ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
What is Obesity Surgery?


Obesity Surgery is surgery to help us lose weight. There are many types of surgery. It is never the first choice.

In cases where successful results cannot be obtained in obesity patients after diet, exercise and drug therapy, obesity surgery can be applied.

Who is Obesity Surgery suitable for?

The obesity surgery method is suitable for people who have applied all other treatment methods before the surgical procedure but have not been successful. The patient should be evaluated with all relevant units before undergoing a surgical procedure and should be suitable for surgery in terms of anesthesia. Patient selection is made according to body mass index. If the body mass index is over 40, the patient can be operated. Between 35 and 40, in people with an additional disease (such as hypertension, Type 2 diabetes, sleep apnea syndrome, high triglyceride heart disease, hypoventilation syndrome, fatty liver), If the body mass index is between 30-35, surgery may be recommended for Type 2 Diabetes patients whose blood sugar cannot be controlled by medical treatments.

Types of Surgery for Obesity Treatment

With the developing technology, there are various surgical techniques used in obesity. The choice of surgery is decided by the physician and the patient together according to the patient's condition.

Stomach Balloon

The simplest method to help lose weight is the stomach balloon application. In this method, a balloon filled with liquid or air in the stomach is placed under mild anesthesia with the help of an endoscope.  This operation takes 15-20 minutes. Thus, the food intake capacity of the stomach is reduced and quick saturation is provided. With this method, patients can lose 7-8 kilos in a few months. However, this balloon can remain in the body for 6 months, a maximum of 1 year, and is removed within 5-6 minutes by endoscopic method.  Although it is the advantage of the method that it is simple to apply and there is no permanent change in the body, if the patient does not change his lifestyle and does not continue his diet after the balloon is removed, the lost weight can be regained. However, within the period of use of 6 months-1 year, people get training on how to eat by trying them out. Today, the stomach balloon method is used as a preparation for basic morbid obesity surgery either in patients who are too risky for surgery or in super obese people. It can also be used by those who are not overweight.

Sleeve gastrectomy

It is one of the most applied methods to lose weight in the world. In this method, 80-90% of the stomach is removed and the stomach is turned into a tube. The person's calorie intake is reduced. Gastric sleeve surgery is also performed with the closed method, in a period of one to two hours. The hospital stay is two to three days. After the surgery, patients can switch to normal food after consuming liquids for two weeks and soft foods for the next two weeks. Vitamin supplements may be required. In this surgical method, the fundus region of the stomach is completely removed and the release of the Ghrelin hormone is prevented, thus reducing the appetite of the person.

After this surgery, people can lose an average of 80% of their excess weight within 1 year. After this surgery, care should be taken to chew the food thoroughly and consume it in small portions. In addition, exercise should not be forgotten. In order not to regain the lost weight, especially high-calorie liquid foods with refined sugar should be avoided. 

Gastric By-Pass

In these methods, the stomach is basically divided into two parts. One is big and the other is small piece. With the newly formed small stomach, a part of the small intestine from the beginning and the duodenum are bypassed and reunited. Two situations are targeted. First, the person's calorie intake is restricted, and secondly, the absorption of edible nutrients is reduced. These methods are also successfully applied laparoscopically today.  Gastric Bypass surgeries are one of the most common bariatric surgical procedures in the world. It is one of the methods with the highest metabolic efficiency in solving obesity and obesity-related health problems.  Weight loss can continue for up to 1.5 years. Post-operative follow-up is important. Patients may need to use vitamins for a long time. It is important that they are in contact with their dieticians and physicians about their nutrition.

Duodenal Switch

Duodenal Switch process leads to more weight loss as it directly affects the metabolism. It is an applicable method especially for people with a BMI of more than 50 Kg/m2. In this surgery, both food intake is restricted and the absorption of food taken is reduced.  It is an effective method in the treatment of diabetes, hypertension and high cholesterol diseases due to excess weight. Since it is an application that reduces fat absorption, it is an effective surgery in patients who consume fatty foods. Although it is among the surgical methods that provide the most weight loss in obesity surgery, it is not used very often due to the excess of complications during and after surgery. After this surgery, chronic malodorous diarrhea and vitamin and protein deficiencies due to reduced fat absorption are common. 

Mini Gastric By-Pass

It is a more easily applicable modification of gastric bypass surgery. After a long stomach pouch is formed, the small intestine piece 2 meters from the beginning is combined with the stomach pouch. Although the operation time is shorter and the cost is less, the effect of passing type 2 diabetes and losing weight is very successful. The most important disadvantage is; As in the RNY gastric bypass, the remaining stomach, except for the created pouch, is not visualized later endoscopically and patients may need vitamin intake in the long term.

Before Obesity Surgery

First of all, the person is examined in detail by surgeons. After the doctor decides whether he is suitable for surgery, he informs the patient about obesity surgery. After the acceptance of the patient, it is evaluated by cardiologist, chest diseases, psychologist and anesthesiologist, endocrinology and metabolic diseases. In addition, gastric endoscopy, abdominal ultrasonography and many laboratory tests are performed on the patient before the operation.

How is Obesity Surgery performed?

Surgeries are performed by an experienced surgical team under general anesthesia with the laparoscopic (closed) method. After the operation, the patient may be taken to the intensive care unit overnight for observation purposes, depending on the patient's condition and the recommendation of the anesthesiologist. Patients who are out of this situation are sent to their rooms when they fully awaken from anesthesia.

After Obesity Surgery

After a successful surgery, patients should be careful in order to get rid of obesity and to have a healthy and quality life. After the necessary controls are made in the hospital and the patient is discharged, the treatment process continues. The diet program deemed appropriate by the dietitian and the surgeon performing the surgery should be carefully applied by the patient. The patient should not exercise during the processes specified by the doctor and should not disrupt her/his regular controls.

Obesity Surgery S.S.S.

Which Obesity Surgery is more suitable for you?

The type of surgery to be performed is decided together by the General Surgery Specialist experienced in bariatric surgery of our hospital and the relevant specialists who are consulted according to the needs of the patient. In this decision, the patient's history, habits and other diseases, if any, are taken into consideration. You can contact our surgeons and get detailed information about the obesity surgery that is suitable for you.

Post-Operation Weight Loss

Nutrition after obesity surgery is an issue that needs attention. General weight loss continues for up to 1 year. We must establish a new eating habit and lifestyle after the surgery. We should not continue our old habits. We need to eat more protein-rich nutrition. In addition to regular and healthy nutrition, we should not forget exercises for permanent weight loss. Do not lose contact with your dietitian and doctor.

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