One of the most serious surgical complications that can occur following Roux En Y Gastric Bypass or Sleeve Gastrectomy is a leak. In a Gastric Bypass a leak can occur from the connection between the new stomach pouch and the small intestine, or at the connection between the bowel. In Sleeve Gastrectomy a leak could occur from the stomach. The occurence of a leak is quite rare, and we test it during surgery. If a leak is suspected after surgery, further testing is done. There are several methods used to treat leak and they usually involve surgery or endoscopic procedures. The risk of this complication is in the range of 1 or 2 out of 1000.
The heart is required to do extra work during any surgery or stress, and because Gastric Bypass surgery is a major stress it should be apparent that it will result in significant extra demands on the heart. For this reason, we evaluate our patients carefully pre-operatively. We will consult with cardiologists when needed to help make your surgery as safe as possible.
Pulmonary Embolus (Blood Clots)
Lack of movement following surgery can allow blood clots to form in the large leg veins, which can float up into the blood vessels of the lungs. This is a serious and even life threatening event, usually (but not always) manifested by sudden shortness of breath, rapid heartbeat, and a feeling of weakness. Blood clots will most likely occur during hospitalization, but the risk persists at ever-decreasing levels until a month or so after surgery. This is why compression devices are used on your legs during hospitalization and blood thinners are given. Further, flexing your ankles and wiggling your toes are encouraged throughout your hospitalization and until you are at full mobility following surgery.
The "rerouting" of the intestine and the scar left in the abdomen by the operation can cause the intestine to become blocked at some point after the operation. This can occur from weeks to months or even years after the surgery and can require re-operation.
A few patients have long term nausea or intolerance to food, in the absence of a physically identifiable problem. This is a rare problem.
Pulmonary (lung) problems
Pneumonia, and fluid on the lungs are some complications that can focus specifically on the lungs. These complications show up within the first 72 hours after surgery or within the first week. Usually they can be managed by medications and getting the patient walking. The best defense against this set of complications is for the patient to be up and walking as soon as possible after surgery and as often as possible.
Every abdominal operation has a risk of causing a hernia. Obesity is a risk factor for hernias. Hernias are more common after "open" operations (occurring up to 20% of the time) but are rare with the laparoscopic method. This is one reason our doctors perform surgery laparoscopically.
A number of blood vessels must be divided and secured in the natural course of the gastric bypass. The spleen or liver can also bleed if injured. Nevertheless it is uncommon for patients to require a blood transfusion. If bleeding occurs after surgery it will do so within the first 24 hours, and in rare instances may require returning to the operating room.
Bacteria can gather in the fat tissue just under the skin during the operation, and subsequently causes an infection. This is very uncommon, but when it occurs it shows up as a tender red bulge in the incision, usually between 4 and 7 days after surgery. It is necessary to open the wound and drain the fluid. This is generally done in the office. An infection can also occur within the abdomen after surgery, but this is uncommon. In all patients, some of the fat tissue under the skin liquefies. This is called a wound seroma. In most cases, the body reabsorbs this fluid over a few weeks and the patient is never even aware of it. In a few patients this fluid finds its way to the outside through a weak spot in the incision, usually a week or two after the skin staples are removed. The drainage can be a large amount of yellow/orange fluid. Usually nothing needs to be done other than to cover the open spot to protect the clothes, but your surgeon should still be contacted because similar fluid can come out of the wound in the setting of a rare but more serious wound complication