are the long-term complications the surgery can have? If you had a gastric band surgery, there are some well defined complications with a probability of around 3% of happening.
The gastric band could slide or the stomach could suffer a hernia through the band, causing great gastric deposit above the band and will be to relocate or to retire the band.
Sometimes the band can migrate or to erode towards the interior of the stomach and its retirement will be necessary.
The smaller complications can appear in the site of the port or of access to the band, where leaks, pain, inflammation, could require of small surgeries to correct the situation.
In the case of the duodenal switch surgery, the complications could be related to the ingestion and the absorption of vitamins, minerals and proteins. Nevertheless, if the person takes the supplements in a suitable form, it is little probable that these complications would appear.
Can I return to gain weight as time passes by? In the purely restrictive surgery, this can happen after the first 5 to 6 years. Nevertheless, with the adjusting possibilities in the case of the bands, it is possible try to close more the band, to be put under suitable nourishing regimes and weight can be maintained and not to regain more weight.
In the case of the duodenal switch surgery, it is less probable that this happens since the mechanism of bad absorption is in charge to avoid the re-gain of weight and it has demonstrated this for more than 15 years.
How long will I stay out of my working activities? If the surgery was made by laparoscopic means, we habitually recommend around 10 days outside the working activities.
In the case of conventional open surgery, it is recommended for the patient to take around 18 to 20 days.
Finally, this also depends on the kind of surgery and not only on the procedure, but also in the recovery capacity of each patient.
What type of anesthesia is used? General anesthesia is always used, placing a tube within the trachea to maintain suitable pulmonary ventilation.
The control measures taken in the operating room to watch the respiratory and cardiac operation are highly safe.
The experience and equipment of the anesthesiologic team also makes this procedure safer.
The obese people can have certain characteristics that can make difficult to put the endotracheal tube, but having the necessary technology for these kinds of situations will allow this difficulties to be solved.
