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Risks and Complications

Important Considerations:

Prior to undergoing weight loss (bariatric) surgery, most people will have tried many weight loss programs. When considering surgery, it is important to realize that the potential benefits of weight control surgery outweigh the risks.

Weight loss surgery is not cosmetic surgery and does not involve the removal of fatty (adipose) tissue. It also involves a long term commitment to lifestyle changes including diet and exercise which are important to the success of weight loss surgery.

Patients who have undergone weight loss surgery have significantly reduced the effects of diabetes, hypertension, sleep apnoea and cardiovascular disease. In most cases surgery has also reduced the rate at which these diseases occur.

Although gastric banding is performed laparoscopically and is considered minimally invasive, there are still risks and complications. Please note that your weight, age and medical history play a significant role in determining your specific risks.

Some of the risks and complications of gastric banding surgery are:

  • Anaesthetic risks: Anaesthesia is a long-practised and very safe technique. The risk of dying under anaesthetic is very low, about 1 in 40,000.
  • Infections: All patients are given antibiotics during the operation. Infections may develop around the wounds or at the access port. If there are any signs of infection, early treatment is required. This can be attended to either by your surgeon or general practitioner where a course of antibiotics is usually prescribed. Uncommonly, the infection may be more severe, requiring dressings as the wound will be opened slightly to allow for drainage. The worst case scenario is the need for the port to be removed. This is done as a day surgery case and the port can be replaced about 3 months later.
  • Swallowing difficulty and regurgitation: This may occur if the band is too tight. To ensure proper functioning, the Laparoscopic Adjustable Gastric Band (LAGB) can be adjusted to suit the needs of the individual patient. It is important that patients follow their eating plan to reduce the risk of swallowing difficulty and regurgitation.
  • Slippage: This occurs in less than 5% of cases. The band slips out of position causing the upper pouch to dilate. A barium swallow x-ray would confirm the slippage and re-operation is necessary to remove or reposition the band. If necessary another band can be inserted at the same operation. Slippage can occur months or years after surgery.
  • Stomach pouch dilatation: Overeating may stretch the small stomach pouch making it less effective.
  • Band erosion: In less than 1% of cases, the band works its way through or migrates to the inside of the stomach wall. An endoscopy confirms that this has occurred. The band needs to be removed and the stomach repaired. Another band is not usually inserted and further bariatric surgery may be offered.
  • Acid reflux and oesophagitis: This may be treated with medications to reduce acid. In some cases, it may indicate that the pouch has dilated or the band has slipped.
  • Gallstones: Weight loss may predispose to gallstone formation.
  • Nutritional deficiencies are uncommon.
  • Disconnection or leakage: Disconnection of the tubing system, or leakage of the access port may occur, requiring re-operation and replacement.
  • Reaction to the band: The band is made of solid silicone. There are no known side effects of having it implanted in the body.
  • Spleen complications: Bleeding or injury to the spleen may require conversion to an open surgical procedure. Injury to the spleen and other organs, including the stomach, during surgery is rare.
  • Deep Venous Thrombosis and pulmonary embolism: Blood clots may develop in the leg veins, which may travel to the lungs, thus causing death. All patients are encouraged to wear TED stockings to help prevent clots from occurring. Patients are also given an injection of a blood thinning medication during operation.
  • Death: The risk of dying during the operation is very small (about 0.5 in 1,000). Death may result from a heart attack or a blood clot passing into the lungs.
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Risks associated with Sleeve Gastrectomy:

Some of the risks associated with sleeve gastrectomy are similar to those for gastric banding as it is still abdominal surgery. The specific risks are:

  • Leakage along staple line
  • Not adjustable
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