Bariatric surgery in a public hospital: a 10-year experience

Introduction: Obesity is common and adversely impacts quality-of-life and healthcare cost. In Australia, less than 10% of bariatric surgeries are performed in the public sector. This study reports our 10-year experience from a high volume public bariatric service which delivers multi-disciplinary care for primary and revisional procedures with mid- to long-term follow-up. Methods: A prospectively maintained database of all patients who underwent bariatric surgery from January 2010 to January 2020 at a tertiary metropolitan hospital was analysed. We analysed patient demographics, comorbidities, perioperative outcomes, 2- and 5-year weight loss as well as comorbidities reduction. Results: A total of 995 patients underwent 1086 (674 primary and 412 revisional) bariatric procedures with mean age of 46.9 years, mean BMI of 49.6 ± 9.1 kg/m² and 92% patients with ≥1 obesity-related co-morbidity. Length-of-stay was longer for revisional than primary surgery (5.6 vs. 3.5 days). Major complication rate was 4.2%. Overall, % Total body weight loss (%TBWL) for primary surgeries at 2 years was 26.2%, and for revision surgery was 17.4%. At 2 years follow-up, treatment was ceased or reduced in 65% of diabetics, 29% of hypertensive patients and 69% of sleep apnoea patients. Conclusion: This study confirms that bariatric surgery in Australia can be delivered effectively in resource constrained public health system with outcomes similar to private sector.