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Author:
Donald Saunders

Weight loss surgery has advanced considerably in the past 50 years and modern forms of surgery such as gastric lap band surgery are certainly a lot safer and carry far fewer complications than early forms of open gastric bypass surgery. Nevertheless, there are risks and these should be fully discussed with your surgeon before embarking on surgery.

Gastric lap band surgery carries a number of risks which are specific to this form of surgery but it also carries the same risks that come will all major surgeries. In addition, there are a number of general risks which accompany any surgery involving patients who are overweight.

The first and most serious risk is that of death occurring either during surgery or shortly after and directly related to surgery. At this early stage (gastric lap band surgery has been around for some 12 years now but has only been licensed for use in the United States since 2001) very few deaths have been reported and it is difficult to give a figure, although it is generally held that the risk of death from gastric lap band surgery is less than 1%.

It is interesting to note that in one study in Australia no deaths at all were reported amongst a group of 2700 patients who have undergone laparoscopic adjustable gastric banding surgery since 1994. It should be said however that Australia has been in the forefront of pioneering the use of the laparoscopic adjustable gastric band and that over 90% of all weight loss surgeries conducted in Australia now use this method. This is significant as, in interpreting data from this study, it should be borne in mind that the experience of the surgeon is a very significant factor in terms of both risk and complication. Surgeons with considerable experience of this technique (having performed at least 100 procedures) show a very much higher success rate.

Many of the risks during surgery are general rather than "lap band" specific and are common surgical risks associated with such things as your age, weight, reaction to anesthesia and the presence of disease (whether or not this is directly related to your weight problem). The main "lap band" specific risk during surgery is that of gastric perforation (a tear in the wall of the stomach) which occurs in about 1% of cases.

The vast majority of complications will occur following gastric lap band surgery and most patients (in one US study the figure was as high as 88%) will experience some form of complication in the weeks and months following surgery. Such complications will not necessarily be serious and will range from mild to severe.

Approximately half of all patients will suffer varying degrees of nausea and vomiting and in the region of one-third of patients will also suffer from regurgitation (gastroesophageal reflux). About a quarter of patients will experience a slippage of the band and about one patient in seven will experience a blockage of the passage between the two sections of the stomach.

Other moderate to severe problems following gastric lap band surgery can include erosion of the band into the stomach and twisting or leakage of the access port. Difficulty in swallowing (dysphagia), constipation and diarrhea are also quite common.

In a very small number of patients (less than 1%) a whole series of non-series complications may arise including (but not limited to) inflammation of the stomach (gastritis), migration of the stomach above the diaphragm (hiatal hernia), inflammation of the pancreas (pancreatitis), dehydration, abdominal pain, gas (flatulence), chest pain and infection.

In general gastric lap band surgery, particularly when performed laparoscopically, carries fewer risks and complications than other forms of weight loss surgery, but these risks are nonetheless significant and should be fully discussed with your surgeon and understood before any decision is taken to undergo surgery.

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