Obesity Surgery
Obesity surgery is a treatment method applied to individuals who have tried to lose weight through medication, exercise, and diet but have not succeeded with these methods. These surgical interventions are generally considered a last resort for patients with a body mass index (BMI) over 40-50. However, obesity surgery not only facilitates weight loss but also contributes to resolving various health problems associated with excess weight.
Who Is Suitable for Obesity Surgery?
Obesity surgery is suitable for individuals with a BMI over 40-50. Before opting for surgery, individuals must have attempted weight loss through diet, exercise, and medication. Surgical intervention is chosen not only to manage weight but also to treat health issues related to obesity. These health issues include diabetes, high triglycerides, sleep apnea, heart disease, and fatty liver, among other serious conditions.
Types of Obesity Surgery
Obesity surgery is performed using various methods tailored to the individual’s health condition and needs. Here are the most common types of obesity surgery:
Gastric Balloon:
The gastric balloon is an endoscopic procedure where a balloon is placed in the stomach to reduce its volume, creating a feeling of fullness. This method serves as a temporary solution for those seeking non-surgical weight loss.Gastric Botox:
Gastric botox involves injecting botulinum toxin into the stomach muscles to slow gastric contractions and increase the feeling of fullness. It is a non-surgical weight loss option.Sleeve Gastrectomy (Gastric Sleeve):
Gastric sleeve surgery involves surgically removing a large portion of the stomach, reducing its capacity. This helps individuals consume less food and lose weight.Gastric Bypass:
Gastric bypass reroutes a portion of the stomach, allowing food to pass directly into the small intestine. This reduces both stomach capacity and nutrient absorption.Duodenal Switch:
The duodenal switch combines stomach size reduction with intestinal restructuring. This complex procedure is usually reserved for severe cases of obesity and yields highly effective results.Mini Gastric Bypass:
Similar to standard gastric bypass, the mini gastric bypass is less invasive and requires a shorter operation time. It reduces stomach volume and decreases food absorption.
Conclusion
Obesity surgery offers an effective treatment option for individuals struggling with significant weight issues. However, it is crucial for individuals to have tried other weight loss methods and made efforts toward weight reduction before considering surgical intervention. Obesity surgery not only helps in weight loss but also alleviates obesity-related health problems, ultimately enhancing overall quality of life.
Duodenal Switch
Duodenal Switch (Biliopancreatic Diversion with Duodenal Switch)
The duodenal switch surgery, also known as biliopancreatic diversion with duodenal switch, is a long-standing and reliable method in obesity surgery. This procedure is designed to facilitate weight loss and address metabolic disorders. Similar to gastric bypass, it delivers effective results by both restricting food intake and reducing nutrient absorption.
How Is Duodenal Switch Performed?
Duodenal switch surgery is carried out in two stages:
Stage One - Gastric Sleeve Surgery:
In the first stage, approximately 85% of the stomach is surgically removed, leaving a narrow tube-shaped stomach. This significantly restricts the amount of food the patient can consume.
Stage Two - Intestinal Shortening:
In the second stage, the duodenum (part of the small intestine just beyond the stomach outlet called the pylorus) is divided. The surgeon then connects the remaining stomach to the small intestine at a point where only 250 cm of the small intestine is left for nutrient absorption. This reduces the absorption of fats and calories.
Post-Operative Outcomes of Duodenal Switch
Duodenal switch is one of the most preferred methods in obesity surgery due to its effectiveness. Patients typically lose 80-90% of their excess weight within 9 months. Additionally, it is highly effective in treating metabolic conditions such as Type 2 diabetes, along with other obesity-related health issues like sleep apnea, hypertension, and high cholesterol.
However, a common side effect of this procedure is frequent and foul-smelling diarrhea. This occurs as the intestines adapt to the new digestive process.
Is Duodenal Switch Suitable for Everyone?
The duodenal switch procedure is primarily suitable for individuals with a body mass index (BMI) over 50 and those with severe health issues like uncontrolled diabetes. However, it may not be appropriate for individuals with the following conditions:
- Crohn’s disease
- Vitamin and mineral deficiencies
- Long-term corticosteroid use
- Irritable bowel syndrome (IBS)
Duodenal switch is a highly effective method for weight loss and addressing metabolic health problems, but each patient’s condition must be carefully evaluated to determine suitability.
Metabolic Surgery
Metabolic Surgery
Metabolic surgery encompasses surgical procedures aimed at treating obesity and obesity-related metabolic disorders. These procedures not only facilitate weight loss but also address metabolic issues such as Type 2 diabetes, hypertension, high cholesterol, and sleep apnea. Metabolic surgery is typically recommended for individuals who have not achieved success with diet, exercise, or medication.
What Is Metabolic Surgery?
Metabolic surgery is considered a subset of bariatric surgery and is specifically designed to treat metabolic disorders such as Type 2 diabetes. These surgical methods focus on restructuring the intestines and reducing stomach size to achieve weight loss and better blood sugar control. Metabolic surgery can benefit individuals with obesity-related metabolic diseases as well as those who are overweight but not obese yet struggle to manage Type 2 diabetes effectively.
Types of Metabolic Surgery
Several approaches fall under metabolic surgery, all involving the restructuring of the stomach and intestines to achieve weight loss and treat metabolic disorders:
Gastric Bypass:
This procedure reroutes part of the stomach, allowing food to bypass the stomach and pass directly into the small intestine. It reduces stomach size and nutrient absorption, aiding in weight loss and blood sugar control.Sleeve Gastrectomy (Gastric Sleeve):
In this surgery, a significant portion of the stomach is removed, leaving a narrow, tube-shaped stomach. It limits food intake and supports the management of Type 2 diabetes.Duodenal Switch:
This method combines sleeve gastrectomy with intestinal rerouting, significantly reducing calorie and fat absorption while delivering strong metabolic benefits.Mini Gastric Bypass:
A less invasive alternative to the traditional gastric bypass, this surgery reduces stomach size and nutrient absorption, effectively aiding in weight loss and metabolic disease control.
Benefits of Metabolic Surgery
Metabolic surgery offers multiple benefits beyond weight loss, particularly in managing metabolic diseases:
Control of Type 2 Diabetes:
Metabolic surgery is highly effective in managing Type 2 diabetes, reducing blood sugar levels, and often eliminating the need for diabetes medications.Improvement in Blood Pressure and Cholesterol Levels:
Post-surgery, hypertension and cholesterol levels typically normalize, reducing the risk of heart disease.Relief from Sleep Apnea:
Weight loss achieved through metabolic surgery significantly improves obesity-related sleep apnea and other respiratory issues.Enhanced Quality of Life:
Patients experience increased energy levels, improved mobility, and an overall better quality of life following metabolic surgery.
Who Is Eligible for Metabolic Surgery?
Metabolic surgery is suitable for individuals with a body mass index (BMI) of 35 or higher who suffer from obesity-related metabolic conditions. It is also beneficial for patients with uncontrolled Type 2 diabetes who have not responded to other treatment methods. However, each patient must undergo a thorough medical evaluation to determine suitability for the procedure.
Metabolic surgery is a transformative option for managing obesity and its associated complications, offering a path to improved health and well-being.
Gastric Bypass Surgery (Stomach Bypass)
Gastric Bypass Surgery (Stomach Bypass)
Gastric bypass surgery, also known as laparoscopic gastric bypass, is a commonly performed surgical procedure for treating obesity. This operation reduces the stomach's capacity and reconfigures the absorption process in the small intestines, promoting weight loss and reducing the body's intake of high-calorie foods.
What is Gastric Bypass Surgery?
In gastric bypass surgery, a small portion of the stomach (approximately 30-50 cc) is preserved, and the larger portion is bypassed. The small intestine is then connected to the smaller stomach pouch. This adjustment enables patients to feel full with smaller meals and reduces the absorption of high-calorie foods. As a result, patients lose weight and experience improvements in obesity-related health issues.
How is Gastric Bypass Surgery Performed?
Gastric bypass surgery is typically performed using laparoscopic techniques, and robotic surgery has become a popular alternative in recent years. The procedure is carried out through 4-6 incisions, each about 1 cm in diameter. Unlike sleeve gastrectomy, gastric bypass surgery bypasses approximately 95% of the stomach, effectively excluding it from food intake. The stomach is divided into two parts, and a portion of the small intestine is connected directly to the newly formed stomach pouch. This allows food to bypass the duodenum and reach the intestines, reducing absorption and achieving satiety with smaller portions.
Post-Surgery Care
Patients typically stay in the hospital for 5-6 days after the surgery. Following discharge, a structured diet plan is implemented under the guidance of a dietitian. During the first year, patients are monitored regularly by a multidisciplinary team, including specialists in psychiatry, endocrinology, and nutrition. This comprehensive follow-up helps ensure healthy and sustained weight loss after the procedure.
Types of Gastric Bypass Surgery
There are different types of gastric bypass surgery, with the most common being:
Roux-en-Y Gastric Bypass:
In this method, the stomach is divided into a smaller pouch of 25-30 cc. The smaller stomach pouch remains functional, while the larger portion is rendered inactive. The small intestine is attached to the small pouch, bypassing a significant part of the digestive system.Mini Gastric Bypass:
This variation reshapes the stomach into a tube-like structure. A segment of the small intestine is rerouted, approximately 200 cm away, to connect with the stomach pouch. This method is less invasive and typically takes less time to complete.
Outcome
Gastric bypass surgery is a highly effective method for treating obesity, helping patients achieve significant weight loss while alleviating obesity-related health problems. A disciplined post-surgery diet plan and regular follow-up care are critical for long-term success.
Sleeve Gastrectomy (Gastric Sleeve Surgery)
Sleeve Gastrectomy (Gastric Sleeve Surgery)
Sleeve gastrectomy, commonly known as gastric sleeve surgery, is a surgical procedure aimed at reducing the stomach's size. It is one of the most widely used methods in obesity surgery today. During this operation, approximately 80% of the stomach is removed, leaving a tube-shaped portion that constitutes about 20% of the original stomach. Due to this shape, the procedure is referred to as a "gastric sleeve." This surgery is also performed laparoscopically, often referred to as minimally invasive surgery.
How is Sleeve Gastrectomy Performed?
The procedure is carried out laparoscopically, meaning it involves small incisions rather than the large 10 cm cuts used in traditional open surgeries. Several small incisions (approximately 0.5 cm each) are made in the abdominal area, and the majority of the stomach is removed through these incisions. A high-resolution camera is inserted into the abdominal cavity, allowing the surgeon to perform the operation by viewing the internal area on a monitor. The procedure is done under general anesthesia, ensuring minimal pain and a quick recovery process for the patient.
In the final stage of the surgery, controlling bleeding along the suture line is crucial. Once bleeding is under control, drainage tubes are placed to remove excess fluids, and these are removed after the operation.
Advantages of Sleeve Gastrectomy
The gastric sleeve offers numerous benefits to patients:
Reduced Stomach Volume:
The smaller stomach volume allows patients to feel full faster and consume less food, accelerating the weight loss process. Unlike other surgeries, patients do not face lifelong severe dietary restrictions.Decreased Hunger Hormone Production:
Ghrelin, the hunger hormone, is mainly produced in the part of the stomach that is removed. As a result, patients experience a significant reduction in appetite after surgery.No Intestinal Alterations:
Since the intestines are not manipulated, the risks of complications such as bowel obstruction, leakage, or bleeding are minimized.Shorter Hospital Stay:
Patients typically have a shorter recovery period and reduced hospital stay compared to other types of weight loss surgeries.No Foreign Body Usage:
The procedure does not involve inserting foreign objects or materials into the body.Minimal Nutritional Deficiencies:
Since the absorption process of nutrients is unaffected, the risk of vitamin and mineral deficiencies is minimal.
Post-Surgery Recovery
Due to the minimally invasive nature of the procedure, patients experience a relatively comfortable recovery process. The small incisions result in minimal pain, and the healing process progresses rapidly. Patients are routinely monitored at 1, 3, 6, and 12 months after surgery. In the first month post-surgery, patients typically lose an average of 20 kg, and by the end of the first year, they can expect to lose approximately 80% of their excess weight.
Sleeve gastrectomy not only promotes effective weight loss but also improves overall health and quality of life for individuals struggling with obesity.
