We have recently been having many admissions from patients choosing to travel abroad to Turkey for bariatric surgery or procedures. The British Obesity and Metabolic Surgery Society (BOMSS) has recently issued guidance on this. They have raised concerns raised about:

1. Lack of adequate expert pre-operative assessment, discussion and counselling

2. Poor choice of procedure offered and the number of combined procedures offered in one surgical sitting

3. Different procedures being performed to the one the patient expected, or the details of the procedure conducted being unknown

4. Unknown quality and safety of the team providing surgery

5. Risks of long-distance travel immediately following surgery, for example developing a blood clot in the leg or lung (which can be potentially life-threatening)

6. Poor or non-existent access to routine post-operative follow up care, increasing the possibility of outcomes such as weight regain and nutritional deficiencies in bariatric patients and increasing the risks of sub-optimal outcomes and complications in plastic surgery patients.

7. No direct access to expert care if a complication occurs (and most GPs are not trained in the care of patients who have had bariatric or plastic surgery)

As a surgeon all of this is extremely dangerous and I would be very worried about an organisation prepared to offer surgery based on the contents of a WhatsApp message as seems to be the growing trend.

The advice from BOMSS is to seek a consultation with a UK Bariatric Surgeon before committing to travel abroad for surgery.

We continue to work hard alongside Covid-19 which is moving more into the background of every day life. It still presents with challenges of staff absence and cancelled operations due to testing positive. We are obliged to defer elective (non-urgent) operations until 6-7 weeks after someone tests positive for Covid-19. This is causing some frustration and disappointment for some of those who have been waiting patiently for operations.

Several Covid-19 vaccines have been found to be effective at preventing severe illness and in December 2020, Leeds Teaching Hospitals started its vaccination programme. I attended a session on Wednesday 16th December and helped consent and prescribe the Pfizer mRNA vaccine to care home staff. I managed to receive a spare dose that would otherwise have been discarded. Hopefully this is the start of the recovery phase now fingers crossed.

There has been an unprescented challenge to the world presented by the Coronavirus pandemic. As a consequence of significant restrictions of social interaction and the seriousness of the Covid-19 disease and its potential effect on NHS resources, our attention has been diverted to dealing with this emergency. As a consequence there has been a prolonged pause placed on routine cases including private work. We are hoping that as the NHS and the Nation recovers, some private work will gradually resume. Please stay safe in these difficult times.

Whilst off from work managed to complete an on-line course in business and management from the London School of Economics. Kept me occupied whilst away from usual work. Excellent course and content provided invaluable knowledge and skills for the future.

Having recovered from surgery returning to work amidst the Covid-19 pandemic is not easy to say the least. Currently preparing NHS Hospital for potential surge in demand for beds. All non-urgent work cancelled for the time-being.

Found myself requiring surgery and now taking a pause from work to recover from this and looking forward to getting back into normal life in the next few months.

Words of wisdom from Lord Woolf amongst others at the Church House Conference Centre. An excellent update on matters for experts.

Attended this course for a simplified version of the roux en y gastric bypass to treat morbid obesity. Hoping we can bring this operation in as part of our repertoire in Leeds.

I have the pleasure of being invited to a Gastrointestinal Stromal Tumour Charity Educational Day on Friday 4th October 2019 in Leeds to speak about surgical treatment for this rare group of tumours.