Training Day Report 2015

BOMSS 4th Annual Bariatric Training Day 2015

Wednesday, 21 January 2015, Marriott Hotel Gosforth Newcastle

The fourth BOMSS training day was organised by the BOMSS Education and Training Committee, led by Mr Sean Woodcock. He introduced the training day, which was held at the Newcastle Gosforth Marriott Hotel and had a record attendance of 98 delegates, including trainee surgeons and allied health professionals (AHPs). The excellent conference facilities included one main lecture theatre and several breakout rooms plus a wetlab simulation room, allowing groups to rotate between practical skills sessions and small group sessions.

Mr Woodcock’s welcome included an overview of the day and the educational objectives. In the main lecture suite surgeons and AHPs participated jointly in the first three sessions, providing updates on some very important aspects of multi-disciplinary care.

Dr Manisha Sharma, consultant chemical pathologist from Homerton University Hospital comprehensively covered complications of mineral and vitamin deficiencies. This was followed by Ms Mary O’ Kane, Consultant Dietitian at Leeds Teaching Hospital, who recently wrote the BOMSS nutritional guidelines and who gave an update on vitamin and mineral supplements and monitoring for the post-surgical patient. To complete the first session Mr Conor Magee, Consultant Upper GI and Bariatric Surgeon and Honorary Senior Lecturer, Phoenix Health & Aintree University Hospital ran through the complications of bariatric surgery, identifying the key issues for the main bariatric operations.

After coffee, the group was divided into three break-out sessions. There was a combined generic surgical & basic AHP session, where in smaller groups Mr Keith Seymour Upper GI & Bariatric Surgeon, North Tyneside, Ms Cynthia Borg, Consultant Bariatric & Upper GI surgeon, University Hospital Lewisham and Mr Peter Small, Consultant Surgeon, Sunderland Royal Hospital educated everyone on the basics and finer details of gastric band filling using a model simulator. Also Dr Georgina Ingall, Chartered Health Psychologist, Portsmouth Hospital NHS Trust and Yitka Graham, Researcher, City Hospitals Sunderland, provided everyone with important insight into how to talk to bariatric patients, with a view to bringing out the best of a bariatric consultation, and those all-important things not to say.

The second session for trainee surgeons was a surgical skills wetlab using laparoscopic stacks and simulators from Olympus with a fresh animal tissue UGI simulation model. Hands-on training was lead by from Marco Adamo (UCL), Khrishna Moorthy (Imperial) and Sanjay Agarwal (Homerton), Jon Barry (Wales), while Mr Hopkins kept time and order. Trainees rotated around the stations to get experience of different energy sources, stapling devices (including reinforcement) and instruments from all our industry partners including Ethicon, Covidien, GORE and Olympus:

Station one involved dissection and enterotomy using the Thunderbeat as the energy source and suturing using Olympus instruments

Station two was dissection using the harmonic and stapling using the Echelon system.

Station three involved dissection using Ligasure, and stapling using the Tristapler system.

Station four 4 allowed exposure to reinforcement, using Gore Seam guard, of the previously tried stapling systems.

The simultaneous advanced AHP session was an in-depth discussion on the spectrum of disturbed and disordered eating post surgery with a diverse faculty of:

Ms Beth Greenslade, Bariatric Dietitian, Musgrove Park Hospital;
Dr Vanessa Snowdon-Carr, Lead Clinical Psychologist, Taunton and Somerset NHS Foundation Trust;
Matilda Moffett, Clinical Psychologist Newcastle;
Gail Pinnock, Specialist Bariatric Surgery Dietitian from Homerton University Hospital London.

The AHPs focused on understanding the consequences of bariatric surgery from advanced dietetics and nutritional monitoring to psychology and discussions included weight regain with the challenge of repeated diet cycles and eating habits or disorders. Participants discussed their experiences of many issues using peer-group learning strategies to cover advanced psychology including disturbed eating behaviours, mental health issues and substance replacement (replacing food as a coping mechanism.

After lunch everyone came together for an extensive review of the management of hypoglycaemia by Dr Rachel Batterham, UCLH Centre for Obesity Research, focusing on the management of refractory post-op hypoglycaemia. The second half of this session was a new addition to the training day with the Top 4 research papers of the previous year, selected by Ms Cynthia Borg and Mr James Hopkins, reviewed and presented by four of the current Ethicon BOMSS Bariatric fellows:

Richard Thompson reviewed: Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

John Bennett reviewed: Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation.

Jennifer Darien reviewed Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass.

Hazem Al-Momani reviewed: Thromboembolic events in bariatric surgery: a large multi-institutional referral center experience

Finally for the afternoon, one of the most popular sessions of the training day, the interactive mock MDT under the guidance of:

Mr Keith Seymour, Upper GI & Bariatric Surgeon, North Tyneside
Mr Omar Khan, Upper GI & Bariatric Surgeon, Whittington Hospital
Ms Beth Greenslade, Musgrove Park Hospital Bariatric Dietitian
Dr Vanessa Snowdon-Carr, Lead Clinical Psychologist Musgrove Park Hospital

All participants together again, enjoyed a lively and interactive MDT discussions with out specialists from across the UK, and discussed surgical, dietitian and psychological issues including the challenges involved with ensuring quality outcomes and managing complications. The MDT session remains one of the most popular parts of the day as we gain insights into the different thoughts everyone can bring to the same cases.

The coach then delivered us safely to the Training Day Dinner at The Fat Buddha Restaurant, Newcastle-upon-Tyne. A highly enjoyable Training Day Quiz delivered by Jen Darrien and James Hopkins provided some comedic relief to the aspects of bariatric surgery and an insight into local Newcastle culture.

I concluded by thanking Mr Sean Woodcock and all the BOMSS faculty involved for running such an enjoyable day. The benefits of a training day for the trainee & AHP members of BOMSS were clear and we are very grateful to everyone who gave up their valuable time to help teach.

We look forward to seeing you all next year in Cardiff.

James Hopkins
Trainee Representative on BOMSS Council