Twenty-year review of the bariatric programme at Te Whatu Ora Waitematā.

Abstract

Obesity is a significant health issue. Te Whatu Ora Waitematā serves a population of 650,000 patients across the North Shore, Waitākere and Rodney areas. The Waitematā bariatric service at North Shore Hospital was introduced in October 2001. The aim of this study was to review the development and impact of the service over the last 20 years, and identify whether equivalent bariatric services could viably be introduced into other hospitals in Aotearoa New Zealand. A retrospective audit was conducted of the 20-year results of the Waitematā bariatric surgical service to identify the impact of technology, teaching and research on service provision. Since its inception, the Waitematā bariatric service has launched minimally invasive surgery, multiple operative options and an enhanced recovery after surgery (ERAS) protocol. Approximately 100 cases are performed per year. Of these, 3.4% of patients require admission to the intensive care unit/high dependency unit (ICU/HDU), with an average length of stay (LOS) of 0.66 days. The 1-year mortality rate is 0.39%. Eleven surgical fellows have undergone post-fellowship training with the service, which is a recognised training unit for the post-fellowship AANZGOSA/ANZMOSS programme. Bariatric surgery can be performed safely and has good long-term outcomes. The Waitematā bariatric service is dedicated to providing excellent care within the resource constraints of a public healthcare system. The high number of procedures, low requirement for ICU/HDU and low mortality rate suggest that bariatric surgery could be safely performed within a public setting in secondary and regional hospitals across the country.