Bariatric surgery (surgery to reduce weight) can have life-changing and even life-saving results.
The decision to perform a bariatric operation should be given careful consideration. Our task is to offer you sensible preliminary advice, understandable information and support both before and after the operation, as well as long-term treatment. For our performance of these tasks we have been accredited as a Centre of Excellence EAC.
We have a close interdisciplinary working relationship with Dr. med. J. Zehetner, Professor (USC) / PD Dr. med. R. Steffen and the abdominal surgery team at Klinik Beau-Site, with whom we operate a joint treatment strategy.
Zentrum für bariatrische Chirurgie
med. prakt. Michèle Gasser
med. prakt. Claudia Meier-Estermann
Dr. med. Yvette Ottiger
Dr. med. Stefan Schäfer
PD Dr. med. Ulf Kessler
Tel.: +41 31 310 15 99
Fax: +41 31 310 15 98
Anyone who is tired of the struggle with the pounds and endless dieting, while nevertheless watching on as their body weight relentlessly rises, is likely eventually to contemplate bariatric surgery as the only solution.
As so often, before a serious decision can be made well-founded advice and explanation is needed. Under Swiss guidelines at least three months must elapse between first contact and an eventual operation. Lay people will not know whether they satisfy the conditions for their health insurance to agree to meet the costs of the treatment, nor will they be aware of the consequences and risks inherent in the procedure or what life will be like thereafter.
Thus advice and explanation are the first steps, involving consultation between the doctor and patient until both sides properly understand all aspects of the situation. Until that has been done nobody should agonise over the question ‘should I or shouldn’t I?’. After going through this process it will be easier to arrive at an informed decision. It should be born in mind here that as weight increases the risks of an operation also grow, making it harder to achieve optimum end results.
All this is what we are there for! A team with 20 years of experience and all the necessary understanding and respect for you.
Ideally you will have been referred by your general practitioner (GP). However, if you have a BMI of 34 or above you can register yourself. (Health insurance schemes will not meet the costs of an operation unless the patient has a BMI of at least 35). Please note that, before insurers will agree to meet the costs, attempted dietary cures lasting a total of 24 months (not all in one period) must have taken place.
Anyone preferring to have their initial contact with the surgeon should register directly with Dr. med. J. Zehetner, Professor (USC) / PD Dr. med. R. Steffen – the requirements to be met are the same.
After registering you will be given a questionnaire in order to obtain your details and diets you have been on.
Initial consultation by team doctor
Explanations and information from the GP or consultant before surgical intervention
ECG (if necessary including cardiac stress test ECG)
Gastroscopy (poss. colonoscopy)
(poss. lung function test and sleep apnoea testing)
Discussion of the results of the initial consultation
Obtaining agreement to meet the costs from your health insurance scheme
Reference to the surgeon Dr. med. J. Zehetner, Professor (USC) / PD Dr. med. R. Steffen
Follow-up check one month after the operation
Appointment with doctor for checkup
In the first year, during the rapid weight loss phase, more frequent checks will be necessary. We schedule four such checkups, followed by two during the second year and one a year thereafter. Naturally, though, if necessary you can also make appointments with us at times other than the routine checkup dates.
Herr Dr. med. J. Zehetner, Professor (USC) / Herr PD Dr. med. R. Steffen/hospital stay
Dr. med. J. Zehetner, Professor (USC) / PD Dr. med. R. Steffen, Schänzlihalde 1, 3013 Bern, Ärztehaus Beau-Site
In compliance with Annex 1 of the Swiss Health Care Services Regulations (Krankenpflege-Leistungsverordnung - KLV) we are required to conduct structured annual follow-up checks, and these will be arranged with you.
The annual checkups involve an examination by a doctor plus a subsequent blood test. You will be notified in writing of the blood test results. In addition to the medical examination and blood test the following tests will be conducted:
x-ray of the oesophagus; gastroscopy at the 2nd, 5th, 10th, 15th, etc., annual checkups, colonoscopy at the 10th, 20th, etc., annual checkups.
These tests are generally made two or three weeks before the annual checkup dates.
Bariatric surgery changes the lives of severely obese people. They lose weight, become more healthy and live longer. However, they have not been cured. The predisposition towards obesity does not go away, and nor does our affluent consumer society. Furthermore, the effects of the surgery may diminish, meal volumes may get larger or the tendency to snacking may return, leading to renewed weight gain. Thus the struggle against excess fat will not be over, but our follow-up care will assist you in that struggle and ensure you do not face it alone.
A healthy digestive system is programmed by nature to absorb all the nutrition supplied to it, a task which it performs superbly. However, it cannot detect that too much has been consumed, and so any excess is stored as fatty tissue to draw on if lean times arrive. However, as lean times normally never do arrive these days, the process of storing of fat under the skin, in the belly and in the organs continues unabated. It is this process which is changed by a bariatric operation.
Alongside the desired effects such as weight loss or the immediate improvement of diabetes if present, the surgical changes to the digestive system also have undesired consequences. For instance, insufficient quantities of certain vitamins are absorbed, principal among them vitamin B12, and the same applies to certain minerals such as calcium and also some trace elements such as copper. It can take a long time for these deficiencies to be noticed, and by that time permanent harm may already have been caused, for instance damage to nerve cells or loss of bone density. For this reason specialist medical monitoring is indispensible. We are aware of any potential deficiencies and check for them before they can cause irreparable damage.
After an operation it is possible that patients may be unable to consume sufficient food, leading to malnutrition. Thus medical, endoscopic (conducted by gastroenterologists) or surgical intervention may be necessary.
In the great majority of cases patients’ psychological well-being improves after they lose weight, but the opposite can sometimes occur. It is important not to ignore this issue, and it will be addressed by our psychologist.
During life after surgery your treatment will not stop, which is why we will always be there for you, together with Klinik Beau-Site’s round-the-clock emergency unit.
Our close working relationship with the surgeon Dr. med. J. Zehetner, Professor (USC) / PD Dr. med. R. Steffen and with the gastroenterologists and radiologists assists us in answering your questions as and when they arise.