Bariatric surgery, or metabolic surgery as it might be more precisely described, has evolved since its origins over 75 years ago. The procedures have changed and that means the side effects and potential complications of bariatric surgery have changed as well.
Potential Complications of Sleeve Gastrectomy
Today the most frequently performed procedure is also the least invasive. It’s the simplest and safest, and it has the fewest complications. It goes by the name of sleeve gastrectomy and involves trimming off the outer portion of the stomach tissue. It reduces the volume of the stomach by as much as 75%, but that is not the real magic of why it produces long-term weight reduction and diabetes reversal. Those results stem primarily from the change in the hormonal profile, the biochemistry that controls the body weight setpoint and the baseline blood sugar levels. It turns out that specific stomach tissue is an epicenter for the production and stimulation of a whole family of hormones that are key to the regulation of body weight setpoint and blood sugar level.
The complications or side effects follow two main categories. First are the initial side effects or complications from surgery on the stomach. These include specific stomach side effects such as nausea, vomiting, bleeding from suture lines, or gastritis. A rare case could involve leakage from the staple line that might require surgical intervention. The longer-term potential complications include reduced absorption of iron, B12, vitamin D and rarely, other micronutrients. This is usually easily avoidable by taking the recommended vitamins the doctor will prescribe.
Past Procedures for Weight Loss
Before the sleeve came into widespread use about 15 years ago, the most performed procedures involved bypassing the stomach to achieve the same hormonal results or placing a band around the stomach, which was more of a restrictive mechanism. The band is rarely performed today, but I will touch on its side effects. These include the mechanical discomfort of the band constricting the stomach, vomiting or regurgitation, and pain in some cases. Over the years of long-term implantation, the band could cause erosion through the tissue and require removal.
Bypass procedures tend to have a longer list of potential complications. These include a higher chance of malabsorption of micronutrients including the vitamins I mentioned above as well as some additional ones. A few people will get diarrhea and more serious malabsorption. Because there is a bypass that involves rerouting the plumbing of our intestinal anatomy, in a rare case that could lead to a blockage requiring surgery. Gastric bypass also has a few unusual and specific complications: one of these is called dumping syndrome, a phenomenon involving hot flashes, palpitations, and wooziness after eating high sugar type foods such as ice cream. Another is the development of a serious ulcer due to alcohol, tobacco, or the use of nonsteroidal anti-inflammatory medications like Motrin or Advil. That can be a pretty serious problem that could require surgery.
Perspective is always warranted when you’re considering the pros and cons of any medical procedure. Overall, research shows that the complications associated with metabolic surgery is lower than a list of health problems among similar weight people who choose not to have metabolic surgery. Your program and surgeon should give you some good guidance on how to prevent all these complications and others that could occur after any surgery. Make sure to ask lots of questions so that you understand what to expect.