Chapter 66

Surgical complications of metabolic surgery

Todd A. Kellogg

Todd A. Kellogg

Mayo Clinic, Rochester, MN, USA

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Joseph N. Badaoui

Joseph N. Badaoui

Mayo Clinic, Rochester, MN, USA

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Omar M. Ghanem

Omar M. Ghanem

Mayo Clinic, Rochester, MN, USA

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First published: 25 February 2022

Summary

The American Society for Metabolic and Bariatric Surgery (ASMBS) endorses sleeve gastrectomy, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), and biliopancreatic diversion with duodenal switch as primary bariatric operations in the United States. The ASMBS endorsed single anastomosis duodenoileal bypass with sleeve gastrectomy as well. Sleeve gastrectomy has become the most popular bariatric operation both in the US and worldwide. Since alteration of intestinal anatomy is a component of the RYGB by design, internal herniation and small bowel obstruction (SBO) can occur. The small intestine can herniate through defects necessarily created during bowel reconstruction, leading to partial or complete SBO. Several device-related complications are associated with AGB including band prolapse or slippage, band erosion, and tubing and port problems. Internal herniation through iatrogenic mesenteric defects can lead to bowel incarceration and SBO.

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