The Bariatric Surgeon

Dr. LEUNG Siu Kee - Chapter Member, HKOS

Morbid obesity becomes a global health problem. Bariatric surgery has been proved as an effective method to achieve significant long-term weight loss. The bariatric surgeon is therefore an important member of the multi-disciplinary team in the weight reduction program. He or she must be proficient in endoscopy, open abdominal surgery, minimal access surgery and techniques pertaining to bariatric procedure. The surgical pathway starts from pre-operative counselling, the choice of surgery, the operation, post-operative care, early detection of complications, management of complications, follow-up of patients and clinical audit.

Meanwhile in Hong Kong, bariatric surgery is not a stand-alone surgical subspecialty in public hospital setting. Bariatric surgery is incorporated in the subspecialty of Upper Gastrointestinal Surgery. Bariatric surgeons are part-time, having to deal with other surgical conditions like emergency surgery and cancer surgery. The amount of time they can allocate to bariatric surgery depends on manpower provision and availability of operation sessions in the hospital. Thus it is a tremendous challenge for them.

Adequate training in bariatric surgery is a prerequisite to kick off the program. Since the bariatric surgeon-to-be should have comprehensive experience in open and laparoscopic surgery, the learning curve will be quite steep. An intensive and intermediate-term training is advantageous. A structured, “mini-fellowship program”, like 4-6 weeks in a center of excellence is recommended. Training in bariatric surgery will be one of the targets for the group of bariatric surgeons to work on.