(The following article was provided by Dr Hani)
Gastric bypass surgery continues to grow in popularity as a safe procedure to help obese people lose weight. A large number of patients had this procedure in the last few years and the numbers are expected to grow even further. The long-term death rate related to obesity has shown to decrease by 40% in patients who have undergone gastric bypass surgery (1) and thus for the majority of patients, this procedure can be a lifesaver.
However, as with any other surgical intervention, death can also occur due to gastric bypass surgery. Post-operative complications and deaths related to surgery can occur in 2% patients who had gastric bypass surgery (2). If a patient died within one month after surgery, then such death is attributed to the operation itself no matter what caused the death of the patient. This is a kind of statistical dilemma but this is how it works. The overall complication rates seen in patients after laparoscopic gastric bypass surgery was shown to be 7% comparing to 14.5% in patients with open incision surgery. Similarly, the death rate is a bit higher in patients with the open incision gastric bypass surgery.
The major cause of mortality in patients after gastric bypass surgery is obesity and complications like heart disease, diabetes mellitus, obstructive sleep apnea, and pulmonary embolism. General anesthesia itself poses a greater risk, and it may become a nightmare if performed in obese patients. It is difficult to pass anesthetic tube in the airway of an obese person, and if it comes out too early, it may cause serious complications. Medications and anesthetic drugs given to an obese person are largely absorbed by the extra fat and thus these patients need higher doses of medications and anesthesia which itself complicates the overall procedure.
Breathing in an obese person is often not smooth. Obese people face more difficulty in breathing normally after their surgery. Surgical procedure itself becomes more difficult if the patient is obese and thus requires high surgical skills. Due to the presence of a large amount of abdominal fat, the proper exposure of the abdominal organs becomes very hard. Moreover, extra fat also hinders the proper placement of sutures on the surface of the organs. Surgeon needs special instruments made to operate obese patients and it makes the surgical procedure more difficult.
Studies have shown that the rate of post-surgical complications is higher in obese patients as obesity is a major risk factor for pulmonary embolism, pneumonia, and wound infections. Furthermore, if the patient is having concurrent health problems like diabetes mellitus, hypertension, and heart problems, it may further affect the prognosis after surgery. Moreover, diagnosis of complications is much harder in obese patients due to the presence of extra fat. Radiographic equipments like x-ray and Computed Tomography (CT-Scan) often give inferior results due to poor penetration.
It becomes evident from the above discussion that any type of surgery including gastric bypass surgery poses greater risks in obese patients. Therefore, it is of utmost importance that you choose a team with excellent experience, knowledge, skills, and good reputation for bariatric surgery including gastric bypass surgery.