My doctor said point blank that he doesn't operate on smokers but he doesn't care if you start smoking again after surgery. Why? What are the surgical risks?
Smoking and Gastric Bypass Surgery
Doctor Answers 4
Smoking and weight loss surgery
I do not operate on smokers. This is for many reasons. Smokers do not heal well and have a higher risks of leaks and developing ulcers. Also if we are going to perform a surgery to increase your lifespan by 12 - 15 years, what is the purpose if you just die from lung cancer?
Smoking and Gastric Bypass Surgery
The reason that bariatric surgeons will not operate on smokers is because complications are significantly increased due to smoking. The risk of a leak from the connection that we make is much higher because smokers do not heal properly. Also your risk of Deep Venous Thrombosis increases significantly as well. Bariatric surgeons make their patients quit smoking at least eight weeks prior to surgery because this improves healing.
I'm sure that your bariatric surgeon does care that you have started smoking once again. You have done this procedure to improve your over all health. Smoking is the number one preventable cause of death in the United States. So why start smoking now?
There are plenty of risks associated with smoking after gastric bypass surgery. Smokers are at a much higher risk of gastric pouch ulcers which can cause significant pain in the upper abdomen. Smoking can also cause bleeding ulcers and perforated ulcers which can be life-threatening. If you have restarted smoking my suggestion would be to quit as soon as possible.
Smoke Yes? Weight Loss Surgery No!
I sort of agree with your surgeon. I also don't operate on anybody who is an active smoker, but I STRONGLY urge patients not to start smoking again once they have had their surgery. Unfortunately I have a lot less control of a patient's smoking behavior after surgery. Here are some of the reasons why I don't operate on smokers:
1) Smoking increases the likelihood of the two biggest killers of weight loss surgery patients in the early post-operative period: leaks and blood clots. By getting someone to stop smoking at least 6-8 weeks before surgery it likely makes it safer for them to undergo the surgery on many different levels.
2) If someone can't stop smoking before surgery, why would I think that they would be committed to make the OTHER very difficult and challenging lifestyle changes (dietary, behavioral, and exercise) that are needed after surgery to create long-term success?
3) Patients that start smoking after their gastric bypass often will get ulcers at the connection of their pouch and small intestine (gastrojejunal ulcer). These ulcers can be VERY difficult to treat and I personally have had to do two gastric bypass reversals because the patients developed ulcers that would not go away and they refused to stop smoking.
4) I went into medicine to make people healthier. If I can use my "power" before surgery to help (some would say force :) ) someone to stop smoking, which we KNOW will improve their health, I would be remiss if I didn't use that opportunity. In my experience, although some patients will start smoking again after surgery, many will not.
Stopping smoking is hard. Really hard. But smoking and weight loss surgery really don't mix well and the results of smoking, unfortunately can be disasterous.
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Smoking and Gastric Bypass
I choose not operate on patients that smoke and choose to have a gastric bypass. Clearly the complication rate which includes leaks after gastric bypass is higher with smoker than non-smokers. The healing is compromised in patients that smoke. Also patients that smoke after surgery have a higher complication rate as well such as ulcers developing in the anastomosis and these ulcers can bleed or ultimately perforate.
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