The first Bariatric Surgery (or weight loss surgery) Unit of Sefako Makgatho Health Sciences University (SMU) has been recently established at Dr. George Mukhari Academic Hospital (DGMAH). This collaboration between the Gauteng Department of Health and SMU Department of Surgery represents an important advance in bringing this type of surgery within reach of the poor. The surgery also represents the multidisciplinary approach to the management of a patient with morbid obesity where surgeons, physicians, anesthetists, psychologists and other disciplines all contribute to the initial screening, workup and ongoing management and surgery of these patients.

The Bariatric surgery workshop held at SMU provided a real-time information for the numerous attendees including professors, specialists and doctors from both the public and private sectors as well as students. Unit head Professor Zach Koto said, “The surgery includes a variety of procedures performed on people who have morbid obesity. The weight loss is achieved by reducing the size of the stomach making it the size of an egg and re-routing the small
intestine to a small stomach pouch. Patients are still advised to eat healthy afterwards because the surgery does the 50% and healthy eating does the rest”.

Prof Koto said the other type of bariatric procedure is reducing the size of the stomach by two-thirds (70%) in a procedure called sleeve gastrectomy. “This works by two mechanisms, Firstly, it reduces the size of the stomach so that the patient eats less. Secondly, it reduces the hunger hormones where the patient does not feel hungry”, he emphasised.

Obesity is a significant public health problem in South Africa with serious potential metabolic complications. “One out of three patients in South Africa is obese and this leads to diseases such as high blood pressure, diabetes, high cholesterol and arthritis, hence it is important for a patient to go through a proper screening process before they can be considered for bariatric surgery which is a complete life style change for the patients. What is intriguing is that bariatric surgery is able to permanently cure diabetes, hypertension, sleep apnea and other obesity related comorbid conditions” added Prof Koto.

SMU through the department of surgery is spearheading the registration and accreditation of a qualification in Bariatric and minimal access surgery in South Africa. Koto said the service would help the government to save money as it could cure diabetes and ensure that there were no more premature deaths. He further said that the procedure had to be looked at, and be made available to the public throughout the country.

Prof Dhaneshwar Bhagwandass, Clinical Head in the Department of Anaesthesiology at SMU and DGMAH, welcomed the opportunity for the team involved in this venture to grow professionally as individuals and as members of a team. “Bringing such initiatives to the public sector, and succeeding, proves that collaborative efforts from clinicians can improve the lives of all South Africans,”emphasised Prof Bhagwandass.

After the presentations at the workshop, the audience was shown live Roux Y gastric bypass procedure on eight patients. This was done using the state-of-the-art 3D laparoscopic camera system in the high-tech room in the department of surgery at SMU. It was transmitted a distance from theatre at DGMAH to the Clinical Pathology Building (SMU). All the patients did well and were discharged two days later.

At this workshop, they also showcased the 4k (ultra-high definition) camera system. This interactive live surgery symposium is a significant education tool which is a growing intervention for learning and professional development. Attendees came from all over the country and some surgeons came all the way from
Namibia. Members of the SMU Surgical Students Society were also in attendance