Stomach reduction abroad? Here’s what you really need to know.

You are thinking about gastric bypass surgery abroad.
You may have heard, for example, that the waiting times are shorter there or that others have had a good experience.
Gastric surgery is a big deal and you want to know whether it is safe to undergo gastric bypass surgery abroad and who you can turn to if you develop physical complaints. Dr. Kevin Göttgens, gastrointestinal surgeon at WeightWorks, has now performed more than a thousand gastric reduction surgeries successfully since 2015.
He knows that sometimes people make the decision to have gastric reduction surgery done in Turkey, Belgium or other countries.
“The quality of care in the field of gastric reduction is very good in the Netherlands.
Surgeons are very technically trained and, in addition, there is extensive aftercare to ensure that you get the maximum long-term benefit from the gastric reduction. Abroad, the quality of care is often much lower.
We do not recommend stomach reductions abroad. ”

If you do think seriously about going abroad for a stomach reduction, be sure to read this article.
We discuss what you need to take into account when considering gastric bypass surgery abroad.
We explain what to expect in terms of pre- and aftercare in the Netherlands and abroad.
We also explain what you can expect in terms of reimbursement for a gastric reduction program in the Netherlands and abroad and whether you will be helped faster abroad.
In addition, we explain what questions you can ask the clinic abroad to find out if you can expect good care.
Choosing to have gastric bypass surgery is not just a decision.
It is important that you have the surgery performed at a treatment location where the medical staff is technically well-trained and where you receive proper pre- and post-operative care.

Stomach reduction in the Netherlands and abroad: the main differences

Studies show that “medical tourism” has been on the rise in recent years. Medical tourism for stomach reduction means that people travel to another country to have stomach surgery.
They usually do this because they think surgery abroad is cheaper or because they can be helped more quickly.
But is this the wise choice?
We explain what the biggest differences are between gastric reduction procedures in the Netherlands and abroad.

Stomach reduction program in the Netherlands

This is what you can expect if you choose gastric bypass surgery in the Netherlands:

• Quality of Care: Dutch hospitals and clinics are known for their high medical standards and good care.
  This means that Dutch doctors are well trained and use methods that are scientifically proven.
  It also means that the chances of a successful treatment course are high because you will receive good guidance on lifestyle changes.
  You will also be helped if you suffer from physical or mental complaints after the gastric reduction.
• Reimbursement stomach reduction: If you are insured in the Netherlands and meet the conditions for a stomach reduction, the entire treatment – with the exception of the deductible – will be reimbursed by the insurer from your basic insurance.
  Hieronder vallen ook de nacontroles, nazorggesprekken en medicatie die je na de operatie krijgt voorgeschreven.
• Aftercare and Follow-up: If you go to a hospital in the Netherlands for a gastric bypass, you will always have a pre- and aftercare program, with a multidisciplinary team (internist, nurse, dietician, psychologist, exercise specialist, etc..).
  Dit zorgt voor betere resultaten op lange termijn.
  Per ziekenhuis of kliniek kan het verschillen of je een groepstraject of individueel traject aangeboden krijgt.
• Waiting times: In the Netherlands, you may have to wait before you can come to an intake appointment (screening) and undergo surgery.
  It is wise to ask what the waiting times are so you know where you stand.
• Distance treatment location: The distance to your treatment location is generally a maximum 2-3 hour drive within the Netherlands.
  If you need care at short notice after surgery, the distances within the Netherlands are quite manageable.
• Language and Communication.: No language barriers, for example during explanations of surgery or aftercare discussions about lifestyle change.

Stomach reduction abroad

What to expect with gastric bypass surgery abroad:

• Quality of care: There is no global standard of care.
  This means that the level of care abroad may differ greatly from care in the Netherlands.
  This also applies to the quality requirements and quality controls of medical staff and facilities (treatment location, hygiene, etc.).
  In the Netherlands, there are quality requirements for surgeons, caregivers and medical facilities (the rooms in which you are operated on; the materials used during surgery, etc.).
• Aftercare: There is probably no extensive aftercare program associated with surgery abroad.
  Research shows that people who follow an aftercare program do better in the long term, than those who do not follow this program.
• Stomach reduction criteria: You must meet certain conditions (criteria); If you do not meet these requirements, for example because your BMI is too low, you may not be able to get a stomach reduction in the Netherlands.
  However, you may be eligible for gastric reduction surgery abroad.
  Good to know: If you don’t meet the criteria for a stomach reduction, a stomach reduction may not be the wisest choice for you.
• Gastric reduction reimbursement: Gastric reduction programs abroad are generally not reimbursed by the Dutch health insurance company
• Distance treatment location: The treatment clinic or hospital where you had the gastric bypass is a long distance away.
  If you suffer physical symptoms (complications), you cannot go there directly for care.
• Air travel: Air travel within 4 weeks of surgery may lead to an increased risk of physical symptoms, such as thrombosis.
  Daarom wordt fly right after gastric bypass surgery is not recommended.
• Stomach reduction offer: The type of stomach reduction you can get abroad is often more limited.
  The operation is mainly based on the technical ability of the surgeon.
  Often a sleeve is offered.
  This does not mean that this is the best surgery for you.
• Other language: You do not speak Dutch or English and you can communicate more easily with caregivers in your country of origin (native language).
  Good to know: The question is whether speaking one’s own language gives much benefit.
  Language is especially important if you are receiving guidance from social workers in a before-and-after process.
  This is often lacking abroad (especially outside Europe).
• Waiting timesYou may be able to get gastric bypass surgery quickly abroad.
  It is not certain whether you can get it faster than in the Netherlands; you can find out by asking what the waiting times are at different treatment locations.

Are stomach reduction costs lower abroad?

No.
If you meet stomach reduction criteria it is not the case that stomach reduction surgery abroad is cheaper .
Wanneer je voldoet aan maagverkleiningscriteria en je in Nederland verzekerd bent, dan vergoedt de verzekeraar het behandeltraject in Nederland.
Wanneer je niet voldoet aan de maagverkleiningscriteria en je de keuze maakt om de operatie zelf te betalen, kan het zo zijn dat de operatie in het buitenland minder kost dan in Nederland.
Zoals eerder gezegd is het de vraag of het een verstandig besluit is te kiezen voor een maagverkleining als je niet aan de criteria voldoet.

My relative/neighbor does not speak Dutch; can he/she get a gastric bypass in the Netherlands?

This may vary by hospital or clinic.
At WeightWorks, it is not possible to enter treatment if you do not speak Dutch or English because then we cannot provide proper care. If you want to be considered for a stomach reduction in the Netherlands, you are generally asked to have a good command of the Dutch or English language.
This is important because in the pre- and post-surgery phase, you will receive explanations and advice about nutrition, lifestyle, care of your body, etc.
It is necessary that you understand information and advice these and can talk to practitioners when you need additional guidance.

What should I pay attention to when choosing a gastric reduction clinic abroad?

If you want to get gastric bypass surgery abroad, pay attention to the following 6 points:

1. Approved clinic: Go to a treatment site that is affiliated with a recognized (quality care) agency.
   Please note that this varies from country to country.
   No general advice can be given by us on which clinic is recommended.
2. Surgeons’ qualifications: Which surgeons work at the clinic/hospital and what is their experience?
   Not every country has a quality system to indicate whether surgeons can do gastric bypasses safely.
3. Treatment plan clinic: At the clinic, you can ask the following questions to find out what the treatment plan looks like:– What exactly does the care plan look like? – Is there a team preparing me for surgery? Here you can think of good explanations about nutrition and lifestyle or help with binge eating. – Does the treatment program include an aftercare program?
   If so, how long can I contact the clinic for care after the gastric bypass? – What are the treatment arrangements with the clinic when I return to the Netherlands?
   What can I do if I suffer from physical complaints (complications)? – Who checks my blood values every year?
   How can the clinic help me if my blood values are not good? – Is there a treatment team (medical team, dietitian, psychologist) to guide me after surgery? – Where can I go if I develop physical symptoms, short- and long-term?
4. Additional costs: If you develop physical complaints (complications) after the gastric bypass, are the healthcare costs included in the course of the clinic where you underwent surgery?
   If not, your Dutch insurer may not cover (part of) the costs.
   You will have to check this with your insurer.
5. Medical record: Is the complete medical file transferred to you as a patient so that you can take it with you to the Netherlands?
   Preferably, the file is in English.
   This file should contain the following information: the type of gastric bypass, any adjustments made during surgery, and a report on your physical condition after surgery.
6. Stay after gastric bypass: As discussed earlier, flying within a period of 4 weeks after surgery is not advised due to increased risk of thrombosis.
   So think carefully if you can stay in the country where you are having the surgery done for at least a few weeks.

What can I do for symptoms if I have had gastric bypass surgery abroad?

Before surgery, discuss with the clinic abroad whether they will help you if you develop symptoms afterwards. If you had a gastric bypass abroad, it may be that not all aftercare (such as blood checks, physicals, dietician appointments, etc.) is included in the treatment plan.
If you develop physical complaints (complications) when you are back in the Netherlands, it can be a barrier to fly back to the country where you had surgery.
Possibly due to costs, or because treatment of certain complaints is not included.
Also, you may not feel physically well enough to fly.
If you then go to a hospital in the Netherlands, surgeons (or other specialists) may be reluctant to treat you.
The reason is because there may not be a surgical report available.
Also, it may be unclear what gastric bypass surgery was done and how it was technically performed. If there are complaints with which you have to be helped immediately (acute complaints), then you will be helped at the emergency room in the Netherlands.
If there are general questions and non-acute problems, then the question is where you could go in the Netherlands.
It is best to contact the clinic abroad where you were treated.

I now know more about the differences between treatment pathways in the Netherlands and abroad: How can I make a good decision?

Gastric bypass surgery is a procedure that has a lot of impact on your life, so it is important that you think carefully about where you will have it performed.
Dr. Kevin Göttgens advises you to consider more things than just waiting times or costs. “Consider quality of care, aftercare and accessibility of the treatment site. The quality at all centers in the Netherlands is so good that we advise against undergoing gastric bypass surgery abroad.
De ervaring leert dat operaties die in het buitenland uitgevoerd zijn (met name buiten Europa) op langere termijn voor veel problemen kunnen zorgen.
Enerzijds door technische redenen, maar met name door géén goede screening om te bepalen of iemand er klaar voor is.
Daarnaast ontbreekt vaak een langdurig natraject.
Hierdoor is de kans op goed en veilig langdurig gewichtsverlies stukken lager.
” Ga voordat je een besluit neemt met je huisarts in gesprek over locaties waar je veilig een maagverkleining kunt ondergaan.