Sodiq Oyeleke
Consultant Laparoscopic and Bariatric Surgeon, Dr. Abuchi Okaro, has said that Nigerians who need treatment for obesity and diabetes may no longer have to travel overseas, insisting that surgical interventions for both conditions do not have to be invasive.
London-based Okaro said this in Lagos during a working visit with a professional colleague, Dr. Marco Adamo.
Okaro and his team of surgeons who specialise in the surgical weight loss and metabolic surgery successfully performed what he called “Nigeria’s first single anastomosis gastric bypass (mini-gastric bypass) weight loss procedure at the Euracare Multi Specialist Hospital, Victoria Island, Lagos.
Speaking on the challenges of laparoscopic surgery in Nigeria and the options available, he said bariatric or metabolic surgery is a rapidly expanding branch of upper gastro-intestinal surgery around the world.
“The ability to surgically adjust the upper digestive tract and cause, over time, significant weight loss for the patient, has transformational impact on weight which affects diseases such as Type 2 diabetes, hypertension, sleep apnea, etc.” Okaro said.
Noting that a record number of 30 percent of Nigerian adults are obese, the weight reduction expert said he performed his first bariatric surgical procedure — a lap sleeve gastrectomy — in Lagos in 2011.
“Since then, we have made significant progress over the years in terms of building the team and partnerships that have allowed us put together a fully functional service that comprises high quality infrastructure, personnel and system,” Okaro said.
Relating the benefits of bariatric surgery, Okaro said they could be both medical and psychological.
In terms of medical benefits, he said the surgery could aid in the treatment of diabetes, improving fertility, and curing hypertension; while in terms of psychological benefits, issues such as improved self-confidence and overall productivity come to the fore.
He expressed confidence that very soon, their centre — Euracare Multi Specialist Hospital —and other centres like it would make it unnecessary for patients to travel overseas for medical treatment, “particularly in bariatric surgery and continuity of care (follow up), all of which can be delivered at international standards locally, offering the best long-term outcomes and solutions for patients.”
In reaction to the question of cost or affordability, which many believe is one of the reasons why metabolic surgery or gastric by-pass is not used broadly in Nigeria, Okaro counseled the healthcare industry to consider affordability of services if they are to become sustainable.
“I am sure affordability has some impact on its wider acceptance in the short term. I, however, feel that the medium to long-term benefits in terms of improving overall health, treating diabetes, and preventing certain cancers etc., will go a long way in further demonstrating the value of such services in Nigeria,” he enthused.
Describing the strategies used in helping patients to overcome weight loss and attendant health issues, Okaro said there are a number of procedures on offer in the weight loss and metabolic surgery clinics.
“Our usual practice is, upon full appraisal and patient assessment, we base our recommendation on the patient’s age, weight, dietary habits and overall lifestyle and let the patient choose what suits him.
“We are continuously striving to broaden the range of options available locally. For instance, in modern day cancer treatment, you have options like surgery, chemotherapy, and radiotherapy.
“Something similar applies in treating obesity and there is a range of treatments. Surgery is one of the options, probably the best option.
“However, the priority remains proper and effective counseling. Then the patient can pick the preferred choice.”
Okaro noted that the principles of healthy weight reduction treatments are centred around sensible dieting, regular exercise, and portion control.
“Where diet is concerned, we analyse things in terms of calories consumed. When trying to reduce the amount of calories a patient consumes, we take a lot of things into consideration. One is appetite, which is the desire to consume more; it is a physical, psychological and emotional process.
“Another key issue is the feeling of fullness during meals, otherwise called satiety.
“You also cannot talk about overeating without looking at how active we are. Obviously, we rarely burn enough energy, even as we consume food massively,” the surgeon warned.
He revealed that in metabolic surgery, the key thing is to make people feel full quicker, so that the patient has a reduced appetite or is satisfied quicker.
“What is done to the stomach tends to reduce its volume (restrictive). Another thing is to change how the intestines and other parts of digestive system function, so that when you eat, the bulk of the food is not absorbed, and most things just pass along till they are excreted in the waste movement. These are the two major aspects of bariatric surgery,” he said.
Distinguishing between cosmetic surgery such as tummy tuck and liposuction, Okaro said unlike what obtains in cosmetic surgery, in weight loss surgery, the way various parts function — intestines, pancreas, etc, — are fundamentally influenced.
“It is not that there would be no changes in image or looks, but those changes are not the primary purpose of the surgery,” he said.
He, however, warned that bariatric surgery must not be performed on young subjects.
Rather, he said, children should be encouraged to imbibe healthy dietary habits and to engage in more physical exercise.
Talking about the risks involved in his area of specialisation — Single Anastomosis Gastric Bypass — Okaro said that having treated over 250 patients without any serious complications or deaths, he and his team are confident of delivering perfect surgical procedures to their patients.
from Punch Newspapers
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