Weight loss surgery – increasing in popularity, but what are the risks?

Posted: 18/03/2014

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It is estimated that the cost to the NHS in England of diseases related to being overweight or obese could rise to £6.3 billion by 2015. There is no doubt that obesity presents many health risk factors to an individual as well as having an impact socially and personally.

Weight loss surgery (also known as gastric banding or bariatric surgery) continues to be the source of great debate with some experts warning that many obese people are opting for a ‘quick fix’ and the risks inherent in surgery rather than seriously attempting to diet. They advise that such surgery should only be used as a last resort when other weight loss measures have failed. In spite of this advice, increasing numbers of people in the UK are electing for surgery without properly exploring other options – and are often being encouraged to do so within the private medical sector.

The hope for those who undergo surgery, whether under the NHS or privately, is to achieve weight loss and generally have a healthier life. People tend to have high expectations of the outcome. If the surgery does not go to plan, the consequences can be potentially devastating for the patient and those around them. It is therefore important that those carrying out the surgery ensure that all patients are appropriately advised of both the risks and benefits of the surgery.

The Medical Defence Union (MDU) indicates that the most common problems encountered following this type of surgery include:

• post-operative infection
• gastric bands slipping or leaking
• delays in diagnosing these problems
• difficulties and complications in adjusting bands
• failure to obtain consent from patients, for example not consulting them about the risks involved.

It is important to note that not all these problems represent negligent care and some are just recognised complications of the procedure. That being said, we are seeing enquiries from those undergoing this type of surgery who have not been properly advised about the potential risks. Do these people have a potential claim?

Issues which may be regarded as substandard or negligent care that result in claims include:

• if the band is put on the wrong part of the stomach or at the wrong angle during the gastric banding operation as this can lead to a complete blockage requiring emergency surgery. A failure to spot the situation developing post- operatively can often, in itself, be negligent;
• failure to staple the joins properly in gastric bypass surgery can cause a leak and again, a failure to recognise the development of a leak post-operatively can often be open to criticism;
• sometimes the wrong type of bypass procedure has been performed;
• surgeons performing the procedure without sufficient expertise and making unacceptable technical errors;
• there can be issues with the quality of the gastric band itself which may result in a product liability claim against the manufacturer rather than the surgeon.

A further consideration is that this type of surgery is often carried out in a list of procedures at a private clinic. This is all well and good if the patient fully understands the procedure, it goes smoothly and there are no complications. However, the pressure of a full list of patients may mean that a surgeon cannot spend enough time consulting with the patient beforehand or cannot deal with complications that arise. At best, the patient may be disappointed by the outcome of their surgery but, at worst,  their clinical condition deteriorates significantly in an environment not equipped to deal with emergency care, resulting in emergency hospital transfer and potentially further surgery.

Amy Milner, an associate in the clinical negligence team at Penningtons Manches who specialises in claims involving cosmetic surgery, said: “It is important that anyone undergoing weight loss surgery is given enough information about what the surgery entails and any problems that may arise and that surgery is undertaken only by those who are experienced in this field.  A high standard of post-operative care and a quick recognition of developing complications also appears to be key. This procedure is after all an elective procedure, and patients need to be happy about what they are signing up for.

“We are currently dealing with claims for patients with a range of unexpected problems arising from gastric band surgery – ranging from a faulty band to incorrect insertion (and therefore function of the band) to suffering significant bleeding as a result of arterial damage during the procedure. All these clients have suffered very significant problems and are evidence of the importance of patients being properly advised and the procedure being undertaken by a suitably experienced practitioner.”

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