Complications of Gastric Banding
While complications after adjustable gastric band surgery are possible, they are becoming increasingly unusual as surgical techniques and standards of post operative care continue to develop. Any surgery is associated with some risk and placing an adjustable gastric band in the abdomen is no exception.
Before undergoing gastric banding, as with any surgical procedure, it’s important to be fully informed of the potential risks. You should also be aware of your role in helping to prevent certain complications. When you’re completely aware of the risks involved, you can make an educated decision about whether or not the risks, for you, outweigh the potential benefits.
The Risk of Death
The risk of dying during or shortly after bariatric surgery is very low, but does exist. Globally, the fatality rate for gastric banding procedures is about 1 death for every 2 to 3,000 procedures. This is lower than many other abdominal surgeries and significantly less than the risk associated with gastric bypass or duodenal switch surgeries.
People who are older or who have certain diseases associated with obesity, like heart disease, are at greater risk for death. Deaths associated with gastric banding are most commonly the result of heart attacks after the operation, clots passing to the lungs, or infection due to the breakdown of some part of the stomach wall.
Your risk of death during gastric band surgery can be greatly reduced by the selecting a surgeon who is experienced in adjustable gastric band surgery. It is best to work with a surgeon who has experience with gastric banding as opposed to a general experience with weight loss surgery. Never be afraid to ask your surgeon how many procedures the surgical center has performed and talk specifically about complication and fatality rates. Dr. Bagnato is always willing to share details about his surgeries and outcomes.
About 1 in 50 gastric banding patients will experience some type of minor short-term complication during or shortly after surgery. Most of these complications are easily managed and will not slow your recovery. It is important to be aware of them however, and report any problems to your surgical team so that you can prevent further problems.
Short term complications from gastric banding may include:
- Infection: This can occur in the lung, near the band, or at the port site.
- Blood clots: These usually form in the legs and can pass to the lungs if left untreated.
- Stomach damage: During placement of the band injury can occur to the stomach
- Vomiting: As you adjust to the band and a new way of eating vomiting episodes may occur.
Know that Dr. Bagnato is aware of these risks and will take steps to prevent complications. Most of the post-operative instructions you’ll be given will be designed to prevent complications, so it’s important to follow any directions Dr. Bagnato gives you, especially those related to diet, wound care, and follow-up appointments.
Between 5 and 10 percent of gastric banding patients may experience problems after the initial surgery and recovery. In some cases, these problems will need to be resolved with an additional surgery. The three most notable problems you may experience are prolapse, erosion, or tubing/port problems.
The most common long-term complication of gastric banding is enlargement of the stomach pouch above the band, which can prevent continued weight loss. This can be caused by prolapse, also known as slippage, or symmetrical enlargement.
During surgery, the gastric band is secured to the outer wall of your stomach at a specific location. In some cases, eating too much or too quickly can cause a portion of the stomach that wasn’t secured properly to slip up through the band and create an additional pouch above the band. This is known as prolapse or slippage.
If you eat large meals or eat too quickly, the upper portion of your stomach may stretch, even if the band has been adequately fastened. Over time, this stretching can lead to a permanent enlargement of the stomach pouch, a condition referred to as symmetrical enlargement.
Prolapse and symmetrical enlargement will cause you to experience heartburn or acid reflux, most notably at night. If left unrepaired, the enlarged upper stomach can become blocked and cause vomiting. If you’re experiencing heartburn, choking, coughing spells, or frequent vomiting, tell your surgeon so that they can determine if you need fluid removed from your band or an additional surgery.
A prolapse or symmetrical enlargement can be resolved with another laparoscopic procedure. In the long run, this should not effect your weight loss efforts once the band and stomach pouch have been readjusted. However, it’s best to take a proactive approach to avoiding prolapse or symmetrical enlargement by following the guidelines for portion size and making an effort to eat slowly.
Erosion is another possible long-term complication of gastric banding, but occurs much less frequently than slippage.
Over time, the band can work its way through the stomach wall until it is lying inside the stomach. This is known as an erosion of the band, and it will prevent you from losing weight. If you have an erosion, it’s unlikely that you’ll experience any pain or acute illness, but you will no longer feel any restriction in how much you can eat.
If erosion occurs, you will need to undergo another surgery to have the band removed and the affected portion of your stomach repaired. After a recovery period of about three months, you can have an additional surgery to place a new band, and then continue with your weight loss program.
It’s important to note that, while erosion of the band can occur, it’s an extremely rare and manageable complication.
In addition to problems with the band itself, it’s possible to have problems with the tubing that connects the gastric band to the access port that’s placed under your skin. In rare cases, the needle used to inject fluid into your access port can puncture the tubing. If the tubing or access port is punctured or leaking, another surgery will be required to replace these parts. This procedure, like the original gastric banding surgery, will require general anesthesia and hospital admission.
Technological advancements in port design and fill technique have greatly reduced the risk for tubing or port problems in recent years. Talk to your surgeon about which model of access port they intend to use for your gastric banding and the features of that model that may affect your complication rates.