By Ajay Goyal, MD, FACS, New Jersey Bariatric Center
Weight loss surgery, whether it’s Gastric Bypass, Lap Band or REALIZE
Band surgery, and the post-op monitoring of weight loss and health benefits
is a long term commitment. You and your surgeon will go on the journey
together. When it comes to choosing the right surgeon, I recommend looking
for someone who has the right combination of training, experience, compassion
and commitment to ensure you get the best care possible. Be sure that
the person you choose is an experienced surgeon, with a multi-disciplinary
team, who is the right person for you, in both the short-term when it comes
to pre-op and surgical care as well as in the long term to coach and motivate
you after surgery. Below are key qualities I recommend patients consider
when choosing a bariatric surgeon, use them as a guide to help narrow your
search as well as for a discussion with your prospective doctor.
1. Fellowship-Trained + Board Certified
To start, one of the first things you should look for is a fellowship-trained,
board certified surgeon. Fellowship-trained means in addition
to the required five years spent in a general surgery residency
gaining surgical experience, your surgeon chose to train an
additional year focusing on enhancing his/her laparoscopic
general and bariatric surgery skills. Board certified
means that your surgeon has passed a post-residency certification
written and oral exam about all aspects of surgery given by
the American College of Surgeons. (Dr.
Ajay Goyal’s
Bio)
2. ASMBS Center of Excellence
As you’ll see when you start a search for a surgeon there
are lots of certifications. In addition to fellowship-trained
and board certification, the next one you need to pay particular
attention to is the ASMBS [American Society for Metabolic and
Bariatric Surgery] Center of Excellence certification, which
is for both the surgeon and the hospital. The ASMBS is
a professional society for bariatric surgeons. They’ve
determine – that is experts in bariatric surgery, not insurance
companies, or other organizations - a strict set of criteria
based on their experience for both surgeons and hospitals to
meet to earn a Center of Excellence designation. While
Center of Excellence certification doesn’t guarantee that
a surgeon is the right one for you, what it does do is make sure
the surgeon has the right level of experience, including performing
a minimum of 125 procedures a year, that the surgeon and
the hospital’s facilities are designed specifically for
bariatric patients including proper furniture, surgical instruments
and multidisciplinary specialists. It also ensures that
the surgeon and hospital are set up for long term care and support,
which is key for weight loss success. (NJBC – Center
of Excellence)
3. Discusses Benefits + Risks
Everyone talks about the benefits, weight loss, improvements
to your health, including diabetes and heart disease, but if
your surgeon isn’t also upfront about the risks you need
to ask yourself why? Bariatric surgery is serious surgery,
and each procedure – Gastric Bypass, Lap Band and REALIZE
Band - just like any other surgery, comes with risks. Each
patient needs to understand the risks and then weigh the benefits
vs. the risks before determining if surgery is right for them. If
you aren’t clear on the risks or your surgeon doesn’t
mention them don’t be shy. Ask your surgeon to
explain them to you so you can make an informed decision. (Benefits
of Surgery) (Risks of Surgery)
4. Multi-Disciplinary Team
Make sure the surgeon you choose has the right support players
in place to ensure success. Success after weight loss
surgery includes not only an experienced surgeon, but also
a team of nutritionists, psychologists and exercise-specialists
who will help you navigate life, food and fitness before and
after surgery to help you maximize weight loss. Working
with a multi-disciplinary team, with a support system in place
for both before and after surgery, signals that your surgeon
is committed to your long-term success. (Support
System)
5. Complication and Mortality Rates
Even in the hands of the best, most experienced surgeons’ complications,
and in some cases mortality does occur. It’s important
to know the national averages – gastric bypass mortality
rate is 1 in 200 and gastric band mortality rate is 1 in 1000. You
want to find a surgeon who’s either under or on par with
the national averages. Most experienced and skilled surgeons
post this information on their Web sites or talk about it in
their seminars. If this information isn’t readily
available or the surgeon is reluctant to talk about it you need
to ask yourself why, and if this person is the right one for
you.
6. ASMBS Member
Membership in ASMBS, the bariatric professional society, show’s
a commitment to the craft - a commitment to keeping up-to-date
on the latest techniques and research. A surgeon keeping
current with the latest studies, and interested in constantly
learning more about the practice of bariatric surgery is the
kind of surgeon you want for surgery.
7. Straight Forward Answers to the Tough Questions
If you’re like most patients I see [and you probably are
if you’re reading this article!] you’ve done a lot
of research to help you determine if Gastric Bypass, LAP Band
or REALIZE Band surgery is right for you. A natural outcome
of all that research is often a lot of questions on everything
from what will the hospital stay be like to some tough questions
on complications and risks. Be sure your surgeon answers
all questions, but particularly the tougher ones like risks,
complications and mortality in a straight forward manner. Now
is not time to have someone beat around the bush, you want a
surgeon who’s upfront with you on all aspects of the surgery. This
doesn’t mean I’m encouraging you to play stump the
surgeon nor does it mean that every once in a while you’ll
have a question for your surgeon that is really better answered
by one of his multi-disciplinary team members, and he’ll
point you in their direction. It simply means look for
someone who will be upfront and truthful about the procedure
and the long term commitment you’ll be making to lose weight
and get healthy.
You’ve made sure the certifications are there, spoken to
your surgeon, and asked the tough questions, now it’s time
to go with your gut. Has the surgeon earned your trust? Do
you feel he or she will offer you the best level of care? Will
they be in it for the long-term with you cheering your successes
and encouraging you through the tough times? If after talking
to your prospective surgeon and the answer for you is yes to
the questions above, then I think you’ve found the right
surgeon for you.
