The prevalence of obesity and obesity-related diseases (type 2 diabetes, i.e., diabetes, hypertension, sleep apnea, metabolic syndrome, fatty liver, insulin resistance, etc.), which are defined as the most important epidemic of our age by the World Health Organization (WHO), is gradually increasing. Although obesity is a disease that shortens the life span alone, it also decreases the quality of life due to causes of type 2 diabetes (diabetes mellitus), hypertension, cardiac and lung problems. In addition to cardiovascular diseases, obesity also causes other important diseases such as cancer and infertility.
Operations such as laparoscopic sleeve gastrectomy (popularly known as stomach reduction surgery) known as obesity surgery and diabetes surgery (metabolic surgery), stomach bypass (gastric bypass), transit bipartition, duodenal switch, gastric balloon are performed in our obesity and diabetes surgery department. Operations are carried out with a multidisciplinary approach at Yeni Yüzyıl University Gaziosmanpaşa Hospital.
Closed method (laparoscopic) surgery is applied to type 2 diabetes patients with a body mass index of 30 and above through diabetes surgery. The pancreas produces insulin more rapidly and in greater amounts with the weight lost after the diabetes surgery and releases insulin faster throughout the body. Accordingly, blood sugar returns to normal.
In our bariatric and metabolic surgery center, revision surgeries are also performed due to complications after obesity surgery, regaining lost weight or unsuccessful first operations.
In our team, there are trained and experienced bariatric and metabolic surgery, interventional radiology and interventional gastroenterology faculty members who can intervene laparoscopically and endoscopically in complications that may occur in bariatric and metabolic surgery (leak, fistula, bleeding, obstruction, stenosis, hernia, etc.).
What is Obesity?
Obesity can simply be defined as abnormal and excessive fat accumulation in the body. According to another definition, obesity means that the body fat tissue is more than 25% in males and 30% in females. One of the genetic, environmental, and cultural factors may be effective in the formation of obesity, and all of these reasons can be found together.
BMI ( kg/m2): Body weight (kg) / Height2(m)
If under 18.5 kg / m2
If between 18.5-24.9 kg / m2
If between 25-29.9 kg / m2
If between 30-34.9 kg / m2
I. degree obesity
If between 35-39.9 kg / m2
II. degree obesity
If between 40 and 50 kg / m2
III. degree morbid obesity
If over 50 kg / m2
Who is Eligible for Obesity Surgery?
Patients with a Body Mass Index over 40 and unable to lose weight despite regular diet and exercise.
Patients who have a Body Mass Index between 35 and 40 with additional diseases such as hypertension, diabetes, or sleep apnea due to obesity and who cannot lose weight despite regular diet and exercise.
Conditions Preventing Surgery
- Patients with serious psychiatric problems
- Patients unable to comply with post-operative treatment
- Patients with substance and alcohol addiction
- Patients with a condition of obstacle to anesthesia.
Benefits of Obesity Surgery
In obesity patients with hypertension problem, there are serious improvements in postoperative blood pressure measurements. These patients stop taking blood pressure medications at a rate of 60-70%.
There are serious improvements in blood sugar levels in patients with type 2 diabetes. More than half of the patients can quit their antidiabetic drugs.
There is a significant reduction in the risk of heart disease after surgery.
There are improvements in sleep apnea problems due to excess weight.
There are improvements in respiratory system problems.
As a result of the benefits mentioned above, the quality of life of the patients increases significantly.
Types of Surgery
Vertical banded is an operation performed by laparoscopic method. A small stomach pouch is created by means of a band placed 3-4 cm below the entrance of the stomach. The most important advantage is that the band is adjustable. The tightness of the band can be increased or decreased according to the patient's follow-up. To make this adjustment, a port is placed under the skin. Since there is no absorption disorder in patients with vertical banded, no vitamin deficiency is generally observed.
Band slippage, band erosion, swallowing problems, band damage and port insertion problems can be considered as problems that can be encountered after surgery.
The most popular obesity surgery is sleeve gastrectomy surgery. The surgery can be successfully performed by laparoscopic method. In this surgery, most of the stomach is removed and approximately 25-30% of the total volume of the stomach remains. Since the remaining stomach part is in the form of a tube, the surgery is called by this name.
In surgery, the upper part of the stomach called fundus is removed. Therefore, ghrelin levels, an appetite hormone secreted from the fundus of the stomach, decrease, and postoperative appetite control becomes easier in patients.
Although there is a decrease in stomach capacity in this surgery, there is no deterioration in stomach functions. The risk of developing stomach ulcers is reduced. Since the surgery does not cause malabsorption, less vitamin deficiencies are seen compared to bypass surgeries.
In this surgery, a stomach volume of approximately 25-30 cc is created at the stomach entrance and a small intestine area 100-150 cm away from the stomach is combined with this pouch. This surgery is an operation that both restricts eating and reduces absorption. It is technically more difficult and has higher risks and is an irreversible surgery. Long-term results are similar to those of sleeve gastrectomy, therefore, sleeve gastrectomy has started to be preferred a little more nowadays. Patients should definitely receive vitamin support after surgery.