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BY DR. MUFFI

Setting up an OR

Dr. Muffi    18/4/2018   |   Wednesday

When a morbidly obese person is in a hospital, the smallest details matter. It matters that the bed is strong enough for the patient. It matters that the staff do not smirk, or pass embarrassing comments, but maintain a professional interaction, just as they would for any other patient. It matters that the patient is made to feel completely comfortable, because surgery is always life-changing, and more so in the case of a bariatric procedure, which involves so many psycho-social-emotional factors.

This consideration is at the fulcrum of the work at DIGESTIVE HEALTH INSTITUTE.

So when we were given the chance to set up a bariatric floor at Saifee Hospital in Mumbai, it was not a chance we could pass up. The first opportunity came along in 2004, when we created one OT. Then, in 2009, the hospital gave us the chance to create an entire department, which was a real privilege, and a challenge that DIGESTIVE HEALTH INSTITUTE was ready to take on.

And the result is an infrastructure that have been rewarded for its excellence, while setting industry standards in India, and internationally.

It all started, though, with the simplest of things.

Like getting beds manufactured that can stand a minimum weight of 130 kgs. And chairs without arm rests. Mounting commodes on the wall, and not on the floor, to make them stronger. Creating wider doors, and corridors.

These seemingly tiny details formed the basis of what we set out to do – build an international-standard, advanced, kind and attentive infrastructure and staff for bariatric surgery.

Working with as many morbidly obese patients as we do, we knew every small detail that was missing in surgical facilities.

We knew that if hospital staff were not sensitised, it could pull a patient’s spirits down. No one wants to be smirked at, or hear unkind comments being passed about them. Staff and attendants need training to understand this, and why it matters so much.

We knew that surgical instruments needed to meet certain specifications. (They need to be bigger, in cases of bariatric surgery.) 

We knew that everything from wheelchairs to beds needs to be strong, and big enough to support the patient. There have been earlier cases of furniture caving in, or breaking, and this is hugely embarrassing and demoralising for both the patient, and the medical team. Hospital gowns, and other pieces of clothing, also needed to be made in larger sizes so patients were comfortable.

We knew that the technology needed to be completely of-the-moment, so that the facility is the best that there is. Our OTs are now equipped for live transmission of the surgery, which is something to be very proud of; it helps us promote and share knowledge and best practices.

All of our learnings, experiences, cases, and wish-lists had to be put to use. Everything that we had hoped for, or lacked, while performing surgeries in the past had to be thought of.

This is where our biggest advantage of experience and knowledge came in handy. As a team, at DIGESTIVE HEALTH INSTITUTE, we are aware of every aspect of what makes a surgery, and the time before and after, as smooth as possible. So to implement all of that into creating a physical infrastructure at a leading hospital was really a testament to the work we do.

Was it tough? Yes.

It involved educating everyone, at all levels, and in that process, learning so much ourselves. It involved me getting down to the smallest detail, because we needed to make sure that everything was set in place.

In a field like bariatric surgery, which is fairly new in India, and can be ridden with misconceptions and misrepresentation, it is a bigger responsibility for us to make sure that we do all we can to keep the process and the experience pleasant, and not frightening.

At the end of the day, it’s the little things that make a surgeon and their team people that the patient and their loved ones are happy to place their faith in. If the patient knows that the medical team has made sure that everything from the gown to post-operative counselling has already been thought of, and taken care of, they are going to be more optimistic, and more positive about what is a very demanding and difficult experience.

A surgeon is so much more than just someone who conducts an operation. He or she is a beacon of hope, and, along with their team, the source of comfort, counsel and confidence. At DIGESTIVE HEALTH INSTITUTE , we stay in touch with patients for years after a surgery, because one year in, it’s easy for them to forget what they need to do in order to avoid ill-health. If you have knocked off the extra weight, and your health parameters are better, you will succumb to that high-calorie meal, and miss your workouts, and not take the vitamins you need to every day. That’s human nature.

The difference between a good recovery and a permanent recovery is what we set out to achieve with each patient.

Creating this infrastructure at Saifee is the first step. Keep reading to know what the others are.