Bariatric/Metabolic Surgery in Nigeria: prospects and challenges – A Case Series and Discussion

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Fasanmade, O.A
Okaro, A
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Endocrinology and metabolism society of Nigeria
Introduction Obesity is an “epidemic” with associated life-threatening co-morbidities including diabetes, hypercholesterolemia, hypertension, and cancer. The real proportion of adult Nigerians with obesity is unknown; there is however a large and growing number of Nigerians affected by complicated hypertension and diabetes. Obesity is now considered one of the leading preventable causes of death worldwide Aim To open up a platform for engagement and discussions on the opportunities and challenges facing the development of Bariatric surgery in Nigeria Case Series We report these landmark cases. The first case is of a middle-aged retired nurse, otherwise, fit and well, who weighed 148kg (BMI – 55kg/m2) when 1st seen in the Weight loss clinic. Following careful discussions and preparation, she underwent a laparoscopic sleeve gastrectomy in a Lagos minimally invasive unit. There were 10 cases of Intra-Gastric Balloon-assisted weight loss with an average Weight loss of 24kg over 6 months. One of the patients was thought to be a type 1 diabetes patient. Results The procedures and recovery were uneventful. The sleeve gastrectomy case was discharged home on the 3rd postoperative day on a liquid diet for 2 weeks and a long-term daily vitamin supplement. Her weight in the clinic 1 year after her surgery was 108kg (BMI – 39kg/m2), a loss of nearly 60% of excess body weight. All balloon cases spent on average 1.5 hours in our unit after balloon insertion. The type 1 DM case had full resolution of his diabetes by 2 months into the treatment Conclusion Safe minimally invasive bariatric surgery can be performed in Nigeria. The patient selection and choice of surgical procedure in terms of early and late complications need to be carefully considered and discussed with the patient and relatives. A multi-disciplinary team approach for the delivery of such highly specialised and high-risk services cannot be overemphasised. The future demand for bariatric/metabolic surgery in Nigeria is likely to increase as international organisations like WHO increasingly highlight the long-term health benefits of these types of procedures
Scholarly articles
Bariatric surgery , Obesity , Diabetes mellitus , Hypercholesterolemia , Research Subject Categories::MEDICINE
Okaro A, Fasanmade OA. Bariatric/Metabolic Surgery in Nigeria: prospects and challenges – A Case Series and Discussion. Abstract in book of abstracts EMSON AGM/SC 2012