Ramsay Health Care UK | 14/08/2014
Do some homework
It’s worth reading up about your weight loss surgery options such as gastric banding, sleeve gastrectomy, gastric bypass and gastric balloons. If you’re familiar with what each procedure involves and the associated benefits and risks, you’ll be better informed when talking through these options with your surgeon.
Where to start
Your GP can discuss your weight loss options with you. They can refer you to a bariatric surgeon through the NHS or as a private patient. Alternatively you can opt to contact a specialist weight loss surgery clinic instead. For example, Ramsay Health Care offers a wide range of weight loss procedures performed by top bariatric surgeons.
Choose a surgeon who is fully trained and qualified in bariatric surgery
For peace of mind it is best to investigate and check that your proposed surgeon is fully trained and qualified in bariatric surgery and ticks the following:
• GMC registered and on the GMC “specialist register” for general surgery
The General Medical Council maintains a specialist register with the names of all consultant surgeons in the United Kingdom. Your surgeon should be on that register and should be on the GMC specialist register specifically for general surgery¹.
• Holds an FRCS
Fellowship of the Royal College of Surgeons (FRCS) is a professional qualification to practise as a surgeon in Ireland or the United Kingdom. Your surgeon will need to hold an FRCS. More recently surgeons have to obtain the FRCS (General Surgery).
• Most likely trained in upper gastrointestinal surgery
Surgeons who perform bariatric surgery are most likely to have been trained in upper gastrointestinal (stomach, gullet, liver and pancreas) surgery.
• Holds membership for an organisation like AUGIS, BOMSS, IFSO
There are a number of professional organisations to which your surgeon can belong, such as the Association of Upper Gastrointestinal Surgeons (AUGIS)², the British Obesity & Metabolic Surgery Society (BOMSS)³ and International Federation for the Surgery of Obesity and metabolic disorders (IFSO)⁴. Membership of these societies can mean they are up to date with the latest techniques, although this cannot be guaranteed.
Look for substantial experience and expertise in performing weight loss procedures
Find out if your proposed surgeon is an experienced bariatric surgeon, what type of bariatric procedures have they carried out , which ones they do most often and how many of these operations have they performed.
It is worth finding out if your weight loss surgeon performs open or laparoscopic surgery. Laparoscopic surgery takes longer than open surgery but the advantages include your surgery being less painful, less scarring and you will have a quicker recovery. Most UK bariatric surgeons do weight loss surgery laparoscopically. However, there are no differences in outcomes of surgery from laparoscopic to open operations. If your bariatric surgeon is skilled at doing open operations, this may be preferable to someone who may be skilled at other laparoscopic surgery but less skilled at bariatric operations⁵.
You should keep in mind that the number of cases is an indicator of quantity, but may not reflect quality. However, quality surgeons tend to attract a large quantity of work.
What are your surgeon’s results?
- Ask you surgeon for their expected weight loss figures for each operation they do.
- You should also ask them for their complication rates including mortality, leakage and other complications.
- It is also worth asking your surgeon what steps they use to prevent this from happening.
How conveniently located is your surgeon?
Choosing a bariatric surgeon close to where you live is encouraged if there is one available with the skills and service you require. If you chose to travel for your bariatric surgery or you choose a surgeon who is not based in the UK and who flies in to undertake operations, because the price of the operation is cheaper, this may be a problem if you need help urgently. You will need to check that robust arrangements are in place for emergency contact with your surgery provider.
What hospital is your surgeon affiliated to?
Your surgeon works with a team of health care professionals at either a hospital or outpatient surgical centre. It’s important that the facility is a respected centre that provides excellent care. It’s worth checking to see that the facility has a high caseload of procedures similar to the one you’re considering.
Weight loss centres must adhere to the highest possible standards. They should only offer surgery to patients who meet national criteria. In the UK this means patients must satisfy the NICE criteria.
It’s important to have your obesity surgery performed in a specialist unit that caters for the needs of bariatric patients such as larger beds and chairs, individual rooms with walk-in showers, hoists and moving equipment. Medical and nursing staff in these facilities will also be sympathetic and understanding to your specific needs.
Does your surgeon have a multidisciplinary team?
The key to successful bariatric surgery is choosing the right "team"⁶. Your bariatric surgeon should be part of a dynamic multi-disciplinary team (MDT). The team should ideally compose of a specialist anaesthetist, nutritionist, clinical behaviourists and physiotherapists as well as your bariatric surgeon.
This MDT will provide your care from the day of assessment onwards so it's important that you feel comfortable with the entire team.
Know who is doing your surgery
It is worth checking with your surgeon if they will be performing the entire surgery. In many academic institutions residents or fellows under the supervision of the attending surgeon may perform much of the surgery. There are also many surgeons who assign a good deal of the surgical work to their assistants or junior colleagues. This does not necessarily diminish the end result but it is important to know up front who will be doing what when it comes to your own surgery.
Do you like your surgeon?
This may not seem that important but as you are entering a professional relationship with your bariatric surgeon, you will need to be completely open and honest with them. If you don't like your weight loss surgeon, you are unlikely to trust and respect them and you may find it harder to fulfil the post-operative requirements and attend the necessary appointments.
What support will your surgeon and their MDT offer after surgery?
Bariatric patients need to be followed up to ensure if any complications arise they are picked up. If you have a gastric band this will need adjusting a number of times in an outpatient clinic following surgery. It is worth finding out what aftercare and support is available from your surgeon and their team together with the associated costs.
The MDT will also support you to make diet and lifestyle changes that are necessary for you to achieve your weight loss targets.
Here you can find our guide prices for weight loss surgery procedures.
Weight Loss Surgery Basics - 10 Things to Know Before the Procedure
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About Ramsay Health Care Weight Loss Services and Surgeons
Ramsay Health Care is a leading provider of weight loss surgery in the UK. Ramsay is proud to work in partnership with some of the highest qualified and experienced weight loss surgeons in the UK. These consultant surgeons have undergone intensive training in their speciality. Convenient appointment times with short waiting times are offered.
Ramsay offers gastric banding, sleeve gastrectomy, gastric bypass, gastric balloons and conversion procedures. A multidisciplinary team who liaise with each other to provide the best plan of action for you. They include a dietitian who will meet with you and produce a bespoke eating plan, and specialist trained nurses who will be by your side during your journey to offer support and guidance to ensure that you achieve your goals.
This content is intended for information purposes only and should not replace advice that your GP or Consultant surgeon would give you.
Please contact us if you would like more information about the bariatric surgeons who work out of Ramsay Health Care Hospitals.