Bariatric Program
Our Bariatric Program
After more than 15 years of experience in the field of Bariatric (obesity) surgery in South Africa, with more than 3000 patient surgeries, lessons have been learned about what patients really want when it comes to surgery for obesity and associated co-morbidities. Excellent professional care both around the surgery and for the rest of the patient’s lives after surgery, is expected as a norm. To achieve this, the centre must have a large multidisciplinary team, not only to address the surgical preparation of the patient but also the medical and psychological aspects as well. Patients have the right to always access of the best care and in setting up this centre, we will particularly make sure that the patient will always have an open access to all professionals in the team. Medical professionals are not available 365 days a year but with a large team, including multiple surgeons and physicians, that access will almost always be available.
What is bariatric surgery?
Bariatric (aka metabolic, obesity) surgery is the term for a surgery that is done not only to help you lose weight but primarily address, or prevent, other coexisting chronic medical diseases. These chronic medical conditions that are related to being obese include diseases such as high blood pressure, obstructive sleep apnoea, high cholesterol, arthritic joint diseases, and diabetes. Bariatric surgery includes operations that involve surgery on the stomach and/ or small intestine. Any surgery, without lifestyle changes, is unlikely to be successful for the patient in the long-term and hence the multidisciplinary team approach and intensive life-long follow up programme.
What bariatric surgery is right for you?
Bariatric surgery is major surgery, and your motivation for surgery should be discussed in detail with you. As this will be a life changing experiences for you, both positively or negatively, we encourage you to do your own research, so you are prepared to ask questions. Your decision to have bariatric surgery should come only after careful consideration and consultation with an experienced bariatric team or a knowledgeable healthcare professional.
A complete explanation of the routine evaluation for bariatric surgery, known as the work-up, including consultation with a surgeon, physician, dietician and a psychologist, will be provided. This is to help ensure you have clear understanding of the postoperative changes in lifestyle behaviour that are essential for long-term success and the reality of the follow-up care that will be required. A qualified surgeon will explain clearly and concisely, the benefits, risks (signs or symptoms of complications during and after surgery) and costs, as well as the recovery period of the available procedures to you, to assist you with your decision. We also recommend speaking to patients that have gone through our program before you about their own experience. The team will recommend a surgical procedure they feel is going to give you the best outcome after initial consultations but the decision on what procedure you as a patient chooses, will always be respected.
How do I choose my Bariatric service?
An important part of the research that you do in finding the best bariatric service is to investigate the experience of both the members of the team, (specifically the surgeon performing the procedures) and the hospital facility (infrastructure, equipment, and experience with managing bariatric patients) and respective outcomes (sustainable results and complication rates). A full coordinated program of care from pre assessment to long term post operative care and support should be available, and the surgery should not be unnecessarily long, as this also may lead to complications. Although the results of bariatric surgery can be dramatic, there are potential risks and complications, therefore before making your decision and providing “informed” consent to treatment, you should be well-informed.
To help achieve your goals, your Bariatric service should offer follow-up care that includes support groups, dieticians, and other forms of continuing education. Bariatric surgery and the entire program is only a means to an end, but ultimately success depends on your strict adherence to recommended dietary, exercise, and lifestyle changes.
Who qualifies for bariatric surgery
Any patient with a BMI greater than 35 kg/m2 and on treatment for 2 chronic medical diseases that bariatric surgery resolves or BMI > 40 kg/m2 qualifies for medical aid funding but only by selected medical aids and plan types. Your qualification for medical aid funding can be discussed with the staff in the centre before proceeding with any consultations. BMI criteria are not strictly applied for private funding patients, but ethical and moral standards will always be applied regarding the benefits of surgery in a lower BMI patient.
BMI Calculator
What is the process for bariatric surgery?
Multiple consultations with team professionals, blood tests, ecg, lung function test, CXR, ultrasound abdomen, pre-operative gastroscopy and dietary modification is all part of the 4 – 6 week work up before the surgery is actually performed. This is to prevent unnecessary complications from the surgery and to prepare the patient for the radical lifestyle and eating habits the patient will have to face after the surgery. Depending on the type of surgery done, which is almost always done laparoscopically, the hospital stay is usually only 2 – 3 nights. Time required to take sick leave for recovery is usually never longer than 2 to 3 weeks. Most patients who are self-employed are usually back at work within a week of surgery.
What are the costs for bariatric surgery?
There is very limited access to bariatric surgery in the government hospital setup. Most patients seeking this form of treatment will have to do it in the private sector. No matter which procedure you choose, the technology required to perform these operations safely, are all costly. Some medical aids fund this type of surgery but invariably not all the costs. Our team will prepare you on all the costs related, not only for the surgery, but also for lifelong follow up maintenance as well. We will never sacrifice quality of care, but always endeavour to keep costs to a minimum.
Costs of surgery and major complications are reduced significantly by surgeon experience. A German national study showed a 3 fold reduction in complications related to bariatric surgery in those centres doing more than 100 cases a year compared to those doing less than 20 cases a year. As in all aspects of surgery, outcomes are always better in high volume centres.
