Q and A on Laparoscopic Robotic, Bariatric, Hernia, and Other Procedures
A Note On Release Of Superannuation Funds
Administration of claims for early release of superannuation benefits on compassionate grounds transferred to the Department of Human Services(DHS) on 1 November 2011. Please refer to the DHS website for further information on this. You may also contact DHS by phone on 1300 131 060 if you would like further information.
Bariatric Surgery
CAN I HAVE THE SURGERY REVERSED?
It is possible to reverse a gastric band but it should be remembered that the majority of patients who have the gastric band removed and do not have an alternative procedure will regain the weight that they have lost.
Please note, we no longer offer the Gastric Band as a weight loss option. Other forms of treatment, including medically managed weight loss have been shown to be just as effective, without the disadvantages of the Gastric Band.
FINANCING OBESITY SURGERY
As there are currently less than 100 weight loss procedures performed in the public sector in Queensland, the majority of patients requiring the surgery will have it performed as a private patient. As such we would encourage all patients to consider taking out private health cover to assist with the costs of their surgery, in particular having private health cover will assist with any additional surgical procedures or intensive care stay that might be required due to unforeseen complications.
Obviously, patients taking out new private health cover will be required by the insurance companies to wait 12 months prior to having their surgery. As a practice, we are happy to provide a dietician and psychologist in the last few months running up to surgery, for those patients who are waiting for their private health cover to commence.
Alternatives to private health cover includes utilising super funds to pay for surgery or using a specialist financing company. My rooms will be happy to provide you with information or alternatively you can find more information on accessing super funds at www.apra.gov.au
HOW DO I KNOW IF I QUALIFY FOR OBESITY SURGERY?
BMI is quick method used by HCPs all over the world. However, living with obesity is much more complex than a single number. You should therefore discuss surgical options with the surgeon for the options available.
The BMI calculator on this website can be used to calculate your BMI. If your BMI is greater than 35 you immediately qualify for obesity surgery. To calculate your BMI, click here. Patients with a BMI of between 30 to 35 should generally have another medical condition such as high blood pressure or high cholesterol. However increasingly, patients with BMIs between 30 and 35 are being considered for surgery.
In keeping with the World Obesity Federation we also use the following to determine suitability:
- Waist/height ratio
- Waist/hip ratio
- Weight distribution
- Presence of Metabolic Disease (eg OSA, hypertension, diabetes)
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Patients who are frequently/constantly dieting to maintain their weight weight will likely see weight increase over time and therefore I do not see the point in making them waiting until their BMI is greater than 35 before offering them surgery. However the decision as to whether or not to proceed with surgery will be made on an individual patient basis.
HOW MUCH WEIGHT WILL I LOSE?
Weight loss surgery operations are tools to help you lose weight. Ultimately the amount of weight that is lost depends on your ability to comply with a healthy diet and combine this with an appropriate level of exercise.
As the procedures are purely restrictive procedures, if you consume too many calories you will not lose weight, or you will lose less weight than you would like.
The advantages of Dr Lockie and the Brisbane Institute of Obesity Surgery are that we offer a comprehensive, tailored package of support appointments together with a free patient support group. Both of these support mechanisms have been shown to maximise the potential of any weight loss surgery.
It should be remembered that percentages quoted are average figures and some patients will do better and others will not do as well.
I’M WORRIED ABOUT THE RISKS ASSOCIATED WITH SURGERY - WOULD IT BE SAFER TO DO NOTHING?
Generally patients considering weight loss surgery can expect their weight to increase steadily year on year without surgical intervention. As your weight increases, so do your risks of mortality, together with other medical conditions such as diabetes, high blood pressure and high cholesterol. These comorbidities will impact on your quality of life and ultimately your length of life.
Almost universally, the only regret that my patients have expressed after their surgery was why they did not have it sooner.
ONCE I’VE LOST THE WEIGHT WILL IT STAY OFF?
Weight loss surgery offers the best opportunity for long term weight loss. Evidence demonstrates that in the majority of cases, once the weight is lost, it remains off in the long term. There may be some weight regain after five years but I would be hopeful by that stage that you have established healthy eating and exercising habits which would minimise any weight gain.
WHAT IS THE BEST OPERATION?
One of the benefits of this practice is the ability to offer individual patients a tailored approach to their weight loss surgery. Each of the operations offered in the practice does produce effective weight loss.
Unless there is a particular medical reason to suggest a particular operation, ultimately it will be your decision as to which operation you are most comfortable with and which one you feel fits best with your lifestyle.
ARE THERE NON-SURGICAL WEIGHT LOSS OPTIONS?
Yes. Dr Lockie offers two main forms of non-surgical weight loss. Depending on your individual situation, it may be more appropriate to use one of these options
Recent developments have made the use of a special class of drugs, an option for weight loss. Dr Lockie's practice offers medically managed weight loss as a way to control your weight especially when it can be used to get weight down in order to change your lifestyle.
Also available is the use of a Gastric Balloon which does not require surgery. This option may suit some patients.
WILL I FEEL HUNGRY?
Although these operations restrict how much you get in, they also work by altering the feeling of fullness you get when you eat. Therefore despite eating relatively small amounts, you will feel full and you will not feel particularly hungry. With the gastric band, it can take a number of adjustments before this point is reached, whereas with the other two operations there is an immediate loss of appetite.
HERNIA & GENERAL SURGERY
WHICH SURGICAL PROCEDURES DOES DR PHIL LOCKIE PERFORM?
The following is a list of operations performed by Dr Lockie. It is not exhaustive but does give an indication of those areas where Dr Lockie has specialist training and wishes to concentrate his expertise.
Whilst Dr Lockie does perform the majority of operations by a laparoscopic approach, not all patients and situations will be suitable for laparoscopic surgery in such cases traditional open surgery will be performed.
For some patients, Robotic Assisted Surgery (RAS) provides the best option for a successful procedure and fastest recovery. Where this is the case, Dr Lockie will discuss these options with you.
It is not always possible to determine if a laparoscopic approach will be possible prior to surgery, if an operation is converted to an open approach this is done in the patient's best interest.
Anti-reflux & Oesophageal Surgery
Biliary Surgery
Endoscopy
- Colonoscopy
- Gastroscopy
- PEG feeding tube
Gastric Surgery
- Laparoscopic partial gastrectomy and wedge resection for benign and some malignant tumours
- Laparoscopic open total and partial gastrectomy for Malignant tumours
Laparoscopic feeding gastrostomy Hernia Surgery
- Laparoscopic inguinal & femoral hernia repair
- Laparoscopic incisional & ventral hernia repair
- Laparoscopic open inguinal/femoral & incisional hernia repair
Obesity Surgery
Non-Surgical Options
Small Bowel and Appendix
- Laparoscopic small bowel resection
- Laparoscopic appendicectomy
Spleen & Other Operations
- Laparoscopic Splenectomy.
NEW PATIENT INFORMATION
HOW DO YOU OFFER A FREE CONSULTATION?
Our initial consultation (100% Medicare funded - no GAP) is with Shirley Lockie, our SCOPE (World Obesity Federation) certified NP HCP Metabolic Professional.
Shirley will conduct a metabolic assessment to determine your state of health as it relates to risk factors for weight as well as advising on a range of issues around your weight loss options
DO I NEED A REFERRAL?
No. Of course we accept referrals from GPs and other health professionals, but your initial consulation does not require a referral.
Shirley Lockie can provide referrals to our in house team (including Dr Lockie) and to external health care professionals where appropriate
FEE STRUCTURE
Medicare does not completely cover the costs of your consultation as set by the Australian Medical Association. For this reason modest GAP payments are charged for all consultations with Dr Phil Lockie. The cost of all procedures will be discussed beforehand and you will receive a written quotation.
WHAT TO BRING TO YOUR FIRST APPOINTMENT
- Referral letter from your GP
- Medicare card
- Details of your private insurance
- A list of current medications
- Any relevant X-rays or Investigations
