Services
Dr Thinus Smit is committed to providing unparalleled care and expertise in the field of surgery. Partnering with a team of highly skilled surgeons and dedicated healthcare professionals, they strive to deliver the highest standard of treatment to patients. He is passionate about minimally invasive surgery and dedicated to making a positive impact on the lives of patients.
Bariatric and metabolic surgery
Understanding obesity
Multidisciplinary team approach
Different patients have different needs and different challenges to face. The journey to preparing you for surgery is different for every patient, but on average it takes 3 to 4 months, from starting with our team, until you will be ready for surgery.
Meet the team
Dr Rouxzanne Roos
General surgeon, Fellow in upper GIT, bariatric and minimal invasive surgery - Pretoria
Procedures
Sleeve Gastrectomy
Roux-en-Y Gastric Bypass
SADI: Single Anastomosis Duodeno-Ileostomy
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
Mini Gastric Bypass
Do you qualify?
Obesity is a chronic disease and needs an appropriate treatment plan to ensure successful therapy.
One option is bariatric/metabolic surgery. For many years this option carried significant stigma, especially relating to the safety of the procedures. Over the last 30 years much research has been done and it has been proven to be an effective, safe treatment option. Considering this extensive research, the entry criteria for bariatric surgery have been updated in 2022
A patient can be considered for bariatric surgery if:
- You have a BMI > 35 kg/m2.
- You have a BMI 30 – 34.9 kg/m2 with one obesity associated condition, especially if first line medical therapy failed.
- In the Asian population bariatric surgery can be considered if BMI > 27.5 kg/m2
- Adolescents and the elderly can be considered for surgery. Age per se is not an exclusion factor.
The list of obesity related medical conditions are long and examples include the following:
- Type 2 diabetes
- Hypertension
- Dyslipidemia
- Obstructive sleep apnea
- Cardiovascular diseases like heart failure, atrial fibrillation, and coronary artery disease
- Fatty liver disease
- Polycystic ovarian syndrome
- Infertility
- Gastroesophageal reflux
- Joint disease
- Chronic kidney disease
Bariatric surgery should be done under guidance of a multidisciplinary team, consisting of a bariatric surgeon, physician/endocrinologist, psychologist, and dietitian.Â
Funding/Medical aid options
Below are the details of the medical aids that we are working with. However, currently no medical aid funds bariatric surgery in full. For most units a copayment of R20,000-R60,000 is required, depending on the procedure. Contact your medical aid for more details.
Upper GIT surgery
Hiatus hernia surgery
What is reflux disease?
Reflux disease is caused by regular reflux of regurgitation of food, acid or bile. The esophagus is not designed to withstand stomach contents pushing up regularly.
The most common cause of reflux disease is usually a hiatus hernia. When you have a hiatus hernia, it means the opening in the diaphragm, where your esophagus enters into your abdominal cavity, is larger than normal. This causes the valve (EG Junction) between the stomach and the esophagus to migrate or slide up, into your chest. Often a large part of the stomach can also migrate into your chest. When this happens, the valve can lose its ability to prevent food or acid from pushing up into your esophagus.
Long term acid reflux can lead to complications such as Barrett’s esophagus and narrowing of the esophagus, so it should be followed up by a specialist.
Commons symptoms:
1. Acid reflux
2. Food reflux or regurgitation
3. A feeling of something stuck in your esophagus (globus)
4. Hoarseness of your voice
5. Bloating and burping
6. Difficulty in swallowing
7. Coughing, especially at night
8. Chest pain or upper abdominal pain.
Who needs surgery?
1. If you suffer from food reflux (volume reflux)
2. Regular and severe acid reflux
3. Failure of medical therapy
Endoscopy
We perform gastroscopies and colonoscopies in rooms.
Do you need a gastroscopy?
1. Regular reflux or acid reflux
2. Regurgitation of food
3. Coughing at night
4. Painful swallowing
5. Difficulty in swallowing
6. Pain after eating
7. Loss of appetite
8. Unexplained weight loss
9. Vomiting undigested food.
1. Are you older than 50?
2. Changes in your bowel movements
3. Blood in your stools
4. Family history of colon cancer
5. Unexplained weight loss
6. Feeling of not emptying your bowels
7. Persistent abdominal pain
8. Fecal occult blood positive
9. Unexplained anemia.
Day case surgeries
Zuid Afrikaans Hospital has recently opened its day hospital. This has enabled us to expand our service to now include day case surgeries. These include smaller surgeries where patients do not have to stay overnight in hospital. These procedures are much more cost effective and affordable for patients, when performed in the ZAH Day Hospital.
Procedures include:
- Laparoscopic and open inguinal hernia surgeries
- Umbilical hernias
- Small incisional hernias or port site herniasÂ
- Skin cancer surgeries
- Uncomplicated laparoscopic cholecystectomies
- Haemorrhoid
- Anal fissures
- Benign breast lumps
- Lipoma removal
Our medical team will assess you and determine whether your surgery can be done safely in a day case setting.