Although a quite new form of weight loss surgery, laparoscopic gastric banding (and in particular the use of the adjustable lap band approved for use in the United States in 2001) is growing rapidly in popularity due in part to its relatively low level of risk and post-operative complication. In many circles this is giving rise to the view that laparoscopic gastric banding is a simple procedure which can be chosen without too much forethought. Nothing could be further from the truth.
Laparoscopic gastric banding is major surgery and, while it may well be safer than many other forms of surgery, it still carries a number of risks and complications which need to be fully understood and considered before any decision to have surgery is made.
The risks and complications (in addition to the general risks associated with any form of major surgery) can be divided into four main groups:
- Band Specific Risks. Laparoscopic gastric banding involves the placement of a band around the upper section of the stomach and, in the case of adjustable banding, the placement of an access port just under the skin through which the restriction produced by the band can be adjusted, together with a length of tubing joining the access port and the band. Problems with the band assembly can include slippage of the band, erosion of the band into the stomach wall, mechanical malfunction (leakage from the inner inflatable ring, access port or tubing), displacement of the access port or pain in the area around the access port. In addition some patients may experience an allergic reaction to the material of the band assembly itself.
- Laparoscopic Risks. Laparoscopy can sometimes result in electrical burns causing perforation to organs within the abdomen and to peritonitis. Patients may also react to the gas needed to inflate the stomach for surgery, particularly where the patient already suffers from a pulmonary disorder. Scar tissue from previous abdominal surgery can also pose a risk.
- Digestive Problems. Laparoscopic gastric banding can give rise to a variety of digestive problems which will range from the quite mild to the very severe and can include nausea and vomiting, regurgitation, difficulty swallowing, blockage of the passage between the two sections of the stomach, constipation and diarrhea.
- General Complication. Finally, there is a long list of general problems reported by laparoscopic gastric banding patients including abdominal pain, chest pain, pain at the site of the operation incisions, fever, infection, hernia, gastritis, pancreatitis, flatulence, belching, esophageal ulcers, hematemsis, dyspepsia and dehydration.
All of these risks must of course be viewed in context and, for the vast majority of people suffering from morbid obesity, the benefits of laparoscopic gastric banding will be considered to outweigh the risks. Nevertheless, these risks are very real and should be discussed in detail with your surgeon before you reach any decision.
