Gastric Sleeve Complications

surgeons at work

Before you decide on gastric sleeve surgery, you need to know as much as you can about the surgery itself. It will help you understand whatever pre-operation tests and procedures you need to go through. You should also be fully aware of the very possible complications of gastric sleeve surgery. In that way, you will be able to help reduce them as much as possible.

Gastric Sleeve Complications

Gastric Sleeve Complications During Surgery

Allergic Reaction

1 in 5,000 people are allergic to certain kinds of anesthesia. If you are already allergic to something, be it pollen, antibiotics, or certain drugs, you are more likely to have an allergy to anesthesia as well. Tell your doctors exactly what you know you are allergic to. They will try to find the best anesthetic agent that will meet your medical needs.


Even if you are already asleep when the allergic reactions begin, the physicians should be able to catch your reaction. There will be rashes, and some differences in your breathing patterns. They can then change the anesthetic agent.  

Abdominal Adhesions

If you have had prior surgery, or an abdominal injury that resulted in a cut to the abdomen, you may have abdominal adhesions that could make surgery more complicated. Abdominal adhesions are fibrous tissues that cause your organs and tissues to stick together. They are caused by scar tissue automatically growing to protect places it felt were injured.

When you have gastric sleeve surgery, your surgeon may find that some of your organs and tissues have adhered to one another, making it more difficult for him to perform the surgery. Your surgeon will have to cut through the adhesions to move the organs around. You are also almost definitely (a 93% chance) going to have abdominal adhesions after surgery.

Accidental Gastric Laceration

One of the risks run by anyone in surgery is that of an accidental cut where the surgeon did not mean to place one. During gastric sleeve surgery, the surgeon may accidentally inflict a wound in the stomach.

As long as the surgeon checks for such lacerations and fixes it (stopping the bleeding, stapling and sewing it), there should be no problem. However, the laceration may go unnoticed and the surgery completed without the laceration being fixed.

Uncontrolled Bleeding

Every surgery has a clear risk of blood loss. When surgeons are performing a procedure, they automatically avoid the largest blood vessels to prevent their patient bleeding out. However, in the case of any accidental injury to a major blood vessel, they will need to close it. If they take too long, or if the closing does not work, the patient risks too much blood loss.

Liver Injury

Obese patients tend to have more enlarged livers than is healthy. A pre-operation diet brings down the liver size, but not to healthy levels. Surgery puts the liver at risk of injury. It may be accidentally cut by the surgeon, or suffer trauma from the surgery. Liver injury can be fatal if there is liver failure.

Post-Surgery Gastric Sleeve Complications

Wound Infection

After surgery, you will have several (if laparoscopic) or one (if open) surgical cuts on your abdomen. Your surgeon will stitch them shut, so the wounds have time to heal. Your challenge is now how to keep the area clean and dry to avoid infection.

Open wounds let bacteria into the body. If an infection begins, you will struggle with fever and risk of other diseases. The wound will also take longer to heal and close. If you have diabetes, take extra care as there is higher risk of infection in that case.

Gastric Leak

In gastric sleeve surgery, 80% of the stomach is removed. This means the surgeon will have to cut away that part of the stomach, and then staple it shut. The staples are then sewn over to ensure the cut is fully closed. However, there is a risk of the cut not being fully closed, thus causing gastric leak.


Ideally, the surgeon will pump air or liquid into the stomach to test the seam. If he or she does not, stomach fluids may leak and damage organs in the body. If your surgery is laparoscopic (through a series of small cuts rather than through one large cut), the risk of gastric leak is higher.

Blood Clot or Thrombosis

Blood clotting automatically happens when you have a cut or abrasion, or basically any time you bleed. It is what clogs the wound so that you will not suffer blood loss. During the surgery, clotting will also happen to slow the blood loss. However, after the surgery is done and the vessels sutured, the blood-flow should be normal.

Because you are most likely going to be immobile after surgery, it is possible for blood clots to develop within the blood vessels. Because there is no bleeding, the clots end up clogging the vessels and stopping blood flow. If you feel pain in your chest that feels like squeezing, or pain and paralysis along your extremities for no reason, see a doctor.

Nutritional Deficiency

Gastric sleeve surgery does not require the reattaching of the stomach lower on the small intestine, as gastric bypass does. The gastric bypass causes less calorie absorption, but simultaneously less nutrient absorption. Gastric sleeve surgery, therefore, is considered a better choice if nutritional deficiency is the danger.

However, there is still some deficiency. A study shows that the nutrient absorption drops for the next 3 months after surgery, perhaps due to trauma. However, after those first 3 months, most nutrient levels go back to normal. Iron in particular may become deficient, requiring supplements. Supplements are also needed for calcium, selenium, Vitamin B12, and others.


4.7% of patients who take gastric sleeve surgery develop complicated gallstone problems afterwards. Obese people, especially if they have diabetes, are at risk of developing gallstones. However, rapid weight loss can also have an impact. The liver makes more cholesterol as the body loses weight, which may cause cholesterol gallstones.

The best thing to do would be to go regularly to the doctor for checkups, and to watch out for any of the symptoms. It may develop over a number of years. Routine blood tests should be enough to tell your physician whether or not you have gallstones.


Heartburn is in itself a symptom of acid reflux. Acid reflux is when some of the stomach’s contents, along with stomach acid, go back up the esophagus. Because the sensation causes a burning in the lower part of the chest, it is often referred to as heartburn. Obesity is one of the causes of acid reflux.

As your body adjusts to the surgery and the lessened stomach space, you may experience heartburn a little more than you are accustomed to. However, as your diet and lifestyle change, the feelings of heartburn will go down. Make certain your doctor knows what you are experiencing, as he or she might prescribe some pills or drugs.


The Best Way to Prevent Gastric Sleeve Complications

Although you can never really do away with the risks of surgery, you can do your part to lessen them as much as you can. In that way, you will have a better chance of an uncomplicated surgery, and of a faster recovery after.

Fully Disclose any Pre-Existing Condition or Allergy

In most cases, you will already have one co-morbidity along with obesity. Most insurance companies and some hospitals only admit patients with at least one obesity-related complication. This can be sleep apnea, Type-2 diabetes, and others.

However, whatever other allergy or sickness you have, disclose it to your physician. Even if the allergy seems as unrelated as possible, such as lactose-intolerance, tell the physician. Remember, if you have one recurrent allergy (a pollen allergy, seasonal allergies), you are more likely to be allergic to other chemicals and allergens.

Follow the Pre-Operation Diet

Especially for weight loss or bariatric surgery, the surgeon will prescribe a pre-operation diet. If it is not followed, your surgery might even be cancelled. The diet is for you to shed as much excess weight as you can before the surgery, so that there is less risk to you. It will also lower the risk of your co-morbidities causing complications.

Most importantly, the pre-operation diet will reduce the size of your liver. Your surgeon has to lift the liver out of the way to get to the stomach. The more enlarged the liver is, the more difficult the surgery will be for the surgeon, and the more dangerous for you.

Gastric Sleeve Surgery: Solution of Last Resort

You might think that gastric sleeve surgery is unreasonably hard to get. After all, if you want weight loss surgery, why can you not just have it? One of the main reasons surgery is reasonably difficult to have is because of the risks involved. No one is trying to make your life harder by recommending diet and exercise.

Gastric sleeve surgery will change your life. However, there are risks involved that you have to know. None of the complications described are 100% sure to happen, but neither can they be a 100% removed. As you consider this kind of life change, balancing the pros and cons of gastric sleeve surgery will help you make the best decision for you.


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