Mr Ali Alhamdani

Mr Ali Alhamdani
Surgery
Central London


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Mr Ali Alhamdani

Surgeon in
London &
Watford

MBChB MD FRCS

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Mr Ali Alhamdani areas of expertise:

Professional statement

Mr Ali Alhamdani is one of London's leading bariatric surgeons. He has performed over 2,500 procedures and provides the full range of obesity surgery procedures including gastric bypass, gastric band, gastric sleeve and revisional bariatric surgery.

Mr Alhamdani has had extensive training in laparoscopic (keyhole) surgery in the UK, Europe and America. A surgeon at the forefront of his field, he was one of the pioneers in using the stretta procedure - a minimally invasive endoscopic procedure used to treat GORD (gastro-oesophageal reflux disease). 

Mr Alhamdani has a reputation for performing extremely safe surgery with a very low complication rate and a zero mortality rate. He always prioritises the well-being of his patients, and makes sure they understand all of the options available and are actively involved in making decisions about their treatment. 

He has published several articles about bariatric surgery in reputable scientific magazines.

 Videos of doctor

Can weight loss surgery cure diabetes?

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 Doctor's articles

morbid-obesity-diabetes
Why should someone with diabetes consid...

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 Credentials

GMC: ‍5200855

 Professional experience

• More than 15 years of experience
• Consultant Laparoscopic, Bariatric and General Surgeon, BMI The Clementine Churchill Hospital (present)
• Consultant Laparoscopic Upper GI, Bariatric (Obesity) and General Surgeon, The Wellington Hospital (present)
• Consultant Laparoscopic, Bariatric and General Surgeon, The Spire Bushey Hospital (present)
• Consultant Laparoscopic, Bariatric and General Surgeon, Bupa Cromwell Hospital (present)
• Consultant Upper GI, Bariatric and General Surgeon at Highgate Hospital (present)
• Bariatric Fellow in Laparoscopic Bariatric Surgery, SRH (2010 - 2012)

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 Sub-specialties

• Obesity - weight loss surgery
• Bariatric surgery
• Gallstone surgery
• Gastroesophagael reflux
• Disease management
• Stretta procedures

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 Education

• FRCS, Royal College of Surgeons of Edinburgh (2010)
• MD (Doctor of Medicine), Swansea University (2003 - 2006)
• MB ChB, Baghdad University (1990 - 1996)

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 Publications and conferences

• Has published several articles about bariatric surgery in important scientific magazines

 Professional membership

• International Federation of Surgery for Obesity (IFSO)
• Association of Upper GI Surgeons (AUGIS)
• British Obesity and Metabolic Surgery Society (BOMSS)
• Royal College of Surgeons (RCS)

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Languages spoken

  • English
  • Arabic

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12/01/2018

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Diseases, Medical Tests and Treatments

Acid reflux

Gastroesophageal reflux is a digestive disorder where acid from the stomach leaks back into the oesophagus. It usually occurs because of weakness in t ...

Bariatric surgery

Bariatric surgery uses of a set of techniques and surgical procedures that help fight obesity and improve the patient's health. It is not to be mistak ...

Endoscopy

What is it? Endoscopy is the use of cameras to relay images from inside the body.  The device used, known as an endoscope, is a long thin flexible ...

Gastric band

What is a gastric band? Getting a gastric band is a type of bariatric surgery (weight loss surgery). Bariatric surgery aims to reduce the amou ...

Gastric bypass

What is a gastric bypass? Gastric bypass surgery is a type of bariatric surgery. Bariatric surgery aims to reduce the patient’s food and/or calorie intake via operations on the upper digestive system (particularly the stomach), which physically and psychologically affect the patient’s approach to food. A gastric bypass involves dividing the stomach into two “pouches”, and connecting the smaller top pouch directly to the small intestine, allowing food to “bypass” most of the stomach. This means that fewer calories are absorbed by the stomach, and due to the smaller space, the patient feels full quicker. As a consequence, they eat less.   Why would you have a gastric bypass? Gastric bypasses are used to treat a variety of conditions which require the patient to eat less or reduce calorie intake. It is commonly used as a weight loss treatment for morbid obesity, although surgery is rarely the first option – major operations carry risks, and can be expensive, so trying to lose weight via exercise and dietary changes is usually the first port of call. If this doesn’t help you to lose weight, your doctor might discuss surgical options, such as a gastric bypass. Other conditions that could warrant a gastric bypass include type 2 diabetes, sleep apnoea and hypertension. Long-term mortality of gastric bypass patients has been shown to be reduced by 40%.   What does it involve? The amount of food a patient can eat is limited by creating a small pouch in the upper stomach and dividing it from the rest of the stomach. This can either be done by creating a partition (which runs the risk of the stomach healing and returning to its pre-operative function) or by totally separating the two parts. The small intestine is reconstructed so that both parts of the stomach drain into it, rather than just from the bottom of the stomach. The surgery is often laparoscopic, i.e. using small incisions to insert a small camera and specialised surgical equipment to perform the operation without cutting the patient open.   How long does it take to recover from gastric bypass surgery? If the surgery is done laparoscopically, the patient may stay in the hospital for 2-3 days, and should be fully recovered in 3-5 weeks. Recovery time will be longer if open surgery is performed.   How much weight will you lose after a gastric bypass? On average, following gastric bypass surgery patients lose 60% of their extra weight.  Studies have shown it also significantly reduces the risk of impaired glucose tolerance (IGT) progressing to type 2 diabetes.  ...

Obesity surgery

What is obesity surgery? Obesity surgery, otherwise known as bariatric or weight-loss surgery, describes a range of procedures that are designed to treat people with obesity. Whilst there are different types of gastric surgery, the aim of the procedure is always to reduce the size of the stomach. Why would you do it? Bariatric surgery is a type of treatment for people who are obese. The surgery helps a person to lose weight and is generally carried out to reduce the risk of serious weight-related health problems which can be potentially life-threatening. Over time obesity can lead to multiple conditions such as heart disease, diabetes, high blood pressure and an increased risk of stroke. As a general rule, bariatric surgery is usually for those with a BMI of over 40 or those with a BMI of over 35, accompanied by a serious weight-related health problem. What does it involve? Some of the most common procedures, aimed at reducing the size of the stomach and making the patient feel full sooner and/or decreasing the ability to absorb nutrients are as follows: A gastric band can be fitted around the stomach in order to reduce its size. The band is usually placed around the top part of the stomach and is adjustable. A gastric bypass joins the top part of the stomach to the small intestine, thereby bypassing most of the stomach and small intestine. A sleeve gastrectomy removes part of the stomach, decreasing its volume significantly. All types of weight-loss surgery are done under general anaesthetic. Depending on the circumstances, the operation can be performed using open surgery or laparoscopically using smaller incisions and cameras to guide the process. The latter is also known as keyhole surgery. How to prepare for it Preparation for obesity surgery will depend on the individual to an extent. Restrictions are often placed on food and drink prior to surgery and certain medications may also need to be stopped for a period. Post-operative care Obesity surgery is a major operation and patients will normally wake up in a recovery room before being moved to a ward. There is no food or drink allowed for the first couple of days to allow the stomach and digestive system time to heal. After that, patients can progress to clear liquids and are often discharged around three days after surgery, providing everything goes well. A specific diet will then need to be followed for some weeks after surgery, usually centered on liquids and soft foods. Permanent lifestyle changes after surgery are also required to help keep weight off. Regular exercise and a balanced diet should be maintained to ensure that patients don’t put the weight they have lost back on. ...

Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder as a treatment for gallstones or other gallbladder problems.

Cholelithiasis (gallstones)

What is cholelithiasis? Cholelithiasis refers to the presence of one or more gallstones in the gallbladder. Gallstones are little stones made of cholesterol formed in the gallbladder. The gallbladder is a small organ found underneath the liver and aids digestion by releasing a digestive fluid called bile into the small intestine. What are the symptoms of cholelithiasis? Most of time gallstones do not cause any symptoms and do not require treatment, however, if a gallstone happens to get trapped in a duct inside the gallbladder, it can cause the following symptoms: Intense and constant abdominal pain (called biliary colic) Pain between your shoulders Nausea and/or vomiting Sometimes cholelithiasis can be more serious, especially if the gallstone blocks the flow of bile, and the following symptoms can be triggered: Fever More intense pain Diarrhoea Jaundice No appetite What causes cholelithiasis? Although causes of gallstones are not totally clear, they are thought to occur when there is an imbalance in the make-up of the bile inside the gallbladder. Such imbalances are thought to occur when: High levels of cholesterol are found in the gallbladder, meaning there is not enough bile to digest the amount of cholesterol in the gallbladder. The excess cholesterol then forms into gallstones. High levels of bilirubin are found in the gallbladder. Bilirubin is a waste product made when red blood cells are broken down. Excess bilirubin contribute to the formation of gallstones. How can cholelithiasis be prevented? Research indicates that weight-loss and diet can help to prevent gallstones developing. A healthy, low-saturated fat diet is recommended. This is helps to reduce the intake of bad cholesterol which can cause gallstones to form. Also recommended, is avoiding the consumption of large amounts of alcohol. Being overweight is also a risk-factor for developing gallstones. Therefore, maintaining a healthy weight by eating healthily and exercising regularly is highly recommended. Losing weight via low-calorie diets are not recommended however, as they have been linked to disrupting bile production, and can therefore increase chances of gallstones developing. What is the treatment for cholelithiasis? If your gallstones do not cause symptoms, then most likely you will not need treatment, but will be recommended to actively monitor your condition, and to return to a specialist if symptoms occur. However, those who do experience symptoms will likely have the following treatment options: Gallbladder removal surgery (cholecystectomy) – gallstones can reoccur, so removing the gallbladder entirely is one way to ensure that gallstones do not recur. After it is removed, bile goes straight from the liver in to the small intestine. Medications – there are certain medications designed to dissolve gallstones and are taken orally. These need to be taken over a long period of time and are not always effective. ...

Diabetes

What is diabetes? Diabetes mellitus (DM), or just diabetes refers to a group of metabolic diseases which result in an inability to regulate blood sugar levels. Having too much glucose in your blood can damage the kidneys, eyes, nerves and other parts of the body, including the blood vessels themselves. In extreme cases, diabetes can cause heart disease and strokes, and patients may even require amputation of limbs. This inability to control blood sugar comes from a problem with the hormone insulin. Insulin is produced by the pancreas, enters the bloodstream, and moves glucose out of the blood and into cells, where it is used to generate energy. There are two types of diabetes: Type 1 diabetes – the cells that create insulin are attacked and destroyed by the body’s immune system as part of a defective immune response. It can develop rapidly over weeks or even days. Type 2 diabetes – either the body does not produce enough insulin, or the body’s cells stop responding to it. Patients may not be diagnosed for years, due to generic symptoms. It is by far the most common type of diabetes.   What are the symptoms? Classic diabetes symptoms include: Thirst Frequent urination Fatigue Itching around the genitals, or thrush Weight loss/muscle loss Blurred vision Slow healing   What causes diabetes? Type 1 diabetes is an autoimmune condition – something causes the immune system to attack healthy pancreatic cells that produce insulin. It appears to run in families, so may be genetic. No one knows exactly what causes the immune system to attack the pancreas, but one theory is that it is triggered by a virus. Type 2 diabetes is acquired, and usually affects older people. It tends to be associated with obesity and lack of exercise.   How can it be prevented? Type 1 diabetes appears to be genetic, so there is no way to prevent it. To reduce the risk of developing type 2 diabetes, it is important to have a healthy and balanced diet, take plenty of exercise, and lose weight if you are overweight or obese. Stopping smoking and drinking alcohol in moderation are also useful tips.   What is the treatment? Diabetes can’t be cured, but the symptoms can be managed. A healthy diet, regular exercise, and regular blood tests are essential to keep blood glucose levels in check. Type 1 diabetes patients require regular insulin injections for the rest of their lives to make up for the lack of insulin production by the pancreas. Type 2 diabetes patients may eventually need to take tablets, as the condition is progressive (it will worsen over time). You should see your doctor or a specialist as soon as possible if you are experiencing symptoms. If diagnosed with diabetes, a patient is usually referred to a specialist care team for treatment and long-term monitoring of the condition. ...

Diabetes surgery

Type 2 diabetes is a condition where a person has a high blood sugar level, and is often associated with obesity, and is more common as people get older. There are a number of surgical options that can be used to lose weight that have a direct effect on how the body uses insulin, and improves blood sugar levels, making the diabetes much more manageable.   Types of diabetes surgery   There are a number of surgical options which can help you to manage your diabetes. These surgical options were originally only used as a solution to excessive obesity, as they cause weight loss in the patient. More recent studies have found that this surgery, known as bariatric surgery, has not only led to a loss of weight, but also that insulin and blood sugar levels become more normalised following surgery. The types of bariatric surgery available that have been shown to improve blood sugar levels are:   Gastric bypass A procedure where the stomach is made smaller, and food bypasses parts of the small intestine, giving the patient the sensation of feeling full quicker. Gastric band Surgery where an adjustable band is placed around the top of the stomach, creating a pouch which holds less food and causes the patient to feel fuller quicker. The less food held in the stomach, the easier it is to lose weight. Gastric sleeve A large section of the stomach is effectively stapled closed, which causes the stomach to reduce in size, again causing the patient to feel fuller quicker, and therefore reduce their intake of food. Biliopancreatic diversion This is a two-step procedure where a pouch a quarter of the size of the stomach is initially created using staples, as with the gastric sleeve, the remaining part of the stomach is then removed. The small intestine will then be joined to the end of the pouch, closer to the large intestine than before. This then causes food absorption to be greatly reduced, and weight loss becoming easier following the procedure.   Benefits of diabetes surgery   Surgery is not fully recognised as a standard option for the treatment of diabetes, however it is increasingly being chosen as the most suitable option, especially in patients where changes to lifestyle and diet, alongside diabetes medication hasn’t sufficiently controlled diabetes and blood sugar levels. The benefits of this type of surgery are that positive results are almost guaranteed, and much more instantaneous than with lifestyle and diet management, with medication. Once the weight has initially been lost in the patient, it becomes much easier to manage the weight afterwards, and therefore the blood sugar levels become more manageable.   Risks of diabetes surgery   The surgery carries the usual risk of complications that any form of surgery carry, namely risk of infection, but the surgery is commonly performed and is a standard procedure. Outside of the surgical procedure, there are risks of nutritional deficiencies as a result of the stomach not having the capacity to take in as many nutrients. These can be managed with nutritional supplementation. If you would like to discuss diabetes surgery with a specialist, you can make an appointment here. ...

Gallbladder surgery

What is gallbladder surgery? Gallbladder surgery is a surgical procedure that is performed to remove the gallbladder, an organ located in the lower part of the liver that serves as a reserve for bile. Why is gallbladder surgery performed? Gallbladder surgery is performed when the patient is experiencing pain or presenting with symptoms caused by the formation of calculi (stones) in the gallbladder. What does gallbladder surgery consist of? The intervention can be minimally-invasive or open. In the first case the surgeon will make three or four incisions in the abdomen and through one of the holes will introduce a laparoscope (thin and illuminated tube connected to a camera that allows the surgeon to see the inside the cavity) and other instruments necessary to perform the procedure. Subsequently, the specialist will insert gas with a needle to expand the abdomen and cut the bile duct and blood vessels leading to the gallbladder. Finally, the gallbladder is removed. When gallstones are more severe or there are complications during surgery, an open operation is carried out. This involves making a small cut in the abdomen to open it and extracting the gallbladder through the incision. Preparation for gallbladder surgery Before gallbladder surgery, you must undergo certain tests, such as blood tests, urine tests, or certain types of scan (e.g ultrasound) so the specialist can assess your health status, and determine if you are suitable for surgery. Care after gallbladder surgery Recovery after gallbladder surgery will depend on the surgical technique used. Normally, in the case of performing an open surgery, 2-4 days recuperation in the hospital is recommended, and in the case of minimally-invasive surgery, day-case procedures can be performed, or an overnight stay may be recommended. After you are discharged from hospital, postoperative recovery at home e.g resting and avoiding strenuous activity is necessary. Follow your surgeon’s instructions as recovery time depends on the type of procedure performed. You will also be advised how to clean your wound, and how to change dressings if necessary. ...

Gallstones

What are gallstones? Gallstones are hard lumps or stones, usually made of cholesterol or sometimes other substances like bilirubin that form in the gallbladder.   The gallbladder is a small organ situation underneath the liver which releases bile (produced by the liver but stored and concentrated in the gallbladder) into the digestive system to help the body breakdown fats into fatty acids for absorption. What are the symptoms? Gallstones don’t always produce symptoms and do not always need treating. In fact, the vast majority of people will not experience symptoms as the gallstones themselves do not cause pain. In certain circumstances however, a gallstone might become trapped, causing intense pain known as biliary colic. The pain usually starts in the upper right part of the abdomen and radiates to the shoulder. Further complications can arise whereby the gallbladder becomes inflamed - symptoms can include jaundice (a yellowing of the eyes and skin), fever, persistent pain, nausea and vomiting. What causes gallstones? The development of gallstones is thought to be due to too much cholesterol or bilirubin in the bile, leading to the formation of stones. In the majority of cases gallstones are made of cholesterol, however if the liver is producing too much bilirubin (often due to damage) this can result in the formation of stones also. Improper emptying of the gallbladder is also thought to cause stones, as the bile becomes too concentrated. How can gallstones be prevented? Risk factors for the development of gallstones include being overweight, a lack of exercise, a diet containing too much cholesterol and fat that is also low in fibre, and rapid weight loss. It stands to reason therefore that maintaining a balanced diet and a healthy weight can help to prevent the development of gallstones.  Other risk factors for the disease include liver problems and diabetes. What is the treatment? Gallstones don’t always need treatment and in many cases the best option is to monitor them and only treat them if symptoms appear. If, however they are causing complications it might be necessary to treat them immediatley. Additionally, patients who have conditions which increase the risk of complications, such as portal hypertension (high blood pressure in the liver), cirrhosis of the liver or diabetes may need more urgent treatment. In most cases, keyhole surgery is performed to remove the gallbladder, in an operation known as a cholecystectomy. Following the operation, patients can lead a normal life without the gallbladder as the liver will continue to produce bile.  ...

Gastric balloon

What is the gastric balloon? A gastric balloon is a silicone device of a spherical shape that is introduced into the stomach of patients struggling with obesity. By doing so, patients do not feel the need to eat as much and feel full for longer. This can help such patients to lose weight. It is the most effective solution to fight obesity without the need for invasive surgery. Why have a gastric balloon? The gastric balloon is indicated for obese patients between 18 and 60 years old with a body mass index (BMI) of 30-40. The gastric balloon makes it easier for patients to maintain a diet aimed at losing weight and reducing food intake. It is important that those who choose to have a gastric band are committed to weight loss and having a healthier lifestyle for the long-term. What does having a gastric balloon involve? First there is an initial assessment in which the patient's clinical history is assessed, and a physical examination performed. The gastric balloon is introduced endoscopically and filled with serum to fill the balloon. By doing this, the filled balloon occupies a considerable portion of the stomach, causing a sensation of satiety in the patient and, as a result, the patient feels less hungry and fuller for longer after eating. Preparation for the gastric balloon: Before placing the gastric balloon, a post-procedure diet will be discussed with the specialist, as well as advice given on exercise. Before the balloon is inserted, the patient must fast for 6-12 hours. Aftercare: You can consume some liquids a few hours after the procedure. During the first few days of adaptation of the gastric balloon, a transition is made from a liquid diet to a solid diet, which is adjusted to each patient and situation. The balloon is usually removed six months after insertion and it is removed using an endoscope. Once withdrawn, the patient continues undergoing a multidisciplinary medical follow-up to consolidate the healthy dietary habits. ...

Gastric sleeve

What is a gastric sleeve? Gastric sleeve (or sleeve gastrectomy) is a restrictive weight loss surgical procedure, where the capacity of the stomach is dramatically reduced by about 75% to aid in long-term weight loss. The procedure is called gastric sleeve as the surgeon removes part of the stomach and joins the remainder together, which resembles a ‘sleeve’ and is the size of a banana. A reduction in stomach size makes it difficult for a patient to overeat. The surgeon also removes the part of the stomach that produces the hunger hormone ghrelin, which is known to boost appetite.   Why is a gastric sleeve operation performed? A gastric sleeve is an option for patients who are obese, with a body mass index (BMI) greater than 50 and who have not managed to lose the necessary weight through other methods such as a healthy diet and exercise.   What does it consist of? Sleeve gastrectomy intervention is done by laparoscopy that usually lasts between 60 to 90 minutes. The surgeon will make a few small cuts, between 2 and 5 incisions, in the abdomen through which the laparoscope (an instrument with a tiny camera that sends pictures to a monitor) will be introduced. This enables the surgeon to see the inside of the abdomen during the operation. Then the removal of most of the stomach will be carried out, leaving a vertical tube shape, which is an irreversible procedure.   How do I prepare for a gastric sleeve? Before having a gastric sleeve operation the patient should undergo various tests, such as a complete physical examination, blood tests and an ultrasound of the gallbladder to confirm that they are healthy enough to have weight loss surgery. There are essential steps that a patient must take to prepare for bariatric surgery, including a lot of lifestyle changes. It is recommended to quit smoking as the use of tobacco products have been proven to increase the risk of complications during and after surgery. Changes to diet, such as eating three regular meals a day with two small snacks per day, is a good way to prepare the body for the routine following surgery. Most doctors require a special pre-operation diet. Patients are advised to drink more water and limit other beverages. They should incorporate physical activity into their everyday lives and start with a small exercise routine. A nutritionist and personal trainer would be able to advise the patients on how best implement these positive changes.   What is recovery like? Normally, the patient can go home two days after the gastric sleeve and will have to take analgesics. There are four phases for a patient to follow post-operation to help transition to a solid food diet. They are: Phase 1 – which usually lasts for a week after surgery. Patients should only consume clear liquids and will find that they have no appetite. Phase 2 – around 10 days after surgery, most people will start to feel hungry again. At this stage, they start to incorporate foods that are of low nutritional value but adding in more protein. They should drink lots of water and drink protein powder that is sugar-free and mixed with clear liquid. Towards the end of this week, patients can add in Greek yoghurt, oatmeal, mashed potatoes, smoothies and scrambled eggs. Phase 3 – patients transition to soft foods including soft fish, eggs, vegetables and soups. Phase 4 – after four weeks it is time to transition to solids, sticking to three small meals a day and two snacks. All sugar, processed and low-fibre foods should be avoided. ...

Laparoscopy

What is laparoscopy? Laparoscopy is a minimally invasive surgical technique which allows the surgeon to operate without the need for deep or large incisions in the skin. This means the recovery period is generally shorter, there is less pain after the operation, and scarring is reduced significantly for the patient. This technique is also known as keyhole surgery. Why is it done? Laparoscopy can be used to both treat and diagnose a range of conditions across specialties such as surgery, gynaecology, gastroenterology, and urology. Laparoscopy may be used in investigation, to check symptoms and attempt to reach a diagnosis, for example in cases of ovarian cysts, fibroids, pelvic inflammatory disease, and appendicitis. Laparoscopy can also be used to take a biopsy (a small sample of tissue) meaning it can be used to investigate certain cancers, e.g liver cancer, ovarian cancer, pancreatic cancer, and many more. As a surgical technique, laparoscopy is especially useful as it allows for minimal scarring and a shorter recovery period, which is advantageous to the patient. Laparoscopy can be used as a surgical technique in many situations, such as: Weight loss surgery Removal of the gallbladder as a treatment for gallstones Removal of the appendix Repairing stomach ulcers Hysterectomy Treating ectopic pregnancy Removal of organs affected by cancer What does it involve? Laparoscopy is performed under general anaesthetic. The surgeon makes small incisions in the abdomen and inserts a laparoscope, which is a small camera attached to the end of a thin tube, allowing the surgeon to see inside the abdomen through a projection on a TV monitor in front of them. The surgeon uses small instruments to perform surgery, looking at the TV monitor for a clear view of the area they need to operate on. How do you prepare for laparoscopy? Generally, you will be asked not to eat or drink anything for 6-12 hours before the procedure. You will also be asked to stop taking blood-thinning medication a few days before the procedure takes place. If you are a smoker, your surgeon may advise you not to smoke for a few days before the procedure, as smoking can delay the healing process. Aftercare As laparoscopy is a minimally invasive procedure, you can generally go home either on the same day or the day following surgery. Someone will need to accompany you home as you will be advised not to drive for the 24 hours following the procedure. Recovery from laparoscopy depends on the type of procedure performed. After diagnostic laparoscopy, for example, you may be able to resume normal activity after five days. If surgery is more minor, for example ulcer repair, normal activity may be resumed in around three weeks. Major surgery, such as hysterectomy or organ removal (e.g kidney) typically takes longer – up to 12 weeks. Your surgeon or doctor will advise you on how to clean your stitches and keep wounds clean. Expect to feel tired or somewhat drained after surgery for a few days, but this should pass as your body uses less and less energy as the recovery process goes on. If you experience any pain, you can take over-the-counter medication pain relief to reduce it. Alternatives to laparoscopy Laparoscopy is a minimally invasive technique which is used as an alternative to traditional open surgery. Open surgery may be necessary in certain situations and your surgeon will speak to you regarding your options before making a decision as to which type of surgery will be performed. ...

Morbid obesity

Morbid obesity is also known as severe obesity or class III obesity. People are considered morbidly obese when their body mass index is above 40, or even 35 if the patient has a disease or severe disability as a result of being overweight. In many countries it is a public health problem due to the new eating habits of the society. Morbid obesity can be treated with a low calorie diet and regular exercise. In extreme cases patients can have bariatric surgery. ...

Obesity

Obesity is defined as having an abnormal or excessive accumulation of fat on the body, enough so that it can be a risk to the health of the person. There most common way of classifying the amount of weight on the body, and what constitutes as a healthy balance, is the body mass index (BMI), which is calculated by dividing your weight in kilograms, by your height, squared. The NHS classifies obesity as having a body mass index of 30 to 39.9, with those over 40 being classified as severely obese, though it is not necessarily the case as those with a large amount of muscle could be classified as obese due to their weight, when it may not actually be accurate. Another way of measuring excess fat is to measure waist circumference, for men, obesity is generally considered as being larger than 94cm (37in), and 80cm (21.5in) for women.   What causes obesity?   Simply speaking, obesity is caused by consuming more calories than are burned off through physical activity. When food is consumed, especially excessive amounts of fat and sugar in the diet, the body stores it as energy, in the form of fat. There are some health conditions that can lead to obesity and weight gain, such as problems with the thyroid, especially hypothyroidism.   How is obesity treated?   The best ways of treating obesity is to increase the amount of physical activity you perform on a regular basis, and to reduce the amount of calories eaten, along with eating a healthy, balanced diet. There are a number of ways that you can do this, such as joining a weight loss group to help you manage your diet and motivate you to continue sticking to it. You can also start activities such as walking, swimming or running. You can begin with exercising for short periods of time, before building up to longer periods. There are a number of surgical procedures available to help deal with weight loss in more severe circumstances, such as gastric band, gastric bypass, and biliopancreatic diversion.   What problems can obesity lead to?   Obesity can be detrimental to the health, leading to problems in different areas of the body. It can cause strain on the heart, leading to coronary artery disease, high blood pressure, high cholesterol, and other conditions. It is one of the leading causes of diabetes type 2, polycystic ovarian syndrome (PCOS), and infertility and can also have detrimental psychiatric effects such as depression along side often having a social stigma. To see a specialist to help with obesity, click here. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. Obesity is one of the most common diseases of modern society, caused by bad eating habits that cause a metabolic disorder in the form of excess fat and consequently overweight. If the caloric intake that provides the body is greater than that required or consumed is stored as fat. Besides, obesity may result in the acquisition of other diseases, such as diabetes mellitus, hypertension, high cholesterol or cardiovascular risk. In any case, obesity treatment tailored to each person according to their age, physique, medical history and daily habits is required. By measuring the body mass index patient's degree of obesity it is known and established a slimming diet should be low calorie, low fat, with the establishment of a rehabilitation plan of eating habits and exercise. The tandem diet-exercise physical is essential for weight loss. ...

Pancreatitis

What is pancreatitis? Pancreatitis is the inflammation of the pancreas, which is a gland found behind the stomach. The pancreas is key to the digestion of food, through the production of certain enzymes as well as the production of hormones that aid in the processing of blood glucose levels. There are two types of pancreatitis; acute and chronic. Acute pancreatitis is when the pancreas becomes inflamed suddenly. Chronic pancreatitis is when the pancreas becomes permanently damaged due to inflammation of the pancreas over many years. What are the symptoms of pancreatitis? The symptoms of acute pancreatitis include: Sudden abdominal pain Fever Diarrhoea Nausea & vomiting The symptoms of chronic pancreatitis include: Repeated, and often severe abdominal pain (sometimes accompanied by nausea) Oily, bad-smelling stools If you experience frequent abdominal pain, it is important to see a specialist. What causes pancreatitis? Acute pancreatitis is thought to occur when digestive enzymes activate whilst still in the pancreas, causing irritation of the pancreatic cells and hence inflammation. Acute pancreatitis has also been linked to both gallstones, alcohol consumption, infections, and some medications. Chronic pancreatitis has largely been attributed to long-term alcohol abuse, smoking, hereditary genetic mutations and immune system problems. In some cases, the cause for a pancreatitis diagnosis is never confirmed. How is pancreatitis diagnosed? There are a number of tests used to make a diagnosis, such as: Blood tests to check for enzyme levels in the pancreas. Stool tests to measure fat levels. Oily stools can indicate that there are problems with the digestive system. MRI or CT scans to check for gallstones. What is the treatment for pancreatitis? Treatment for acute pancreatitis looks to support bodily functions until inflammation has subsided. The first step in treating acute pancreatitis is to let the pancreas heal, and for the inflammation to subside. To do so, you must be treated in hospital where you will receive intravenous fluids to replace lost fluids, and medicines to manage pain. Fasting for a few days also helps the pancreas to recover. Once the pancreas has recovered, doctors can get to work on treating the underlying cause of pancreatitis. Frequently, such additional treatments can include: Pancreas surgery – sometimes it is necessary to either remove damaged pancreatic tissue, or to drain excess fluid from the pancreas. Gallbladder surgery – removing the gallbladder may be necessary if gallstones are the cause of your pancreatitis. Treating alcohol dependency – if alcohol abuse is the cause of your pancreatitis, then you may be entered into an alcohol addiction program. For those suffering from chronic pancreatitis, then further treatments might be needed, including: Lifestyle changes – adopting a low-fat, nutritious diet, avoiding alcohol and stopping smoking tends to show the best results for people suffering from chronic pancreatitis. Enzyme supplements – these assist in the digestion of food and can be taken with each meal. Pain medication – chronic pancreatitis causes continual abdominal pain, so managing this pain is often needed. ...

Robotic surgery in surgery

What is robotic-assisted surgery? Robotic-assisted surgery, or robotic surgery, with the da Vinci System allows doctors to perform surgical procedures in a very accurate way. Operations are performed with more precision, flexibility and control compared to using conventional techniques. Robotic-assisted surgery is commonly associated with minimally invasive surgery, where procedures are performed using tiny incisions. How does robotic- assisted surgery work? Robotic-assisted surgery with the da Vinci Surgical System uses a camera arm and mechanical arms with surgical instruments attached to them.  The surgeon is able to control the arms whilst seated at a computer console near the operating table. The surgeon has a high-definition 3D view of the surgical site and leads other team members who assist them during the surgery. The surgeon makes small cuts to insert the instruments in the patient’s body. A thin tube with a camera attached to the end of it, as with an endoscopy, enables the surgeon to view enlarged 3D images of the patient’s body during the surgery. The robot corresponds and matches the hand movements of the doctor to perform the procedure using tiny instruments. What is da Vinci Surgery used for? Cardiac surgery Colorectal surgery General surgery Gynaecological surgery Head and neck surgery Thoracic surgery Urological surgery What are the advantages and risks of robotic-assisted surgery? Surgeons who use the robotic system find that for many procedures it enhances control during the operation and allows them to see the site more clearly. The benefits of minimally invasive surgery using the da Vinci Surgical System include:   Fewer complications, such as infections Reduced blood loss and transfusions Reduced pain and discomfort Quicker recovery time – shorter hospitalisation and faster return to normal activities Less noticeable scars   Robotic-assisted surgery has small risk factors, which may be similar to those of conventional open surgery. The risks could include:   Infections Bleeding Mechanical failure – unlike traditional surgery Who are the best candidates for robotic-assisted surgery? The ideal patient for the robotic-assisted procedure is someone who has not had many abdominal surgeries. Typical abdominal surgeries such as an appendectomy, gallbladder removal and hernia repair do not exclude individuals from having robotic surgery. The decision will be made by the surgeon. Patients with prevalent cardiovascular and pulmonary diseases may require more consideration beforehand. How long does it take to recover from robotic-assisted surgery? Traditional open surgery recovery time can last several months, including several days of hospitalisation. Even though every case of surgery is unique, the return to everyday activities for a patient following robotic-assisted surgery can occur in as little as two to three weeks. ...

Stomach reduction

What is stomach reduction? A stomach reduction is an operation to reduce the size of the stomach; it is mainly performed in people who are morbidly obese. Different techniques exist, some of which involve removal of specific parts of the stomach.   Why is it done? The operation is performed to eliminate excess weight in people who are morbidly obese. It is performed when the specialist the patient cannot lose weight via dieting and physical activity, and their BMI is higher than 40 or 35. What does it involve? Currently, there are operations that do not require traditional open surgery; rather they can be carried out using an endoscopy. Stomach reduction by endoscopy, also known as POSE (Primary Obesity Surgery Endoluminal), is a new minimally invasive technique that does not require incisions and is performed orally. Specifically, an endoscope is inserted through the mouth until it reaches the stomach. In the stomach, folds are created to reduce its size and capacity, and to slow emptying. Endoscopic stomach reduction has several advantages: it provides a permanent result without external scars and does not require a hospital stay.  How to prepare for the operation You will have to follow a strict diet for a few weeks before the operation, in order to reduce cardiac risk during the operation. It is also advisable to perform breathing exercises and physical activity. Post-operative care As a result of the operation, your body will have undergone a major change, in terms of how you digest food. You will, therefore, have to change your lifestyle. After the operation, your stomach will be about the size of a walnut, have a lower capacity and will absorb nutrients differently. Your stomach will increase in size over time; during this period, you should not eat excess food. A normal stomach can receive up to 1 litre of food, whereas a “reduced” stomach should not exceed 250 ml of food. ...

Stomach surgery

What is stomach surgery? Stomach surgery describes the group of surgical procedures that remove, repair or modify the stomach, depending on what the underlying illness or problem is. Stomach disorders that can require surgery include: Stomach acid disease – a condition in which the stomach overproduces stomach acid, and can lead to stomach ulcers forming. Stomach cancer Gastroparesis – a condition where the stomach cannot properly empty itself of food due to a damaged vagus nerve which controls the digestive system. Stomach dumping – a condition in which food moves too quickly along the small intestine. Dysphagia – a condition where patients are unable to swallow food properly. Gastric bypass for weight-loss – some patients suffering from obesity will undergo gastric bypass surgery (a type of bariatric surgery) to help them lose weight. Why would you need stomach surgery? Surgery is generally required if other means of treatment and lifestyle changes have not worked to cure or overcome a problem. For emergency problems, or later stage stomach cancer, surgery will usually be the best option for treatment. What does it involve? The various procedures for treating bad cases of stomach acid disease are: Vagotomy – a procedure where the vagus nerve, which stimulates stomach acid production, is cut. Pyloroplasty – a procedure that widens the opening in the lower part of the stomach, which allows food to empty into the small intestine more easily. Partial gastrectomy – this procedure involves removing a section of the stomach. This may be required when part of the stomach tissue is badly damaged by stomach acid. Surgery for treating stomach cancer will usually be combined with other treatments, such as chemotherapy or radiation therapy. To treat stomach cancer surgically, usually the stomach will need to be partially or completely removed. Often, nearby lymph nodes will also be removed. When the stomach is completely removed, the oesophagus will be connected directly to the small intestine. If gastroparesis is severe and nutrients and medications cannot reach the bloodstream, surgery will be recommended. For this condition, a gastrostomy tube might be inserted through the abdominal skin and into the stomach. This should decompress the stomach, and allow feeding through the tube. To surgically treat stomach (gastric) dumping, the pyloric sphincter muscle can be reconstructed to improve the controlled release of food into the small intestine from the stomach. Patients suffering from dysphagia may require a tube to be implanted into the stomach to allow the intake of nutrition and hydration. This tube can either be inserted endoscopically through the throat or via an incision made in the abdomen. Bariatric surgery is a group of procedures that assist in weight-loss for obese patients. Gastric bypass surgery is one of the most common options and involves decreasing the size of the stomach by stapling a section of the stomach together, thereby limiting the amount of food that can enter the stomach. Next, the small intestine is attached to this section of the stomach, meaning food bypasses a section of the digestive system and fewer calories and nutrients are absorbed. How to prepare for it Most of these surgical interventions require general anaesthetic and are relatively intensive procedures, each with their own sizeable recovery period. As these surgeries are dealing with the digestive system, a period of fasting will generally be necessary before surgery. Post-operative care Many of these stomach surgeries will result in necessary lifestyle changes, including dietary adjustments, portion control, the need to use a feeding tube, and being aware of taking in enough of the right nutrients. Each procedure will have its own set of adjustments to make after surgery with the support of a specialist to assist in these being actioned.  ...

Stomach ulcer

What is it?            A gastric ulcer, which is also known as peptic or stomach ulcer, is a sore in the mucous membrane that lines the stomach or duodenum, the first segment of the small intestine.   The most common symptom is heartburn, which may happen after eating or during the night, this can last several hours.   Prognosis Withh treatment and dietary changes (having a balanced diet, not smoking, reducing alcohol consumption) symptoms normally improve over time.   What are the symptoms? The symptoms of a gastric ulcer vary from person to person, and in some people they are asymptomatic, this is especially true of small ulcers. Heartburn is considered to be the most common symptom of peptic ulcers, and it can last between a few minutes to several hours, and can affect the person intermittently for several days or weeks.   Other common symptoms include: Feeling full Difficulties drinking a normal amount of liquid Hunger and feeling empty after eating Nausea Stomach ache.  A gastric ulcer can also cause other less common symptoms: Swelling Being gassy and burping Lack of appetite Felling fatigued Vomiting Chest pain Weight loss Dark stools. Medical tests The specialist will ask the patient about the symptoms being experienced, their medical history, and they will carry out a physical examination to check if there is swelling and pain the stomach. They will also use a stethoscope to check for any unusual sounds around the abdomen area.   An ulcer is often treated with medications, and a test is carried out two weeks later to check that they have been effective.   If the medication has not worked, the doctor may opt to carry out an upper endoscopy, where a thin tube with a camera on the end is inserted in the throat to examine the state of the stomach. A biopsy may also be carried out.       What causes it? The gastric ulcer sore is formed when the stomach is exposed and vulnerable to its own acidity. This can be caused by different things: Genetics Medications that affect the lining of the stomach Infection caused by Helicobacter pylori Excessive consumption of alcoholic drinks, which irritate the gastric mucosa Stress The patient’s lifestyle can also be the cause of an ulcer. Having an unbalanced diet rich in fat and sugar can worsen symptoms. Irritants such as caffeine, spices, and peppers can aggravate symptoms and cause the ulcer to worsen. This can cause other gastric issues to appear or progress, and example being gastroesophageal reflux disease (GERD).   How can it be prevented? A gastric ulcer is known to get worse with alcohol and tobacco use. In the past it was thought that it was caused by eating too much spicy food. Now we know that stress can be a contributing factor.    A person can live with an ulcer, they normally heal between eight and ten weeks. By following a balanced diet, and dropping habits such as smoking, coffee, alcohol, and chocolate consumption, can prevent an ulcer forming. Not eating too late at night can also help.         What is the treatment? There are several medications that can be used to treat a gastric ulcer. If H. Pylori is the cause of the ulcer, the treatment will be what is known as triple therapy. This is a combination of antibiotics with bismuth subsalicylate.     Other medications that can neutralise heartburn and the stomach lining include: Proton pump inhibitors Histamine receptor blocker Stomach protectors. If anti-inflammatory medications have caused the ulcer and there is no sign of H. Pylori, then reducing the amount of medications taken is crucial, another option is to look into a different type of painkiller.        What specialist should I see? The specialist who treats gastric ulcers is a gastroenterologist.      ...

Upper GI surgery

Upper gastrointestinal (GI) surgery is surgery performed to treat pathologies of either the upper gastrointestinal tract (small bowel), gall bladder, liver, pancreas or oesophagus.  ...

Weight control

What is weight management?      Weight management is a strategy to stay healthy and prevent future diseases. It is quite often used for people who have a chronic illness. However, it is more often used for people who need to lose or put on weight, in stages of growth, and for people who have eating disorders. Maintaining a healthy weight can help control cholesterol, blood pressure, and blood sugar. It can also help prevent weight related diseases (heart diseases, diabetes, arthritis, and some types of cancer).   Eating too much or not doing enough exercise can also lead to weight gain. In order to maintain a healthy weight the calories consumed should be equivalent to the energy used, and for weight loss, less calories than are burnt should be consumed. Weight monitoring and the ideal weight are often linked to the trend to lose weight that is prevalent in today’s society. The body mass index (BMI) is used to calculate what your ideal weight should be: weight (lbs)/height (ft). It calculates what weight range the person is in, and is only applicable to adults. A normal BMI is between 18.5 and 24.9.  Why would you do it?  Weight management is used to keep the body healthy, according to body type and needs. This is particularly important for patients with chronic diseases (diabetes, high blood pressure, high cholesterol, or obesity for example), but also for patients who need to lose weight and for those who need to gain weight.  It is also useful to assess and monitor growth in the infant stage, and to check that enough nutrients are being ingested. It is quite often used in cases of eating disorders such as anorexia or bulimia, and to help recovery after illnesses or surgery. What does it involve? It is a series of methods and procedures to ensure that the patient is getting the correct intake of food. Weight control diets should not only focus on caloric intake and weight loss, but they should ensure that the person is following a balanced diet without nutritional deficiencies. The specialist may recommend having 5 meals a day, drinking plenty of water, and avoiding unhealthy snacks, among other recommendations. The aim of weight management programmes is to modify eating habits, so that the patient reaches a healthy weight from a clinical and aesthetic point of view. All weight management programmes should be personalised to promote metabolic adaptations maintaining results over time, as well as teaching the patient how to avoid weight fluctuations.       Even though many diets involve calorie restriction, weight control should be influenced by the distribution of intake rather than the quantity.    How to prepare for it If a patient decides that they want to start a weight loss or weight management programme, they should see a doctor so that they can assess their weight and potential health risks, as well as determine the patient’s real needs (weight loss or weight gain for example) and what can help them make informed decisions relating to weight management.   Before embarking on any kind of weight management treatment, it is important to bear in mind that:   Motivation is crucial when starting a nutrition treatment.   The targets set should be reasonable: the ideal weight means a person is healthier and has a better quality of life.    Weight loss should be gradual and permanent, avoiding big fluctuations. Weight loss maintained over time favours the reduction of fat deposits, limits protein loss, and prevents the basal metabolic rate from decreasing. The diet should be balanced, without causing micronutrient deficiencies as these can worsen the patient’s health. The diet should be varied, avoiding meal monotony, which could demotivate the patient and make it difficult for them to succeed.       Post treatment care     The main task after weight management treatment is to maintain the routines and healthy habits acquired thanks to the help of the nutrition and dietetics specialist.   Obesity is a major health and nutrition problem in today’s society. Excess body fat can raise your chances of digestive, respiratory, and cardiovascular diseases, as well as osteoarthritis or cancer. Thus it is not only an aesthetic matter, it is also a health issue.       ...

Weight loss

What is weight loss? Weight loss is a decrease in body weight by either following a diet and exercise regime or because of involuntarily circumstances such as illness. Body weight is determined by the amount of energy that is consumed as food and the amount of energy expended during daily activities. If a person wants to intentionally lose weight, it is recommended that they eat a lower quantity of wholesome and filling foods to create a calorie deficit. This is in comparison to eating excessive volume of unhealthy food groups, which has caused the weight gain. The amount of calories a person consumes daily to maintain, lose or gain weight varies and depends on the individual’s metabolic rate, height, weight, age, gender and level of activity. Why do some people need to lose weight? When a person is overweight, they are more at risk of developing potentially life-threatening illnesses. Excess weight can potentially increase the risk of certain cancers and type 2 diabetes. There is also a higher risk of heart disease, high blood pressure, sleep apnoea, infertility and gallstones. These conditions should be motivating enough for those who are overweight to change their habits and lifestyle. Some people may experience shame, low self-esteem and depression, meaning weight loss can help them to feel better both physically and mentally. What causes weight gain and obesity? In cases of obesity, genetics can play a role, especially if a child is born to obese parents. Of course, what is eaten has a huge effect on which genes are expressed and which ones are not. Processed foods contain refined ingredients, additives and can also be addictive. The manufacturers of these products heavily promote overeating due to marketing low prices and deals, carefully placing products in certain positions in supermarkets, to make unhealthy food seem irresistible. Some of their tactics are unethical, advertising unhealthy foods as healthy. Many sugary foods are often compared to having the same effects on the brain as drugs, alcohol and nicotine, which causes addiction, overeating and strong cravings for junk food. Foods that are high in sugar can change the hormones and biochemistry of the body when consumed in excess. How can weight gain be prevented? Weight gain can be prevented by choosing a healthy lifestyle, which includes improving eating habits and regular physical activity. The goal should be to choose foods that are nutritious and wholesome, such as fruits, vegetables, lean cuts of meat, fish and pulses. A positive method is to add these foods into the diet and ‘crowd out’ unhealthy processed foods such as refined carbohydrates and foods laden with sugar and to eat little and often throughout the day. Adding exercise to a daily routine means that calories will be burned and likely that weight will be lost. Consulting with a nutritionist, GP or personal trainer can provide guidance and support. Please consult a GP or physician for guidance if considering following a weight loss plan. ...

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