Frequently Asked Questions of Dr. Anderson
Bariatric Surgery
Q. How long does the surgery usually take?
A. Laparoscopic gastric banding usually takes about 45 minutes, you spend another 45 minutes in recovery before going up to the Ward.
Q. Do you do any other kind of bariatric surgery?
A. Yes --I do gastric bypass in situations where patients feel it would be more appropriate, and where they understand the risks.
Q. Is this-- the lap band, considered to be the least risky of all the weight loss surgeries?
A. It is the surgery with the least immediate complications and lowest the death rate of all the weight loss surgeries
Q. You don’t recommend sleeve gastrectomy on your website why is that?
A. All the data currently available, suggests that the surgery will only produce weight loss up to five years, at which stage the sleeve stretches up and will need to either be converted to another weight loss procedure or re done. laparoscopic gastric banding now has good data to suggest at 10 years it is as effective as the previous gold standard which was/is gastric bypass. If sleeve gastrectomy proves itself to be as good we will offer it as a surgical procedure.
Q You state on your website that the post operative period is almost as important as the surgery. Why is that?
A. We have set up a very comprehensive clinic because of the nature of laparoscopic gastric banding. It has been established that a great part of that success is in seeing patients regularly and helping them with the food behaviour modification that is part and parcel of laparoscopic gastric banding
Q I have had a sleeve gastrectomy four years ago and i have been told that it has stretched up which is why i have regained my weight---is there anything that can be done?
A Yes there is ---you can have the operation redone again but there are significant risks of complications with that.You can have it converted to a gastric bypass---also risk high, or you caqn have a band placed above the stretched sleeve
Q. Does the “facility fee” that you have created mean that we don’t get any gap charges from other people involved in the surgery?
A. Yes that’s what it is designed to do, so that patients can concentrate on the surgery and post operative period without having to deal with multiple bills having to be paid from the surgery,and then there are no gaps charged for post op visits which can be $70-100 per visit with some clinics and add thousands of dollars to costs over a 5 -10 year period
Q. Is it true that you won’t accept patients from outside South Australia?
A. Not completely –those patients who can assure us that they will have good post-operative follow-up through a similar clinic to ours-- we are happy to undertake the surgery.
Q. Why is it so much cheaper to have the surgery done here than in the eastern or western states?
A. It’s part of our philosophy, we feel that people have taken out a private health cover to have this operation it’s because they really need it to turn around their life, and that we should keep that as affordable as possible for them so that as many as possible can benefit.
Q. You don’t charge for follow up visits, do you?
A. No we don’t--- again it’s about our philosophy that the post operative period is really important to see patients and see how they’re doing, and we know from research that some clinics charge in excess of hundred dollars a visit discourages patients from being seen and therefore obviously not doing as well as others who are seen regularly
Q how many of your patients are not successful with the lap band.
A we think that varies between the 12% reported worldwide and 20%that we would see sometimes--.Its difficult as this procedure is so dependent on good follow up and ongoing efforts both on the clinics part and the patients part to develop new eating habits with the band.We believe that if we could get all people to stay in our follow up programme we could achieve possibly a 90% satisfaction
QYou have one of the largest practices in this type of surgery in Australia, can i request you as the surgeon?
AYes you can---but we have three very experienced surgeons and will currently be joined by a 4th in July 2010
Q Why do we all have to go on a Optifast diet before surgery?
A. Research has shown that Optifast prior to surgery shrinks the liver volume which makes it easier to get the lap band in with keyhole surgery
Q. I’ve read about the Optifast diet being a requirement of prior to surgery and can tolerate it does that mean I can’t have the surgery?
A. No – we have alternatives
Q. You say on your website that you don’t like to operate on privately insured patients – why is that?
A. We will operate on privately insured patients provided they can assure us that they won’t suffer financial hardship by paying up to $18,000 for the surgery. We don’t want any patients to be worried about the financial costs and would rather they just concentrate on getting better. Although this is very low risk surgery there is always the possibility that a patient may end up in intensive care which could add $1000 per day to the total cost of the surgery. There is also the matter of any ongoing surgery which may result from the original surgery which would then be an additional cost.
Q. Are there many complications from the surgery?
A. Fortunately there aren’t,--we usually tell patients about stretching of the pouch and slippage of the stomach which can happen in up to 3% of cases and erosion of the band in a similar percentage of cases and the issue of reflux.
Q. Some clinics offer a loan to have the surgery, do you do that and if not why not?
A. We realise that is done in some “circles” but we are completely against mixing those two areas.--we don’t think it creates the right impression when patients are being talked to about loans and interest rates when we would prefer them to be concentrating on the surgery its success for them and their subsequent diet --- not worrying how it is going to be paid for.
Q How long do you normally have to wait to have the surgery after your first visit?
A. You would usually have three consultations, and six weeks from the time of your first consultation to surgery is what it takes when all examinations and blood tests are done
Q. I have heard in some clinics you have to go and see four or five different people such as psychologists exercise therapist,nurse educators and dietitians and each of them can charge various amounts – it doesn’t say that you do this on your website
A. That is correct. – we organise for a Dietitian consultation on a group basis so as not to increase the cost of the procedure. We don’t believe that consulting with psychologists or exercise therapist improves the outcome if there was research to indicate that it did we would incorporate them,which is not to say we dont use them but on an individual basis if it appears the patient needs them
Q You have a link on your website to Specialists without Borders, what is that?
A A charity that takes medical education into developing countries that I am a director of—a way of putting back where there is the greatest need-- which we do for two weeks out the year taking like-minded medical and nursing specialists from around the world ,although mostly Australasian, to countries that request medical teaching seminars
Q. If we ever had trouble with our band is there someone to contact who knows about and surgery?
A. Yes we have firm directions on our answering machine and an alliance with Dr Justin Bessell’s Wakefield surgical obesity clinic, that allows us to look after our wide number of patients.