BARIATRIC SURGERY
IN TURKEY
Bariatric surgery is a medically proven way to treat obesity and has helped many people live a more fulfilling, active and healthier life.
Obesity-related diseases that can be prevented or improved following weight loss surgery. Research shows that bariatric surgery can be an effective way to lose weight, manage chronic conditions and live longer
WHAT IS BARIATRIC SURGERY ?
In Bariatric (Stomach Reduction Surgery) surgeries, also known as Sleeve Gastrectomy, the stomach volume is reduced to make the patient feel full with very little food. In this operation, a certain part of the stomach (the part that stretches the most, expands and manages appetite) is surgically removed and a tube-shaped stomach (about the size of a banana) is left behind. Due to the hormone called ghrelin secreted from the removed part of the stomach, appetite control and a feeling of satiety are provided.
Bariatric Surgery is performed in patients with a body mass index above 40% or in patients with a body mass index of 30% who have conditions such as diabetes, hypertension and asthma. Bariatric Surgery is used by people who cannot lose their excess weight with diet and exercise and need obesity treatment.
This operation should be performed by specialist surgeons and doctor control is of great importance before and after the operation.
WHO IS SUITABLE FOR BARIATRIC
SURGERY ?
In order to have stomach reduction surgery, the patient must be between the ages of 18-80 and have a body that can handle anesthesia.
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Body Mass Index (BMI) over 40,
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BMI between 35-40,
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Having an additional disease related to obesity,
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Individuals with a BMI between 30-35 and those with diseases such as diabetes and metabolic syndrome can have stomach reduction surgery.
WHAT ARE THE STOMACH REDUCTION METHODS ?
In sleeve gastrectomy and gastric band surgeries, a part of the stomach is removed. Since a part of the stomach is removed, the amount of food that can be eaten decreases and thus weight loss is targeted.
In duodenal switch surgery, a part of the intestine is removed along with the stomach. Since there is no part of the intestine, absorption decreases and weight loss occurs.
Gastric reduction surgeries can be performed open or closed (laparoscopically). Laparoscopic surgery is more advantageous than open surgery because a small scar remains after the surgery. Complications are less likely and recovery time is faster than open surgery.
Sleeve gastrectomy surgery is the removal of approximately 75% of the stomach. The stomach remains as small as a tube after the surgery, so that with very little food, a feeling of saturation occurs immediately. This reduces the feeling of hunger. In addition, since the part of the stomach that produces the 'hunger hormone' is removed in this surgery, you do not feel hungry after the meal. This surgery can be performed by laparoscopic method.
In Roux-Y Gastric Bypass surgery, a new, small stomach is made by deactivating a part of the stomach. It attaches to the end of your small stomach by cutting a portion of your intestine. The deactivated stomach connects with the duodenum. Thus, the image of the letter 'Y' appears. As a result of this surgery, most of the stomach loses its function. The nutrients go to the new small stomach and the part of the intestine attached to it.
In biliopancreatic diversion surgery, it is aimed to reduce nutrient absorption by removing both the stomach and the large part of the intestines. Food intake is limited by creating a small pocket in the stomach. Since this surgery is more serious than others, it is preferred in patients who have a lot of weight.
BEFORE OPERATION
At least 1 week before the operation, the use of aspirin or aspirin-containing drugs and blood thinners should be discontinued. In addition to these, you should apply a diet as recommended by the physician 24-48 hours before.
The patient remains under control in the hospital for a certain period of time after the surgery. In the meantime, the patient is given painkillers and is followed closely. During this process, attention is paid to fluid consumption and blood sugar is constantly controlled since post-operative nutrition is slow. After the surgery, firstly, liquid foods are started to be fed, then mash and finally solid foods are fed and nutrition is provided gradually. After the surgery, the dietitian prepares a special nutrition plan. This nutrition plan is planned in accordance with adequate and balanced nutrition. Portion sizes are smaller than pre-operative nutrition because the stomach has shrunk.
AFTER OPERATION
Gastric sleeve surgery, which restricts food and calorie intake by only reducing stomach capacity, does not affect nutrient absorption in the intestines as in some other surgical methods. Treatment methods in which nutrient absorption is affected make the person prone to many diseases, especially iron deficiency anemia. For this reason, sleeve gastrectomy surgery is a more reliable option than other methods, as it not only treats obesity, but also protects the general health integrity of the person. In addition, ghrelin, also known as the hunger hormone, is secreted from a part of the stomach called the gastric fundus, and a large part of the gastric fundus is removed by sleeve gastrectomy surgery. As a result, the amount of hunger hormone secreted from the stomach decreases and the person's appetite decreases considerably after the operation compared to the past. Thanks to all these effects, extremely fast and permanent weight loss is achieved with sleeve gastrectomy surgery. The physical and mental relaxation brought about by weight loss noticeably increases the quality of daily life. Most of the excess weight can be lost within 1 year. This may correspond to a weight of almost 40-50 kilograms for a morbidly obese patient. After surgery, three-quarters of obesity-related diseases such as type 2 diabetes and sleep apnea, more than half of high blood fat and high blood pressure problems, half of knee pain, and most of leg varicose are resolved. These improvements occur spontaneously with the onset of weight loss, without the need for any other treatment. A rapid improvement in the general health level of the person occurs.
FREQUENTLY ASKED QUESTIONS
What are the Risks of Stomach Reduction Surgery?
Like any surgery, stomach reduction surgery has some risks. Infection, blood clotting, embolism, leakage from sleeve gastrectomy or other anastomoses, gallstone formation due to weight loss, malnutrition, sagging skin due to weight loss, depressions, dumping syndrome (foods and fluids taken after gastric bypass surgery go into the intestine very quickly. are the complications of the surgery. These complications are more common in older people, those with blood clotting problems, or those who are extremely obese. If you follow the recommendations of your dietitian and doctor after the surgery, the likelihood of these complications will decrease.
Is There Any Pain After Surgery?
Gastric sleeve surgery, which is performed under general anesthesia and laparoscopically (closed surgical intervention), is one of the most reliable methods compared to many other surgical interventions. However, sleeve gastrectomy surgery is an extremely advantageous method, especially as it has less risk of complications compared to applications such as clamps, and provides permanent weight loss for a much longer period of time. So much so that with the discovery of sleeve gastrectomy, clamps and similar applications have almost completely disappeared, and sleeve gastrectomy operation has become the most preferred bariatric surgery method thanks to all its advantages. Patients continue their normal life with a new diet after a few days of hospitalization.
Does the Stomach Enlarge Again After Stomach Reduction Surgery?
With sleeve gastrectomy, 80-85% of the stomach is removed and the stomach volume is reduced to approximately 100 ml. After the surgery, the stomach capacity increases slightly, but if it is not fed in accordance with the physician's recommendations, the stomach may grow more than necessary. As a result, the patient regains the weight they lost quickly after the surgery. In order to see the most accurate benefit from sleeve gastrectomy surgery, it is extremely important to strictly follow the nutritional recommendations planned by the physician during the postoperative period.
What is the Age Limit for Sleeve Gastrectomy Surgery?
One of the most frequently preferred operations by patients who want to lose weight, Sleeve Gastrectomy (Tube Stomach) surgery is frequently preferred by individuals between the ages of 18-65 whose health conditions allow. Since obesity is a serious health problem that causes many chronic diseases, its solution cannot be postponed. For this reason, many experienced physicians recommend sleeve gastrectomy or other gastric reduction and obesity surgery operations before additional complications and chronic discomfort occur in the patient.
Will There Be Any Scars After Stomach Reduction Surgery?
Sleeve Gastrectomy operations are usually performed with a laparoscopic, that is, closed method. The holes formed for the operation performed with a small incision through the abdominal wall are not large enough to cause an aesthetic problem, and they usually close spontaneously over time.
Is it Possible to Do Sports or Exercise After the Stomach Reduction Operation?
Exercise, especially swimming and muscle exercises, will be effective in the recovery of skin sagging due to rapid weight loss. It is claimed that some creams and massages can help tighten the skin. It is not recommended by physicians to do heavy sports immediately after the operation. Instead, simple walks are preferred. However, in the following months, the person can achieve the desired sports order and rhythm in a short time.
Can Gastric Sleeve Surgery be Performed Twice?
It may take 12-18 months to reach the ideal and healthy weight after sleeve gastrectomy. This period varies from patient to patient. The gender of the person in the weight loss process, age, whether they have chronic diseases, metabolic rate and many other things affect the time to reach the ideal weight. Revision sleeve gastrectomy surgery can generally be applied to all patients who have had sleeve gastrectomy surgery before and have not achieved the required results at the end of this period. The fact that the first operation is not performed correctly, as well as the fact that the patient does not pay attention to the next diet, can be effective here. In such patients, re-sleeve or revision sleeve gastrectomy operations may be preferred. In addition, a second sleeve gastrectomy or different surgical procedures can be applied to patients whose obesity level is so intense that they require two surgical procedures.