Op. Dr. Mehmet Akgun Tepeli

We are by your side in your fight against obesity

TAKE A STEP TO A HEALTHY LIFE

Nowadays, especially in developed Western societies, the frequency of obesity is gradually increasing with the decrease in mobility thanks to the ease of access to concentrated food and the comfort brought to our lives by technological developments. Obesity is a serious health problem that prepares the ground for many diseases that shorten human life such as hypertension, heart diseases and diabetes. In cases where diet and exercise do not produce the desired results, we recommend an individualized surgical approach to treatment, taking into account the patients eating habits and metabolic state.

OBESITY AND DIABETES

Excessive accumulation of fat in the body prevents the release of hormones that help insulin reach the cells. In case diabetes has developed due to obesity, it is necessary to solve the obesity problem first in order to subsequently treat the diabetes. As the excess weight in the body increases, the hormone balance deteriorates and the body shows resistance to insulin.

OBESITY AND HEART DISEASE

Obesity has many harmful effects on the heart. These can be direct or indirect depending on their mechanisms. In simple terms, the heart has to pump blood for greater body mass and this increases its workload. The heart responds to this increased workload by increasing in size, and this is the beginning of its impaired function.

WEIGHT LOSS AFTER BARIATRIC SURGERY

The first 4 months after surgery is the period of the fastest weight loss. When lifestyle changes, healthy and low-calorie nutrition diets and exercise programmes are applied together and with discipline, a complete improvement in the weight problem is achieved. As long as this order is maintained, the weight is also maintained.

What is Morbid Obesity?

Morbid obesity is a disease characterized by an increase in the natural energy stores, stored in the fat cells of the human body to a level that seriously increases the risk of mortality. Obesity is a serious global health problem characterized by endocrine (hormonal), metabolic and behavioral changes. In simple terms, it is the abnormal and excessive accumulation of fat in the human body to the extent that it impairs health, or in other words, more than 30% of body weight in adult women and more than 25% fat in men.

Surgery of Morbid Obesity (Bariatric Surgery)

Morbid Obesity Surgery (Bariatric Surgery) is the general name for a variety of surgeries that help in weight loss. Surgical treatment is planned for patients who do not have a hormonal disorder, who cannot lose weight permanently with diet, exercise and medication. These patients are people between the ages of 18 and 60 who have an average of 40-50 kg more than normal weight (body-mass index more than 40kg / m2) and who do not have a medical condition that would preclude surgical treatment. The above methods are not aesthetic operations, but operations aimed at permanent weight loss characterised by changes in the size and absorption distance of the stomach and intestines.

Sleeve Gastrectomy (Gastric volume reduction surgery)

Gastric volume reduction surgery, also known as Sleeve Gastrectomy, aims to reduce the volume of the stomach (approximately 60-100 cc) so that the patient feels full with a very small amount of food. For this purpose, a certain part of the stomach is surgically removed, leaving a tubular stomach (about the size of a banana). The main effect of Sleeve Gastrectomy is to achieve early satiety by taking less food due to the small volume of the stomach.

Metabolic Surgery

Metabolic syndrome is a condition characterized by obesity, diabetes, high cholesterol and high blood pressure. The treatment of metabolic syndrome through surgical methods is called Metabolic Surgery. Type 2 diabetes is a multi-factorial, heterogeneous and dynamic spectrum of diseases. It is a health problem characterized not only by hormonal but also by neural, psychogenic and environmental factors. When classical treatment methods are not sufficient in type 2 diabetes, surgical treatment comes to the agenda.

Obesity Surgeries

Metabolic Surgeries

Endoscopies

Colonoscopies

Other Treatments

Anal Fissure (Rupture of the superficial layer of the anus)

A typical symptom of this health problem is severe pain (resembling a cut with a knife) accompanied by a few drops of blood during defecation bowel movement. All diseases occurring in the anus area are mistaken for hemorrhoids, and we usually encounter a patient who has already used various medications for hemorrhoids.

It is particularly common in people with chronic constipation and women after childbirth. The skin of the anus torn by hard faeces, acquires a chronic character when defecation recurs before it has time to heal. The protruding part of the skin in the area of the laceration, which attempts to correct this situation, is assumed to be hemorrhoids.

Although medical treatment and dietary recommendations are the first approaches, they are usually insufficient.

Anal Fissure (Rupture of the superficial layer of the anus)

Circumcision of boys

Circumcision is the surgical removal of some part of the skin covering the glans (head) of the penis.

Circumcision is performed on young boys for religious and cultural reasons.

In our centre, circumcision procedures are performed at different ages, including the newborn period.

Goitre (Thyroid Surgery)

The thyroid gland is a butterfly-shaped organ located in front of the trachea. It is responsible for the production of the vital hormones T3 and T4.

Some thyroid diseases are treated with surgery. These are thyroid cancer and large neoplasms.

Hemorrhoids

Hemorrhoids are swelling of the veins in the anus like varicose veins in the legs. It is a common health problem that is painful, bleeding and disrupts the quality of life as a result of clustering and blood clotting in it.

Hemorrhoids can be in stage 1, where a simple thrombosed (clotted) hemorrhoidal knot is drained, after which it is possible for the patient to return to normal life the very next day.

Hernia Surgery

Hernia is the displacement of some organs or parts of our body due to congenital or acquired causes.

For example, in inguinal hernia, the inguinal canal is opened and the intestines in the abdomen move to the neighbourhood of the testicles.

In surgical hernias, as a result of tearing of the muscle layers in the operated area, the organs rupture the abdominal membrane and move under the skin.

PILONIDAL DISEASE (PILAR CYST)

Ingrown hairs are a health problem in which hairs falling from the nape of the neck or hairs that originate in the tailbone area become stuck in the skin and grow internally causing inflammation.

Ingrown hair (pilonidal sinus) destroys the are it ingrows into, just like a mole, and sometimes there is also possible leakage of purulent fluid from the starting point.

There are various options for surgical or chemical treatment. The important thing in this case is that the treatment is determined by issues such as the size and location of the area of damage caused by the pilonidal disease, as well as the elasticity of the patient's skin.

Oncological Surgery

Compared to the past, much progress has been made in cancer treatment both in surgery and chemotherapy. However, cancer remains one of the biggest problems of today's modern world.

For all organ cancers (e.g. breast, stomach, colon), early diagnosis gives a higher rate of successful treatment, both surgically and with other treatments (radiotherapy, chemotherapy) and a chance of a longer life.

Although the symptoms of cancer in each organ are different, early diagnosis is possible if the necessary examinations are performed, especially in cases where routine functioning is impaired. For example, if there are symptoms such as loss of appetite, nausea, weakness, faintness of unknown cause, stomach cancer can be detected with a simple endoscopy. As another example; breast cancer can be detected and treated at an early stage thanks to a routine breast ultrasound performed at certain intervals.

Reflux Surgery

After eating, the direction of movement of food follows a way through mouth - oesophagus - stomach and intestines, i.e. food movement is from top to bottom. Food mixed with acid in the stomach do not harm the stomach due to the properties of the stomach wall.

Gallstone Disease

When a stone formed as a result of bile sedimentation in the gallbladder blocks the bile duct, it requires serious and urgent surgery. Therefore, it is extremely important to plan immediate surgery when gallstones are detected on ultrasound.

Gastric Botox

Gastric Botox is an endoscopic (non-surgical) procedure that does not require general anaesthesia and takes approximately 10 minutes.

Its advantage is that the procedure is short and does not require hospitalisation.

Gastric Balloon

A gastric balloon is a device filled with fluid or water that is inserted into the stomach endoscopically (non-surgical, placed through the mouth) and remains there for a period of 6 months to 1 year, after which it must be removed.

Since it occupies volume in the stomach, it causes a feeling of satiety with less food intake.

OUR TEAM

Op.Dr. Mehmet Akgün Tepeli

Obesity and General Surgery Specialist

Büşra Buse Eren

Assistant and Patient Coordinator

Aylin Çetin

International Patient Coordinator

Güler Güneş

Responsible Operating Unit Nurse

Sevcan Kılıç

Surgical Nurse

Dyt. Belemir İnanç Yıldız

Dietitian

Dyt. İnci Mutlu

Dietitian

Uzm. Dr. Ahmet Malik Öğün

Anaesthesia and Reanimation

Frequently Asked Questions

What is the cause of Obesity? Is it just the nutrition habit? Is it genetic?

Obesity has many causes, or in other words it is multifactorial. Lifestyle, diet, genetics are some of the causes.
Who can undergo Bariatric Surgery (Obesity Surgery)?

Individuals who cannot lose weight with diet and exercise or who gain weight later may undergo surgery.
How much weight do you need to be in order to have an operation?

There is no weight figure required for surgery. BMI (body mass index) BMI Weight / Height For example; Height 150/ Weight 90 If BMI > 35, surgery may be considered.
How long does the surgery last?

The operation takes approximately 1-1.5 hours.
How many days is the average hospital stay?

If everything is normal, it is sufficient to stay in hospital for 3 days.
Is it possible to regain previous weight after obesity surgery? Which surgical method does not allow weight regain?

If proper eating habits are not acquired after surgery, it is possible to regain the previous weight. Usually weight gain begins in the second year after surgery. There is no surgical technique that guarantees no weight regain.
Which is the best technique for bariatric surgery?

The methods used in obesity surgery should be handled separately for each patient. The metabolic and individual conditions of the patient must be considered. However, the ease of learning, the popularity of the methods, the low - high number of risks are effective in the doctor's choice of method. Nowadays, sleeve gastrectomy is the most common method all over the world because it is the most physiologically and anatomically close to the usual, effective and easy-to-learn operation.
Which surgery is recommended for people with diabetes?

The surgery is not recommended in diabetics whose disease is under control with medication and insulin therapy. If diabetes is controlled but is associated with obesity, we recommend the Sleeve Gastrectomy procedure. If sugar is not controlled despite all treatments, we recommend Transit Bipartition surgery.
Does bariatric surgery carry a risk?

The surgical procedure itself, even just the anesthesia, carries some risks. Today, in centers that have the necessary experience, obesity surgery is close to the degree of risks of gallbladder surgery.