I acknowledge that it has been explained to me that surgery can result in unpredictable events and unpredictable complications can occur.
I acknowledge and understand that while many patients never have a complication, every surgical procedure involves a certain amount of risk. It has been explained to me that it is important that I understand the risks involved with Sleeve Gastrectomy. My choice to undergo any surgical procedure is based upon my assessment of the risks relative to the potential benefits. I acknowledge that I have had the opportunity to discuss with my surgeon each of the complications referred to below, and that I understand all of the material consequences of Sleeve Gastrectomy. I am aware that if I have further questions about my surgery or any possible complication, I should discuss them with my surgeon prior to surgery.
Each of the following potential complications has been explained to me and I understand and accept the risk of each of them. I have had the opportunity to ask questions and have my questions answered. Where the potential complication could give rise to the requirement for unanticipated but necessary treatment during surgery, as described below, I consent to such treatment.
MATERIAL RISKS OF SURGERY
Bleeding: It is possible, though unusual, to experience a bleeding episode during or after surgery. Should postoperative bleeding occur, it may require emergency treatment to stop the bleeding which may involve making a larger incision in the abdomen (open procedure) or blood transfusion.
Conversion to Open Surgery at Surgeon’s Discretion: It may be necessary to complete the Sleeve Gastrectomy procedure by making a larger incision in the abdomen. Experience shows that this occurs in less than 0.5% of procedures. This may occur if anatomical or other considerations preclude the safe conclusion of my operation using the laparoscopic approach. Other possible conditions that may lead to conversion to open surgery include bleeding, extremely large liver size, extreme amounts of fat around the stomach or equipment malfunction. It is also possible that anatomical or other considerations preclude the completion of the Sleeve Gastrectomy procedure, under any condition. In this rare situation, other options will be discussed with the patient postoperatively.
Possible Unexpected Medically Necessary Procedures: Other procedures may be necessary at the discretion of the surgeon during the Sleeve Gastrectomy procedure. These may include, but are not limited to, liver biopsy if an abnormal or abnormally enlarged liver is identified. The least intrusive measures will be undertaken in these circumstances until express patient consent can be obtained.
Admission to hospital: If there are unanticipated difficulties with the surgical procedure, anaesthesia or postoperative recovery, it may be necessary to admit the patient to hospital. If this becomes necessary it will be arranged by the surgeon who will manage the in-hospital care.
Death: The death rate with Sleeve Gastrectomy worldwide is approximately 1 in 5000 procedures. Although Sleeve Gastrectomy is considered to be a minimally invasive surgical procedure, complications are still possible which may, in very rare cases, be fatal.
Esophageal or Stomach Injury: These are rare complications. Injury to the esophagus or stomach can be a very serious complication. It may require prolonged hospital stay, further surgery, antibiotics and very rarely death.
Infection: Infection is rare after this type of surgery. Should infection occur, treatment, including antibiotics or additional surgery, may be necessary.
Skin scarring: Excessive scarring is uncommon, but all surgery leaves permanent scars. Sleeve Gastrectomy leaves a small number of scars on the abdominal wall. In rare cases, abnormal scarring may occur.
Anaesthesia: General anaesthesia involves risks. Patients who have any specific concerns about the risk of general anaesthesia have been advised they should contact the clinic or the surgeon to discuss these concerns with the assistance of an anaesthesia specialist. However, there is the possibility of complications, injury, and even death from all forms of surgical anaesthesia.
Smokers: Smokers have a greater risk of wound healing complications.
Allergic reactions: In rare cases, local allergies to tape, suture materials, or topical preparations have been reported. Systemic reactions, which are more serious, may occur to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment, including possible hospitalization.
Deep Venous Thrombosis / Pulmonary (lung) complications: Pulmonary complications (pulmonary emboli) may occur, secondary to both blood clots (deep venous thrombosis) and partial collapse of the lungs after general anesthesia. Should either of these complications occur, hospitalization and additional treatment may be required. Pulmonary emboli are rare, but can be life-threatening or fatal in some circumstances.
Pain: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after Sleeve Gastrectomy.
Complications: I acknowledge that it is not possible to list every complication possible during and after this procedure. By signing this consent, I agree that I have been informed of the risks and complications associated with the treatment that are significant in making a decision as to whether or not I should proceed with the surgery. I have also been informed of more serious risks, even if they are less likely to occur.
I acknowledge and agree that I have been given the opportunity to ask questions regarding potential complications and other questions of concern to me and/or to my family relating to the surgery and my questions have been answered to my satisfaction.