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Obesity Surgery; They are surgeries performed 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, bariatric surgery can be applied.
The obesity surgery method is suitable for people who have applied all other treatment methods before the surgery but have not been successful. The patient should be evaluated by all relevant units before the 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. If he is between 35-40 years old, if he has an additional disease (such as hypertension, Type 2 diabetes, sleep apnea syndrome, high triglyceride levels, heart disease, hypoventilation syndrome, fatty liver), if his body mass index is between 30 and 40, his blood sugar is 35, and his blood sugar is controlled by medical treatments. uncontrollable, Type 2 Diabetes patients may be offered surgery.
Types of Surgery in the Treatment of Obesity
Along with the developing technology, there are various surgical techniques used in obesity. Depending on the patient’s condition, the physician and the patient decide together on the choice of surgery.
Gastric Balloon
The simplest method that helps to lose weight is the gastric balloon application. In this method, a balloon filled with liquid or air is placed in the stomach with the help of an endoscope under light anesthesia. This process takes 15-20 minutes. Thus, the nutrient intake capacity of the stomach is reduced and rapid 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 the method is simple to apply and there is no permanent change in the body, if the patient does not change his lifestyle after the balloon is removed and does not continue his diet, 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. Today, the gastric balloon method is used as a preparation for basic morbid bariatric surgery in both high-risk patients and super-obese patients. Those who are not overweight can also use it.
Tube Stomach
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 formed into a tube. The person’s calorie intake is reduced. Gastric sleeve surgery is also performed in 1-2 hours with the closed method. The hospital stay is two to three days. After the surgery, patients can switch to normal nutrition 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 and the person’s appetite decreases.
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 food thoroughly and to consume it in small portions. In addition, exercise should not be forgotten. In order not to regain the lost weight, especially high-calorie, refined sugar liquid foods should be avoided.
Gastric Bypass
In these methods, the stomach is basically divided into two parts. one big and the other small. The newly formed small stomach and part of the small intestine and 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 surgery procedures in the world. It is one of the methods with the highest metabolic efficiency in the solution of 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 take 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 causes more weight loss as it directly affects the metabolism. It is an applicable method especially for people with BMI over 50 Kg/m2. In this surgery, both food intake is restricted and the absorption of the 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 high complications during and after the 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 quite successful. The most important disadvantage is; As in the RNY gastric bypass father, the remaining stomach is not visualized except for the endoscopically created pouch, 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 bariatric surgery. After the admission of the patient, it is evaluated by cardiologist, pulmonologist, psychologist and anesthesiologist, endocrinology and metabolic diseases. In addition, preoperative gastric endoscopy, abdominal ultrasonography and many laboratory tests are performed on the patient.
How Is Obesity Surgery Performed?
The operations are performed by an experienced surgical team under general anesthesia with the laparoscopic (closed) method. After the operation, depending on the patient’s condition and the recommendation of the anesthesiologist, the patient can be taken to the intensive care unit overnight for observation purposes. Patients who come out of this situation are sent to their rooms when they fully awaken from anesthesia.
How Is Obesity Surgery Performed?
The operations are performed by an experienced surgical team under general anesthesia with the laparoscopic (closed) method. After the operation, depending on the patient’s condition and the recommendation of the anesthesiologist, the patient can be taken to the intensive care unit overnight for observation purposes. Patients who come out of this situation are sent to their rooms when they fully awaken from anesthesia.
After Obesity Surgery
Patients should be careful in order to get rid of obesity after a successful surgery and to lead 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 approved by the dietitian and the surgeon performing the surgery should be carefully applied by the patient. The patient should not exercise during the procedures indicated by his doctor and should not disrupt his regular controls.
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