| |
|
|
| |
|
|
|
|
|
| |
Atelectasis
|
|
| |
This
condition is a partial collapse of a part of the lung, caused by lack
of motion of the chest wall. The best treatment is to prevent it,
by deep breathing and lung exercises. Atelectasis can cause a fever
after surgery, and can also lead to developing pneumonia.
|
|
| |
|
|
|
|
|
| |
Pneumonia
|
|
| |
Pneumonia
is an infection in the lungs, and after surgery it can be especially
serious, because the infecting organisms often come from the gastrointestinal
tract. |
|
| |
|
|
|
|
|
| |
Pulmonary
Embolism
|
|
| |
This
problem affects the lungs and the heart, but it usually starts in
the legs, with the formation of blood clots. Although these can occur
at any time, and are more likely in overweight patients, they are
especially likely at the time of and soon after surgery, because people
who have an operation don't like to move around, or exercise their
legs. The blood becomes stagnant and clots in the leg veins, and if
a clot breaks off and floats through the veins to the lungs, it is
called a pulmonary embolism. The blood clot blocks the arteries in
the lungs, and can cause a part of the lung to lose its circulation
and die. If the circulation to a large part of the lung is affected,
the heart is placed under a lot of strain, and it may fail suddenly,
which can be fatal. The chances of pulmonary embolism can be reduced,
first, by thinning the blood, which makes it less likely to clot,
and secondly by prescribing elastic stockings, to compress the legs
and keep the blood flowing faster in the veins.
|
|
| |
|
|
|
|
|
| |
Abscess
and Wound Infection
|
|
| |
An
abscess is a collection of infected fluid, or pus, which occurs somewhere
in the body. After an abdominal operation, a pocket of fluid may develop,
and if any bacteria are present, they may infect it and create an
abscess. The treatment of any abscess is to drain away the infected
fluid, and kill the bacteria with antibiotics.
|
|
| |
|
|
|
|
|
| |
Hemorrhage
|
|
| |
When
surgery is performed, blood vessels must be cut. We handle these by
tying them with a piece of thread, called a ligature, or by using
a device called an electrocautery, which coagulates the blood, and
the end of the blood vessel. Sometimes, a blood vessel may escape,
and then begin to bleed again several hours later. This can cause
a hemorrhage, either inside the abdomen, or at the skin level.
|
|
| |
|
|
|
|
|
| |
Transfusions
|
|
| |
When
blood loss occurs, that tend to make the pulse and blood pressure
unstable, a transfusion may be needed. The blood bank has very high
quality standards, and the blood is quite safe, but there is still
a possibility of getting hepatitis, and a very small risk of receiving
the AIDS virus (about 1 in 500,000), from a transfusion. These risks
can be reduced, by donating your own blood and having it saved for
your surgery - a procedure called autologous donation. This costs
quite a lot and we feel it is probably not economically sound, since
the likelihood of needing the blood is quite low. |
|
| |
|
|
|
|
|
| |
Bowel
Obstruction |
|
| |
After
any abdominal operation, scars called adhesions will form in the abdomen.
These look like strands of latex, or sometimes like a piece of fibrous
cord, and can snag a piece of bowel - just like your garden hose can
wrap itself around the smallest bump, when you pull on it. Sometimes,
even many years after the original operation, the bowel becomes kinked
around an adhesion, becomes obstructed, and nothing can get through.
This must be relieved, especially before the bowel loses its blood
supply and dies, which can make the bad situation even worse. Usually
an emergency operation is necessary.
|
|
| |
|
|
|
|
|
| |
Leakage
of Bowel Connections
|
|
| |
When
the surgeon fastens bowel to bowel, or bowel to stomach, the connection
is called an anastamosis. If it does not form a complete seal, and
leakage of fluid from within the bowel occurs, it is called an anastamotic
leak. Fluid from the GI tract, containing at least some bacteria,
leaks out into the abdomen where it doesn't belong, and causes a serious
infection, accompanied by much swelling, a rapid pulse rate, and sometimes,
formation of an abscess. This is always a very serious complication,
and its diagnosis and treatment are made much more difficult by severe
obesity.
|
|
| |
|
|
|
|
|
| |
Obstruction
of the Stomach Outlet |
|
| |
In
performing the Gastric Bypass, when the stomach is connected to the
bowel, to opening is deliberately made small, about ½ inch
in diameter, to slow the flow of food out of the small stomach pouch.
All healing occurs by scar formation, and scars always have a tendency
to contract. This may cause the opening between stomach and bowel
to become too small, so that no food can get through. This causes
repeated vomiting, and must be corrected.
|
|
| |
|
|
|
|
|
| |
Protein
Deficiency
|
|
| |
Protein
is the essential stuff, of which our muscles, organs, heart and brain
are all constructed. Our bodies require a constant supply of protein
building materials, to repair and replace tissues, which become worn
out or damaged. The procedure reduces the capacity of the stomach
to a very small volume, so that protein-containing foods must be carefully
eaten with each meal, to be sure that the body gets enough to maintain
itself. If the first half of each meal is taken as protein-containing
foods, deficiency is very unlikely to occur. |
|
| |
|
|
|
|
|
| |
Vitamin
and Mineral Deficiency
|
|
| |
After
weight-control surgery, the diet is initially much less than enough
to supply complete nutrition - that's why you lose weight. In order
to have any chance of getting enough vitamins and minerals, a high
potency multivitamin supplement must be taken daily. The nutrients
which are most dependent on the stomach are Vitamin B-12, Iron, and
Calcium.
|
|
| |
|
|
| |
|
|
|
