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Very Important QuestionsWhen considering weight loss surgery there are some very important questions that you need to ask your surgeon.
Q: How many of Laparoscopic procedures have you performed?AIWC: Over 10,000 procedures. Q: How many gastric band procedures?AIWC: In excess of 7,000 Q: What complications have you encountered?AIWC: Refer to Research section Q: What professional organizations do you belong to that relate to weight loss surgery?
Q: Can I be considered a candidate for surgery even though I have one or more associated health conditions (co-morbidities) related to my weight problem?AIWC: Yes you can be considered a candidate with co-morbidities, at a BMI >35. Q: Can I be considered a candidate for surgery even though I have no health conditions (co-morbidities) related to my weight problem?AIWC: You may be considered a candidate for weight loss surgery if your BMI is in excess of 35 even though you present no co-morbidity symptoms. Q: After receiving your medical assessment how long will it take before I can undergo surgery?AIWC: There is no waiting period for surgery if you are suitable. Your surgeon will discuss with you how much weight you will need to lose before the surgery in order to shrink the liver and make the key hole surgery possible. We use a very low caloric meal replacement (Optifast). We aim to achieve 5% of weight loss before the operation and this usually takes between 2 to 4 weeks depending upon the initial weight. Q: Does your practice have age limitations on patients choosing a surgical solution?AIWC: There are no age limitations per se, except for the elderly and children. Mature adolescents can be considered for surgery. Q: Does your practice have weight limitations for patients choosing a surgical option?AIWC: There are no weight limitations. However, super obese patients may need to lose some weight prior to the operation using very low caloric meal replacements. Q: Why might I need to have a gastrointestinal (GI) evaluation?AIWC: Most patients will be asked to undergo a barium swallow test to determine whether patients have reflux, abnormal oesophageal anatomy or hiatal hernia. The latter may need to be repaired at the time of gastric band surgery. An upper abdominal ultrasound is requested to determine the size of the liver and ascertain the presence or absence of gall stones. Q: If I’ve had an ulcer, will that make a difference whether or not I can have weight loss surgery?AIWC: An old stomach ulcer which has been previously treated is not a contraindication to surgery. If a previous ulcer required a stomach operation then your surgeon will determine whether gastric banding is possible depending upon the exact site of the previous surgery. Q: Do I have to lose weight before having surgery? Why? How much?AIWC: You may be required to lose weight prior to surgery depending upon your BMI and your body habitus. Most patients are asked to take a very low caloric meal replacement to reduce the size of the liver (as most patients have fatty liver disease). Q: Will I be asked to stop smoking?AIWC: All current smokers will be asked to stop smoking as smoking increases the risk of an anaesthetic complication especially for the obese patient. Q: What pre-operative tests or evaluations will you perform? Why?AIWC: There will be a series of blood tests and x-rays to evaluate the suitability of a patient prior to surgery. Q: Is this a multidisciplinary practice?AIWC: Yes, we have a team of health professionals on site to provide support and assistance during your weight loss, including dieticians, psychologists and exercise consultants. Q: What is the immediate follow-up care plan for your practice? Long term follow-up?AIWC: You will commence with the follow-up care plan around 2 weeks after surgery and through the first 12 months, which includes support groups. Following the first 12 months we offer long term support and follow-up care from all professionals on a needs basis. Q: If I am from out of the practice’s geographic area, how will my follow-up be managed?AIWC: We are able to manage the majority of your post operative care remotely for outer Metropolitan regions. Band adjustments will require you to travel to one of our centres. Q: What role does my general practitioner play in this process?AIWC: Your GP will be involved in managing all you other health requirements, your post operative care and changes in medications. He/she will be kept informed of your progress through correspondence by our team. Q: How long will I be in surgery?AIWC: The surgery takes about 60 to 90 minutes, and is followed by a period in the recovery area. Q: What precautions do you undertake to prevent deep vein thrombosis (DVT) or pulmonary embolism?AIWC: All patients are given a subcutaneous injection of heparin on the day of the operation and are given TED stockings to wear during their short hospital stay. In addition, during the operation, all patients wear lower limb compression stockings. Q: How long will I be off solid foods?AIWC: After surgery you will follow a 2 week Liquid Diet followed by a 2 week Puree/Soft Diet. After this time you will move onto normal food. Q: How will my eating habits have to change?AIWC: You will eat small portion sizes about the size of a small entrée, take small bites, and not eat and drink at the same time. Our dietician, as part of the circle of care program runs sessions on “How to Eat with the Gastric Band” for all our patients. There are also some foods which are difficult to eat with the band such as white bread, steak and some fibrous vegetables and fruit. Q: Will I have to take a vitamin supplement following surgery?AIWC: All patients are encouraged to take a multivitamin. Q: Will I be able to continue my current medications after surgery?AIWC: Yes. However, tablets should be cut into smaller pieces before swallowing. Also, patients need to bear in mind that the dose of the medication may need to be altered with weight loss. This is done in consultation with the patient’s General Practitioner. Q: Will I be able to take oral contraceptives after surgery?AIWC: Yes. Q: Is sexual activity restricted?AIWC: Not at all. Q: How long will it be before I can return to pre-surgery levels of activity?AIWC: Surgery usually involves an overnight stay in hospital. Patients are usually ambulating (moving) a few hours after the procedure. They return to work usually after 5 to 7 days. The Circle of Care program involves a graded exercise program and our research has shown that over 65% of patients exercise more than 3 times/week. So, not only does activity return to pre surgery levels but dramatically increases. Q: How soon will I be able to drive?AIWC: Usually 5 days after the operation as the operation involves a general anaesthetic. Q: What is the typical excess weight loss and improvement of associated health conditions for your patients?AIWC: Our patients typically lose between 50 to 60% of excess weight with improvement and/or resolution of many diseases associated with obesity. Many patients see improvement in diabetes, high blood pressure, obstructive sleep apnoea, asthma and bone and joint problems. Patients also see improvement in quality of life, being more active, and productive at work. Q: Do you have patients who are willing to share their experiences, both positive and negative?AIWC: Yes. Our Patient Liaison will assist you in contacting previous weight loss surgery patients. Q: Does your practice provide support groups and/or counselling services?AIWC: All the information provided by our allied health professionals to assist patients to lose weight takes place in group sessions. We find these advantageous as patients are able to share experiences and learn from one another. Support groups are also regularly held at each centre.
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