Complications in bariatric surgery: Early identification is the key to avoiding disasters

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C Rajkumar Vinayak

Hospital Taiping, Malaysia

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Abstract

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Statement of the Problem: The prevalence of obesity and success of bariatric surgeries are well established. The surgical impact of GI manipulation is well known but complications are often under reported. There is a need to balance the risks vs. benefits of such anatomical manipulation for all patients keeping in mind complications that may arise.With the increasing number of bariatric surgeries performed worldwide, complications are bound to arise so, do revisional surgeries. Methodology & Theoretical Orientation: We have performed 201 bariatric procedures during 2015-2016 and of which 22 were revisional procedures. All surgeries were performed by the same surgeon. 63.64% of revisional procedures were performed for weight recidivism issues and 36.36% for complications. Among the complications needing revisions were; PEM (n=2), chronic diarrhoea (n=2), stomal ulcers and obstruction (n=1), efferent limb obstruction (n=2) and gastric band erosions (n=1). Outcomes: Zero 30-day mortality, zero rate of laparoscopic conversion to open and 9.09% re-interventions. Our series attempts to illustrate the complexities involved, early warning signs and revisional options available when complications arise. Conclusion: Despite the best technical skills, complications are unavoidable. However, early identification can avoid disasters. Surgeons need to familiarize themselves with the technical variations and effects of these interventions so as to be able to recognize warning signs. The cornerstone for optimal surgical outcome in revisional surgeries is good laparoscopic technical ability.

Biography

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C Rajkumar Vinayak is a Consultant General and Bariatric Surgeon at General Hospital Taiping, Malaysia. He has completed his MBBS in 1996 and MS (General Surgery) from Osmania University, India in 2002. He has achieved his FIAGES and then went on to complete his Fellowship in Advanced Laparoscopy and Bariatric Surgery from L.O.C. Pune, India. He has been performing bariatric surgeries in Northern Malaysia since 2007 and became the 1st Surgeon from Malaysia and ASEAN region to be designated as Surgeon of Excellence on Metabolic and Bariatric Surgery by Surgical Review Corporation (SOEMBS), USA in 2017.

Email: rajkumarvnyk@yahoo.com