Obesity is an abnormal accumulation of fat, usually 20% or more over an indıvıdual’s ideal body weight, caused by an imbalance between the intake calory and the amount of calory which is used per day. Obesity is associated with significant increased risk of illnesses, disability and death
Diseases caused by obesity
Excessıve weight can result in many serious, potentially life threatenıng preoblems,including asthma, sleep apnea, joint deseases, polycystic ovary syndrome, migraine, urinary incontinence, reflux, liver deseases ,Type 2 diabetes, metabolic syndrome, hypertension,increased risk for coronary artery disease, pripheral veins disease such as varicosis, increased unexplained heart attack, hyperlipidemia, infirtility,and a higher prevalence of colon, prostate, endometrial, and possibly breast cancer
Who needs Obesity Surgery?
Patients with a body mass index of 35 and above are advised to undergo medical obesity surgery, which can not be attenuated by methods such as medical nutrition, exercise and medical treatment.
In addition, patients with a body mass index of over 30, such as high blood pressure, diabetes, sleep apnea, are recommended to affect the quality and duration of the patient’s life. Which surgery is appropriate is determined by various examinations and examinations.
Obesity surgery methods
Baritric surgery contributes to weight loss in two main ways:
Restriction; Sizeable vertical band, Sleeve gastrectomy, Gastroplicasion
Malabsorbtion; Roux-en-Y gastric bypass (RYGB), Mini gastric by-pass, Duodenal switch with Biliopancreatic diversion, Single Anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI -S)
Each patient’s situation should be considered individually to make decision about the right Surgical method by surgeon, according to patient’s comorbidities, and the other crucial factors such as age and BMI.
Results of Obesity Surgery;
It is necessary to wait at least 2 years to get an ideal weight after surgery.
But in the first year after surgery, the ideal weight of patients approaches 80%.
Worldwide studies have shown that 80% of patients undergoing obesity surgery maintain their ideal weight within 10 years postoperatively. More than 20% of people who have undergone obesity surgery weigh about 3-5 pounds and only 1-2% return to obesity.
If there is no risk, the age range of 18-65 is suitable for obesity surgery. If there is no risk after the doctor has examined the patient, they will decide together with the obesity operation.
Sleeve gastrectomy is the most commonly performed operation in obesity surgeons. Other obesity surgeries are as effective as sleeve gastrectomy surgery. However, obesity surgeons recommend Sleeve gastrectomy surgery.
Complications related to sleeve gastrectomide operations are less than other types of surgery. The risk and benefit ratio are assessed according to the patient’s condition.
More complex and long-lasting and ultimately more close follow-up is preferred in the surgery. Sleeve gastrectomy results in similar and desirable results in weight loss and metabolic adjustments. This requires less frequent follow-up. Less vitamin is lost.
In addition, this operation is done laparoscopically and results are close to perfection with the developing technical processes.
Sleeve Gastrectomy Surgery
Standard sleeve gastrectomy is performed laparoscopically. 5 or 6 small holes are cut into the abdominal wall. Carbon dioxide gas is injected into the abdomen to create the necessary area for surgery. A special tube is placed on the stomach to make the stomach the ideal size.
In the custom tube criteria, disposable devices called stomach staples are used and made into tubes. The stapler stitches and cuts the same thing. Approximately 80% of the stomach is removed. The remaining stomach volume is 100-150 ml. This amount is a small glass. Leak test is done at the end of the operation. It is investigated whether leaks from operation areas are given by injecting painted material into the stomach. The cut stomach is removed from one of the holes in the abdominal wall.
For safer results, one more stitch is placed on the suture line and a special glue (fibrin glue) is applied. Finally, a thin-silicon drain is placed in the surgical field. The duration of the surgery is 60-90 minutes.
Gastric bypass surgery is performed entirely by laparoscopic methods. It was the most applied method until last years. Gastric bypass surgery is less preferred because of the shorter duration of Sleeve Gastrectomy surgery and less complication.
Gastric Bypass Surgery
Standard gastric bypass surgery is performed by laparoscopic method. The abdominal wall is opened with 5 or 6 entries in the millimeter size. The flat tubes called the tural trocar are placed. The camera, work tools and stapler will be used through the trocar. Carbon dioxide gas is injected into the abdomen to create the necessary working area. First a small sac is created. The stomach is divided into two, close to the food pipe, about 30-50 ml. The cut volume is 5% of the total stomach volume. This will reduce food intake. The food will no longer pass the remaining 95% of the stomach.
In the second stage, the small intestine is separated from the determined distance by two. The following gut is lifted upwards and combined with the stomach pouch.
In the third step, the upper tip of the small intestine is joined at a distance of about 100 cm to the lower end of the stomach-associated small intestine. Thus, the food will be digested directly without passing through a significant portion of the mint and about 100 cm of the small intestine. This process is called gastric bypass.
A shortcut to the digestion of food has been established. The amount of food taken together with the shrinking stomach has been reduced. Bypass will reduce the absorption of food. At every step of the surgery, tools called stapler are used to cut the same side. Finally, a thin silicon drain (tube) is placed in the area of the operation required. The total duration of the operation is an average of two hours. This period may be prolonged depending on the patient’s body mass index and previous operations.