Is it Safe?

Overall, the risks of bariatric surgery are low, and most patients experience few, if any, complications. However, this is major surgery and serious, even fatal, problems may arise. Bariatric surgery should be considered only after other weight loss options have been attempted.

The safety of bariatric surgery varies considerably, depending on several factors, particularly the type of operation, the experience of the surgeon and the hospital and the condition of the patient.

A general rule of thumb is that the longer and more complicated the surgery, the higher the risk. Gastric banding surgery, which does not involve cutting and suturing of the stomach and intestines, is considered to be much safer than Roux-en-Y gastric bypass surgery, sleeve gastrectomy, biliopancreatic diversion (BPD), or biliopancreatic diversion with duodenal switch (BPD/DS). In general, the risk of mortality with gastric banding is about 1 in 2,000, while the risk of mortality with a gastric bypass or sleeve gastsrectomy is about 1 in 100-200. The mortality rate of BPD and BPD/DS procedures are somewhat higher.

No matter which operation you ultimately choose, it is vital to have it performed by a highly experienced team. Simply put, the more experience, the better the outcomes. In a recent study that looked at the safety profile of several of hospitals that perform laparoscopic gastric bypasses, the rate of major complications fell significantly only after the institutions had performed 100 operations. (Shikora S et al.: "Laparoscopic Roux-en-Y Gastric Bypass: Results and Learning Curve of a High-Volume Academic Program." Archives of Surgery, 2005;140:362-367.)

Suffice it to say, deciding whether to undergo bariatric surgery should not be taken lightly. Its risks must be balanced against the benefits that can be gained from losing a large amount of weight. It is important to discuss all these factors with your surgeon and your family.