Bariatric Surgery in Tunis

Bariatric surgery is a group of weight-loss surgeries that involves making changes to the digestive system, some of which are non-reversible. The idea behind these types of surgeries is to help patients lose weight by either limiting the amount of food they can consume/digest at any one time or reducing their body’s ability to absorb nutrients. Some procedures do both. 

Bariatric surgeries should only ever be the final option when diet and exercise have proved inadequate and there are now serious health concerns caused by a person's weight. In general, these surgeries can only be an option for patients whose body mass index (BMI) is 40 or higher (extreme obesity). In certain cases, patients whose BMI is 30 to 39.9 may qualify for certain types of bariatric surgery if they have serious weight-related problems, such as type 2 diabetes.

The three most common types of Bariatric Surgeries are as follows:

1. Gastric Sleeve – The most common surgery, in which about 80% of the stomach is irreversibly removed, resulting in a sleeve or tube-like structure. This smaller stomach will not be able to hold as much food and produces less of the hormone that regulates appetite (ghrelin), which can lessen the patient’s desire to eat. 
2. Gastric Bypass – A more complicated procedure in which the stomach is divided into two parts; a small upper pouch and a large lower ‘remnant’ pouch. The small intestine is rearranged to bypass the large pouch. As a result, the volume of the stomach is significantly reduced. This causes food to go into the small upper pouch of the stomach and then directly into the small intestine. The small upper pouch can only hold around an ounce of food. Gastric Bypass is typically not reversible. 
3. Gastric Band – Involves an inflatable silicone device that is fitted around the top portion of the stomach to create a smaller stomach pouch. This procedure causes the patient to feel fuller with less food but still allows the body to digest food as usual, without malabsorption. The device can be removed when the patient reaches their desired weight.

The bariatric surgeries mentioned above are typically performed laparoscopically, in which the surgeon creates around one to five small incisions in the abdomen to insert a laparoscope (a long narrow tube with a camera) and surgical tools. The patients are usually given a general anesthetic, so they will not feel anything throughout the surgery.

How Long Should I Stay in Tunis?

After bariatric surgery, an overnight stay in the hospital is usually required. In some cases, you may need to stay longer (around 3 to 5 days). However, it is not advisable to leave Tunis as soon as you are discharged from the hospital. Stay at least 10 to 14 days following your surgery for initial recovery and follow-up checkups. During the follow-up checkups, your surgeon will remove your stitches and check your overall condition.

What's the Expected Recovery Time?

The recovery time may take around 3 to 6 weeks until you are allowed to go back to your normal activities, including work, with some restrictions. You must avoid heavy work and strenuous activities, such as lifting, pushing, or carrying heavy loads for at least the first three months after surgery. You should also avoid sitting and standing without moving for long periods to avoid blood clots forming in your legs.

What Aftercare is Required?

You will be given a special diet plan immediately after your surgery, as well as detailed post-operative instructions. Make sure to follow the diet plan and instructions to avoid complications and speed up your recovery. In order to maximize and maintain weight loss, it is important that you commit to healthy eating and regular exercise. There may be restrictions on how much food you can consume. You may also need to change your eating habits, such as eating 6 small meals instead of 3 large meals each day. You should take vitamins and mineral supplements to ensure proper nutrition. 

What's the Success Rate?

The success rates vary for each of the different types of bariatric surgery. In general, within the first six months following the surgery, most patients lose around 30% to 55% of their excess weight. Then, as early as 12 months after surgery, most patients lose over 70% of their excess weight. Patients could also maintain a 50% to 60% loss of excess weight for 10 to 14 years after their bariatric surgery. Although the success rates are high, there are risks associated with bariatric surgery, such as bleeding, deep vein thrombosis, infections, spleen injury, stenosis, and infections.

Are there Alternatives?

There is a non-surgical Bariatric procedure, known as the Gastric Balloon. This involves an inflatable device that is temporarily inserted into the stomach via endoscopic placement. A sizable area of the stomach is obstructed by the balloon or balloons, thus reducing the amount of food it can contain at any one time, leading to eventual weight loss. The balloons are usually removed after 6 or 12 months. 

If you cannot or do not want to undergo any surgery or medical procedure, you may be able to work with a doctor who is experienced in treating extreme obesity and a dietician as the alternative. They may recommend you to change your diet, adding physical activity, and prescribe medications.

Bariatric Surgery in and around Tunis

About Tunis

Tunis is the capital and the largest city of Tunisia and is the center of government and administration as well as the center of commercial and cultural activities. It is divided into two parts, the old city known as Medina and the new city or Ville nouvelle. Even though it is located on the southern shores of the Mediterranean Sea, the city does not have many beaches. Still, it has managed to attract millions of tourists in 2018 thanks to its rich history displayed in numerous ancient buildings. These buildings have an enchanting blend of North African and French Architecture that will leave anyone in awe. Many tourists come to see the Roman ruins of Carthage or to stroll around and shop in the Medina.

Tunis is known to have a high standard of healthcare, which attracts an increasing number of medical tourists each year. Many of the medical tourists come from other African countries that have an inferior healthcare system. However, the city’s excellent reputation in cosmetic surgery and dental treatment appeal to many patients from Europe, the Middle East, and Asia. The private medical centers are armed with the best equipment and English speaking staff. The Tunisian Ministry of Health regulates cosmetic and plastic surgeons to ensure that there is a high standard. In addition to exceptional healthcare, Tunis also offer attractive prices for medical treatment and the cost of living. 

Popular Areas in Tunis

Although it is the largest city in Tunisia, Tunis can feel like a compact city and can be explored on foot. The city has a number of famous attractions that are always packed with tourists.

• Carthage was founded in the 9th century BC and was once a powerful empire of the Mediterranean as well as home to a wonderful civilization before being destroyed by the Romans in the Third Punic War. It was then to become an important Christian center until the Islamic invaders destroyed it. Today, the ruins have become a UNESCO World Heritage Site that tourists can visit.   
• The Medina in Tunis is one of the most remarkable medieval medinas in North Africa. There are over 700 monuments within the area, from mosques to madrassas to historical places. It is easy to get lost in the impressive maze-like alleyways, but tourists are encouraged to admire the Islamic architecture and art or learn more about the city’s history. Tourists can also shop in one of the souqs selling everything from shisha pipes to shoes or enjoy one of the cafes.
• Sidi Bou Saïd is a picturesque cliff-top village with cobbled streets, blue-and-white walls, and glimpses of pristine blue waters. It is probably one of the most beautiful places in Tunisia. The beautiful architecture is a blend of the Ottoman and the Andalusian. It is now a sleepy fishing village perfect for anyone who wants to get away from busy city life. The village has been a gateway for artists, bohemians, and pilgrimage for centuries.
• Bardo Museum is the second-largest museum in Africa and the main attraction of this museum is the ancient Roman mosaics recovered from Carthage. The museum also exhibits Greek statues, artifacts of the region’s Berber, and the accomplishments of the Islamic culture in the country. Other than the exhibitions, the building itself is decorated in impressive historic Islamic decorative arts.

Weather and Climate in Tunis

Tunis has a hot-summer Mediterranean climate meaning the city enjoys warm and sunny weather all year round. The summer can be hot and dry because rain is very rare and the summer usually lasts from June to August and the average temperature is around 25 °C but can get as high as 40 °C. July and August are the high tourist season, especially at the beach resorts. The city begins to get rain in autumn, often accompanied by a short thunderstorm. The winter is the wettest season of the year because it can rain every two or three days and the temperature can drop to 7 °C in the morning and 16 °C in the afternoon. The rainfall decreases in spring, and in March, the temperature ranges between 8 °C to 24 °C and the sunshine usually becomes dominant in May.

Getting Around in Tunis

Tunis-Carthage International Airport is the main airport in Tunisia and the airport connects Tunis with other cities in the country as well as the rest of the world as it serves flights to and from the Middle East, Africa, and major Europeans countries. It is the hub for Tunisair, Tunisair Express, and Nouvelair, but there are not many budget airlines operating flights from the airport. To get to the city center from the airport, tourists can opt for a taxi or bus. The bus is operated by the SNT bus line and departs every 30 minutes. It is very affordable with a single ticket costing less than 1 TND. There is also a more luxurious and expensive bus line known as the TUT bus and the bus departs every 15 minutes. If you want a more private mode of transportation use an airport taxis and they are usually metered.

Tourists have plenty of options to get around Tunis. There is a tram system in the city with inexpensive tickets, usually around .48 TND. However, be aware that it can be packed during the rush hours. Taxis are a good option to get around, the taxis are metered, and the base fare is around .4 TND but can be much more expensive if you hail one off the street. 

Tourist Visas in Tunis

Nationals of 97 countries including Australia, China, Singapore, the United States, and Russia can enter and stay in Tunis for up to 90 days without a visa. Other nationalities not listed in the visa exemption agreement are advised to check at their nearest Tunisia embassy or consulate. The country provides an online visa application to simplify the process of obtaining a visa to enter the country.

Additional Information

1. Local Currency: Tunisian dinar (TND) is the official currency of Tunisia. 1 USD will get you 2.61 TND. 
2. Money & Payments: ATMs are widespread in Tunis. Credit Cards, particularly MasterCard and Visa, are accepted in most top-end restaurants, hotels, and shops. Tipping is by no means mandatory but will be greatly appreciated.
3. Local Language: Arabic is the official language and French is very common. English is not widely spoken except in tourist areas and hospitals.
4. Local Culture and Religion: Most of the population follows Islam, but there are small groups of Christian and Jews.
5. Public Holidays: The city celebrates major nationals and Islamic holidays such as Independence Day, Eid Al-Fitr, and Prophet Mohammed’s Birthday.