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Berkshire Weight Loss Surgery

Berkshire Weight Loss Surgery offers a range of surgical procedures for obesity and diabetes, including gastric bypass, gastric band, sleeve gastrectomy, and gastric balloon. Our experienced team provides comprehensive support and lifelong follow-up for successful weight loss.

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Berkshire Weight Loss Surgery

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  1. Berkshire Weight Loss Surgery Royal Berkshire Hospital, Reading James Ramus, Consultant UGI & Bariatric Suregon

  2. Background • Obesity epidemic – 25% UK (no.5) • Predicted 50% by 2050 • ‘metabolic syndrome’ – (x20 risk of DM if BMI>35) • NBSR 2010 – 27.5% DM

  3. Treatment of obesity • Diet/exercise • Drugs • Surgery – sustained weight loss 85.5% ‘resolution’ of DM (2 years) 0.1% overall mortality average 57.8% EWL

  4. Surgery for obesity • Laparoscopic gastric (‘roux en Y’) bypass • Laparoscopic gastric band • (Laparoscopic sleeve gastrectomy) • Endoscopic gastric balloon

  5. Normal Stomach

  6. Gastric band

  7. Gastric band

  8. Gastric band • 50-60% EWL within 2 years NBSR • Day case – 1 night stay • 50-75% ‘resolution’ of type 2 DM NBSR

  9. Gastric bypass

  10. Gastric bypass steps

  11. Gastric bypass • 60-85% EWL 2 years NBSR • 2-4 night stay • 60-90% ‘resolution’ of DM at 2 years NBSR

  12. Sleeve gastrectomy

  13. Sleeve gastrectomy • 50-70% EWL • 1-3 night stay • DM resolution good but ?not quite as good as post bypass

  14. Gastric balloon

  15. Gastric balloon • ?primary weight loss procedure • Sedation/ ‘light GA’ - Day case • Need to remove/replace after 6 months • 20-30% EWL 6 months

  16. Berkshire weight loss service • Referral to consultant endocrinologist • Assessment by full weight loss team • Commencement of non surgical ‘tier 3’ management as necessary • Referral to bariatric MDT clinic • Surgery • Lifelong follow-up by MDT

  17. Criteria for surgery • NICE BMI >35 & comorbidity BMI >40 • Clinical Commissioning Policy: Complex and Specialised Obesity Surgery; April 2013 – advises commissioning based on NICE guidelines

  18. SIGN 2013 • ‘Obese adults with T2DM should be offered individualised interventions to encourage weight loss (including lifestyle, pharmacological or surgical interventions) …..’

  19. ADA 2013 • ‘Bariatric surgery may be considered for adults with T2DM with BMI >35 ……in particular if diabetes or associated comorbidities are difficult to control with lifestyle and pharmacological therapy..’

  20. NICE 2012 • prevention of DM July 2012 – ‘…if the above weight management interventions have been unsuccessful, refer people to a specialist obesity management service (see NICE guidance on obesity)…’

  21. Economic impact • Obesity has been estimated to cost the NHS £4.3 billion a year. Figures published by the office of health economics in 2010 calculated that by operating on just 5% of the eligible bariatric population, the economic impact on the UK would be a saving of approximately £191 million a year.

  22. Berkshire Weight Loss Surgery • James Ramus Consultant Surgeon • Marianne Sampson Consultant Surgeon • Usha Ayyagari Consultant Endocrinologist • Kathy Krzeminska Consultant Anaesthetist • Kath Hallworth-Cook Specialist Bariatric Nurse • Lisa Lovell Specialist Bariatric Dietitian • Rachael Brastock Consultant Clinical Pyschologist • Please refer to Dr Usha Ayyagari, Berkshire Weight Loss Surgery, Department of Endocrinology, Royal Berkshire Hospital, Reading

  23. References • The National Bariatric Surgery Registry. March 2010. Dendrite Clinical Systems Ltd. Oxon • Shedding the pounds. Obesity management, NICE guidelines and Bariatric Surgery in England. Nov 2010. Office of Health Economics. London • Scottish Intercollegiate Guidelines Network, Healthcare improvement Scotland. SIGN March 2010 • American Diabetes Association. ADA. Standard of medical care in diabetes – 2013. Diabetes Care. 2013;36 (suppl 1): S11-S66

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