The methods of attaining best practices in gastric bypass, metabolic, and other weight-loss surgery in the country dominated discussions at a two-day forum organised by the Bariatric and Metabolic Surgeons Society of Nigeria (BMSSN).
Gastric bypass and other weight-loss surgeries- known collectively as bariatric surgery- involves making changes to your digestive system to help you lose weight. Bariatric surgery is done when diet and exercise have not worked or when you have serious health problems because of your weight.
The forum came under the theme, “bariatric practice in Nigeria: defining the standard of care through learning and collaboration’’ had in attendance surgeons from Nigeria and French speaking region of West African, nutritionists, dieticians.
Speaking at Euracare Hospital Lagos, venue of the programme, President of the Bariatric/Metabolic Surgeons Society of Nigeria, Abuchi Okaro explained that the gathering was necessary to build the capacity of medical doctors who want to practise bariatric surgery in the country.
According to Okaro: “We have been really looking for ways of bringing experts together. There is nothing like having a collective opinion, collective experience, because I think concrete problems are solved when competent, keen and dedicated minds come together to really share single purpose of trying to get better and source better solutions, better ways for the people in Nigeria.
“The focus has to be on the ability to offer patient options for having weight reduction surgery in the area of Nigeria or any other place in west Africa, the only reason for that is simply because patients are really suffering with things like obesity or over weight, diabetes, hypertension and other issues related to infertility, issues with sleep problems among others.
“Ultimately, the aim is to ensure that we give patients the option, which means that when they are trying to make a decision with themselves and loved ones, if they feel that they need some help with their weight in Nigeria in local area like Lagos, Abuja or Kano, it does not have to be Turkey, India or United Sates,” he said.
Considering the reason to perform bariatric and metabolic surgery, Okaro said the surgery is ideal as it optimises the control of obesity–based chronic diseases.
While describing obesity as a public health issue, the medical practitioner said that a lot of people in Nigeria are obsessed.
In his words: “Obesity or been over weight is a condition of having more fats in the body or around ones organs.
“Sadly because some of these organs or part of the body behave differently when there is fat around, abnormal signaling, things we call chronic inflammation, impel insulin sensitivity otherwise called insulin resistance are been keyed and once it happens, first of all you have issues of poor blood sugar control otherwise known as diabetes, you have problems with high blood pressure, heart problem because high blood pressure and heart conditions can lead to heart attacks, strokes.
“If it happens in the brain, it could lead to dementia, if you have problem with the lung, you will have sleep apnea, which means that if you are sleeping in the night you will not breath very well other areas of concern, you could get joints getting aged quickly and back pain, knee pain, because such an individual is carrying a lot of weight.
“This could lead to arthritis, other problems that occur could affect the intestine, one can get reflux ties, cancer of the uterus, colon all associated with obesity.
“In women you can get things like infertility, so quiet a lot of organs in the body get affected with, the most important one is our self -esteem, our confidence, our mood , every part of the body is badly affected by over -weight and people die young.”
Stating that BMSSN is a society of surgeons and other health professionals such as physicians, nurses, dieticians, psychologists who specialise in the treatment of severe obesity and its metabolic complications, the medical practitioner said: “Our mission is to promote the highest standards of expert multidisciplinary care for those living with complex obesity through delivery of education, training opportunities, research and through the promotion of cohesive team working in high quality bariatric surgery centres.
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”As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline.’’
For Okaro, Bariatric and Metabolic Surgeons society of Nigeria has an opportunity to lead the way in both the promotion and dissemination of needed and impactful surgical intervention in the communities through advocacy and specialist training in establishing centre of excellence in the field.
He also urged bariatric and metabolic surgeons in the country to exhibit high level of commitment in the services they render so that patients would have trust and confident in their work which will in turn discourage medical tourism.
Lamenting high cost of surgical equipment in the country, Okaro appealed to government to ensure reduction in the price of such consumable, adding that such effort would go a long way in reducing the cost of bariatric and metabolic surgery in the country.
Speaking on ‘Theatre set up for bariatric surgery,’ theatre manager Euracare multi –specialist hospital Lagos, Idris Olasunkanmi described Minimally Invasive Surgery (MIS)/ Lap surgery as a modern day surgery.
According to him, to achieve success in the procedure and safety of the patient, a team approach is essential.
Explaining further, he said : “each and every member of the team plays a crucial role, Important to the success of a laparoscopic procedure is the vital role played by the nurses , the scrub and circulating nurse in the operating room, and the recovery room nurses who does the post- operative patient management.’’
Consultant general surgeon, Timi Adenuga, who, spoke on ‘Data collection and collaboration,’ said that data collection is needed to set quality benchmarks and expedite evidence-based improvement in patient safety and care.
Also, he observed that collecting and analysing data are essential for identifying areas for improvements and optimising outcomes and patient care.
On the way forward, Adenuga stressed the need for the following; careful documentation of data; publications and presentation at meetings of sister association and; communication among centers and formation of a central database.
On “How important is sleep study report?’’ consultant laparoscopic surgeon,
I.K.Salu, defined a sleep study as a diagnostic test used to evaluate the severity of sleep-disordered breathing.
He further explained that the test involves sensors that track the activity of multiple body systems, including the heart, brain and respiratory system and added that it gives comprehensive view of the quality of the sleep.
For him, a clear understanding of the sleep study report facilitates appropriate patient treatment and follow up.
Speaking on ‘The role of dietician and nutritionist,’ Clinical nutritionist consultant and gut health practitioner, Sheres Ijewere explained that their goal as nutritionists and dieticians was to provide personalise care for each patient, understand their challenges, improve their quality of life, while helping them achieve their weight goals.
A professor from Cotonou, Benin Republic, Olory Togbe who spoke on, ‘A snapshot of the state of affairs in bariatric/metabolic surgery in French- speaking West Africa’ said that there were lots of obesity cases everywhere.
Stating that surgery is a new procedure in West Africa, he appealed to surgeons to ensure surgeries are well performed.
“Bariatric and metabolic surgery is a new specialty in medical care and it has to be done very well, if not there will be problem and patient will look for help elsewhere.’’
While commending the effort of the Bariatric and Metabolic Surgeons Society of Nigeria for organising the forum, Adrain Nedelcu from Paris, France, expressed the optimism that the event would go a long way in encouraging the society members to be more effective in their work as medical practitioners.
Nedelcu stressed the need for patient to be involved while surgeons are taking decision to perform surgery on such an individual, adding that ‘’making the patient to be his own doctor is excellent.’’
The forum witnessed several life surgeries by the members Bariatric/ Metabolic Society of Nigeria.
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