All surgery has elements of risk and danger and modern Surgeons are very familiar with the risk factors involved with their Specialty.

But obesity is also very risky.

Obese patients tend to have considerable risks to their health & lives, a reduction in weight by surgery reduces these trends.

WHAT HAPPENS IN SURGERY & WHAT CAN GO WRONG?

Fasting before surgery dehydrates patients, they are asleep, and the patient is operated upon in a semi-sitting position using pressure of inert gas to allow enough space for the surgeon to view the stomach safely.

All of these factors increase risk and the experienced surgeon will rehydrate a patient with an intravenous drip, inject a blood-thinning agent under the patient's skin and use calf massaging stockings and early mobilization to reduce the risks of clotting in veins.

A respiratory implement called a Triflo, comprising three balls, will be provided to increase lung function, to diminish the common problems of pneumonia and breathing problems.

Antibiotics will be used intravenously during the operation and hospital stay to decrease the risk of infection, for all skin is potentially infected with a patient's own skin bacteria and those bugs living in hair follicles, for example, can never be truly sterilized. Wherever possible, the Surgeon will assess and reduce these risks.

Bleeding within the abdominal cavity, technical problems with large fragile liver tissue, and previous surgery are common intraoperative problems whilst extra demands on the heart and lungs may show up in the obese patient causing heart attacks or a need for assistance to breathe, perhaps in the Intensive Care Unit.

A foreign, though inert, material is being implanted about the stomach with the reservoir in the fatty tissue of the abdominal wall and this material may be at risk of local infection.

All care is taken to avoid the problems mentioned but still they might occasionally occur.

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The placement of the band requires dissection behind the stomach often almost a metre from the surface and damage can occasionally occur to the gullet or stomach wall during this. Such damage may lead to a need to change the operation to an open one, and for the repair of a leak, which would negate the implanting of a band about the upper stomach.

The band is, by necessity, a little tight about the stomach and this varies with the size of the patient and the amount of fat about the upper stomach. Effort is made to make sure this is not too tight for this may induce early vomiting, which is not ideal. Damage might occur from such vomiting and can lead to the stomach tearing away from some of the fine sutures placed to hold the band. This may allow the stomach to slip up through the band, narrowing the passage so that the patient incessantly vomits. This is called slippage and can lead to further surgery to replace the band in position and fix it there. 

The Band might be able to be undone in some cases though it can also lead to the total replacement of the band. Whilst this slippage is more common early after surgery, before the band is cemented in place by scarring, it can occur years later if constant attention to the rule of eating, small volumes chewed well, are ignored.

Surgery is a dangerous occupation and it is vital that you, the patient, understand the process of decision and choices that are available to you to lose weight. There is also a need to understand how to maintain that loss.

 Success is generally achieved by surgery however it does require dedication and assistance from the patient to achieve those ends. The aim is to assist in the loss of roughly 2/3 of excess body weight reducing the BMI down to approximately 27. The target weight must be attainable and maintainable.

Think carefully, do you really want this surgery?

When a band is placed, the intention is to never have to remove it. If removal is foremost in your mind, or reversability features high on your enquiry list, it is questionable whether you are an appropriate person for surgery.

Placing a band is a permanent procedure, a process of weight reduction and control for the rest of your life and to that end, the Surgeon expects that you will return for review yearly, forever. If you cannot return for review you must contact us with your statistics annually. Removal once you reach your target weight is not really an option as it has been documented that the weight of that patient will IMMEDIATELY start to balloon out once more.

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