Types of Obesity and Metabolic Surgery in Turkey
- Gastric bypass surgery
- Mini gastric bypass surgery
- Gastric sleeve surgery
- Metabolic surgery for diabetics
- Gastric balloon insertion process
- Stomach botox intervention
- Robotic operations for obesity surgery
- Obesity and diabetes operation by robot
- Laparoscopic bariatric surgery
Gastric bypass and Gastric sleeve
With the change in eating habits and the spread of what we call fast food, obesity has taken its place among the most common health problems today. People resort to many ways to solve the problem of obesity. Gastric bypass is one of the frequently used methods to solve the problem of obesity.
What is gastric bypass?
Gastric bypass surgery, also called Roxane, is a bariatric surgical method that restricts food intake and reduces nutrient absorption by causing changes in bowel function. As for obesity surgery, it is a general term that covers obesity treatments.
In this surgical way, the structures of the stomach and intestines are changed. As this change in the structure of the intestine reduces the absorption of nutrients. In the case of reducing the stomach, eating will become restricted.
Morbid obesity in this surgical direction (defined as a body mass index greater than 40), which is used to treat type 2 diabetes, high blood pressure, sleep apnea and other associated pathological conditions. Thanks to the gastric bypass method, it has been observed that the long-term mortality rate for patients is reduced up to 40%.
What are the types of gastric bypass?
Gastric bypass surgery has 3 different types depending on how it is performed. These methods are:
- Rocks – in – y (near)
Rocks – in – y (near) is one of the methods that cause a few feeding problems, as it is the most used type in gastric bypass operations. In this way most of the absorption functions of the small intestine are preserved. When a person eats especially who we done this procedure on him, he feels full in a very short time.
- Rocks – in – j (distal)
As a result of a change in the structure of the small intestine, malabsorption of fats and starches mainly occurs, as well as the dissolution of many minerals and vitamins in fats, but nutritional side effects in this method are the most common.
- Gastric bypass / Gastric bypass (small gastric bypass)
It is used to rebuild the loop. It is rarely used due to its simple construction and sophistication in laparoscopic surgery, as it is an alternative to the Rocks – NY procedure.
How is gastric bypass surgery performed?
This surgical method is applied in two stages. In the first stage, the upper part of the stomach is divided into a small part and the lower part into a large part, so that the nutrients are collected in a small part, this small part of the stomach can accommodate only 28 grams of weight. In this way, although the patient eats less, it is ensured that the feeling of satiety is reached more quickly.
In the second stage the transformation process also known as bridging is applied. At this point a structural change is made in the small intestine and the small intestine tract is shortened allowing for less absorption of nutrients. The first part of the small intestine is bypassed as the small part formed in the stomach and the lower part of the intestine connect to each other. The foods eaten go first to the small part of the stomach and then to the second part of the intestine, as a result of this surgical method, a large part of the stomach and part of the intestine are removed from the digestive system. In this way, during meals, it is ensured that the patient eats less and absorbs fewer calories.
What are the surgical methods used in gastric surgery?
During gastric bypass surgery, surgical methods are selected according to the patient’s condition, taking into account the patient’s needs and desire. There are 3 different surgical methods for this surgery. These surgical methods are:
- Robotic surgery
This method is done through a few small incisions in the patient’s abdomen. Thanks to the small size of these incisions, the patient can return to his daily life more easily after surgery, as recovery takes a short time.
- Open surgery
In this surgical method, a large incision is made in the patient’s abdomen. The biggest advantage of this method is that the surgeon can see the patient’s tissue more clearly. The large size of the incision in abdomen delays the return to daily life and the healing process.
- Endoscopic Surgery
It is done by making several small incisions in the patient’s abdomen. It is method that is preformed under the supervision of a camera called a Laparoscope that appears inside the patient in two dimensions.
What are the positive effects of gastric bypass surgery?
It is known that gastric bypass surgery is generally used in the treatment of Obesity, but it is very effective in curing many diseases associated with being overweight. The positive effects of gastric bypass surgery on health are:
- In the first year after surgery, people lose 75% of their excess weight.
- In second period, the rate of weight loss slows down and 80-90% of this excess weight is lost in the second year. Some chronic diseases caused by excess weight also show improvement in this way.
- 94% cure rate in hyperlipidemia patients.
- The cure rate in patients with essential hypertension is about 60-70%, and a decrease in the need for medication in noted.
- The recovery rate from obstructive sleep apnea reaches 75%, which is one of the most important causes of weight gain. It is also noted that the frequency of snoring decreases among people.
- The cure rate for patients with gastroesophageal reflux disease is about 90%
The cure rate for diabetes mellitus, especially type 2, is about 70-80%, as it was often noticed after surgery that the blood sugar level had returned to normal.
In patients at risk of developing diabetes, this risk is reduced by 30%. In patients with asthma the cure rate was observed up to 82%.
Because of the decrease in weight gain, the load on the knee and waist of the patient decreases, and as a result, the recovery rate, especially in diseases such as osteoporosis in the knee and foot areas, increases to 85%.
When a person loses excess weight, his confidence is restored and the risk of depression is reduced by 72%.
There is also a decrease in the blockage (venous thrombosis), which is one of the reasons that lead to leg swelling.
What are the possible complications of gastric bypass surgery?
These complications are divided into long-term and short-term complications:
- Complications that can be seen in the short term: risk of leakage, risk of bleeding, respiratory infection, obstruction, incisional hernia, inflammatory wounds.
- Long- term complications: stomach ulcers, gallstones, incisional hernia, intestinal obstruction.
What is the gastric sleeve operation?
Sleeve gastrectomy, has an important place in the treatment of obesity. The vertical sleeve gastrectomy is the removal of part of the stomach to reduce it. As the size of the stomach becomes smaller, which aims to create a feeling of fullness faster in the patient.
In recent years, gastric sleeve surgery has become very popular because it can be performed quickly and has fewer side effects.
In addition, patients lose weight well in the postoperative period, and accordingly, health problems resulting from weight gain are eliminated as soon as possible.
In this way, it is very easy to preform the second stage surgery when necessary. After this surgery, patients lose 81-54 percent of their excess weight in about one year.
In this process, the mechanism of weight loss is carried out in two ways. These two mechanisms are: restrictive and hormonal. As a result of making the stomach smaller than its normal size, the patient reaches a feeling of fullness faster. This is called the restrictive mechanism.
Hormone ghrelin (hunger hormone) that produced in the stomach and released when your stomach is empty. The higher your levels of ghrelin, the hungrier you get. The lower your levels, the fuller you feel and the easier it is to eat fewer calories.
Since there is no structural alteration in the intestine in gastric sleeve surgery, there will be no absorption-related deficiency in the patient’s vitamin- mineral levels. Patient’s only need to take certain supplements during certain periods, such as iron.
The biggest reason for weight gain in patients after gastric sleeve is the problems in the process of getting used to the diet. Weight gain after surgery can be observed in 20% of patients.
Gastric bypass and gastric sleeve
Gastric bypass operations and gastric sleeve operations are two different methods used in the treatment of obesity in general, but these two methods have some advantages or disadvantages compared to each other, some differences between these two methods are:
- It was found that gastric bypass is more successful than gastric sleeve in terms of weight loss in the postoperative period.
- Eating is limited in both ways, In gastric bypass operations and gastric sleeve operations. But in gastric bypass surgery, as a result of additional structural changes in the intestine, food absorption decreases and calorie intake decreases. As a result, it is more successful than gastric sleeve in losing excess weight.
- After bariatric surgery, as with any surgical intervention, there may be some late risks (complications).
- When comparing the incidence of these risks, the determination of the incidence of risks after gastric bypass surgery was higher than after sleeve gastrectomy.
- In the gastric bypass process, due to some changes that occur in the intestine. There is a decrease in the absorption of vitamins and minerals, so it is necessary that a person check these values frequently and take them from outside as reinforcements and fortifications when necessary.
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