BARIATRIC & METABOLIC SURGERY, DIABETIC SURGERY
Welcome to Surgicare Integrated Centre for Bariatric
and Metabolic Surgery
At Surgicare, as a centre, we practice the Integrated Approach that emphasizes on patient-centred, customised and effective medical therapies for weight loss and metabolic conditions, such as hypertension and diabetes.
Led by Dr Tan, our enthusiastic multi-disciplinary team includes experienced and compassionate behavioural health practitioners - Nurses, Dietitians and Physiotherapists offer a spectrum of interventional treatment regimens to ensure successful outcomes!
We have a team of in-house Dietitians to provide nutritional counselling and assessments, followed by customised diet and fitness plans for patients with weight-related problems or medical conditions.
Our in-house Physiotherapists provide customised weight management support programme to patients, enabling them to become more active in a safe and enjoyable way.
What is Metabolic Surgery? Or Diabetes Surgery?
While Bariatric Surgery means surgery on the stomach and/or intestine to help a person with obesity to lose weight, Metabolic Surgery is termed as the same set of procedures that is primarily done to help improve the co-morbidities associated with obesity, such as Type 2 Diabetes Mellitus, heart disease, hypertension, Obstructive Sleep Apnoea (OSA), and fatty liver.
Diabetes Surgery is coined in recent years when there is marked improvement in diabetes control when the same set of procedures is performed in Type 2 Diabetes Mellitus patients. Surgery, however, does not “cure” diabetes; they help patients achieve better control or sometimes even achieve remission. Therefore, patients will still need to be monitored closely by their physicians.
Biliopancreatic Diversion with a Duodenal Switch
Mini Gastric Bypass /
One Anastamosis Gastric Bypass (OAGB)
How effective is Bariatric and Metabolic Surgery?
Buchwald, H., et al. (2004). Bariatric surgery: a systematic review and meta-analysis. Journal of the American Medical Association. 292(12) pp. 1724-1737
Studies have shown that patients typically lose the most weight after 1-2 years after bariatric surgery. They are then able to maintain substantial weight loss with improvements in associated co-morbidities.
Buchwald, H., et al. (2009). Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. American Journal of Medicine. 122(3) pp. 205- 206
Chang SH et al. The Effectiveness and Risks of Bariatric Surgery: An Updated Systematic Review and Meta-analysis, 2003-2012 JAMA (3)2014
Patients may lose up to 60% of excess weight six months after surgery, and up to 77% of excess body weight as early as 12 months after surgery
Wittgrove, A. C., et al. (2000). Laparoscopic gastric bypass, roux-en-y: 500 patients: technique and results, with 3-60 month follow-up. Obesity Surgery. 10(3) pp. 233- 239
Majority of bariatric surgery patients with diabetes, hyperlipidemia, hypertension and obstructive sleep apnoea experience complete resolution or improvement.
How long will the procedure take?Generally, a colonoscopy takes less than 30 minutes. If there are polyps to be removed or abnormalities detected, it may take longer. Any polyps seen will be removed immediately and sent to the laboratories
What is a polyp?Colorectal polyps are abnormal growth of cells on the inner lining of the colon and rectum. They are common and incidence increases with age. Most polyps are benign (not cancer). But because polyps are caused by abnormal cell growth and, like cancer, grow through rapidly dividing cells, they can become cancerous. Through a colonoscopy, the polyp can be removed and sent for examination by a pathologist. Colonoscopy and removal of polyps decreases the incidence of colorectal cancer. Countries with colorectal cancer screening programs have reported a significant drop in colorectal cancer cases and deaths. This is due to early detection of colorectal polyps with colonoscopy, the removal of which prevents the development of cancer.
What is the treatment for colonic polyps?The treatment of colonic polyps involves performing a colonoscopy and removing the entire polyp. The removed polyp is then sent for histological examination to determine if it is benign (not cancer) or a malignant change (cancerous) has already occurred. Depending on the number and size of polyps removed, a follow up colonoscopy will be recommended from 1 to 5 years later. If there are any cancer cells found in the polyp, surgery may be required.
Can I do my gastroscopy and colonoscopy at the same time?Yes, we can schedule for gastroscopy and colonoscopy at the same visit.
How long is my recovery time?A colonoscopy is usually performed as an outpatient procedure, which means you will not have to spend the night in the hospital. With sedation, you will be placed under close monitoring at the endoscopy centre. You will be discharged when it’s safe to do so.
What are the alternatives to colonoscopy?Colonoscopy remains the gold standard of detecting and removal of colonic polyps. Other options can be considered for patients who are not fit for colonoscopy, or would like a non-invasive option. CT Colonography – this is a virtual colonoscopy performed by a CT scanner. It is being used to screen for polyps in the large intestine. After adequate bowel preparation, a tube is inserted into the rectum to inflate with gas while CT images of the colon and rectum are taken from various angles. Barium Enema – this entity is seldom used nowadays with the advent of CT colonoscopy. It involves using a white solution being inserted into the anus via a tube to coat the lining of the colon. This allows the colonic lining to be visible on X-ray, highlighting any difficulties of the white solution going through indicating an abnormality at the region. While these options are able to detect polyps in the colon, they are not as accurate as colonoscopy. In the event these polyps are found, colonoscopy will still have to be performed to remove them. Colonoscopy is still the recommended method for screening for colorectal cancer. Dr Tan will advice you according to your needs and preferences.
What are the risks of this procedure?Reaction to the sedation Perforation of the colon is rare, occurring in less than 0.1% of colonoscopy. Bleeding after polypectomies. Please inform Dr Tan if you are on blood thinners or anti-platelets medications. These are usually started if you had a stroke, heart attack or stent placed in your body. These medications are usually started by your GP, cardiologist or neurologist. Bleeding can occur immediately after the scope, or up to 10 days after the procedure. Abdominal Bloating – this usually settles within a day or two after the endoscopy. Sore throat