What is the best surgery for me?

How much weight can I lose?
The continued success of the bariatric procedure depends largely on the quality of aftercare, and on the patient’s own ability to change his or her lifestyle and dietary habits. After a gastric band surgery, a patient will lose on average about 4 stone in the first year. After a gastric bypass, a patient will lose on average between 9.5 and 11 stone in the first year.

What are the risks?
The gastric balloon is a good option if you are unsure about the gastric band surgery. It has been proven that patients who have success with the balloon will have success with the gastric band as well. If, on the other hand, the balloon does not work, then the band may be similarly ineffective, and the gastric bypass procedure is recommended instead. Of course, the choice of procedure is the patient's, but it is important that the patient base his or her decision on an informed understanding of the various procedures. To help the patient make an informed choice, we need the following information, which will be treated with the utmost confidence:

Gastric band or Roux en Y gastric bypass?
The advantage of the gastric band procedure is that it gives the patient an opportunity to adjust the band's size, depending on his or her preferred levels of consumption. The disadvantage of the band is that it may allow sugary food and drink (chocolate, ice cream, sweets, soft drinks, etc.) to pass easily through the stomach. With gastric bypass surgery, on the other hand, the absorption of calories from ingested sugar and fat is lower; it therefore gives better average results for long-term weight loss. International results show that the average weight loss in the first year after gastric band surgery is approximately 25–30% of the patient's excess weight; after bypass surgery, on the other hand, average weight loss in the first year is approximately 40-50% of the excess weight.

How many patients went to Belgium through EOC?
Since October 2005, EOC has helped 400 bariatric patients both before and during their time in Bruges; we have continued to provide aftercare and support to each and every one of these patients.

Can I contact other EOC patients?
Many of our patients will be happy to share their experiences, and if this is desired we can easily arrange an e-mail correspondence. There is also a forum on our website for group discussions.

How soon can I have surgery?
Surgery can be performed in Belgium within 4-6 weeks of the initial telephone consultation. To make an appointment for a consultation, please fill in the online application form. If after the telephone consultation the patient decides to go ahead with the procedure, there will be a further consultation in person, which will take in Bruges, the day before the surgery.

Why choose European Obesity Care?
At European Obesity Care we focus entirely on bariatric surgery; we have therefore acquired, over the years, a great deal of experience with this treatment, and with patient support after the procedure.

Which foods can cause problems to gastric band patients?
With regards to diet, every patient is different. However, there are certain foods which are known to cause serious problems to many patients, for a variety of reasons; these include rice, pasta, white bread, red meat and spicy dishes. Certain fruit can also cause obstructions when not digested properly; these include apples, oranges and mandarins. It is essential when eating these fruits to chew very thoroughly, and patients are advised to choose puréed forms whenever possible.

I have heard different accounts of the gastric bypass Roux en Y procedure; which is correct?
For an exact description of gastric bypass Roux en Y, please see the pictures on this website. The duodenal switch (or biliopancreatic diversion) is often referred to as a ‘gastric bypass’, but this is incorrect. The switch, unlike the bypass, involves the removal of 70% of the stomach. We do not support this procedure, for two reasons—it is irreversible, and there are often many complications after the surgery. The gastric bypass Roux en Y is a much safer procedure.

Is the gastric bypass Roux-Y procedure reversible?
The advantage of the Roux-Y technique is that no vital organs are taken out. Like the gastric band procedure, the bypass is reversible. More details can be provided by our surgeon.

Is it easy to remove the gastric band?
Removing the gastric band is not easy, but it is possible. The gastric band system shown on this website is fixed to the stomach; adherence to the organ tissue makes its removal difficult. Despite this, the surgeon can try to remove the band by laparoscopy, with varying results.

When and why is a protein diet required?
A high-protein, low-fat diet is required for all patients with a BMI over 40. Details can be found on this website here. The protein diet must be followed from three weeks before surgery until the patient’s arrival in Bruges.

This diet helps to reduce the volume of the liver, which makes the laparoscopic procedure easier. Thus, a strict adherence to this diet is beneficial to both patient and surgeon.

What happens in the event of a post-operative complication?
It is essential in any such situation that the patient contact us first. The next step must be a group decision, involving the patient, the surgeon and our UK team. The complication may require additional surgery, at the patient’s expense, but fortunately this outcome is rare.

Will I need extra insurance?
We advise all patients to bring the European standard international insurance, called the E-111. There are no extra costs for this card.

http://en.wikipedia.org/wiki/European_Health_Insurance_Card

If I booked the surgery directly from the hospital, would I save money?
The hospitals listed on our website do not accept direct bookings, for insurance reasons. However, it is also important to realise that EOC provides more than the actual surgery in its fees—this includes travel support, hotel costs with private nursing, and aftercare.

What is the minimum BMI for surgery?
The international weight-criterion for bariatric surgery is a BMI of 40 or over, although if the patient is suffering from problems such as hypertension or diabetes, a BMI of 35 will be accepted.

However important medical studies in 2005 and 2006 has shown that the best results with the gastric band will achieve with BMI 30 and 40.

Always contact us if you have doubts about your BMI

What is the minimum BMI for the gastric balloon procedure
For the gastric balloon there are no international weight-criteria, but in general we will perform this procedure on patients with a BMI of 30 or over. It is more important, however, to maintain stable dietary and lifestyle habits before having the procedure; we advise prospective patients to consult a dietician first.

Is the gastric bypass always an open surgery?
No. The laparoscopic gastric bypass (Roux-en-Y) is a very difficult procedure, which requires a great deal of training; for this reasons many surgeons do not perform it. However, Dr. Dillemans is one of the leading experts in this field, and he has performed many laparoscopic bypass procedures. He prefers this procedure to open surgery when possible. It is important to note that the laparoscopic procedure has stricter BMI requirements than the open surgery; we will be happy to give prospective patients the relevant information on this matter.

How many days do I need to stay in Bruges for the gastric band?
We recommend a 5-night stay for the gastric band procedure: this includes two nights in the hotel before surgery, one night in hospital, and two nights in the hotel after surgery. On one of the days after surgery, our private nurse will visit the patient at the hotel. A shorter stay than five nights is impossible.

How many days do I need to stay in Bruges for the gastric bypass?
We recommend an 8-night stay for the bypass procedure: this includes two nights in the hotel before surgery, three nights in hospital, and three nights in the hotel after surgery. On one of the days after surgery, our private nurse will visit the patient at the hotel. A shorter stay than eight nights is not possible.