Guy Slater: 'At 41, he was so obese, he would have died within a year or two'

My Toughest Case

I am a bariatric surgeon specialising in obesity surgery. One patient, a 41-year-old chap, came to me two years ago. He weighed 42 stone and he was about 5ft 10in, so his BMI was around 82. A normal BMI is below 25. He was incredibly sick with his weight and had a young family and he was desperate to do something. My concern was that the risks of surgery were great and there was a significant chance of him losing his life.

We talked about his weight and the illnesses associated with it. The more obese you are, the more prone you are to various illnesses. This guy was diabetic, he had high blood pressure and respiratory failure. In fact, when I was looking at him in the clinic he was blue with respiratory failure. When we measured his blood gases, his carbon dioxide was nine when it should have been below six; his oxygen, which should have been 12-16, was six. He could only manage a few steps at a time before he was gasping for breath, so his exercise tolerance was very low. I felt that as much as I wanted to operate on him to get him to lose weight, at that time I couldn't safely do it because the risks were just too high and the chances of him dying were probably 20-30 percent.

So what we did was use a temporary means of losing weight where you endoscopically place an inflatable balloon in the stomach. We put it in, filled it up with saline and then gave him some dietary advice and sent him off. The advantage of this procedure is that you can do it very safely under local anaesthetic. It worked very well and he lost six stone over about six months. That took him down to about 36 stone and that weight loss was enough to really improve him; he was able to walk better and it reduced his anaesthetic risk.

We took the balloon out, waited a month or two and then I operated on him, doing what is called a laparoscopic Roux-en Y gastric bypass. In this operation you use keyhole surgery through six small cuts on the tummy, each between about half a centimetre and 1cm long, and you use a telescope and long instruments to operate internally. I found the top of the stomach and stapled and divided it to make a new pouch, which was about 20ml in volume instead of his old stomach with a volume capacity of about 1500ml. I then measured down the small bowel, divided it and joined it up in a new way to make a bypass. I joined the bypass to this pouch with a hole of about 1cm in diameter.

Because he was a very big man, it was technically very challenging. It was a really hard operation and I certainly sweated a lot. It took about three hours but I completed it and was happy at the end.

He went back to the ward, recovered and was subsequently discharged. Since then he has gone down to 24 stone, has a much lower BMI and his respiratory failure is gone, his diabetes is gone and his blood pressure is getting better. It's really turned his life around. If we hadn't operated on him his life expectancy, despite being only 41, was probably a year or two. He was going to die of a heart attack or something very soon but we managed to turn his life around.

A lot of people think of obesity surgery as a cosmetic procedure, but actually in some situations it's very much life-saving surgery – and certainly life-changing.

Interview by Gillian Orr

PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Sport
Manchester United's kit for the 2014/15 season
football
News
Nadine Gordimer died peacefully at home yesterday
peopleNobel laureate was a powerful anti-Apartheid voice
Extras
indybest
Arts and Entertainment
Neil Young performs on stage at Hyde Park
musicAnd his Hyde Park set has rhyme and reason, writes Nick Hasted
News
Women have been desperate to possess dimples like Cheryl Cole's
people Cole has secretly married French boyfriend Jean-Bernard Fernandez-Versini after just three months.
News
Ian Thorpe has thanked his supporters after the athlete said in an interview that he is gay
people
News
The headstone of jazz great Miles Davis at Woodlawn Cemetery in New York
news
News
newsBear sweltering in zoo that reaches temperatures of 40 degrees
Arts and Entertainment
Professor Kathy Willis will showcase plants from the Royal Botanic Gardens at Kew
radioPlants: From Roots to Riches has been two years in the making
Extras
indybestThe tastiest creations for children’s parties this summer
Arts and Entertainment
TV The follow-up documentary that has got locals worried
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Marketing Comms / Digital Marketing Specialist

    Not Specified: Recruitment Genius: An exciting and rewarding role exists for a...

    Search Engine Optimisation/ SEO Executive

    £25000 - £28000 Per Annum: Clearwater People Solutions Ltd: Excellent opportun...

    Electronics Design Engineer

    £35000 - £45000 per annum + Benefits: Progressive Recruitment: My client are l...

    Programme Planner

    £30000 - £45000 Per Annum: Clearwater People Solutions Ltd: Our client based i...

    Day In a Page

    Super Mario crushes the Messi dream as Germany win the 2014 World Cup in Brazil

    Super Mario crushes the Messi dream

    Germany win the 2014 World Cup in Brazil
    Saharan remains may be evidence of the first race war, 13,000 years ago

    The first race war, 13,000 years ago?

    Saharan remains may be evidence of oldest large-scale armed conflict
    Scientists find early warning system for Alzheimer’s

    Scientists find early warning system for Alzheimer’s

    Researchers hope eye tests can spot ‘biomarkers’ of the disease
    Sex, controversy and schoolgirl schtick

    Meet Japan's AKB48

    Pop, sex and schoolgirl schtick make for controversial success
    In pictures: Breathtaking results of this weekend's 'supermoon'

    Weekend's 'supermoon' in pictures

    The moon appeared bigger and brighter at the weekend
    Iraq crisis: How Saudi Arabia helped Isis take over the north of the country

    How Saudi Arabia helped Isis take over northern Iraq

    A speech by an ex-MI6 boss hints at a plan going back over a decade. In some areas, being Shia is akin to being a Jew in Nazi Germany, says Patrick Cockburn
    The evolution of Andy Serkis: First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes

    The evolution of Andy Serkis

    First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes
    You thought 'Benefits Street' was controversial: Follow-up documentary 'Immigrant Street' has got locals worried

    You thought 'Benefits Street' was controversial...

    Follow-up documentary 'Immigrant Street' has got locals worried
    Refugee children from Central America let down by Washington's high ideals

    Refugee children let down by Washington's high ideals

    Democrats and Republicans refuse to set aside their differences to cope with the influx of desperate Central Americas, says Rupert Cornwell
    Children's books are too white, says Laureate

    Children's books are too white, says Laureate

    Malorie Blackman appeals for a better ethnic mix of authors and characters and the illustrator Quentin Blake comes to the rescue
    Blackest is the new black: Scientists have developed a material so dark that you can't see it...

    Blackest is the new black

    Scientists have developed a material so dark that you can't see it...
    Matthew Barzun: America's diplomatic dude

    Matthew Barzun: America's diplomatic dude

    The US Ambassador to London holds 'jeans and beer' gigs at his official residence – it's all part of the job, he tells Chris Green
    Meet the Quantified Selfers: From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor

    Meet the 'Quantified Selfers'

    From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor
    Madani Younis: Five-star reviews are just the opening act for British theatre's first non-white artistic director

    Five-star reviews are just the opening act for British theatre's first non-white artistic director

    Madani Younis wants the neighbourhood to follow his work as closely as his audiences do
    Mrs Brown and her boys: are they having a laugh?

    Mrs Brown and her boys: are they having a laugh?

    When it comes to national stereotyping, the Irish – among others – know it can pay to play up to outsiders' expectations, says DJ Taylor