Blog

ABLE Moving to Dunedin

Posted by on 27 Nov 2017 in Announcements, Dunedin | Comments Off on ABLE Moving to Dunedin

With the holidays approaching, there are some changes in store for ABLE Ltd and myself.  In January 2018, I will be relocating to Dunedin with my family to take up a position at Dunedin hospital.  Although the reasons for any move like this are numerous, one of the primary goals for me was to protect the future of bariatric surgery in the south.  This will entail working with my upper gastrointestinal surgeon colleagues in Dunedin to support the delivery of surgery for benign and malignant upper gastrointestinal disease throughout the south; with the intention in the future of recruiting another well trained bariatric and upper GI surgeon who can grow the present program with me.

In a practical sense this means that from January 2018:

  • I will still offer clinic appointments for new and follow-up patients in Invercargill, Queenstown and Dunedin.
  • I will see patients with a broad range of general surgical and upper gastrointestinal conditions in Queenstown and Dunedin, but limit my Invercargill practice to bariatric surgery and specialist upper gastrointestinal surgery.
  • I will do all my private operating at Mercy Hospital in Dunedin.
  • I will no longer operate in the private sector in Invercargill
  • I will continue to operate on public bariatric patients in Invercargill every month
  • I will continue to conduct public bariatric surgery clinics in Dunedin and Invercargill
  • I will continue to work with Renovate Nutrition Ltd in Invercargill, and Nutrition and Life Ltd in Dunedin

I am very grateful for all the support I have received over the last 6 years in Invercargill and rest assured that although I will be based in Dunedin I will continue with my goal of excellence in Bariatric and Upper GI surgery throughout Southern New Zealand.  If you have any questions, please contact me.

Wilbur: The King in the Ring

Posted by on 28 May 2017 in Announcements, Bariatric Surgery, Dunedin, Sleeve Gastrectomy, Weight Loss | Comments Off on Wilbur: The King in the Ring

Notable Pictures have just released a brilliant New Zealand made documentary of one man’s struggle with obesity and journey back to health. It stars Wilbur McDougall, a former pro wrestler, who agrees to let his best friend J. Ollie Lucks make a documentary about his laparoscopic sleeve gastrectomy surgery and subsequent transformation. It is a very human story, and is told with respect and compassion. I would highly recommend it for anyone contemplating weight loss surgery, or who knows others who have had it.

Wilbur: The King in the Ring is currently touring New Zealand.

For more information, check out the Facebook page.

ORBERA® Intra-gastric Balloon

Posted by on 4 May 2017 in Announcements, Dunedin, Endoscopy, Weight Loss | Comments Off on ORBERA® Intra-gastric Balloon

 

Here at Aspiring Bariatrics we are pleased to announce that we are now offering the ORBERA® Intra-Gastric balloon.  The ORBERA® balloon is a temporary endoscopic treatment that helps people to feel full, and therefore lose more weight while undertaking a diet and exercise program than with diet and exercise alone.  The ORBERA® balloon is placed under conscious sedation during an outpatient endoscopic procedure, and is removed six months later by a similar procedure.  It is accompanied by a supervised diet and exercise program lasting 12 months in total.ORBERA® Balloon in Stomach

On average people lose 10-15 kilograms of weight while the balloon is in place, approximately three times the amount of weight lost through diet and exercise alone.  The ORBERA® balloon is indicated for people with a body mass index of 27 – 40 kg/m².

For further information please click here.

Southern Cross Affiliated Provider for Consultations

Posted by on 30 Oct 2016 in Announcements, Fundoplication, Gallbladder, Hernia, Laparoscopy | Comments Off on Southern Cross Affiliated Provider for Consultations

Southern Cross AP Horizontal Logo for Web

We are pleased to announce that we have added Consultations to the list of Affiliated Provider services we contract with Southern Cross Health Insurance.  This means that for people with Southern Cross Health Insurance, we are able to directly invoice your insurer and all you will need to pay for on the day is your co-pay (if applicable). In addition, we are also Southern Cross Affiliated Providers for laparoscopic gallbladder surgery, hernia surgery, anti-reflux surgery, skin surgery, gastroscopy and colonoscopy.

For people with other health insurers, we are able to provide assistance, cost estimates, and documentation in a timely manner to facilitate your insurance claim.

 

Caution with activity trackers

Posted by on 15 May 2016 in Weight Loss | Comments Off on Caution with activity trackers

I want to share a good link that explains the potential pitfalls with activity trackers.  These devices, like the Fitbit and others, are a common way for people to track their exercise and other physical activity.  Regular physical activity is important for good health, including cardiovascular health and maintaining healthy bones and joints.  Activity is also important for weight loss and long term weight maintenance following bariatric surgery.  We recommend at least 30 minutes of moderate intensity physical activity on most days of the week.

Fitness trackers are a great way to measure physical activity and to ensure you are meeting your physical activity goals.  They can cause problems for people trying to lose weight however, when the calories burned as measured by the activity tracker are added to the daily calorie budget.  This link explains the issue in more detail.

At Aspiring Bariatrics we encourage regular physical activity and support anything that helps people to incorporate this in to their lives.  Just beware of the calories burned measurement provided by physical activity trackers and use it as a measure of day to day activity, not a reason to eat more.

 

Resources added to web site

Posted by on 16 Jun 2015 in Announcements, Bariatric Surgery, Endoscopy, Fundoplication, Laparoscopy, Weight Loss | Comments Off on Resources added to web site

I have been busy updating the web site over the past couple of weeks, in particular adding many resources for patients and doctors.  In particular I have added a page about gallbladder surgery, and updated the previous links page, now called resources.  This page contains downloadable patient information resources about gastro-oesophageal reflux and weight loss surgery, as well as our new patient and GP information guidelines for follow-up after bariatric surgery.

The web site has also been updated to confirm our status as affiliated providers for gallbladder surgery, hernia surgery, anti-reflux surgery, minor skin surgery, gastroscopy and colonoscopy with Southern Cross Health Society.

Southern Cross AP Horizontal Logo for Web

For more information on this or other services please contact us.

 

Change in vitamin recommendations

Posted by on 24 Sep 2014 in Announcements, Bariatric Surgery | Comments Off on Change in vitamin recommendations

I would like to announce a change in our recommended multivitamin for patients who have had gastric bypass or sleeve gastrectomy.

We have been starting to notice a number of patients developing low levels of vitamin B12 at between 18 months to 2 years after gastric bypass surgery.  In response to this, Renee Ladbrook has reviewed the detailed descriptions of all the multivitamins currently available in New Zealand and compared them against the vitamin supplementation recommendations by the American Society of Metabolic and Bariatric Surgery.  She found that most of the available multivitamins do not contain enough B12, and consequently body stores may become slowly depleted over many months.

The new recommended multivitamins are Celebrate Multi-complete capsule or Celebrate Multivitamin Chewable.  Both are available on-line from AMS nutrition here.  These should be taken at the doses recommended on the bottles, and should be taken in addition to calcium and any other individual vitamin recommendations.  Unless you have been noted to have a low vitamin B12 level then it is ok to finish you current multivitamin stocks before switching over.

If you have any questions please contact me or Renee.

 

Weight Loss Surgery Conference

Posted by on 23 Sep 2014 in Announcements, Bariatric Surgery, Gastric Banding, Gastric Bypass, Sleeve Gastrectomy, Uncategorized, Weight Loss | Comments Off on Weight Loss Surgery Conference

This October, Invercargill will be hosting the 5th Weight Loss Surgery NZ Trust National Conference.  The conference runs from October 31st to November 2nd and will be held at the Kelvin Hotel.  Highlights will include patient testimonies, a clothing swap, discussions on weight maintenance and re-gain, and looking at postoperative effects on relationships.

To find out more visit www.weightlosssurgery.org.nz or download a flyer.

 

Laparoscopic groin hernia repairs

Posted by on 12 Aug 2014 in Hernia, Laparoscopy | Comments Off on Laparoscopic groin hernia repairs

Hernias are where a weakness in the abdominal wall allow some of the abdominal contents to squeeze out so they sit directly beneath the skin.  One of the most common sites of hernias is the groin also known as an inguinal hernia.

As a primarily mechanical problem, groin hernias have long been fixed by surgery.  In fact, surgery is the recommended treatment for almost all groin hernias.  The choice of operation has evolved over time with using surgical mesh to reinforce the abdominal wall becoming the gold standard since 1989.  The most recent evolution in hernia repair surgery is using laparoscopy, also known a keyhole surgery, to repair the hernia and place the mesh.

In traditional open groin hernia surgery a cut is made over the groin where the hernia occurs, cutting open the outer of the three layers of abdominal wall muscles and placing a mesh between the outer two muscle layers.  With laparoscopic groin hernia surgery a camera and fine instruments are used to repair the hernia and place the mesh on the inside of the abdominal wall muscles without having to cut the muscles.

Laparoscopic groin hernia surgery has been studied extensively over the last decade and have been demonstrated to reduce the risk of ongoing pain and numbness in the groin after surgery by about half compared to open surgery.  Laparoscopic groin hernia surgery is also associated with people being comfortable to return to their normal activities about 7 days sooner than with open hernia surgery.  There is no difference in the rates of the hernia coming back when comparing open and laparoscopic groin hernia surgery.

Dr Smith is very experienced at laparoscopic groin hernia repairs and stands behind this operation as the new gold standard technique when repairing groin hernias.

 

On mesh and hernia repairs

Posted by on 10 Jul 2014 in Evidence Based Medicine, Hernia, Uncategorized | Comments Off on On mesh and hernia repairs

There have been a number of articles published in the popular press recently discussing the use of mesh in surgery, and associated complications.  Unfortunately this is a complex topic, and the published articles have in many cases made it more confusing.

The use of artificial materials in surgery is something that has been going on for some time, with many benefits.  Millions of people have benefited from joint replacements, mechanical heart valves, and artificial lenses to restore sight following cataract removal.  The role of surgical mesh is to reinforce or reconstruct areas of soft tissue loss or weakness.  Surgical mesh may be a tight weave where the mesh itself provides strength or an open weave to encourage natural scar formation to provide strength.  Mesh may also be artificial, usually polypropylene, or made from natural animal tissues.

The highly publicised problems from mesh use have almost always occurred when artificial meshes have been placed in direct contact with abdominal organs such as to repair weaknesses in the pelvic floor or around the diaphragm.  In some cases, artificial mesh has eroded in to the nearby organs, causing serious infection.  However, in many cases, the same operations are now able to be performed using natural tissue meshes without risk of complications.

The other very common area for mesh to be used is to strengthen the abdominal wall to repair hernias.  Artificial mesh has been used since 1989 to repair groin hernias, and is now used for most open hernia repairs and all laparoscopic hernia repairs.  In hernia repair, artificial mesh is placed in the muscular layers of the abdominal wall, not adjacent to abdominal organs.

The use of mesh in hernia repairs has been extensively studied, with outcomes published for tens of thousands of patients.  Some of the best quality evidence comes from a study combining the results of multiple different trials on using mesh for open groin hernia repairs.  When examining the outcomes of over 4000 patients, randomly assigned to open groin hernia repair with or without mesh they found that the use of mesh was associated with a lower risk of the hernia coming back, lower risk of ongoing pain in the groin after hernia repair, and no change in the risk of infection or other complications after surgery.

Despite the recent articles in the popular press discussing the risks of artificial mesh inside the abdomen, there is little doubt that modern surgical techniques using an open weave artificial mesh is the ‘gold standard’ best way of repairing a groin hernia.  On a follow-up post I will also discuss the option of laparoscopic hernia repair with mesh, and its potential advantages over open hernia repair.