Prevalence of Adverse Intraoperative Events During Obesity Surgery and Their Sequelae

Abstract

BACKGROUND-Adverse intraoperative events (AIEs) during surgery are a well-known entity. A better understanding of the incidence of AIEs and their relationship with outcomes is helpful for surgeon preparation and preoperative patient counseling. The goals of this study are to describe the incidence of AIEs during bariatric surgery and examine their impact on major adverse complications.

Early Complications After Laparoscopic Gastric Bypass Surgery

“…22 The risk was highest for unintentional bowel injury, submucous stapling, or malrotation of the small bowel and for surgical instrument failure. 22 The risk was highest for unintentional bowel injury, submucous stapling, or malrotation of the small bowel and for surgical instrument failure.…”

Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

“…According to reports from large databases in Europe and the US, the prevalence of intraoperative complications is relatively low, ranging from 0.69 to 5.0% [155][156][157]. The incidence rates vary depending on the surgical technique (complexity of surgery), with complications seen in 7.3% of open Roux-en Y gastric bypass procedures, 5.5% of LRYGB procedures, and 3.0% of LAGB procedures [155]. The incidence rate of surgical complications in LSG was lower than that in LRYGB and higher than that in LAGB [158].…”

“…The incidence rate of surgical complications in LSG was lower than that in LRYGB and higher than that in LAGB [158]. The incidence of complications in procedures that involve conversion from laparoscopic to open surgery is a risk factor for serious postoperative complications such as pulmonary embolism and myocardial infarction [155,156]. Representative intraoperative complications include anesthesia-related complications, malfunctioning surgical instruments, intestinal injuries, liver injuries, gastrointestinal anastomosisrelated complications, spleen injuries, and major blood vessel injuries [155].…”

Forensic Considerations in Bariatric Surgery Patients

“…Though many medical examiners and coroner's offices do not investigate therapeutic complications routinely, investigation into postsurgical deaths are considered reportable under most state laws and serve a public health purpose to distinguish accidents from criminal negligence (63, 64). Surgical and anesthestic-related complications are not uncommon, and adverse intraoperative events are correlated with a higher risk of major adverse complications, including death (65). Forensic facilities need to be equipped with bigger body bags, reinforced trolleys and vehicles, lifts, and larger storage facilities to accomodate these patients and allow for proper death investigation (66).…”