Have you found the right surgeon?

This may seem a strange question to pose if you are having your operation as an NHS patient as you are normally expected to take what is offered locally. But with patient choice initiatives in the NHS you will have a greater choice, especially when you live in a city where there are a number of bariatric surgeons practicing.

Having your operation privately will enable you to seek a bariatric surgeon who is more skilled in the operation you wish to have and for it to fit in more easily with your own time frame.

We also suggest you read the article in our news section entitled Advice to a patient seeking bariatric surgery. It's an American article, but there are a lot of good hints in it that are applicable to patients in the UK too.

So, you've found the names of several bariatric surgeons and you need to decide which one to consult. Here are some pointers to guide you through this decision making process.

How conveniently located is your surgeon?
In the event that something goes awry, you need to be able to get in contact with your surgeon immediately for advice or treatment. If you have chosen a private surgeon 500 miles away because the price of the operation was cheaper, or a surgeon who is not based in the UK and who just flies in to undertake operations privately, this may become a problem if you need help urgently. And if your bariatric surgeon does an operation that is not available locally, the staff in your local hospital will not automatically know how best to help you in an emergency situation. Choosing a bariatric surgeon close to where you live is encouraged if there is one available with the skills and service you require. If that is not possible, check that robust arrangements are in place for emergency contact with your surgery provider.
What operations does your surgeon do most often? Your bariatric surgeon will achieve greatest technical expertise in the operation they perform most often. Beware of the surgeon who says they will "have a go" and if you are one of the first patients to undergo this surgery locally, ask if your surgeon is planning to have a more experienced bariatric surgeon to supervise him/her. If they are new to weight loss surgery, they should be expert in the anatomy of the stomach and oesophagus already as an upper GI surgeon, so you may want to check that.
What are the weight loss and side effect results of your local surgeon? The government requires that a bariatric surgeon maintains a database of patients and he/she should be able to tell you the weight loss results easily and also how many have had side effects etc.
Does your surgeon have a multidisciplinary team? Avoid a bariatric surgeon who does not work with at least a dietitian and physician in a multidisciplinary team. Obesity is a complex disease and you will need life–long follow up after surgery. Many of the issues you may face in the longer term, e.g. planning the nutritional content of your meals and ensuring you are not deficient in vitamins and minerals are not in the realms of most surgeon's expertise.
Does your surgeon operate laparoscopically? Laparoscopic surgery takes longer than open surgery (and often costs a little more to do as well) but has huge advantages for the patient in terms of less scarring and 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 operations. Click here for more information about laparoscopic versus open surgery
Is there a local support group? A sensibly structured support group can make a huge difference and the best ones have the input of the local surgeon in them. The support group should do more than meet socially for a chit chat (there is a lot of good that will come from such a meeting, don't get us wrong) but a group that has guest speakers and a proper education–based agenda will be much more useful to you.
Do you like your surgeon? This may seem like a silly question but you are entering a professional relationship with someone for the rest of your life and you will need to be able to be completely open and honest with them. If you don't like your bariatric surgeon, you are unlikely to trust and respect him/her and you will find it harder to comply with the post–op instructions and with keeping appointments. If you have an experience that leaves you concerned, make sure you have not just met him/her on a bad day - speak to other patients if you are concerned. The new NHS patient choice initiatives will make it easier for you to seek out a surgeon who you trust and feel more comfortable with.

It is not BOSPA’s role or intention to address complaints about individual surgeons. However, if you are experiencing difficulties please feel free to call us to discuss your situation and we may be able to put you in touch with someone who can help you.