After suspending visiting earlier in the year, we are now able to offer limited visiting to some wards at the discretion of the nurse in-charge.”
Read more on visiting times...
We recognise the impact that a long stay in hospital can have on families and the importance of maintaining strong communication. Our ward staff are keeping in touch with patients’ next of kin directly and our Patient Advice and Liaison Service (PALS) can help pass on personal messages from family and friends.
After suspending visiting earlier in the year, we are now able to offer limited visiting to some wards at the discretion of the nurse in-charge.”
Read more on visiting times...
We recognise the impact that a long stay in hospital can have on families and the importance of maintaining strong communication. Our ward staff are keeping in touch with patients’ next of kin directly and our Patient Advice and Liaison Service (PALS) can help pass on personal messages from family and friends.
The Queen Alexandra Hospital is located just on the hill slopes of Portsdown Hill overlooking Portsmouth. It is conveniently situated for both the M27 and A3M.
Family members and carers play an important role in supporting patients during an episode of ill health. We are committed to the active involvement of family members, friends and carers during a hospital stay. Family members and carers play an important role in supporting patients during an episode of ill health.
More information on visiting hospital for an appointment.
If you've had experience of using our services and would like to make a comment then please contact the Patient Advice and Liaison Service (PALS). Your views are very important to us and we would like to hear where you think improvements are needed or where things have gone so well that you would like to share your thanks or gratitude with the staff involved. When things have not gone so well then you can be sure that we want to hear from you, so please get in touch with PALS.
During your stay in hospital you will meet a number of different members of staff. All members of staff wear name badges, but if you are not sure who someone is or what they do, please feel free to ask them to introduce themselves and explain what they do.
If you have any questions about your treatment, please ask a doctor or a nurse.
There are lots of opportunities for you to get involved with the Trust, from volunteering to attending our public meetings, our Annual General Meeting or our hospital open day which is held every year.
We welcome and value your feedback and use the views you share with us in a number of ways to learn and make improvements as well as sharing best practice. Feedback can be provided in a number of ways.
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About us
Bariatric & Metabolic Surgery is an effective treatment option for people living with obesity and weight-related illnesses, such as Type 2 Diabetes, high blood pressure, high cholesterol and sleep apnoea. Our department comprises of a highly specialised multidisciplinary team of surgeons, anaesthetists, physicians, nurses, dietitians, and psychologists who will support people through all aspects of their weight-loss journey. We pride ourselves on being a specialist tertiary referral centre for complex obesity and are able to offer primary weight-loss surgery, which is performed via a minimal access approach, either laparoscopically or robotically, as well as revisional surgery.
Services we offer:
We offer a range of treatments/surgeries within our department and these will be discussed with you in detail during your ‘one-stop’ clinic review. All of our surgery is performed laparoscopically (keyhole) or robotically through up to six small incisions under general anaesthetic and will generally require 1 – 2 nights in hospital. The most common operations that we offer are:
A sleeve gastrectomy is a surgical procedure which permanently reduces the size of your stomach to help you lose weight and maintain weight loss. The sleeve restricts the amount of food / drink that your smaller stomach will be able to hold after surgery to less than 200ml (less than ½ pint). Removal of this part of the stomach also helps to reduce hunger as it removes cells that produce a hunger-stimulating. Food absorption is not affected by this operation although absorption of iron and certain vitamins, particularly vitamin B12 can be affected, and you will need supplementation of these long-term including 3 monthly B12 injections.
A Roux-en-Y Gastric Bypass is a surgical procedure where the surgeon will permanently reduce the size of your stomach by stapling across and dividing the top of your stomach to make a small pouch (the size of a large egg). This restricts the amount of food and drink which your stomach “pouch” will be able to hold after surgery (the rest of your stomach continues to help digestion even though it doesn’t fill with food anymore). The second part of the operation involves two joins, the first attaching the small bowel onto the pouch. The second join allows the digestive enzymes to join your food further down which reduces how many calories (but also protein and vitamins) you can absorb. This combination of restriction and reduced absorption makes this one of the most effective weight loss operations available.
A OAGB is a surgical procedure where the surgeon will permanently reduce the size of your stomach by stapling across and dividing the top of your stomach to make a long narrow pouch. This restricts the amount of food and drink which your stomach “pouch” will be able to hold after surgery (the rest of your stomach continues to help digestion even though it doesn’t fill with food anymore). The second part of the operation involves attaching the small bowel onto the bottom of the pouch bypassing the first 1.5m or so of the small bowel. This combination of restriction and reduced absorption makes this one of the most effective weight loss operations available.
An adjustable, inflatable silicone band is placed around the top of the stomach, creating a small pouch above it (approx. 20-30mls). This pouch becomes your new stomach. The creation of this pouch results in a restriction in the amount of food that can be consumed at one time. Weight loss is achieved in part by limiting food intake, reducing appetite, and slowing the digestion. It also stimulates the feeling of “fullness” (satiety) and helps to retrain your brain to know when you are full. The port through which the adjustments are made is usually placed on the left-hand side of your abdomen under the skin. Your first band adjustment is about 6 weeks after the surgery. You will have an adjustment every 4 weeks after that until you have the required restriction to give you a healthy weight loss.
In terms of total body weight lost (TBWL) there are no good quality randomised trials to show one operation to be superior over another and they all can achieve acceptable levels of weight loss. The only high-quality randomized study is the The By-Band-sleeve trial, but long-term results are yet to be published. In terms of non-randomised data, the gastric band, sleeve gastrectomy and gastric bypass (RYGB or OAGB) aim to achieve 20%, 25% and 30% respectively. These weight loss figures are only an estimation and not a guarantee.
Following surgery, you will require lifelong daily vitamin and mineral supplementation as well as vitamin B12 injections every 3 months for life. You will need to commit to be seen regularly in our bariatric and dietetic follow-up clinics for 2 years after your operation in order to have the appropriate post-operative support, monitoring and blood tests. Without these appointments, your outcomes and health may be seriously affected. Weight-loss surgery is merely a tool to be used alongside dietary and lifestyle changes. We therefore expect patients to continue working with the bariatric programme and this will be evident with ongoing gradual weight loss. We do not operate on patients whose weight escalates whilst waiting for their surgery, as this can indicate that patients are not in control of these lifestyle elements and operating in these circumstances means that patients are likely to have poorer outcomes in the long run.
More detailed information about bariatric surgery at Queen Alexandra Hospital can be found here: [LINK TO NEW APPROVED INFO SHEETS]
Other Services
It is recognised that up to 10% of patients will require further surgery at some stage in their lifetime, either due to technical or medical issues arising from the original operation or due to the failure of the primary operation to provide adequate, stable and durable weight loss and/or adequate resolution of weight related health problems. Revisional surgery is therefore an attempt to maintain or secure further improvements in weight loss, weight-related comorbidities, or quality of life. Revisional surgery is subject to strict commissioning guidance, which can be reviewed in detail here: Microsoft Word - Appendix 8 Revision Surgery CCG Guidance (england.nhs.uk).
As you lose weight after surgery, you can be left with excess folds of skin, particularly around your breasts, tummy, hips and limbs. Surgery, such as a tummy tuck (or abdominoplasty/apronectomy), can be used to remove the excess skin but this is usually considered cosmetic surgery. As such, IT IS NOT ROUTINELY AVAILABLE ON THE NHS. If such excess skin poses a significant health concern, then individual funding requests can be made and, in these exceptional circumstances, such surgery can be offered within our trust.
British Obesity and Metabolic Surgery Society (BOMSS) Statement on going abroad for Weight-Loss Surgery:
We understand that accessing bariatric (weight loss) surgery on the NHS can be a frustrating experience and BOMSS is working hard to improve this situation. One consequence of the current lack of NHS provision of this treatment is that people decide to self-fund their care, either in the UK or abroad. BOMSS strongly advises UK residents to be cautious when considering bariatric surgery abroad.
Care in the UK is tightly regulated with all providers regularly monitored and inspected by the Care Quality Commission (CQC). Surgical outcomes are reported on a national bariatric database, UK bariatric surgeons, have completed recognised training and certification, and have full professional insurance so that patients can receive financial compensation in the very unlikely event of serious complications arising from clinical negligence. These processes are designed to ensure high standards of care and to protect patients undergoing surgery.
Full statement: BOMSS-Statement-on-BariatricTourism-1-1.pdf
Recommended Links:
NHS Weight Loss Surgery
Weight loss surgery - Types - NHS (www.nhs.uk)
British Obesity and Metabolic Surgery Society
BOMSS – British Obesity & Metabolic Surgery Society
Obesity Empowerment Network
Obesity Empowerment Network – ‘Nothing about us without us’ (oen.org.uk)
Meet our team
Surgeons:
Bariatric Specialist Nurses:
Consultant in Obesity and Bariatric Medicine:
Anaesthetists:
Specialist Dietitians:
Psychologist:
Bariatric Department Secretary:
Your GP can refer you for specialist multidisciplinary management of obesity if you meet the following criteria (Recommendations | Obesity: identification, assessment and management | Guidance | NICE):
You will first be referred to a specialist weight management service, known as Tier 3, where you will receive support from a specialist team to help you lose weight and lead a healthier lifestyle. This programme will last for approximately six months and will include nutrition and dietary support, specialist psychological therapy, physical activity sessions and support from medical professionals, including introduction of new medical therapies if required. Depending on your geographical area you may be referred to one of the following services:
Once you have completed this programme you can then be referred onwards to our department (also referred to as Tier 4) for consideration of bariatric surgery. Your first visit to us will be via our multidisciplinary ‘one-stop’ clinic where you will be reviewed by a consultant surgeon, an anaesthetist, a bariatric specialist nurse and dietitian. You may also receive input from a psychologist, a consultant endocrinologist, or any number of specialists within Queen Alexandra Hospital in order to evaluate you and get you ready for any proposed surgical treatments.
Department of Upper Gastrointestinal and Bariatric Surgery on E Level, QA Hospital
Ward E2, QA Hospital
Bariatric Secretaries: 02392 283375
Bariatric Specialist Nurses: 02392 285797
