Metabolic Diseases Centre – Thyroid Diseases – Diabetes
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Obesity and diabetes surgery center: All obesity and diabetes surgeries and other operations have achieved full success in Turkey Healthcare Group for more than 10 years.
Thanks to the expert doctors, quality, modern technology, and medical supplies in our hospital, the results of general surgery have achieved high-quality excellence thanks to the techniques we do for all patients such as robotic surgery, microscopic surgery, and other techniques.
A hospital equipped with all modern medical and technological equipment, a high-quality patients’ room, suite rooms, an operation, care and follow-up room, high quality cleaning and basic services.
Professor doctors, the medical team, consultative council and other high-grade employees and their goal is to treat patients by the most modern and global methods.
What is obesity:
According to the WHO definition, if Body mass index (BMI) is more than 30, the person has obesity.
BMI: A statement in which the body mass index is calculated, where the weight is measured with the length this calculation method may not always give accurate results for each patient. High BMI without obesity may also occur for people who play intensive sports and have a high muscle mass. In order to overcome this problem, methods such as impedance measurement for fat-free body weights are also used. However, the most common method is the BMI.
Many obesity patients suffer from chronic diseases and severe health consequences such as diabetes, hypertension and high blood fat levels.
BMI – Body mass Index, the body weight is taken, weight is assessed by using a BMI that examines the relationship between body length and weight.
BMI is the best internationally recognized measure to distinguish excess weight from obesity and thinness or the ideal weight.
The calculation is as follows:
BMI = Length in meters x Length in meters / Body Weight in kilograms (Please read equation from left to right)
| Weight is low if the body indicator ratio is less than | 18.5 |
| Weight is normal if the body index ratio is between | 18.5 – 25 |
| Overweight if the body index ratio is between | 25 – 30 |
| Has obesity if the body indicator ratio between | 30 – 40 |
| Excessive obesity if the body indicator ratio is more than | 40 |
under 18.5: Low weight
18.5 – 25: normal weight
25 – 30: Overweight
30 – 40: obesity
40: Excessive obesity
The BMI is calculated by dividing the weight in kilograms by the square of length in meters
Note: The BMI may not be accurate with athletes and teens
In recent years, why have people with obesity diseases increased?
First, the content of the has changed in recent years. Foods with a lot of high calories and refined carbohydrates
have been consumed. Refined sugar can be described as simple sugars that have completed the semi-digestion process. These foods are more durable than other complex sugars, so they are further used.
In addition, with the expansion of automobiles, increased use of TV and computers, and an increase in the number of office workers, we have quickly become a life without mobility.
With the increase in the number of people living in cities, a decrease in places to play sports between buildings and heavy traffic, still life has increased even further.
The lifestyle that is ultimately accompanied by high calories, but with less movement; unfortunately, many obesity-accompanied diseases are costly.
What are the diseases caused by obesity?
The common consequences of obesity are:
Beware of 5 obesity-caused diseases
1- Diabetes
2- Hypertension
3- Heart failure
4- Arthritis
5- A number of cancers
- Diabetes
- Cancer
- Hypertension
- Cholesterol disorders
- Tumors
- Infertility
- Cardiovascular disease, heart attack and stroke
- Gastroesophageal reflux
- Arthritis and bones diseases
- Phlebitis
- A lot of gynecology’s problems caused by obesity
- Depression
- Dyspnea during sleep, sleep problems, sleep apnea, etc.
It is also known that the possibility of developing cancers such as breast, uterine, large intestine, esophagus, pancreas, kidneys and prostates, increases with obesity.
The majority of obesity-related diseases: unfortunately, obesity problems cause a person to suffer many diseases that affect the person’s health later, especially as most of these diseases are chronic.
What is the cure of oobesity disease?
First: Organizing the permanent diet program: It is necessary to apply a diet determined by nutritionists, the diet to be applied must be in accordance with adequate and balanced nutrition principles. The goal is to get and maintain the habit of feeding for the individual. A very low short-term diet containing calories not only causes significant damage to metabolism, but also causes more weight when the diet is stopped. Therefore, short-term diet is not recommended, but a diet must be permanent, and a doctor must always be required to follow your permanent status and consult your specialist doctor regularly.
Second: sport exercises therapy: Although the weight loss effect is still controversial, physical activity certainly helps reduce fat mass in the abdomen, and helps us to be healthier by avoiding muscle mass losses when following a diet. It is recommended that everyone practice 30 minutes a day, whether obese or not., taking into account the limits of motion methods to reduce the risk of injury.
Third: behavioral change therapy: It is based on the principle of avoiding events that cause us to eat or not move in our lives, including self-monitoring, detection of harmful stimuli, restructuring, control of food behavior, increasing physical activity and social support.
Psychiatrists and psychologists practice between 12 and 20 weeks in groups of 10 to 12 people.
Fourth: Treatment of obesity by medicines: The greatest risk under this heading is the use of weight-loss medicines from the internet, even from pharmacies without doctor’s monitoring. Most herbal products that are used, claiming that the ministry approved, are harmful.
Patients who lost their lives because of herbal medicines, had to undergo to a liver transplant and remained in the intensive care for a long time, were much more than those who were mentioned in the press.
Very important note: Do not use any medicine other than the prescription of obesity therapists. You may lose your life.
Fifth: Treatment of obesity by surgical operations: Bariatric surgery is the best and most modern technology in medicine to treat patients who cannot be treated by the traditional methods mentioned above.
Obesity is also largely related with diabetes, sleep apnea, hypertension, gout, metabolic syndrome, cardiovascular disease, and liver strain diseases as mentioned earlier have many disadvantages.
Who are the suitable patients, candidates for obesity surgery?
Patients with BMI ratio higher than 35 kg/m2 should undergo to a surgery without any other reason.
Patients with BMI ratio higher than 30 kg/m2 and those who suffer from a disease can be treated by bariatric surgery such as diabetes and hypertension, coronary artery disease or sleep apnea stop are also suitable candidates for bariatric surgery.
For patients with BMI ratio within 30-35 kg/m2, in medicine the debate continues whether there is a risk of heart attack or brain hemorrhage due to chemically confirmed obesity, these patients are undergoing to bariatric surgery in Europe and the United States. In Turkey, State Security Investigation has not yet accepted this case except for the necessity of surgery.
However, for patients without associated diseases and BMI within the range of 30-35 kg/m2, Treatment methods non mentioned in the introduction should be considered
What is the Intragastric Balloon System?
Intragastric Balloon System is a non-surgical assistance in obesity therapy. It is an expandable silicone balloon, placed inside the stomach through endoscopy. Once the balloon is inside the stomach, it is filled with saline solution through a small filler tube suspended on the balloon. Once the tube is filled, it is gently removed by pulling it on the outer tip, leaving the balloon inside the stomach. The balloon fills about 30% to 40% of the capacity of the stomach. This increases the feeling of being full with less food, allowing the patient to have effective diet without ever feeling hungry.
A hollow balloon is inserted in the stomach by the endoscopy device then the balloon is blown, creating a fill in the patient’s stomach, giving the feeling of full. This method is not practical. It does not require general anesthesia, does not require operating room conditions, there is no need to make cracks, and does not cause anatomical or hormonal changes.
However, it is safe to keep the balloon for a maximum of one year. Because of long-term balloons, complications such as gastric or duodenum ulcer can be seen and the bowel obstruction can be seen as a result of a balloon explosion. The balloon effect is not permanent. Most of the time, when the balloon is removed and the patients measure their weight again. It is known to be effective with some patients are not suffering from excessive obesity (BMI 25-30 kg/m2). However, it is important to note that there is a temporary solution.
Balloon can be kept in the stomach for up to six months to avoid weakening the balloon material with the acid content of the stomach, resulting in emptying it. When the weight loss target is not reached, the balloon can be replaced with a new one after six-month period. The balloon is removed in the same way as it was placed, through the endoscopy.
The Intragastric Balloon System was designed to help reduce the weight of people weighing between 10 and 15 kg over their ideal weight who have failed to achieve long-term weight loss with other weight control programs. Excess weight loss will be about 70% in a six-month period. It is important to understand that the intragastric balloon system is an aid to weight loss and should be used in conjunction with the diet plan, exercise program and behavioral adjustment treatment.
Types of operations in Bariatric surgery:
There are three types of main operations of Bariatric surgery and have many methods:
Process by reducing stomach size:
First: Sleeve gastrectomy operation, tube stomach surgery
In the reduction of the gastric size for obesity, sleeve gastrectomy is the most common. In this process, the stomach is converted into a thin tube and the saturation is achieved with less food. In addition, a portion of the stomach called Ghrelin hormone is released. Since this part is taken largely by tube stomach surgery, the appetite also decreases, so patients undergoing to tube stomach surgery gain less fasting and saturation.
Second: Laparoscopic Gastric Banding: (adjustable gastric banding): In this technique a silicone cuff is placed that can increase or decrease in the size, around the stomach and is intended to reduce the size of the stomach. A lower pass rate was found than other operations because they did not make hormonal changes due to high complications rates, they are no longer used except in special cases.
It is the least attractive surgery for weight loss by many patients. The process involves placing an implant, a soft silicone ring with an expandable balloon in the middle, around the top of the stomach. It effectively creates a stomach divided into two parts, with an upper part much smaller than above the band. The person only eats enough food to fill the upper part of the stomach. Over time, after the meal, the food passes by opening the division in the rest of the stomach, and the digestion occurs naturally.
The procedure is performed by abdominal endoscopy. It involves placing an adjustable rubber band around the upper part of the stomach, reducing its functional size and emptying time; leaving a tank from about 20 to 30 ml as new stomach. The band has three parts: The same adjustable band, tank, and a flexible tube that connects them.
Subcutaneous injection is done through a soft tube, allowing the division to be adjusted by amplifying or inflating the balloon in the band. Band adjustments are made easily in the office and do not require any special preparation. Adding salt to the division makes the opening between the two parts of the stomach smaller, making the passing of food from the top of the stomach to the rest of the stomach slower. Removing saline from the band allows for faster passing of large food particles.
In order to succeed, patients must be prepared to make significant changes in their nutritional habits and lifestyle. Dining carefully with healthy eating options, accurate chewing, and no mixing of solid food and liquid into a meal is crucial to success. Inability to comply with these behaviors may result in negative symptoms such as vomiting, reflux or pain. In addition, the comprehensive follow-up program, including dietary advice, monthly visits, and potential changes, increases the chances of lasting success. A regular exercise of a healthy lifestyle is also proposed.
Although short-term surgical complications are extremely rare, recent evidences refer to a large long-term multiple rate. Between 15 and 60% of patients need to cartilage re-transplant, repeated vomiting, or weight loss.
An adjustable gastric banding should not be used for someone who is a bad candidate for surgery, or has certain intestinal disorders, or take aspirin repeatedly, or alcohol and drugs addict. It should not be used if someone is unable to follow food recommendations and others, or if his/her frequent visits to the office are expensive.
Third: Laparoscopic Gastric Plication
This procedure has been known for over 5 years as we fold the stomach into the stomach cavity smaller by many times and where the stomach is stitched from inside to be smaller and then stitched back to, and it is a relatively new procedure in the field of bariatric surgery. It is one of the restrictive procedures because their main function is to reduce the capacity of the stomach without modifying the absorption of nutrients.
And the diameter from the stomach is narrowed, the patients may feel more complete early, leaving the stomach capacity of 200-300 ml. The intestine hole attempts to simulate the restrictive effects of Gastrectomy without Gastric stapling. This does not require the use of the restricted devices, or surgical removal of stomach tissues.
This process is performed by the endoscopy surgery where the stomach is released and then folded on each other so that it becomes like a narrow tube similar to the stomach tube we get by the sleeve gastrectomy but without cutting, stitching or removing any part of the stomach. The stomach here is folded on itself or on each other and is not stitched along its entire length or so-called large curvature. This process is therefore almost safe, fast-performing, fast-healing and low-cost and the stomach can be restored to normal by cutting the stitching if the patient wants to do so after a period of time (to restore the stomach to its normal size).
This procedure is performed by abdominal endoscopy under general anesthesia, lasting about one hour, and requires treatment at the hospital overnight. Excess weight loss is about 70% during the first year.
The results have proven the following:
- This method has complications (abdominal pain, nausea, vomiting, bleeding, , stomach rot…) its rate is 5%, it is not as some believe it is 100% safe
- This method produces temporary weight decrease in the first 6 months only and the body weight increases over the long term.
- This procedure is not suitable for people who suffer from excessive obesity and have an increase in weight over 35K.
- This procedure is not suitable for people who suffer from obesity as a result of excessive sweets
- This method is expensive compared with its weak results.
- It gives temporary results to people who have an increase in the weight between 15 and 20 K, and their results are compared with the balloon and the stomach Botox.
- Its results are not comparable to other bariatric surgeries such as sleeve gastrectomy and Gastric Bypass, it is much less effective.
This method did not spread worldwide as a result of not getting satisfying results for patients’ weight loss and this is why many doctors do not recommend this technology.
Roux-en-Y Gastric Bypass (RNY)
The best treatment technique for patients suffer from obesity and is considered the golden technique in treating obesity diseases, and is considered the first internationally approved operation and in America as it proved a high efficiency in weight-loss and maintaining the lost weight over long years after it was performed.
A type of weight-loss surgeries that involves converting food from the stomach and connecting it directly to the small intestine. After the Gastric Bypass, the swallowed food will go to the stomach and then directly to the small intestine, thus exceeding most of the stomach and the first part of the small intestine.
This technique is used globally in bariatric and diabetes surgery and the Gastric Bypass is considered one of the most common types of bariatric surgeries therapy in the United States. The Gastric Bypass is performed when a diet and exercise are not successful or you suffer from serious health problems due to your weight.
One of the most important advantages is the lack of commitment to certain kinds of eating, which doesn’t causes the feeling of deprivation for the person in contrary to the sleeve gastrectomy in which the person refrains from having sugar, sweets, Pepsi and juices, and weight does not return to increase after years of conducting it, one of the most important factors and pros of this remarkable global technology is that patients are treated and permanently dispose of diabetes type 2.
Roux-en-Y Gastric Bypass mechanism:
First, the stomach is divided into two sections near the top. The stomach bag is left at the top and food in a size of about 30 millimeters, then the first part of the small intestine is divided, the lower end of the divided small intestine is connected to the new small stomach bag.
The jejunum in the small intestine is divided by connecting between150 to 200 cm behind the acids in the stomach, bile, pancreas and small intestines, digestive enzymes are provided in the contents to encounter the food in a later stage.
Roux-en-Y Gastric Bypass works with different mechanisms.
First, the size of the stomach is reduced. Foods do not enter the lower part of the stomach. The patient can eat small quantities and the tension has created a feeling of saturation.
Second, Patients feel hungry because the jejunum hormone released by part of the stomach is not active.
Third, digestive enzymes are likely absorbed from the foods in the middle of the small intestine. Less food is added to the digestion process.
The effect of intestinal hormones can be changed because of the redirection of food flow, the diabetes type 2, which is the most important associated diseases with patients suffering from excessive obesity.
Gastric Bypass is one of the most effective techniques of bariatric surgery processes in which patients, who suffer from the morbid obesity, arrive to the ideal physical weight, the morbid obesity that can cause catastrophic effects that occur with the associated diseases.
- Diabetes caused by morbid obesity has been improved 85%. Insulin and/or drug dependence can be totally eradicated.
- Basic hypertension improves in more than 70% of patients or reduces the need for treatment.
- High blood fat improves in more than 70% of patients.
- Lumbar vaginal diseases and the joints related to obesity, may improve.
- Sleep apnea stops; it is one of the most diseases, early immediately after the operation.
- Gastroesophageal reflux disease occurs 20% of patients suffering from excessive obesity, will improve for all patients after surgery.
- Excessive obesity is one of the reasons of the blood clot These risks disappear after surgery.
- In the UK, the excessive obesity is caused by neurological and reproductive disorders “in both sexes. Weight loss is eliminated after surgery and hormonal disorders.
- If patients are willing to have children, women may become pregnant in the second year.
Benefits of Roux-en-Y Gastric Bypass
- Long-term weight loss provides (60% to 80% of the excess body weight).
- It restricts eating and absorption.
- It may save energy.
- It causes positive changes of the intestinal hormones that reduce appetite and increase feeling of saturation.
- Loss of weight is more permanent, overweight rates are lower over the long term.
Defects or disadvantages of Roux-en-Y Gastric Bypass
Technically, it is a more complicated than sleeve gastrectomy and may lead to greater complications, so you should choose the best experienced doctors of bariatric surgery, of course, it is very clear that most surgeons do not have experience in this surgery because any defect occurs, it may lead you to the death, so you should choose high-quality hospitals and the experienced professors.
Long-term vitamin and mineral deficiency, especially vitamin B 12, can lead to Iron, calcium and folate deficiency. Diet recommendations require providing vitamin/mineral supplements lifelong.
Laparoscopic Mini-Gastric Bypass:
The mini-Gastric Bypass is an effective and established procedure that combines some of the characteristics of Gastric Bypass and the standard Roux-en-Y Gastric Bypass. The upper part of the stomach is divided into a tube, similar to the first three quadrants of the sleeve, and then joins a lope of the intestine.
Simple Gastric Bypass can be used as a basic weight loss procedure. It can also be used with patients who have previous gastric banding or Sleeve gastrectomy but did not succeed in order to lose weight, or who have complications with the division and have decided the revision surgery.
In this process the top of the stomach is stapled to form a thin tube (30 ml to 50 ml size). The thin tube becomes a smaller new stomach, which is completely separated from the rest of the stomach, then this stomach is stitched to a loop of the small intestines, exceeding the first part of the intestine called the duodenum and about 150 to 200 cm of the intestine. The rest of the stomach and upper part of the small intestine remain in the body but are no longer used for digestion.
How the Mini-Gastric Bypass mechanism helps you for weight-loss in different ways:
- By reducing the sense of hunger through the modified intestine to the brain signals.
- By enabling a previous feeling of saturation and fullness when eating a meal, resulting in a healthy portion size.
- By reducing the number of calories, you absorb from your food as a result of exceeding 150 to 200 cm from the upper part of the small intestine.
- Redirecting the food stream results to changes in the hormones of the digestive channel that reflect one of the key mechanisms of diabetes type 2, which caused by obesity.
Many studies have been conducted and published over the long time (over 5 years) on the surgical effects of the simple gastric arterial change. After two years of surgery, weight loss is 75-85 % of the excess body weight. Five years after surgery, the excess weight loss is 70-75%.
Weight loss using a mini- Gastric Bypass is good, if not better, than that achieved by using the standard gastric arterial change surgery of people with a high BMI.
Many diseases related to overweight such as sleep apnea, diabetes type 2, arthritis, hypertension or Poly-cystic ovary syndrome, improve or disappear as a result of surgery.
Important! The long-term effects of any surgical operation in the stomach depend on the patient who makes the necessary changes in lifestyle, especially with regard to the diet and exercise.
What are the complications after Mini-Gastric Bypass?
As with any surgical procedure, the mini-Gastric Bypass process has a risk profile, it is important to be understood before proceeding. The following is a comprehensive list of issues that can occur. Most of these complications are extremely rare and 90-95% of patients have no problems. This list is extensive and not intended to worry you, but simply I report you the potential complications, regardless of how scarce the problem is.
Possible early complications:
In our practice, the most likely complications were post-surgical bleeding (1% of patients). Bleeding usually stops and is not so large that blood transfusion is required.
Other early complications (0.5%) may be: peritonitis. A thrombosis in the deep veins and lung artery. myocardial infarction, pneumonia, abdominal abscess, wound infections, surgical hernia, ulcer. 90% of complications requiring additional special medical care, occur within 48 hours after surgery, when the patient is in hospital
Late complications and side effects after Mini-Gastric Bypass:
The internal hernia – The risk of internal hernia is much less after Mini-Gastric Bypass (1:500), but for the standard Gastric Bypass it is (2:100). Sometimes the bowel loops can entangle in the abdomen and falter. If this happens, you need to restart to fix the problem.
Adhesions – any procedure in the abdomen can cause adhesions (scars). This can happen at any time after the operation and can sometimes cause problems with the intestines which can be faltered or twisted. This may require hospitalization and may require restarting.
Gastroesophageal reflux– if the reflux occurred after surgery, some patients may need acid suppression drugs. This process should be avoided for those who have severe symptoms of reflux before surgery.
Malabsorption of vitamins and minerals– low levels of iron, vitamin B12 and other micronutrients, can occur even if you follow the recommendations of supplements. For this reason, regular follow-up visits and blood tests are strongly recommended once a year for the risk of malnutrition.
Which of the best and most suitable surgery techniques for my health?
We cannot perform all the surgical techniques for all patients but perform and choose a technique based on patient characteristics and problems, and we must determine the ideal type of surgery for the patient.
Why is bariatric surgery more effective and successful than all other treatments?
Because the obesity is a vicious circle. The higher the patient’s weight, the harder it becomes to move, and the patient can be paralyzed. so his weight increases. Here, bariatric surgery breaks this vicious circle and makes the patient more moving by eating less food. In addition, changes in insulin hormones provide an unattainable advantage with other treatments in terms of appetite reduction and blood glucose control.
What is the goal of Bariatric surgery?
Bariatric surgery is intended to lose 50% of overweight during the first year. For example, Rokaia is 170 cm tall, the individual pre-surgery weight is 170 kg. There is an ideal weight determined by the age and gender of the individual, for example 70 kg. Therefore, our patients have a surplus of 170-70 = 100 kg. The aim of the process is to give 50 kg of half of this amount in the first year.
However, the majority of our patients overcome these goals and reach normal weights. It’s much easier to get to the normal weight by exercising more easily after the first weights. Patient voltage is very important for loss of overweight after surgery.
After the Bariatric surgery, when will patients leave hospital and when can I start work?
If everything goes well, on day 3 or 4 after surgery, you will leave and you can start at home after 10 to 15 days break. Heavy lifting is uncomfortable for up to 3 months. Recovery times may vary if an unwanted problem is encountered during or after surgery or if normal healing is slow for any reason, it may be necessary to stay in the hospital for a longtime until the problem is resolved.
Does any mark remain after Bariatric surgery?
In Bariatric and diabetes surgeries, all operations we conduct, are closed completely in the surgical endoscopy operations, for this reason, which has no mark or there is no mark in the operation basically.
Is there any skin sagging after bariatric and diabetes surgery?
Anyone suffers from overweight is at risk of skin sagging. Although this may be due to the patient’s skin structure, protein-rich nutrition and regular exercise are measures to reduce skin sagging. Although this skin sagging can be treated by the cosmetic surgery, if the skin on the abdomen, chest and arms or the limbs has sagging. The appropriate time for a Skin expansion is at least 1 years after bariatric surgery, because it should be expected to reach the ideal body weight.
Can I be pregnant after bariatric surgery?
It is recommended not to be pregnant for at least two years after the bariatric surgery. In the early post-operative period, the patient will be prevented from weight loss. The inability to send enough liquid and nutrients to the fetus will be increased. It is recommended that our patients considering pregnancy receive birth control support from family doctors in the period before surgery.
What are the risks of bariatric surgery?
Bariatric surgery also involves various risks, such as surgery. The risk of complications occurring during the initial bariatric surgery is about 2 to 5 %. In other words, 95-98 % of patients leave are being left discharged without any problems and start their new lives. Higher success rates were achieved in the surgeries performed by the general surgery of the gallbladder surgery and the bariatric surgery unit.
What are the risks the patients can generally suffer from after bariatric and diabetes surgery?
Leakage: The most important risk and concern is the evolution of the leakage due to anatomical structure in the stomach and intestine. Although it is seen repeatedly in the first week after surgery, it is well known that patients who have had leakage after a month of the operation, the leakage can be developed due to inflammation inside the abdomen, and a longer period in the hospital, repeated endoscopies, radiation or surgical interventions, recovery and even death can occur even with intensive care.
It is very important that surgical technology is developed and standard methods are applied by experienced surgeons in order not to develop the leakage. During the operation, the leakage test and intervention detected at that time also reduces the possibility of post-surgical leakage. smoking, undisciplined diabetes, and untreated lung diseases increase the risk of leakage. Despite all these procedures, the rate of leakage at bariatric surgery centers in the world is about 1-2%.
Bleeding: There is a risk of bleeding after every surgery. It is known that about 1-2% bleeding occurs after bariatric surgery. The use of blood thinners (aspirin, Clopidogrel, COUMADIN, heparin, etc.) for another cause the risk of bleeding increases after surgery. Bleeding can occur in the abdomen (internal bleeding) or in the digestive system (gastric bleeding). As a preventive measure, it is known that the correct surgical technique and the use of tissue adhesive materials is effective. The vast majority of this bleeding stops automatically. Sometimes the patient may need to get blood and blood products. This rarely requires additional surgery to stop bleeding. Severe bleeding can threaten life.
Clot: Obese individuals, Deep vein thrombosis cause clot in so-called leg angioedema, and the clot is the most common and patients are at great risk after surgery leading to congestion in different veins in the body, including the lungs. Wearing compression stockings and air pressure stockings to achieve this condition, needles, and blood flow (low molecular weight heparin) after surgery, and walking is vital.
Vomiting: It is known that some medicines given during anesthesia cause vomiting in the post-early surgery period. However, this effect usually occurs during one or two days. If longer vomiting and inadequate feeding occur, check for Intestinal obstruction. In both stomach and tube surgery across the stomach, mechanical and functional congestion may develop at different levels. In this case, the obstruction must be opened using endoscopy or surgical therapies.
Internal herniation: Very late complication for very rare operation. It may occur after any type of intraabdominal surgery. Because the location of anatomical structures changes, new potential holes occur. These holes can usually enter the small intestine and squeeze the gangrene, immediately if surgical intervention is not a life-threatening result. It can develop even after years of any surgery.
Surgical site infection: Bacterial infection may occur in surface or deep surgical areas. If the abscess develops, it may need to be discharged and treating it with different antibiotics.
Surgical exacerbation of existing diseases by the patient: Especially lung diseases, hypertension and heart failure may show a slight increase in the post-operative period early. However, in late periods, when the patient loses weight, the reduction of these diseases will be achieved and even the recovery from them will be achieved.
Note: The above is a special risk for bariatric surgery. Any surgery in the digestive system may involve risks that are not mentioned here. In addition, the risks of drugs used, blood transfusions, blood products and anesthesia were not mentioned.
Can we reduce these risks?
Stop smoking (at least 45 days), maintain blood glucose and blood pressure, and lose weight 5% by taking carbohydrates badly during two months before surgery, reducing the risk of surgery and increasing its success.
Does the risk of heart attack increase after obesity surgery?
Individuals suffering obesity diseases are already at high risk in terms of heart attack and death. Research conducted in Sweden in a study of more than 4,000 patients in Sweden. Patients with obesity were monitored and without bariatric surgery for 18 years and these results were explained in 2013.
The risk of heart attack, which may cause death with patients undergoing bariatric surgery, has been reduced by half.
We have noticed that the risk of stroke and even cancer evolution has decreased significantly with patients suffering as a result of bariatric surgery.
What do we need to care about after bariatric surgery?
Before bariatric surgery, it is necessary to consult with a nutritionist and get detailed information about the way of breastfeeding after surgery. You’ll get a diet that you can easily bring it under control. Changing anatomy and hormones will help you follow this diet. It is also recommended that you do not perform hard exercises during the first 3 months. Exercises that don’t force your body like walking and swimming will be more suitable for the first three months. 3 or up to 6 months after surgery you can participate in the required training program. A more active lifestyle is essential to achieve an ideal weight.
In addition, regular follow-up is very important in the post-operative period. If there is no unfortunate incident, you will need to access the controls every 3 months in the first year, every 6 months in the second year and then once a year. The drugs you use for diabetes, blood pressure, cholesterol, or apnea during sleep may change, the doses will decrease or stop.
In addition, there may be some deficiencies due to both malnutrition and absorption disorders in the body regardless of the type of bariatric surgery. It is easy to treat Iron deficiency, vitamin B, calcium, vitamins and other minerals if observed during controls. However, if they cause your control to be disabled, long-term deficiencies cause serious problems. This situation is so important that many centers do not perform surgery for patients who cannot control regularly. As long as you are under control, you don’t need to fear any deficiencies.
Did you get overweight again after bariatric surgery?
After bariatric surgeries, at least 85-90% of patients start a new life and continue their lives without getting overweight again. However, approximately 10 to 15% of patients complain that they cannot lose weight or enough weight-loss. There may be several reasons for this.
The primary BMI is very high (For example, a patient weighing 200 kilograms at 80 kg still has obesity, but is still healthier than ever), even if it has dropped to 120 kg by 80 kg. After bariatric surgery, most patients cannot believe the small quantities they have eaten, and how long they have not been hungry. For this reason, they try to eat after satiation and this imposes an increase in the size of the stomach.
Excessive consumption of foods containing high-calorie liquid such as alcohol, ice cream or chocolate may increase the weight of some patients. Sometimes the tube develops a vague narrowing in the middle of the stomach in gastric surgeries. The patient may feel or suffer from such narrowing with moderate reflux symptoms. However, the remaining stomach may expand in the upper part of this narrowing over time, and may increase the weight again (even if the patient follows all the rules).
Expanding the remaining small stomach during the gastric bypass or expanding the connection between the stomach and intestine may also increase weight.
A thorough examination of patients undergoing bariatric surgery should be carried out. First, he/she should be treated if there is a psychological or hormonal problem. Revision surgery can be considered after overweight again. Although the risk of revision surgery is higher, it is successfully applied in experienced centers.
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