Dr Jon Morrow manages a number of general surgical conditions. Operations can be performed either by a minimally invasive approach (keyhole surgery) or as an open procedure. The best method will be tailored to you.

Successful weight loss requires a combination of both lifestyle changes (including diet and exercise) and surgery. A range of different weight loss surgical procedures (band, sleeve, bypass) are available. Any and all options can be discussed.

Gallstones are very common and can cause a variety of conditions ranging from minor to severe. Surgical removal of the gallbladder via keyhole surgery is the recommended treatment.

Hernias come in all shapes and sizes and should, if possible, be fixed. They can be repaired via a traditional open approach or by using minimally invasive (keyhole) surgery.


Dr Jon Morrow

General & Bariatric Surgeon


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Contact Details

Consulting Rooms:

Ascot Central

Level 1, 7 Ellerslie

Racecourse Drive

Remuera, Auckland


Phone: 09 522 4103

Fax:     09 522 5136

Email:email

Also Consulting at:

Ormiston Hospital

125 Ormiston Road

Botany Junction


Operating Theatre:

Mercy Ascot Hospitals

Ormiston Hospital


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Obesity and Weight Loss

Definition:

Obesity is a medical condition where excess body fat has accumulated to such an extent that it impairs a person’s health and reduces life expectancy. The World Health Organisation (WHO) defines obesity according to a person’s Body Mass Index (BMI). This is calculated using weight and height in the formula: BMI (kg/m2) = Weight (in kgs) / Height (in metres) * Height (in metres)

Therefore,

Underweight
BMI < 18.5 kg/m2
Normal Weight
BMI 18.5 – 25 kg/m2
Overweight
BMI 25 – 30 kg/m2
Obese
BMI 30 – 40 kg/m2
Morbidly Obese
BMI > 40 kg/m2

Demographics:

In New Zealand, approximately 20% of the population is obese and a further 40% are overweight.

The prevalence of obesity by District Health Board (DHB) regions are:

Counties Manukau
33%
Waikato
29.2%
Canterbury
24.5%
Auckland
21.4%
Waitemata
20.5%

Cause of obesity:

The cause of obesity is multifactorial, including:

Obesity affects every body organ to a greater or lesser extent. These include

Management:

There are 3 main operative procedures for the surgical management of weight loss:

  1. Laparoscopic Adjustable Gastric Band
  2. Laparoscopic Gastric Sleeve
  3. Laparoscopic Gastric Bypass

In general, each of them will:

  1. Provide good weight loss – the amount of weight loss varies with each operation
  2. Have associated risks – the degree of risk is different for each operation
  3. Have complications – the types of complications vary with each operation

Laparoscopic Adjustable Gastric Banding

Description: Laparoscopic (keyhole) adjustable gastric banding is performed under general anaesthesia. An incision is made below the lower margin of the left rib cage, a port is placed through this incision, and CO2 introduced to inflate the abdomen and create a working space. A camera (laparoscope) is introduced through this port and under direct vision, a further 4 incisions are made in the abdomen. The left lobe of the liver is lifted to adequately expose the stomach. A space is created around the top of the stomach and the adjustable gastric band is placed like a belt. The stomach is stitched over the top of the band. A small pocket is created under the skin of the abdomen where the access port will be placed and a piece of tubing from the band is connected to this access port. The skin is closed with an absorbable suture.

Follow up: You will be seen one week after surgery then every 4 weeks for the first 12 to 18 months for an adjustment of the band. This requires needling the port via the skin, and injecting or removing water from the band, depending on the degree of restriction you feel with food. The dietician will see you within 4 weeks of surgery.

Expected Weight Loss: Approximately 45-50% of excess weight.

Risk of serious complication: <1%

Risk of Death: 0.05% (1 in 2000)

Laparoscopic Gastric Sleeve

Description: Laparoscopic (keyhole) gastric sleeve is performed under general anaesthesia. An incision is made below the lower margin of the left rib cage, a port is placed through this incision, and CO2 introduced to inflate the abdomen and create a working space. A camera (laparoscope) is then introduced and under direct vision, a further 4 incisions are made. The left lobe of the liver is lifted to adequately expose the stomach. The omentum (an apron of fat attached to the stomach) is detached from the stomach. The stomach is then stapled and cut to create a narrow tube with a volume of between 100-150ml. The remaining 90% of the stomach is removed via an incision on the right side of the abdomen. The skin is closed with an absorbable suture.

Follow-up: You will be seen 1 week after surgery then 3 to 6 monthly for the first year then annually. The dietician will see you within 4 weeks of surgery.

Expected Weight Loss: Approximately 50-60% of excess weight.

Risk of serious complication: 1-5%

Risk of Death: 0.1% (1 in 1000)

Laparoscopic Gastric Bypass

Description: Laparoscopic (keyhole) gastric bypass is performed under general anaesthesia. An incision is made below the lower margin of the left rib cage, a port is placed through this incision, and CO2 introduced to inflate the abdomen and create a working space. A camera (laparoscope) is then introduced and under direct vision, a further 4 incisions are made. The left lobe of the liver is lifted to adequately expose the stomach. A small pouch of approximately 30-50ml is created at the top of the stomach using staplers. The small bowel is then divided and brought up to this pouch and joined together (anastomosed). Another join is created between 2 pieces of small bowel further down in the abdomen. A tube is placed via the nose into your new smaller stomach at the end of the procedure (The tube will be removed 2 to 3 days later on the ward).The skin is closed with an absorbable suture.

Follow-up: You will be seen 1 week after surgery then 3 to 6 monthly for the first year then annually. The dietician will see you within 4 weeks of surgery.

Expected Weight Loss: Approximately 60-70% of excess weight.

Risk of serious complication: 5%

Risk of Death: 0.2% (1 in 500)