Frequently Asked Questions

You will meet with Mr Shenfine, who will take a thorough history and examine you. Please remember to bring any medical information and tests that you have had. You may require further investigations prior to any surgical intervention. Mr Shenfine believes in the right surgery at the right time when appropriate and necessary. You may book surgery or need further follow up.

Yes it really does! For the record, WLS is not a cop out - it's hard work but gives you a very rewarding tool. Many people who suffer from obesity find it hard to lose weight and keep the weight off with diet and exercise alone. This is likely due to high calorie food availability and genes. It is important to be realistic about weight loss and the amount of weight lost after surgery depends on the type of operation, but more importantly on changing your lifestyle and eating habits. Weight loss requires reducing your food intake and increasing exercise. You can get around WLS with liquid calories for example. So you will need to change your lifestyle but the 'tool' makes this so much easier and rewarding. The primary aim of weight loss surgery is to solve the problems caused by your obesity and not to get you to your ideal weight. If you lose more than 50% of your extra (excess) weight and it doesn’t come back on again this will be classed as a success. In general weight loss is faster after gastric bypass and sleeve gastrectomy surgery with most of the weight lost within the first 6 months and stabilising after 12-18 months. 

As a surgeon I attend conferences dedicated to this question; every surgeon and patient has predetermined preferences. Although the bypasses are associated with the most weight loss they come with higher risks, malabsorption of not just calories but nutrients too and you only really need to lose enough weight to be healthy again and get into good habits – none of the procedures will turn you ‘skinny’. What operation suits you and your eating patterns? Most patients fit into one of the following patterns: sweet eaters, snackers, large portion eaters, and skippers (skipping meals). For example, I generally find that sweet eaters do best with a bypass as dumping is an unpleasant a side-effect if you eat sugary foods after this surgery. Similarly, big portion eaters do best with a restrictive procedure such as a sleeve gastrectomy. My problem patients are those that drink a lot of calories either with alcohol, milky drinks or soft drinks and those that binge eat. I will generally work through your story of your weight and dietary pattern and health to determine together what will suit you best.

No it's really not? In fact, WLS is safer than removing your gallbladder or having a knee replacement. But it is not without risk. During your consultation , these risks will be discussed in detail so that an informed decision can be made. All abdominal operations carry the risks of bleeding, infection in the incision, thrombophlebitis of legs (blood clots), lung problems (pneumonia, pulmonary embolisms), strokes or heart attacks, anaesthetic complications, and blockage or obstruction of the intestine. These risks are greater in morbidly obese patients and in revisional (re-do) surgery. There is always a mortality risk with any surgery but it's easy to forget the risks of obesity itself including higher rates of cancer. Basically, WLS is safe and decreases the chance of dying from obesity! Mr Shenfine has a comprehensive risk form that runs through some risks for you to read if you wish to go down this path.

Yes. You will need to take a multi-vitamin for life and agree to annual blood tests to ensure that this is effective. As long as patients take their appropriate vitamins, it is rare to have health problems from vitamin deficiencies.

Some patients may choose to have plastic surgery, but this depends on many factors.

Surgery for weight loss can be reversed, but reversal procedures are usually more dangerous than the original ones. I would only consider reversing these operations in patients who have significant long term problems from the surgery. It is important to note that anyone who has the operation reversed will regain the weight they lost after the first surgery.

Gastro-oesophageal Reflux Disease (GORD) is a chronic, often progressive disease resulting from a weak Lower Oesophageal Sphincter (LOS). The LOS is a muscle at the junction of the stomach and oesophagus that functions as the body’s natural barrier to reflux.  It acts like a valve, allowing food and liquid to pass through to the stomach, closing immediately after swallowing. In people with GORD, the LOS is weak, allowing acid and bile to reflux from the stomach into the oesophagus.

This can cause symptoms like heartburn, but may also include: regurgitation, sore throat, cough, chest pain

Medications for reflux have become widespread: such as proton pump inhibitors (PPIs), H2 blockers (H2RAs), and antacids. These all control or suppress acid in the stomach. But they do not stop reflux, they just change what you reflux and by reducing the acid content, reduce the discomfort and damage. Anti-reflux surgery treats the cause not the effect. Using a keyhole (laparoscopic) technique, the hiatus is repaired and a new valve (fundoplication) is fashioned.It takes about 1-2 hours. Some cases are done as daycases and others require an overnight stay.

There are.

You will need to modify your diet after surgery for around 6 weeks until any swelling inside has settled and the new valve or barrier can make eating solid or dry food more tricky - such as lumps of steak. 

Complications are a risk with any surgeries but anti-reflux surgery is acknowledged as very safe. The main risks that Mr Shenfine will discuss will be:

• bleeding
• injury to the oesophagus, spleen, stomach or internal organs
• infection of the wound, abdomen, or blood
• 5-10% of patients will need re-operation for recurrent reflux
• Gas bloat after eating and increased flatus is common

But most (>90%) patients are delighted by the surgery with many having no symptoms of reflux at all.

All you have to do is ask. I will also try to update this page for the most FAQs from patients.