Tuesday 19 June 2018

HSE plans surgery for obese children

  • New hospital to have weight-loss procedures
  • Some 30 operations to take place each year
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Fiona Dillon

Fiona Dillon

Preparations have begun to allow weight-loss surgery for obese children and teenagers to take place at the new National Children's Hospital, the country's top obesity expert has revealed.

The HSE's clinical lead for obesity, Professor Donal O'Shea, said that gastric band surgery was desperately needed in Ireland to cope with the obesity epidemic in young people.

A number of teenagers are currently sent to the UK for paediatric bariatric surgery - which can either be a reduction in the size of the stomach or the fitting of a gastric band to reduce appetite.

Endocrinologist Prof O'Shea told the Irish Independent that he had already had one meeting with the new hospital about preparing for obesity surgery here, and a follow-up one will be scheduled.

"It is a requirement that we are not meeting at the moment," he said. "Part of my job as HSE lead for obesity is to make sure that we have access to appropriate treatment, and that includes for children."

Prof O'Shea said that a number of healthcare professionals have had problems treating overweight children.

Prof Donal O'Shea
Prof Donal O'Shea

"I know from talking to paediatric anaesthetists and paediatric surgeons that they have already had to upgrade their equipment and their operating theatres and their trolleys to cope with the weight of the kids who are having routine operations like tonsils and appendixes [out]," said Prof O'Shea.

Prof O'Shea said that he expected 20 to 30 procedures a year to be done at the hospital.

"There is a percentage [of children] that are in the height of trouble with their weight.

"At the moment, there isn't really effective medication so it's down to, in the extreme situations, you need to do the gastric by-pass surgery."

He said that the new children's hospital had indicated it would be hoping to appoint a surgeon with an interest in bariatric procedures.

"What the new children's hospital has indicated to me is that they realise it needs to happen and they realise therefore they need to hire the expertise, and you need to recruit a bariatric surgeon and the models of care for childhood disease in Ireland.

"That kind of service could only be in the National Children's Hospital.

"I really would like to think that, over the next 20 years, you would see the need for childhood obesity surgery decrease," he said.

Prof O'Shea pointed out that at this time of year, food retailers' special offers tend to be "very focused around high fat, high salt, and high sugar" items, and relatively little around the fruit and vegetables - particularly when it comes to discounts.

"The majority of the promotions are around the top shelf of the food pyramid, and that is something that the marketers, the chains, really need to look at," he said.

As clinical lead for obesity, Prof O'Shea has been seconded from his clinical post two days a week to work with the HSE's Healthy Eating Active Living policy programme.

A key focus of his role is the development and integration of evidence-based models of care that strengthen prevention, early intervention, treatment for overweight and obese across primary care and acute services for both children and adults.

The weight management clinic at St Columcille's Hospital in Loughlinstown, Dublin, sees people from the age of 16 upwards.

Prof O'Shea said that in terms of addressing adult obesity, a dedicated bariatric surgeon was appointed to St Vincent's University Hospital in 2017, who started in September.

"We have done 30 operations on our obese patients since September, so we are delighted about that. We could be looking at getting to 100 next year," he said.

Irish Independent

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