The service was developed and is supervised by Mr Stephen Pollard, who is a Consultant Surgeon. Mr Pollard trained in London and Cambridge, and also in the USA. In 1994 he and his surgical team went to Richmond, Virginia to learn the surgical technique of the gastric bypass procedure and to familiarise themselves with the special needs of this group of patients - including their assessment and after-care as well as the operation itself.
Mr Pollard operates exclusively on patients with disorders of the gastrointestinal tract. As well as running the most active obesity surgery programme in the UK, he is also Director of Liver and Intestinal Transplantation in Leeds, and runs one of the largest and most successful intestinal transplant units in Europe.
Mr Pollard sees everyone who is referred to him for this procedure personally, and discusses with them whether or not the operation is suitable in their individual case. He is personally present at all the gastric bypass operations that are carried out, and reviews patients' progress in the clinic after the operation. Although often accompanied by other members of the team, the review of patients' post-operatively is not delegated to trainees.
General anaesthesia in overweight patients can be a concern and all patients are anaesthetised by one of three Consultant Anaesthetists with particular expertise in this area - Dr Steve Dean, Dr Mark Bellamy and Dr Yatin Young. These consultants also supervise patients' pain relief after the procedure has taken place. The group has a 100% track record in safe anaesthesia in this potentially high-risk group of patients.
Some patients with morbid obesity suffer from obstructive sleep apnoea. This is a major interest of Dr Mark Elliott. Dr Elliott is a Consultant Physician who works exclusively in the field of respiratory medicine. Like everyone else in the team, he has been involved with the obesity surgery programme since it began.
A small number of people with severe obesity have a glandular disorder such as overactive adrenal glands or an underactive thyroid which causes their excess weight gain. Also, many obese people suffer from diabetes as a complication of their obesity. Dr Stephen Gilbey is a Consultant Endocrinologist with special expertise in the management of these hormonal disorders.
Another important member of the team is Dr Lorenzo Pieri. Dr Pieri is a Consultant Psychiatrist who works exclusively in the field of eating-related disorders. Some patients with morbid obesity do 'comfort eat'. In such cases, Dr Pieri will determine whether it would be harmful to their psychological welfare if this were to be taken away from them, and weigh this up against the potential psychological and medical advantages of substantial weight loss.
Dr Elliott, Dr Gilbey, and Dr Pieri do not see all potential patients routinely, but their expertise is available for any patient who has problems within their areas of expertise.
Carol Middleton is a pivotal member of the team. Carol is Senior Dietician and was awarded an M.B.E. by the Queen in 1997 for her national service to dietetics. Careful dietetic advice and after-care is central to the success of the programme.
The printed post-operative dietary advice given to patients was written by Carol, who personally keeps closely in touch with patients following their surgery, and joins Mr Pollard at the follow-up clinic visits. Carol monitors the weight loss carefully, ensures that the patients' food intake is adequate and appropriate, that bad habits are picked up early, and that supplements are given to patients if required.