We are passionate about healthcare in South Africa and the African continent

Aims and goals of SAMMSS

To improve health delivery in South Africa and the African continent by improving knowledge around aspects of obesity and related diseases, including prevention and treatment.
To promote training of health care professionals in both medical and surgical management of obesity.
To provide guidelines as to the credentials and ethics of the practice of bariatric surgery and to advise and assist official bodies such as the South African Medical Association and the HPCSA on these matters.

Position statement

Regarding indications for bariatric surgery, SAMMSS takes its lead from the revised guidelines set out in 2022 by the International Society for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

In broad terms, an individual should be considered for bariatric surgery if their BMI is greater than 35 kg/m2, or if their BMI is greater than 30 kg/m2 in the presence of certain comorbidities. In all cases, where other means of weight loss have failed or are considered futile.

Memorandum of incorporation

Board of directors

Prof Jeanne Lubbe

President

Prof Zach Koto

Director

Dr Thinus Smit

General secretary

Dr Ian Marr

Director

Dr Marisa Noeth

Director

Endorsed procedures

Roux-en-Y Gastric Bypass

This procedure involves creating a small stomach pouch and rerouting the small intestine to this new pouch. It is considered one of the most common and most effective weight loss procedures.

Sleeve Gastrectomy

This procedure involves removing a large portion of the stomach, leaving behind a smaller “sleeve” shaped stomach. This smaller stomach can hold less food, leading to weight loss.

SADI: Single Anastomosis Duodeno-Ileostomy

This procedure is a variant of BPD/DS, it’s a two-step procedure that includes first a sleeve gastrectomy and then the duodenal switch.

Mini Gastric Bypass

Also known as a single anastomosis gastric bypass or a loop gastric bypass, is a type of weight-loss surgery that is considered a variation of the Roux-en-Y gastric bypass procedure. Like the Roux-en-Y gastric bypass, the mini gastric bypass procedure involves creating a small stomach pouch and rerouting the small intestine to this new pouch. However, in the mini gastric bypass, the small intestine is rerouted in a loop fashion, which creates a shorter connection between the stomach pouch and the small intestine.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

This procedure involves removing a large portion of the stomach and rerouting the small intestine to a new connection with the remaining stomach. This procedure leads to weight loss by limiting the amount of food you can eat and reducing the absorption of calories.

Endorsed devices

Development and improvement continue in the field of bariatric endoscopy. It is currently used more as bridging treatment to improve a patient’s health and weight loss, to enable safer surgery. Currently these procedures are not funded in SA.

Intragastric balloon

This is a safe procedure, but there is no good evidence yet that this leads to long term weight loss and resolution of comorbidities of obesity. The balloon needs to be changed regularly which makes it very expensive. Currently used as a temporary measure for weight loss in very high-risk patients in preparation for surgery. This is not currently funded by medical aids in SA, due to the lack of evidence of good long-term outcomes.

Endoscopic gastroplasty

A novel procedure that is proven to be safe. The 2-year weight loss results average out around 10 to 15%. There is no good evidence yet of long-term maintenance of weight loss. Medical aids are not currently funding this procedure in SA.

Affiliations

SASES

South African Society of Endoscopic Surgeons

www.sases.org

SEMDSA

Society of Endocrinology, Metabolism and Diabetes of South Africa

www.semdsa.org.za

University of Witwatersrand

Public research university

www.wits.ac.za

Stellenbosch University

Public research university

www.sun.ac.za

Sefako Makgatho

Health Sciences University

www.smu.ac.za

University of Pretoria

Public research university

www.up.ac.za