Guidelines published to help patients avoid complications in weight-loss surgeries overseas

The guidelines for patients include discussing their decision to travel with their GP beforehand, understanding the risks of surgery, and ensuring the doctor is appropriately qualified to perform the surgery prior to making the decision.

The Royal College of Surgeons in Ireland (RCSI) has published a list of guidelines for patients considering travelling abroad for bariatric surgery, in a bid to help them manage the greater risk involved in having an operation in another country.

To date, eight people are officially known to have died while undergoing procedures abroad and, of those, several were during or soon after bariatric surgery.

The guidelines for patients include discussing their decision to travel with their GP beforehand, understanding the risks of surgery, and ensuring the doctor is appropriately qualified to perform the surgery prior to making the decision.

Surgeons in Ireland have seen an increase in the number of patients returning from overseas with complications arising in the aftermath of weight-loss surgery.

RCSI Vice president and consultant surgeon in Beaumont Hospital, Professor Deborah McNamara, said that an operation is a “major life event that requires careful planning”, and that complications may arise even after everything runs smoothly.

“Managing their needs in a country where they may not speak the language and may be in a hotel room alone can be challenging,” she explained. Hot weather and transport delays within airports can also create additional challenges to those travelling abroad for surgery.

Air travel greatly increases the risk of developing blood clots such as deep vein thrombosis (DVT) in the leg and/or pulmonary embolus (PE) in the lungs, both conditions which are already more common after an operation.

Prof. McNamara said that many people travel abroad because their operation of choice is not provided by the HSE in Ireland. In the case of bariatric surgery, she said it is vital that candidates undergo a thorough assessment screening to determine suitability, and discuss all the alternative options before proceeding with an operation.

"Surgery is — and should be — the last option to be considered, Sometimes patients seek to bypass that process in the hope of finding a "quick fix" with surgery," Prof. McNamara said.

In these cases, chances are the patient will not obtain their desired result from surgery alone.

Prof. McNamara said she has seen patients who return from overseas, without full understanding of the operation they have undergone and little knowledge "of the lifelong impacts of their particular operation on their health and wellbeing".

Additional guidelines include:

• You should ensure that you are fit to travel/fly before and in particular, after surgery.
• You may need to bring someone with you to assist you once you leave hospital.
• You should ensure there is a robust follow-up plan in place and that a detailed written record of the procedure and your aftercare will be provided to you by your treating doctor abroad.
• It is important to understand your rights and protections in the country where the operation is taking place 
• You should have plans for who will care for you after discharge from hospital as well as where you will stay until you are well enough and it is safe to travel home.