The need for professional services in obesity surgery is increasing. Also in Thun and the surrounding area. And so it was only a logical step that the clinic of Dr. Naef in Thun now became part of the network of specialized facilities of Swiss1Chirurgie. You can learn more about this in the article.
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Severe obesity with all the possible secondary diseases such as type 2 diabetes is one of the widespread diseases in the developed industrialised countries and the number of cases is increasing. Not only in the USA, but also in Europe, morbid overweight (obesity) is rampant. Both in Germany and Switzerland, more and more clinics are specialising in the medical and, above all, surgical treatment of heavyweight contemporaries. Accordingly, surgical procedures are performed more frequently in obesity surgery than they were a few decades ago. Stomach reduction, tube stomach or gastric bypass are the keywords for operations related to obesity. While in Germany, according to current surveys, there is an almost complete lack of professional aftercare, in Switzerland, for example, the Centre for Bariatric Surgery (ZfbC) also sets a good example in the aftercare of patients.
A stomach reduction, in whatever form, is the only way out of the vicious circle of obesity, secondary diseases, lack of exercise and even more obesity for many obese patients. In Germany, but also in Switzerland, clinics have specialised in surgical interventions for obesity and provide patients with at least short-term hope for change. However, in Germany in particular, this hope remains a mere expectation. Because even more important than the success of the actual surgical intervention is the subsequent aftercare. And in most cases, this will be necessary for a lifetime. Postoperative care for obese patients is by no means limited to the control of small scars or wound healing in the gastrointestinal tract. More importantly, after such an operation, patients have to change their whole life decisively. This starts with a new form of nutrition, continues with controlled nutritional supplementation, for example with vitamins, trace elements and protein, and ends with a new way of learning sensible exercise. Only a corresponding change in lifestyle habits can ensure the success of bariatric surgery in the long term and thus make the lives of overweight patients better.
All experienced medical specialists, nutritionists, physiotherapists and psychotherapists agree on this. However, there is a lack of concrete implementation of such follow-up treatment and further care in Germany. As the Norddeutscher Rundfunk NDR recently revealed in a contribution to the health magazine “Visite”, the concept of follow-up treatment is poorly neglected in Germany and virtually not established at all. One of the reasons for this is that the health insurance companies neither include such a lengthy to lifelong care for patients in their cost catalogue, nor do they seem to be interested in it. Anyone who has managed to get an overweight operation financed by German health insurance funds at all is often left alone and downright to fend for themselves afterwards.
Accordingly, few patients then find their way to nutrition counselling and further care. Until the body again sounds the alarm and all short-term successes of bariatric surgery are acutely endangered. Those who are financially well off will treat themselves to the necessary aftercare if they have sufficient insight and self-discipline. Those who are less well-off or do not even know how important further care is, do not act at all at this point due to ignorance or lack of financial mass and thus endanger not only the success of the overweight operation, but their health in general.
The German health system clearly has a duty here and must find ways to ensure that bariatric surgery does not turn into an odyssey through the clinical pictures of accompanying secondary diseases.
It’s different in Switzerland. Here too, medical centres such as Swiss1Chirurgie, together with the Centre for Bariatric Surgery in Bern, have dedicated themselves to surgical interventions for morbid obesity. Unlike its German neighbours, however, the focus here is on the protracted nature of such interventions from the outset. Only patients who are willing to receive lifelong counselling and support are even considered for bariatric surgery. This is already addressed in the initial talks and is also consistently enforced after the interventions. Of course, always with the cooperation of the patients and all the professionals needed for this.
This methodology is also supported in principle by the Swiss health care system. Here it is clear that anyone who has to undergo bariatric surgery will need the support of the relevant specialists such as internists, nutritionists, physiotherapists and psychotherapists for a long time afterwards, if not permanently. This is the only way to ensure the long-term success of obesity surgery, which ultimately not only benefits the health of the patients, but also significantly minimises the follow-up costs due to a lack of follow-up care.such as internists, nutritionists, physiotherapists and psychotherapists.
It remains questionable whether this insight will be reached in Germany in the near future. While the health care system there mainly works on apparent undesirable developments and deficiencies, most obesity patients remain on their own, with or without bariatric surgery.
We have provided more information on the “Visite” report by NDR here http://bit.ly/ndrnachversorgung.
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| Dr. med. Michèle Gasser Dr. med. Claudia Meier Dr. med. Yvette Ottiger Dr. med. Stefan Schäfer Dr. med. Rudolf Steffen Dr. med. Jörg Zehetner Seilerstrasse 8 |
Dr. med. Jörg Zehetner Professor (USC) MMM, FACS, FEBS (hon.) PD Dr. med. Rudolf Steffen Dr. med. Alejandro Metzger Schänzlihalde 1 |
With a population of around 1.4 billion (as of 2018) and a size of approximately 9.6 million square kilometres, China is the most populous country in the world and approximately 233 times larger than Switzerland. These incredible figures alone show that this is a country with huge potential in all kinds of areas.
Among the less pleasant statistics is the fact that the People’s Republic of China alone accounts for more than half of all oesophageal cancer cases worldwide. In general, this disease is much more widespread in Asia than in Europe, for example.
The unusually high incidence of oesophageal cancer in China was one of the reasons for holding the 2019 OESO World Congress in Beijing for the first time ever, rather than in Europe or the USA. The OESO is a medical society made up of leading surgeons, gastroenterologists, pathologists, radiologists and other professionals in the field of oesophagus and stomach. Prof. Dr. Jörg Zehetner, who offers a specialised range of services for reflux diseases and bariatrics in Switzerland with the Swiss1Chirugie locations in Bern, Brig and Solothurn, is one of these specialists with high recognition worldwide.
What was particularly interesting about the organisation of the OESO World Congress in Beijing 2019 was that in the main part, technical presentations were each only five minutes long, each followed by a discussion that was also five minutes long. This gave the opportunity to exchange and discuss a lot of expertise within a short time.
This not only encourages the exchange of scientific expertise and opinions. Ideas for new studies are also conceived quite quickly and compactly in this way and can then be further refined later.
In addition to the lectures and opinion pieces of his professional colleagues, Dr. Jörg Zehetner was also a sought-after subject matter expert. His experience from many years of work in the United States and his specialisation in upper GI diseases were just the right profile for a lively exchange with his colleagues.
Topics such as oesophageal cancer, stomach cancer, reflux diseases and diaphragmatic hernias also played an important role in the professional exchange with colleagues. The interactions and complementarities of bariatric and reflux surgery, especially in operations of the oesophagus, stomach and intestine, are a broad field that did not lack a great deal of attention at this year’s OESO Congress.
In a special lecture, Dr Zehetner addressed the topic of the size of the hiatal hernia and the choice of surgical procedure.
The focus was on selecting the most suitable surgical procedure for the individual. Dr Zehetner, who is the only surgeon in Switzerland who is versed in all currently known surgical procedures in this field, emphasised that decision-making must always take place together with the patient if long-term success is to be ensured. Conventional gastric sleeves, partial fundoplication, variants with partial removal of the stomach, LINX reflux management system (magnetic ring), electrical stimulation with Endostim or the new reflux stop system are a selection of methods that must always be chosen well-considered and based on the patient.
Dr. Jörg Zehetner is one of the world’s recognised experts in the field of diaphragmatic hernia and reflux surgery and has published several articles on the subject. Accordingly, the corresponding lecture was listened to with pleasure and followed attentively.
For Dr. Zehetner, it is important in every case to carefully weigh up every intervention and always make a decision in the best interests of the patient. Sometimes, drug treatment may take precedence, as not every patient is suitable for surgery per se. This decision can only be made in discussion with the expert. In the run-up to this, a good counselling interview, a targeted diagnosis and the prognosis for healing are important stages.
Swiss1Chirurgie, with its locations in Bern, Brig and Solothurn, offers such expertise for all patients undergoing bariatric surgery or therapy for reflux disease, abdominal hernias and similar complaints. You can also find out what Swiss1Chirurgie with Dr Jörg Zehetner can do at www.swiss1chirurgie.ch and, of course, always in personal contact with the medical specialists.
The new year is now a few days old and for many people everyday life has already returned. Yet 2020 began with many good intentions. Less kilos, more sport and active exercise are the most frequently mentioned good intentions for the new year, along with giving up cigarettes and spending more time with the family.
It is becoming clear that more and more people are taking a more conscious look at their own health and are focusing their plans on fitness, resilience and having more fun with active exercise. Especially when overweight, digestive complaints, stomach problems or reflux are daily companions in life, active exercise or regular sport is the way out of the vicious circle for many Swiss people.
We at Swiss1Chirurgie know that especially in cases of morbid obesity, sporting activity is often difficult to implement and ambition quickly wanes if the pounds do not fall off so clearly and quickly. One quickly falls back into old habits or tries to find other excuses for the supposed failure. In many such cases, bariatric surgery may be the best long-term solution. And even after such an operation, physical activity is one of the most important rules if the excess weight is to be permanently reduced and a healthier lifestyle maintained.
Especially in the cold season, the choice for recreational sports is somewhat limited. Cycling, classic hiking, jogging or water sports are often ruled out due to the weather. For some, the only option seems to be to go to the gym or the swimming pool. But many overweight people also fail to do this, mainly for psychological reasons. The shame of showing one’s own body openly, the fear of hidden smiles up to open hostility and certainly also fears of failure make the way into the dumbbell gyms and swimming pools even more difficult. Classic winter sports such as cross-country skiing, skiing, snowboarding or ice skating are also rarely possible.
The good variant of relaxed but active hiking in winter is snowshoeing. Even the old mountain farmers at high altitudes in Switzerland used snowshoes to get around in winter when the snow was heavy. Today, that is actually no longer necessary. But snowshoeing has become a popular leisure activity in winter, which is definitely a good choice of means for overweight people and also reflux patients.
The somewhat more difficult running requires, in addition to a certain degree of discipline, above all endurance and attention to one’s own body. Since snowshoeing is also only possible outdoors, it also contributes to a better supply of fresh air for the organism. Another nice thing about snowshoeing is that it can be done alone or in a group. In addition, there are specially prepared and signposted routes for snowshoe hiking, especially in the winter sports regions of Switzerland. Perfect for all those for whom skiing and tobogganing are rather unsuitable and who nevertheless do not want to do without sporting activity even in snowy winters.
For those who are now more intensively interested in snowshoeing, we offer an excellent possibility to get the sports equipment for snowshoeing quickly, easily and without additional costs. Together with Suzuki Switzerland, Swiss1Chirurgie is giving away a total of 50 snowshoe sets, each with a pair of snowshoes and matching poles.
However, you have to be quick here. Because only the first 50 entrants can enjoy new snowshoes for free and then start their snowshoeing experience with Suzuki snowshoes.
But also for everyone else, snowshoeing is a clear recommendation for more activity in winter. This applies to normal weight people as well as to overweight people or those with certain complaints.
Of course, we will be happy to advise you in the Swiss1Chirurgie clinics in Brig, Solothurn and Bern about your very individual options for an active life. This way, you may be able to keep your good resolutions for 2020 a little better and achieve the first results soon. Maybe even with a snowshoe set from Swiss1Chirurgie and Suzuki Switzerland. Have fun and above all wish you a healthy new year Jörg Zehetner and the entire Swiss1Chirurgie team.
The Centre for Bariatric Surgery (ZfbC) and Swiss1Chirurgie specialise, among other things, in patients who are seeking comprehensive medical help with accompanying care due to a serious and morbid obesity problem. Prof. Dr. Jörg Zehetner, as the leading mind behind the ZfbC and Swiss1Chirurgie, knows that the path from severely overweight patients to a happier and fulfilled life is not an easy one. For decades, he has treated and cared for patients who nevertheless take this long journey. Clear progress can be seen just as much as an occasional relapse into old habits and the difficult fight against obesity and the prejudices associated with it.
Dr Jörg Zehetner has also been able to count Sina Gossweiler among his patients for several years. Many people know the young woman from the show “Deutschland sucht den Superstar” (DSDS), where the Wattenwil native was able to convince with a magnificent voice, and also got into the recall, but not further. The young singer is also known for her fight against obesity, which she finally took up with the professional help of the ZfbC after some back and forth and repeated self-diets.
A gastric bypass operation was finally the right and appropriate way for her to move into a weight-wise and also psychologically lighter future. It was clear from the beginning that this journey does not end with the surgical intervention, but in fact requires follow-up care in a professional environment throughout life. Sina has fought this battle successfully so far and now feels visibly more comfortable in her own skin. In addition to learning healthy eating habits, as well as exercise and sport, she has now reached a healthy weight.
And in terms of music, too, the signs are pointing to success. Even though the DSDS recall almost exactly a year ago didn’t lead any further, the likeable musician is now standing there with her head held high. With their first single “Everything I Want To Be” they got off to a great start in the charts. As Sina Lark, the self-confident young woman makes her commercial debut in the music business and can already enjoy a great deal of attention.
Not only did her new song run for the first time as Song of the Day on SRF 3 at the beginning of February 2020, but a live performance on 14.02.2020, between 19:00 and 20:00 on the station will also show how consistently and with what passion Sina is looking for the way to the top and has now perhaps even already found it. Then she will present two songs live on the SRF 3 programme “Punkt CH”. Her new single will also be presented as “Hit of the Day” on 14.02.2020.
If you take both the gastric bypass operation and the musical path together, it becomes clear that Sina Gossweiler has already taken the long road very successfully as Sina Lark. This gives the soon to be 21-year-old woman from the canton of Bern even more strength to continue on her path now more than ever. On the one hand, this path leads downwards when it comes to weight. On the other hand, it is also the ascent into a new life that Sina has paved for herself with her musical talent. The fact that both directions always involve a lot of effort, challenges, stamina and also the odd setback is impressively demonstrated by Sina Gossweiler’s still young story.
In the end, it is up to each individual to decide how to deal with his or her own problems. Getting the best help at the right time also proved to be a real stroke of luck in this particular case.
Every year at the beginning of March, there is a day dedicated to the topic of obesity as World Obesity Day. Certainly, this is not a holiday for those affected, but at least it is the day when there is a good reason to think about obesity in general and the stigmatisation associated with it in particular.
This year the focus is “Male Obesity”. This cannot simply be categorised as “gluttony” or “self-indulgence”. Male obesity has as many causes as it has manifestations. It primarily affects men from middle age onwards, who (like women) are undergoing a particular type of metabolic change.
Particularly as we get older, the body strives to store food reserves as fat reserves for developmental reasons, in order to provide for possible shortages. Especially for men who consume fewer calories than they take in due to their occupation or limited exercise, this quickly leads to unwanted excess weight. Organic processes in particular play an important role here, which cannot be “switched off” so easily.
In a special video, I personally addressed the importance of World Obesity Day. This is also due to the fact that obesity is now more common worldwide than malnutrition. The actual problem is mainly to be observed in the western industrialised countries, since it is precisely here that there is an ever-increasing surplus of food – practically at all times.
The obesity rate in the USA, for example, is around 35-40 percent of the population, which is a fact that should not be underestimated. This means an overweight of at least 20 kilograms, or a BMI of 30 or more. This is also the case despite the surgical intervention options, although these methods in particular can now be classified as very safe and successful. Nevertheless, the rate of surgical interventions needed in this particular area is far too low.
World Obesity Day is not simply about informing the public and professional colleagues accordingly. Rather, I see it as important to educate people about the modern treatment options of bariatric surgery. The primary aim is always to help patients according to their individual starting situation.
It is important to understand that obesity is always associated with concomitant diseases. Diabetes, high blood pressure, sleep apnoea, high cholesterol – all these manifest themselves in the environment of obesity. But there is also another aspect that has emerged, especially in recent years. The point is that people who are overweight are simply stigmatised. At school, at work and even in private life, overweight people are described as lazy, fat, greedy, careless and lazy about exercise. This puts additional stress on those affected and does not help to tackle the problem in a targeted and conscious way. Significant overweight has been defined as a disease since 2013 at the latest. This puts morbid obesity in the same category as diseases such as diabetes, high blood pressure and many other chronic diseases.
The stigmatisation of obesity is extremely dangerous for patients, as they then withdraw and cannot address their actual problem in a targeted and active way. Professional treatment, counselling and support is the surest way out of obesity.
Everyone is challenged to exercise some restraint in their contact with morbidly obese people, both in their choice of words and in their behaviour. To this end, World Obesity Day can create better awareness. The problem should not only be addressed on this day of the year. But such a day can help to create more sensitivity for the problems of overweight people instead of leaving them to their fate with stigmatisation and devaluation.
Yes, women also suffer from morbid obesity. But men do it in a special way. There are now “curvy models” for women, but not for men. And men by nature already tend to eat the slightly larger portions, even if that seems to be gradually declining. The world view was and still is such that a belly is always subconsciously associated with prosperity. Also in modern industrial societies. The dangers are usually conscious, but are only realised when they are actually there.
In addition, after a certain stage of life at the latest, men do not have this special view of their appearance that many women have. The actual problem is not recognised, or is recognised only very late, and is then gladly accepted as natural. This means that they don’t have to go to the doctor and the obesity surgeon is an unknown quantity for many of those affected. Therefore, men in particular must be sensitised to actively face this problem. World Obesity Day provides an excellent opportunity to do this.
Go directly to the self-test: https://ch.run/20sekunden
Life always comes with particular challenges and some of them we like to think of as a threat to our own existence. Epidemics, pandemics, forces of nature, cancer, accidents, other serious illnesses and, last but not least, violence instil a good deal of fear and anxiety in each of us.
Yet there is a modern widespread disease that is much more dangerous and deadly in the long term than anything already listed here. We are talking about morbid overweight, which is also called obesity in different stages in professional circles. Far more people are affected by morbid obesity, including its accompanying symptoms and secondary diseases, than we generally realise. Trend: Rapidly increasing!
Obesity is particularly rampant in the developed industrialised countries, for example in Europe, but also on the American continent. However, more and more regions in Asia are also affected, and obesity does not even stop at the African continent.
An overabundance of constantly available food, wrongly learned eating habits passed on to one’s own children, lack of exercise and a fast food culture that is often far too rich in fat and sugar are certainly partly responsible for obesity.
But first and foremost, it is the people themselves who fall into the obesity trap due to lack of knowledge, lack of contextual thinking and out of convenience. And they often do so with their eyes open, but without a keen awareness of the consequences of poor nutrition. Liver disease, joint problems, circulatory problems, disorders in fat metabolism, shortness of breath, stroke and psychological impairments due to subsequent stigmatisation are only a sample of a wide range of concomitant and secondary diseases that can ultimately be traced back to morbid obesity. This is accompanied by a significant impairment of the quality of life and sometimes the only way to get a grip on the situation is to have surgery. And even that alone is not the solution to the actual problem, but only a last resort for people who are particularly severely affected by morbid obesity.
From the medical view of the overall situation, it can indeed be concluded that in the longer term, humanity’s existence is threatened by the widespread disease of obesity. This may be an unimaginable scenario now, but it gains in threat potential when we consider the development of obesity on a global scale.
It is up to each individual to decide how to influence his or her diet and physical constitution. Provided there is a firm will to do so and the insight that the blessing of always having enough food in the existing abundance may not be a real blessing at all.
We have presented a quiz at https://ch.run/20sekunden that everyone can use to determine their very own overweight risk score. Valuable conclusions for necessary action can be derived from the results. From the experience of decades of research and practical medical and surgical work with severely overweight people, we know that only timely action can offer a way out of morbid obesity. And often it is the early realisation that a change in lifestyle and eating habits can be the best step towards a healthier and ultimately happier life.
In view of the threat that morbid obesity actually poses, our recommendation is to use the simple quiz to determine one’s personal score with regard to possible medical conditions related to obesity. For many, this can be the first important step towards a more conscious approach to their own lives. And even if life itself always seems to be threatened by serious illnesses, accidents, worldwide pandemics or unavoidable forces of nature, we should never underestimate the dangers to which we voluntarily expose ourselves every day through too much and the wrong diet with a simultaneous lack of exercise.
With our quiz at https://ch.run/20sekunden you can quickly and easily determine your risk score and at the same time receive important information on what you can do now or should do urgently. Because there is nothing more precious than life.
With the newly created Bariatric Curriculum, the ZfbC, Thun Abdominal Surgery and Swiss1Chirurgie prepare their patients even better for the upcoming obesity surgery. In a seminar, all questions regarding preparation and execution, anaesthesia and the time after the surgical intervention are answered and essential procedures are explained. More information and safety are the objectives of the Bariatric Curriculum, which was developed especially for the overweight patients.
Every operation is a serious procedure that always involves certain risks. This also applies to bariatric surgery, even if it can be carried out minimally invasively in large numbers, i.e. without large surgical openings of the abdominal wall.
Many patients have a great interest in knowing how such operations are carried out and what is actually done. This is less about the specific techniques and procedures. Rather, patients are interested in how such an operation is prepared, how it proceeds and what risks are to be expected. And it is also interesting how to behave after such an intervention.
In order to be able to cover this justified interest as far as possible, the Centre for Bariatric Surgery ZfbC, the Abdominal Surgery Thun and Swiss1Chirurgie, under the essential leadership of Dr. med. Sebastien Trachsel, have developed a Bariatric Curriculum, which can provide answers to the most important but also personal questions of patients. This will make a significant contribution to more information, education and patient safety.
Anyone preparing for obesity surgery has many questions. The better such questions can be answered, the greater the patient’s confidence in dealing with the upcoming operation. Patients can take part in this bariatric curriculum as early as two to three weeks before the planned surgery.
The short but very informative seminar explains which clinical procedures are required and how the anaesthesia will proceed. In addition, of course, there is the general information provided by the surgeon, so that after about two hours of seminar the patients are well prepared for their individual operation. Of course, this does not exclude personal counselling and care directly at the clinic. Rather, this is part of the preparation for the operation and helps to objectively classify concerns, fears and reservations. This is also helped by the fact that directly after the bariatric curriculum there is the opportunity to ask personal questions and receive the appropriate answers.
This is especially important for patients who are undergoing surgery for the first time or who have already had less positive experiences in other operations. Knowing everything that is coming is an essential part of obesity surgery, which is a not insignificant intervention in the future shape of one’s life.
This also means that the dietary changes required before and after the operation can be discussed in detail. This way, the patients already know what their special menu will look like in the clinic. Physiotherapeutic counselling and care are also part of the obesity surgery. How do you get up after the procedure? What should be considered in the movement? How is scar protection ensured? These are also questions of general and personal interest that should and must be discussed in the run-up to the operation.
The bariatric curriculum also includes thrombosis prophylaxis, so that our patients know in advance how they can set the points themselves and thus actively participate in the success of their obesity surgery.
The strength of the bariatric curriculum, which we have developed especially for our overweight patients, lies in the totality of counselling, care and support already two to three weeks before the surgical intervention.
We see more information, more security and more self-participation in the process as an important and essential contribution in the interest of our patients, whom we also want to prepare well for the upcoming operation and life afterwards with the Bariatric Curriculum in seminar form and by answering their personal questions.
From their many years of experience, the specialists at Swiss1Chirurgie know that many patients do not receive any or only inadequate medical aftercare following obesity surgery. In this context, consistent and regular follow-up care of patients is enormously important if the success of gastric surgery is not to be gambled away. Furthermore, complications after bariatric surgery can endanger the health or even the life of the patients concerned.
Based on this knowledge, the Swiss1Chirurgie clinics offer continuous follow-up care and treatment for patients, even if they have not been operated on in a Siwss1Chirurgie clinic. In this way, the Swiss1Chirurgie clinics make a valuable and important contribution to the sustainable success of obesity therapy for all patients who have not yet received regular, long-term follow-up care.
Those who face up to their obesity problem must also be aware that successful long-term treatment is an ongoing process that also requires specialist medical support. Especially when the problem of morbid obesity is associated with surgical interventions, long and professional aftercare is needed.
Time and again we meet patients in the Swiss1Chirurgie clinics who are left to their own devices after bariatric surgery. And yet, especially after stomach reduction or similar surgical procedures, it is urgently necessary to accompany and care for these patients in their further development.
In cases of morbid obesity, surgical treatment is always only one of many steps to improve the health of the affected person. Even in the run-up to the surgical procedures, we work together with the patients to ensure that the conditions for the stomach operation can be created. Once the operation is over, however, the process continues.
In addition to the regular discussions and examinations in the follow-up care, it is not uncommon for further interventions to be necessary if the success of the first stomach operation is not to be jeopardised. In many cases, follow-up operations are even part of the treatment concept and are designed to ensure overall success in the treatment of obesity.
Accordingly, thorough counselling, care and support for patients after the first operation is not an optional extra, but a must. For the sake of the patients, their health and their efforts to achieve an improved quality of life.
As already noted, we repeatedly come across patients from other clinics where follow-up care after obesity surgery is clearly neglected or, in the worst case, not carried out at all. This not only poses risks to the success of the obesity surgery, but can even be life-threatening.
Complications that are recognised too late or not at all, unabated inappropriate dietary behaviour and a number of other reasons lead to the success of the stomach operation being gambled away and, in an emergency, the patient’s life being put at risk. We therefore urge all patients who have undergone obesity surgery to contact one of the Swiss1Chirurgie clinics with their problems in the event that follow-up care is lacking or inadequate. Online you will find a simple questionnaire that will give you first clues and possibilities for a professional and continuous aftercare. Use this questionnaire to get into initial contact with us.
Knowing that many patients do not receive consistent and long-term follow-up care after a surgical procedure related to an obesity problem, we offer such regular and professional follow-up care for all obesity patients.
This offer also expressly applies to patients who have undergone an operation for obesity surgery at another clinic. In this way, we want to ensure that all patients receive exactly the follow-up care and treatment that is appropriate to their particular situation. After all, the long-term success of obesity surgery is always based on professional, regular and lasting aftercare.
As an affected patient, contact us to schedule an initial consultation. Ideally, you should fill in our online questionnaire. We will then contact you as soon as possible to discuss the further steps of targeted obesity therapy, even after an obesity operation has already been performed.
Find out more at nachsorge.ch
In an in-depth interview, Dr Steffen from the Centre for Bariatric Surgery ZfbC discusses the importance of follow-up care for overweight patients. In addition to the actual bariatric surgery, structured aftercare is of enormous importance. Only if those affected are actively involved in the process throughout their lives is sustainable success possible. A detailed article on the interview and the interview with Dr Steffen himself can be found here.
New information page for patients: www.nachsorge.ch
Anyone who talks about bariatric surgery, such as stomach reduction or the formation of a tube stomach, must also talk about professional aftercare and further treatment for patients.
This is exactly what Dr Steffen from the ZfbC, Centre for Bariatric Surgery, does in the featured video interview. With over 30 years of experience and 3,600 stomach operations performed himself in the field of obesity surgery, Dr Steffen is one of the leading luminaries in this medical speciality in Switzerland.
Whether gastric banding, gastric bypass, stomach reduction or other techniques, there is always a certain risk of relapse for the treated patients. It is precisely the reduction of the recidivism rate, ZfbC, when it comes to professional aftercare following obesity surgery. Dr Steffen makes this unmistakably clear.
It should also be clear that after an initial operation for the majority of those affected, there will be further interventions to ensure the success of obesity surgery. At the same time, this means that in the majority of cases, surgery alone will not be enough for the rest of one’s life. Accordingly, it is important to accompany and care for the patients continuously and individually in the aftercare.
According to Dr Steffen, children are not excluded from the problem of morbid obesity. Fat children usually also become fat adults, so that early intervention can make sense if there is an appropriate indication. It is important to note that the rules and regulations for bariatric surgery must also be observed for minors.
Dr Steffen believes that ongoing follow-up care is more important than the timing of the surgical intervention. From experience, he knows that many patients do not take proper care of themselves after an initial overweight operation has been performed. However, it is also the professional colleagues who must be held accountable, as they do not always focus on special aftercare in their further care. Here, the ZfbC can definitely fill treatment gaps. One should understand morbid obesity similarly to an incurable disease, so that a good strategy for lifelong aftercare must be presented here as well. What Dr. Steffen cannot understand is the fact that he repeatedly encounters patients who are left alone in their problem situation after obesity surgery and are not sufficiently perceived.
Accordingly, the ZfbC would also like to open up to patients who have not been treated in a Swiss1Chirurgie clinic or an affiliated clinic. Here, anyone who complains about a wide range of problems after bariatric surgery should get a sympathetic ear and professional support. What definitely does not work is that patients are simply left to their own devices after obesity surgery with reference to their diet programme. This contradicts every ethical and medical claim.
It should also be clear in this context that anyone who cannot successfully deal with their excess weight before an operation will not be able to do so without help even after the operation has taken place.
For Swiss1Chirurgie, structured aftercare is part of the standard in obesity surgery. Even though this is unfortunately not the case everywhere, the experts at Swiss1Chirurgie, together with the ZfbC, attach great importance to professional and structured aftercare in the best interests of the patient. This is the only way to ensure initial success, to identify problems in time and to build on the long-term success of the therapy. Anything else doesn’t make much sense.
It is also worth noting that deficiency symptoms can always occur due to the way the different treatment methods work. Such processes must of course be monitored and controlled to show patients how to compensate for certain deficiencies such as calcium deficiency or vitamin deficiency.
Follow-up care for overweight patients is a team effort at ZfbC. In addition to Dr Steffen himself, other specialist colleagues also devote themselves to the patients’ problems in special aftercare consultations. Around 8,000 patients are now being cared for. In the regulations, the Federal Office of Public Health requires follow-up over five years. However, the experts at Swiss1Chirurgie know that, in fact, lifelong follow-up of patients is sensible and necessary. Here, the legislative requirements obviously fall short.
The problems of the individual patients are very different. The aftercare must be correspondingly individualised. Some of the problems are real complications such as chronic abdominal pain, persistent diarrhoea, deficiency symptoms, vomiting or other functional problems. In principle, every affected person must expect that some kind of problems will occur over a short or longer period of time. Even if this ultimately does not affect everyone, it is still a clear proportion of patients who have to deal with certain problems after obesity surgery.
As Dr Steffen clearly explains, alcohol has a special effect on obesity and even more so on patients treated accordingly. In his opinion, alcohol has just as high a caloric value as pure fat, in addition to the typical symptoms of intoxication. Accordingly, it makes little sense or is even counterproductive for overweight patients to consume alcohol beyond a low level. The best thing would be to abstain completely from alcohol. This is also the aim of good aftercare.
Regarding the general risks in obesity surgery, Dr Steffen emphasises that laproscopic surgery as such is first of all extremely safe and associated with only a few risks. The first operation is always less risky than every subsequent one, although it also depends on how experienced the surgeons are in the respective clinics. Much more common are the complications that can occur after the procedures. First and foremost are deficiency symptoms, digestive problems and problems in the area of the oesophagus. This must always be expected after obesity surgery, which is why lifelong aftercare is also sensible and recommended. This must also be clear to the general practitioners and is already addressed in the first educational discussion.
Currently, the corona virus plays a significant role in society as a whole. Those who are overweight must expect a more severe course after an infection due to their physical constitution. If overweight people already have breathing problems, these will certainly be even greater with COVID disease, even more so with assisted or artificial ventilation. It is difficult to decide not to operate on overweight people now, as they will then be much more affected in the event of an infection later on.
The first way for overweight people who want to improve their situation is always to see their family doctor. The latter will then make a referral to the specialists in the given case. Here, the Swiss1Chirurgie clinics are recommended as competence centres for bariatric surgery. The family doctor could also be the first point of contact for appropriate information to the patient. In addition, we as Swiss1Chirurgie offer a comprehensive information service for all those affected. This ranges from our special consultation hours to the detailed and extensive information on the internet and via our app. However, information about any site or place on the internet is always associated with the risk of getting the wrong information. Here, Dr Steffen likes to refer to the pages of Swiss1Chirurgie, which, in contrast to any forums or chat rooms, provide extremely professionally correct, comprehensive and structured information.
