Obesity is a common problem seen all over the world. If obese individuals cannot lose weight despite diet and exercise, they can get rid of this problem by gastric reduction surgery. Stomach reduction surgeries are performed in several ways. One of these is surgery aimed at losing weight by limiting food intake. Another one aims to lose weight by preventing the absorption of the nutrients taken from the intestine. The third surgical method is the operations in which both of these are combined.
What are the Surgical Treatment Methods in Obesity?
For the last 10-15 years, surgical methods have been applied for the treatment of morbid obesity patients and successful results can be obtained. However, as in every surgical operation, there are various risks in bariatric surgery. For this reason, before deciding on the operation, the treatment method for each patient should be evaluated under the guidance of his doctor, and if possible, diet therapy should be applied first. Surgical treatment methods are as follows:
- Intragastric balloon placement
- Sleeve gastrectomy
- Gastric bypass
Who Can Have Stomach Reduction Surgery?
In order to undergo gastric reduction surgery, the patient must be between the ages of 18-80 and have a body that can handle anesthesia.
- Body Mass Index (BMI) is over 40,
- BMI is between 35-40,
- Has an additional disease related to obesity,
- BMI Individuals between 30-35 years of age and with diseases such as diabetes and metabolic syndrome can have gastric reduction surgery.
What are the Methods of Stomach Reduction Surgery?
Sleeve gastrectomy and gastric In band surgery, part of the stomach is removed. Since a part of the stomach is removed, the amount of food that can be eaten decreases and thus weight loss is targeted.
In duodenal switch surgery, a part of the intestine is removed along with the stomach. Since there is no part of the intestine, absorption decreases and weight loss occurs.
Stomach reduction surgeries can be performed open or closed (laparoscopically). Laparoscopic surgery is more advantageous than open surgery because a small scar remains after the surgery. Less chance of developing complications It is smaller and recovery time is faster than open surgery.
Sleeve gastrectomy is the removal of approximately 75% of the stomach. The stomach remains as small as a tube after the surgery, so that with very little food, a feeling of saturation occurs immediately. This reduces the feeling of hunger. In addition, since the part of the stomach that produces the 'hunger hormone' is removed in this surgery, you do not feel hungry after the meal. This surgery can be performed by laparoscopic method.
Roux-Y Gastric Bypass surgery, a part of the stomach is deactivated and a new, small stomach is made. It attaches to the end of your small stomach by cutting a portion of your intestine. The deactivated stomach connects with the duodenum. Thus, the image of the letter 'Y' appears. As a result of this surgery, most of the stomach loses its function. The nutrients go to the new small stomach and the part of the intestine attached to it.
In biliopancreatic diversion surgery, it is aimed to reduce nutrient absorption by removing both the stomach and the large part of the intestines. Food intake is limited by creating a small pocket in the stomach. Since this surgery is more serious than others, it is preferred in patients who have a lot of weight.
How to Prepare for Stomach Reduction Surgery?
The use of aspirin or aspirin-containing drugs and blood thinners should be discontinued at least 1 week before the operation. In addition to these, a diet should be applied 24-48 hours before as recommended by the physician.
The patient stays under control in the hospital for a certain period of time after the surgery. In the meantime, the patient is given painkillers and is followed closely. During this process, attention is paid to fluid consumption and blood sugar is constantly controlled since post-operative nutrition is slow. After the surgery, firstly, liquid foods are started to be fed, then mash and finally solid foods are fed and nutrition is provided gradually. After the surgery, the dietitian prepares a special nutrition plan. This nutrition plan is planned in accordance with adequate and balanced nutrition. Portion sizes are smaller than pre-operative nutrition because the stomach has shrunk.
How to Experience Weight Loss After Stomach Reduction Surgery?
Patients experience rapid weight loss in the first 3 months. For example Although up to 45 kilos can be lost for the first three months, the amounts of these losses vary according to the types of surgery. Those who have any additional diseases related to obesity before the surgery, these diseases are either completely healed or reduced to a degree that does not bother them.
What are the Risks of Stomach Reduction Surgery?
Like any surgery, gastric reduction surgery also has some risks. Infection, blood clotting, embolism, leakage from tube stomach or other anastomoses, formation of gallstones due to weight loss, malnutrition, sagging of the skin due to weight loss, depressions, dumping syndrome (foods and fluids taken after gastric bypass surgery are very quickly transferred to the intestine. are the complications of the surgery. These complications are more common in older people, those with blood clotting problems, or those who are extremely obese. If you follow the recommendations of your dietitian and doctor after the surgery, the likelihood of these complications will decrease.
Can You Get Pregnant After Stomach Surgery?
Weight loss continues until the 18th month after the operation. After the weight loss process; If the diet is adjusted by the dietitian, there is no problem in getting pregnant.
How Should Postoperative Physical Activity be Planned?
After the surgery, you should avoid driving in the first 2 weeks and avoid heavy physical activities in the first 2 months. But it would not be right to completely remove physical activity from your life. After the operation, walking can be done. If your job is not a job that requires heavy physical activity, 2-4. You can also start working after a week. After the 2nd month, you can do activities such as pilates, yoga, swimming.
How Does It Develop After Surgery?
The physician can prescribe medication according to the patient's needs. The dietitian prepares a detailed nutrition program. If there are hiccups, vomiting, fever of 38°C and above, redness and / or swelling in one foot (at least 1-2 cm between the diameters of the two legs), swelling and / or redness at the incision sites in the abdomen after discharge, consult the physician without delay. should be consulted.
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