Metabolic diseases centre – Thyroid diseases – Diabetes

 

Metabolic Diseases Centre – Thyroid Diseases – Diabetes

Metabolic Diseases Centre – Thyroid Diseases – Diabetes pediatric and adult

A center for everything you care about general surgery pediatric and adult

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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.</