It is a surgical procedure that helps to lose weight, applied to obese people who cannot lose weight by means of exercise and diet and do not have hormonal problems. It is also known as bariatric surgery. Its purpose is to reduce food intake by shrinking the stomach and to reduce the absorption of fat and carbohydrates from the intestines.

As the stomach shrinks, the patient feels full very quickly. This allows the patient to eat less and reach the determined weight by losing weight safely. The surgery is performed by applying one of the open or laparoscopic surgery methods, depending on the eligibility for the surgery.

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One week before the surgery, the patient should definitely stop alcohol consumption and prefer salads, soups and juicy meals instead of heavy foods such as red meat and pastries. In this way, the digestive system will be relaxed and a more comfortable operation will be performed, and postoperative complaints such as bloating, gas and pain will be minimized.

Before the operation, the patient’s blood tests, cardiology tests, and pulmonary function tests are checked for compliance with the operation. If there is no abnormality as a result, the patient is accepted for surgical procedure. The patient must be fasting for at least 10 hours and without water for 8 hours before the surgery.

Patients who decide to get a surgical procedure should be determined to make and maintain permanent changes in their lifestyles. In addition to supportive exercise and diet methods, this surgical procedure is applied to accelerate the process. Before the operation, a diet program is prescribed to the patients and they are expected to lose some weight, which is an indication that the person is ready for a new lifestyle.During the pre-operative diet period, patients should prefer foods with low fat and carbohydrates and high protein value. Although the diet program is not the same for every patient, it is determined specifically according to the person’s eating habits and body mass index.As a result of weight loss, the size of the liver is reduced and the risks associated with surgery are minimized. In order to accelerate the healing process and prevent possible complications, it is important to stop or minimize smoking or the consumption of alcohol.
  • Obesity
  • Diabetes Type II
  • Hypertension
  • Severe sleep apnea
  • Heart disease
  • Reflux

The sutures placed on the internal organs during gastric bypass surgery heal within 15 days, but the general healing process takes 30 days.

After the surgery, there may be 2 or 3 scars in the form of a thin line between 2 and 3 cm in size, but these lines become very faint over time and heal. There remain no visible large scar.

Since the stomach is very small after the surgery, the feeling of fullness is achieved very quickly, but if the patient continues to eat persistently despite the feeling of satiety, the stomach will grow again.

1. Tube Stomach Surgery (Sleeve Gastrectomy)

  • It is the most preferred type of gastric surgery. The procedure is performed laparoscopically, by opening 4-6 holes with a diameter of 1 cm, the stomach and by reaching surrounding tissues. 80% of the stomach is removed and it resembles a banana-shaped tube.
  • It is a procedure performed only to reduce the stomach volume. The aim is to create a feeling of early satiety.
  • It limits the amount of food that the stomach can take. It increases the feeling of satiety by causing positive changes in intestinal hormones. Ghrelin, the hunger hormone, decreases by 70-80%.
  • The average duration of hospitalization is 2 days. At the discharge, a diet is prescribed by the dietitian until the first control date.
  • It is an irreversible operation. There is the potential for long-term vitamin/mineral deficiencies.

2. Gastric By-Pass\R-YGB

  • It is a preferred surgery in order to prevent the absorption of carbohydrate and fatty foods by the intestines and mixing with the blood.
  • Thanks to this surgery, 90% of the stomach is removed in obese patients and the remaining 10% of the stomach is approximately the size of a cup in size and is connected 130-150 cm ahead of the small intestine with this section. Since 60-80% of sugar and fat is absorbed from this section, the aim is to disable this section.
  • The procedure is performed by opening 4-6 holes with a diameter of 1 cm and reaching the stomach and surrounding tissues.
  • Post-operative hospitalization is 3-4 days. On the discharge date, the dietitian examines the patient, a nutrition plan is prescribed for the period until the first control.

3. Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

  • Like Gastric By-Pass surgery, it is a surgical procedure that reduces both stomach and absorption. Unlike Gastric By-Pass, stomach reduction is less and the absorption reduction effect is much higher.
  • The surgery consists of two stages, a large part of the stomach is removed and formed into a tube stomach, and as a second stage, it is combined with the small intestine segment.
  • The difference between duodenal switch surgery and classical biliopancreatic diversion is the preservation of the natural valve called Phylor at the gastric outlet.
  • It reduces fat absorption by 70%.
  • It leads to more effective weight loss than sleeve gastrectomy and gastric bypass, and the rate of getting rid of excess weight is 60-70% in a period of 5 years.
  • Since a large part of the small intestines is by-passed, even if patients eat in normal sizes, weight loss continues because food absorption will be very low.
  • It is the most effective stomach reduction surgery to solve the diabetes problem.
  • Vitamin and mineral deficiency may occur in the long term.
  • Longer hospital stay may be required compared to other treatment methods.

4. Intragastric Ellipse Allurion Balloon (Gastric Balloon)

  • It is a non-surgical method without endoscopy.
  • The balloon is in the form of a capsule and is placed by swallowing and the filling process is provided with the filling thread descending from the back of the capsule.
  • The balloon stays in the stomach for 4 months and helps to achieve a weight loss of 15% in 4 months.
  • At the end of 4 months, the liquid in the balloon is emptied into the stomach and the balloon is expelled by natural metabolism without the need to be removed by an operation.
  • The duration of the program is 6 months in total, and after the balloon is removed, the adaptation of the stomach is provided for 2 months with the support of a dietitian.
  • After confirming that the balloon is in the appropriate place by imaging methods, the patient is discharged within 2-3 hours without hospitalization.

The method determined by your physician according to the patient’s body type is always the best method.  Since the expectations of each patient from the treatment are different, the solution method also varies from patient to patient. In this regard, the best choice will be the choice made by an experienced physician who is specialized in this field.

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