The sleeve gastrectomy is a common treatment that has assisted millions of people all over the world in achieving their weight loss goals and improving their overall health. Patients, however, need to be informed of the related risks and repercussions, just as they would with any other type of surgical procedure.
After having a sleeve gastrectomy, patients are at risk for a variety of complications. I’ll discuss just a few in this article.
What is Sleeve Gastrectomy?
A sleeve gastrectomy is a surgical procedure that involves the removal of a large portion of the stomach. The remainder of the stomach is reshaped into a tube or sleeve that is long and narrow in appearance. This new stomach, which is smaller, restricts the amount of food the patient is able to ingest and changes their gastrointestinal (GI) hormones, allowing consumed calories to be partitioned in a more appropriate manner.
Sleeve gastrectomy is typically performed on individuals who have a BMI of 40 or higher. It’s also performed on those who have a BMI of 35 or higher and one or more obesity-related health conditions, such as type 2 diabetes, high blood pressure, or sleep apnea.
5 Possible Complications of Sleeve Gastrectomy
Even though sleeve gastrectomy is generally considered to be a low-risk surgical procedure, there are still potential risks involved. These complications can range from minor and insignificant to lethal.
Some of the most common complications that can occur after sleeve gastrectomy include:
Bleeding is a possible complication that can occur during or after sleeve gastrectomy. During the surgery, the surgeon makes several incisions in the abdomen to access the stomach. While it’s possible for these skin incisions to bleed, it is the stapled edge of the stomach and other areas of the operative field that we monitor closely.
The risk of bleeding can be minimized by following the instructions given to you by your surgeon both before and after surgery. It’s possible that this will require the discontinuation of some medications, such as blood thinners, which increase the likelihood of bleeding.
If bleeding occurs during the surgery, your surgeon will address it while you are in the operating room. If bleeding occurs after the surgery, it’s possible that additional procedures will be necessary to stop it.
Symptoms of bleeding may include a rapid heart rate, low blood pressure, dizziness, and fatigue. If you experience any of these symptoms after surgery, it’s important to contact your surgeon immediately.
Infection is another possible complication that can occur after sleeve gastrectomy. The risk of infection can be minimized by your surgeon giving you antibiotics around the time of surgery.
As a patient, it’s important that you keep your incisions clean and dry. Avoid touching them. You should also avoid swimming or bathing until released to do so by your surgeon. Showering, however, is fine; just let the water run over the incisions and pat them dry.
Fever, chills, redness, swelling, and discharge from the incision site are all symptoms that can be caused by a postoperative infection. If you have any of these symptoms after surgery, it is imperative that you get in touch with your surgeon as soon as possible.
Staple Line Leaks
A leak is one of the most feared complications after a sleeve gastrectomy. A leak occurs when there is a hole or tear in the staple line that your surgeon created to reshape the stomach. This can cause GI and stomach contents to leak into the abdominal cavity, which can lead to infection and other serious complications.
The causes of a staple line leak are usually out of the patient’s control. Poor blood flow to the staple line and mechanical issues associated with the staple line are two of the most common causes. At some point, the pressure inside the sleeve exceeds the strength of the staple line and a leak ensues.
However, there are some factors within the patient’s control. Be sure to inform your surgeon about all your medications, as some will weaken the strength of your tissue. Protect the staple line after surgery by following your surgeon’s instructions about advancing your diet. If you are open and honest with your surgeon and follow their instructions, you’ve done what you can to minimize your risk of a staple line leak.
In my own practice, I’ve done almost 3,000 bariatric cases to date. I’ve had three sleeve leaks. These leaks occurred in patients who didn’t want to walk, which is something we try to push them to do in recovery.
Symptoms of leaks may include abdominal pain, fever, chills, nausea, vomiting, and rapid heart rate. If you experience any of these symptoms after surgery, it’s important to contact your surgeon immediately.
Dehydration is the most common complication after a sleeve gastrectomy. This can occur if a patient is not able to drink enough fluids or if they are not pushing themselves hard enough to drink.
Additionally, there may be some things the patient is ingesting that increase the risk of dehydration. For example, there are some medications that are designed to increase urine output, like those prescribed to control blood pressure. Some drinks also have mild diuretic properties: alcohol, caffeinated beverages, and drinks high in sugar can hasten dehydration.
After surgery, you’ll be instructed to drink a lot. I ask my patients to drink a minimum of 64 ounces a day. It will feel different after a sleeve gastrectomy, but you’ll need to work through the new sensations and make sure you get in enough fluid on a daily basis. Be mindful and communicate with your care team.
Symptoms of dehydration may include dry mouth, thirst, fatigue, and dark urine. You’ll need to monitor your intake and your urine concentration. If you have issues, contact your surgeon immediately. Sometimes, it just takes a little encouragement to increase your intake; at other times, you may need some IV fluid to catch back up. Occasionally, we might admit you to the hospital for aggressive hydration.
Blood clots, which usually form in the legs, can be life-threatening if they reach your lungs. To minimize the risk of blood clots, patients may be given blood-thinning medications, compression hose, and a synchronized compression device on their calves. The best thing to do is get up and start walking as soon as possible after the surgery.
Symptoms of blood clots may include swelling, pain, and redness in the legs. If a clot reaches the lungs, you may have difficulty breathing, a fast heart rate, or chest pain. If you experience any of these symptoms after surgery, it’s important to contact your surgeon immediately.
Follow Your Surgeon’s Guidelines Before & After Sleeve Gastrectomy
Sleeve gastrectomy is a safe and effective weight loss surgery that has helped many people to improve their overall health and quality of life. However, as with any surgical procedure, there are potential risks and complications that patients need to be aware of. Bleeding, infection, leaks, dehydration, and blood clots are some of the possible complications that can occur after sleeve gastrectomy.
To minimize the risk of complications, it’s important for patients to follow their surgeon’s instructions before and after surgery. This may include taking antibiotics, drinking plenty of water, avoiding sugary or high-calorie drinks, and taking blood-thinning medications. Patients should also contact their surgeon immediately if they experience any symptoms of complications after surgery.
By working closely with your surgeon and following their instructions, you can increase the likelihood of a successful outcome after sleeve gastrectomy. If you’re considering sleeve gastrectomy as a weight loss option, be sure to discuss the risks and benefits with your surgeon to determine if it’s the right choice for you.