Bariatric, Obesity and Diabetes Surgery

The Royal Cornwall Hospital Bariatric, Obesity and Diabetes Surgery Service helps patients lose weight, sustain their weight loss and improve obesity-related medical conditions through surgical intervention.

How to access this service

If you are considering weight-loss surgery

You must firstly be referred to the Royal Cornwall Hospitals specialist weight management service by your GP. If they agree that surgery is a potential option for you, they can refer you to us.

If you had gastric band surgery at the Royal Cornwall Hospital more than two years ago

You will have been discharged from our service. If you have any concerns, you can refer yourself back to us, or your GP can refer you via the referral management service.

If you have had a bariatric procedure under NHS care elsewhere in the country

We can see you in the bariatric surgery service. Your GP can refer you directly to us via the referral management service.

If you had private bariatric surgery, or bariatric surgery in another country

We can only see you if there is a medical emergency or if your GP has had agreement from the Kernow Clinical Commissioning Group to fund your ongoing care under the NHS.

What happens when you get referred?

Firstly, we’ll ask you to attend a compulsory education session with the Bariatric Surgery Specialist Nurses. The aim of the session is to give you enough information so you can make sure surgery is the right option for you.

These sessions take place every other Friday in the Cornwall Diabetes Education Centre (CDEC). They start at 2pm and last between one and one and a half hours.

You will be able to ask as many questions as you want to and be given an information leaflet about all the procedures we undertake. When you get home, please read it and jot down any questions you have.

Once you have attended the group education session you will then see the bariatric surgery multidisciplinary team which consists of a surgeon, dietitian, specialist nurse and anaesthetist.

Your multidisciplinary team clinic appointment

What should you do to prepare for you appointment?

Before your multidisciplinary clinic appointment, you’ll need to attend your GP surgery for an ECG. Please book an appointment in the week before your assessment.

Please bring your ECG and a list of your medications with you to your appointment, along with the list of questions from reading the information leaflet.

What happens at the multidisciplinary team appointment?

Your appointment will be at the Royal Cornwall Hospital in Truro. You’ll see all the health professionals individually and attend a clinic where we’ll carry out some tests.

  • The surgeon will assess you to ensure that you are suitable for a surgical procedure and that surgery will be a safe option for you. They can also offer you advice to help you choose which type of operation will be most suitable for you.
  • The dietitian will make sure that, since your last dietitian appointment, you have been able to maintain your weight and are following the dietary advice to make sure that you get the best outcome after surgery and into the future.
  • The bariatric specialist nurse will be your support throughout your surgical experience and into the future. They can help you address any issues you have and help you make an informed decision about which operation will suit you best. They will also look at medication regimens while you are on the liver reduction diet and after the operation, and can refer you to the stop smoking service if appropriate. The nurse will also be your contact after your operation and will undertake your follow up.
  • The anaesthetist will assess you to make sure you are suitable for a general anaesthetic. They have been specially trained to treat obese people and will look carefully at your medical history and the results of the tests that have been performed (such as blood tests, X-rays and ECGs).
  • At the clinic you will have your height, weight, body mass index, blood pressure, pulse and oxygen saturations recorded. You will also have an MRSA screen and blood tests.

Once you have seen them and had all the tests performed you will be free to go home.

After your appointment

The team meets after the clinic to discuss each patient and plan the next actions.

Sometimes we may need to refer you for further medical tests to assess your suitability for an operation. These are safety checks to make sure you are medically fit for an operation, they’re not intended to be a barrier to surgery.

Occasionally a person’s diet has slipped and needs further dietetic support to ensure a good outcome after surgery.

Waiting times

Once you have been added to the waiting list, you may be waiting up to 18 weeks for your surgery, although this can be shorter.

When you are at the top of the list, our coordinator will contact you to arrange a convenient date for your surgery. She will also arrange a date for your pre-operative assessment. The coordinator will then send you out all the relevant information, including a copy of the consent form specific to your procedure and details of the liver reduction diet.

Preparing for your surgery

Pre-op assessment

Two weeks before your surgery, one of our specialist nurses will call you on the phone to do your pre-operative assessment.

The liver reduction diet

In order for the surgeon to do your operation safely, your liver will need to be lifted out of the way. If your liver is too heavy, it may cause bleeding and your operation to be abandoned.

To prevent this happening, we ask you to undertake a special liver reduction diet for two weeks to reduce the size of your liver. It is really important to follow the diet for the time specified so that your operation can go ahead as planned.

Illness in the run up to your surgery

If you develop any sort of cough or cold or become unwell in the week before your operation it is important to let us know immediately so that your operation can be postponed until you are better.

What happens on the day of surgery?

You will be admitted to Theatre Direct at the Royal Cornwall Hospital where the ward staff will take care of you.

You’ll be seen by the surgeon to sign your consent form. (A copy of the consent form will have been posted to you in the admission pack so that you can read it before you come in for the operation). The surgeon will also answer any remaining questions. The anaesthetist will talk you through what happens in theatre and the specialist nurse will make sure you have all the information you need. Being in hospital can be a frightening experience, so if you need any information, advice or support, please ask for it.

During your time in hospital you will be looked after by the teams on either Theatre Direct, Pendennis Ward or the Critical Care Unit – All of whom are experienced in looking after patients undergoing weight loss surgery.

After your surgery

How long will you be in hospital?

Gastric band surgery is undertaken as a day case procedure, meaning you can usually go home on the day of surgery. If you have a medical condition that necessitates a stay in hospital, you should be home the next day.

If you are having a Roux en Y Gastric Bypass or Sleeve Gastrectomy, you’ll need to stay overnight in hospital. Approximately 80% of patients go home the next day, and the rest need to stay an extra night.

The specialist nurses see you before you go home to ensure you have all the necessary information and supplies to help you recover at home. You will also be given contact details if you need any advice or support 24hrs a day.

What follow up will you receive?

Regular follow up is as important as the procedure itself.

In your first week at home the specialist nurses will ring you twice to ensure you are recovering well and answer any questions you have.

After a gastric band insertion, we’ll follow up every four to six weeks for the first six months, and then every eight to twelve weeks, up to two years post-op.

After a Roux en Y Gastric Bypass or Sleeve Gastrectomy, we see you at six weeks, 3, 6, 12, 18 and 24 months, then yearly for life.

These follow-up clinics take place in Truro, Bodmin and Liskeard.

Further reviews can be arranged by contacting the Bariatric Coordinator on 01872 252790. The team supports you every step of the way to your new healthier life. If you have any questions or concerns, please do not hesitate to contact us.

Symptoms to be aware of post-op

What can you eat after bariatric surgery?

After each procedure there is a staged return-to-eating plan, which can be found in the Obesity and Metabolic Surgery patient information leaflet. Once you are back to eating normal solid, healthy food it is important to concentrate on foods that will give you the right nutrients.

The Bariatric, Obesity and Diabetes Surgery Team

Clinical Lead

Mr Ian Finlay, Consultant Bariatric and Upper Gastrointestinal Surgeon

Consultants

Mr Allwyn Cota, Consultant Bariatric and Upper Gastrointestinal Surgeon
Mr Michael Clarke, Consultant Bariatric and Upper Gastrointestinal Surgeon

Specialist Nurses

Mr Jeremy Gilbert, Bariatric Nurse Specialist
Mrs Jackie Dingle, Bariatric and Upper Gastrointestinal Nurse

Specialist Dietitians

Miss Regan Crockett
Miss Leanne Elsey
Mrs Alison Buckingham

Specialist Psychologists

Mrs Tracy Mayes
Mr Tim Keen
Mrs Lisa Hogbin

Bariatric Coordinator

Mrs Gail Salway

Further information and support

Patient Information Leaflets

Patient Support Group

We run a monthly support group in the Outpatient Department at the Royal Cornwall Hospital. We also have a secret Facebook page for patients undergoing bariatric surgery. For details of how to join both, please contact the Bariatric Coordinator on 01872 252790.

Useful Websites