Welcome to the official website for the CM Health Bariatric Service. Bariatric Surgery - Surgical Options for Morbid Obesity In March 2007, CM Health General Surgery commenced Bariatric surgery at Counties Manukau Health (CM Health). It is estimated up to one in five people in New Zealand could be considered obese. The term "Morbid Obesity" does not describe the size of a person, but rather that the weight has become such a problem it is causing morbidity. It is recognised that morbid obesity is not just the result of excess eating, but is a chronic disease with many complex contributing factors. Individuals are considered severely overweight or morbidly obese if the Body Mass Index (BMI) is 30 or over. Surgical weight loss procedures have shown to have the best long term results in dealing with morbid obesity. Surgery is generally considered for obesity only after all other interventions have been exhausted. At CM Health we aim to treat obesity like any other medical condition – in a sensitive, empathetic and non-judgemental way. Please complete the Bariatric Referral Assessment Questionnaire when referring patients to Counties Manukau Health for consideration of Bariatric Surgery. Information on the Bariatric pathway process is also linked below. For further information please refer to the General Surgery website and please direct any queries to our Bariatric Nurse Specialist. Tereapii.VaviaNore@middlemore.co.nz Bariatric Nurse Specialist General Surgical Department Middlemore Hospital CMDHB Bariatric Assessment Questionnaire (PDF, 212.3 KB) Please complete this form when referring patients to Counties Manukau Health for consideration of Bariatric Surgery. Bariatric Pathway (PPTX, 75.2 KB) The timeline for the Bariatric Pathway outpatient appointments

General surgery covers breast diseases including breast cancer. These conditions are often initially dealt with in a specialised breast clinic which is able to perform a number of investigations [e.g. mammography (breast x-ray) and needle biopsy (small samples of tissue taken from any lumps found in the breast)] during the initial outpatient clinic visit.

Abnormalities of the endocrine system treated by general surgery include disorders of the pancreas and adrenal glands in the abdomen and the thyroid and parathyroid glands in the neck. These are often very complex conditions requiring extensive investigations. If surgery is required it is often quite complicated and will usually mean a stay in hospital for several days or even longer. For more information about thyroid operations click here.

Conditions of the gut dealt with by general surgery include disorders of the oesophagus, stomach, small bowel, large bowel and anus. These range from complex conditions such as ulceration or cancer in the bowel through to fairly minor conditions such as haemorrhoids. Many of the more major conditions such as bowel cancer will require surgery, or sometimes treatment with medication, chemotherapy or radiotherapy. Haemorrhoids are a condition where the veins under the lining of the anus are congested and enlarged. Less severe haemorrhoids can be managed with simple treatments such as injection or banding which can be performed in the clinic while larger ones will require surgery.

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall. Hernia operations are very common and may be performed either with a standard open operation or laparoscopically (keyhole surgery).

General surgery covers disorders of the liver and biliary system. The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.

Disorders of the salivary glands may be dealt with by the General Surgical Department or the ENT (ORL) Department depending on the local policy.

Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues. These are often fairly simple conditions that can be dealt with by performing minor operations under local anaesthetic (the area of skin being treated is numbed). Often these procedures are performed as outpatient or day case procedures.

Vascular Surgery is a surgical subspecialty that deals with all diseases that can affect the arteries and veins. The exceptions are the coronary arteries (heart), that the Cardiothoracic Surgeons operate on and the cerebral brain arteries (brain arteries), that the Neurosurgeons are responsible for. There are five main areas in which we work: Aortic Surgery Carotid Surgery Peripheral Vascular Disease Renal Access Surgery Venous Surgery Other areas that we are involved in include: Hyperhidrosis Visceral Artery Thoracic Outlet Syndrome Diabetic Foot Vascular Trauma Click here for more information about the Counties Manukau DHB Vascular Surgery Service