BARIATRIC SURGERY (SURGERY OF MORBID OBESITY)
There are various definitions of morbid (morbid) obesity, but shortly, it is a condition in which an individual has much more weight than is necessary.
Diet and exercise programmes are at the forefront in the treatment of obesity. In cases where diet and exercise programs do not help, one can resort to treatment through surgical intervention, called bariatric surgery (Obesity Surgery).
Surgical treatment methods change and transform over time.
The surgical method to be applied in morbid obesity is determined depending on the eating habits and metabolic state of the patients.
Nowadays, the most common surgical methods are "Gastric Bypass" and "Sleeve Gastrectomy".
In the "Sleeve Gastrectomy" operation, about 2/3 of the stomach is removed, leaving a stomach approximately the size of a banana.
Nowadays, with the development and widespread use of laparoscopic techniques (closed method), sleeve gastrectomy has become the most common technique for obesity surgery all over the world.
In Gastric Bypass (RYGB) surgery, iron and calcium deficiency may be observed in the postoperative period.
Gastric Bypass surgery is more prominent in severely obese individuals, which we call super obese.
One of the reasons for the widespread use of Sleeve Gastrectomy is its ease of learning and application.
TUBE STOMACH SURGERY (SLEEVE GASTRECTOMY)
In sleeve gastrectomy (stomach reduction) surgery, under general anesthesia, the stomach is separated from the surrounding organs by penetrating through 4-5 holes made in the abdominal area using a camera and other technical instruments.
Then, the stomach part to be removed is separated with the help of a cutting and sewing instrument called stapler. The remaining part of the stomach is stitched against the risk of bleeding and opening. The part of the stomach to be removed is also taken out through small holes opened in the abdomen.
Sleeve gastrectomy (stomach reduction) operation is a surgical procedure that takes approximately 1 hour. The patient can walk 3-4 hours after the surgery.
The day after surgery, the patient is given liquid food. On the third day of the surgery, the patient is discharged and begins monitoring the weight loss process under the supervision of a dietician.
After 15 days of stomach reduction (sleeve gastrectomy) surgery, normal nutrition is gradually started. It is recommended to start light tempo exercises like jogging,stretching etc.
Usually in a period of 6 - 8 months after the obesity surgery, the desired weight can be reached.
With sleeve gastrectomy as with other obesity surgeries, ideal weight is usually achieved in about 1 - 3 years after surgery. However, if proper eating habits are not acquired, it is possible to regain the previous weight.
METABOLIC SURGERY (SURGERY FOR TYPE 2 DIABETES MELLITUS)
After all bariatric surgeries, the metabolic status (blood fats and blood sugar) of patients changes for the better.
However, metabolic surgery is used for uncontrolled diabetes and obesity.
In metabolic surgery, the stomach is reduced as in sleeve gastrectomy. In addition, some changes are achieved by using the hormone-active feature of the small intestine.
Metabolic surgery cannot be applied for every diabetic patient.
Patients with type 1 diabetes mellitus are not suitable for this surgery.
Patients with type 2 diabetes mellitus with sufficient insulin reserve may benefit from metabolic surgery.
The best known technique for metabolic surgery is the Transit Bipartition.
In this technique, the stomach is shrunk, then a middle part of the small intestine, which produces active hormones, is connected to the stomach.
This reduces the amount of food entering the body and activates dormant hormones in the small intestine.