Which Technique?
Many different methods are applied for obesity. In order to understand these clearly, it is necessary to take a closer look at the structure and functioning of the digestive system:
The journey of the food The food we eat is softened by saliva after being shredded by the teeth.
Then the phase of the swallowing process begins, where voluntary and involuntary movements are combined. During this phase, the tongue moves upward and backward, pushing the food towards the esophagus. The following stages are organized entirely as reflex movements. The epiglottis closes the windpipe and the soft palate closes the nasopharynx (nasal cavity) and allows food to go to the esophagus. Another factor that allows food to move towards the esophagus is the pressure difference. After food enters the esophagus, it is pushed towards the stomach by peristaltic movements. The stomach ensures that large pieces of food are turned into smaller particles by shaking movements. Although there is some digestive function in the stomach, the main absorption process occurs at the level of the small intestine. The large intestine performs functions such as water absorption and stool storage.
How does the feeling of satiety occur?
The formation of the feeling of satiety depends on many factors. This action is under the influence of social, cultural and personal factors. In recent years, physiological studies on obesity have shown that the feeling of satiety is caused by some hormones formed as a result of tension and expansion in the stomach, creating the feeling of satiety in the hypothalamus region of the brain. Surgeries performed for obesity are called "BARIATRIC SURGERY" in the medical literature. = weight; -iatric (branch of medicine)
We can categorize the treatment methods used for the treatment of obesity under four headings:
1.Restrictive methods
2.Malabsoptive (impairing absorption)methods
3.Both restrictive and malabsoptive methods
4.Methods effective on the satiety center
1. Restrictive methods:The most common of the restrictive methods is the gastric band. Commonly known as the gastric band, it helps you lose weight by narrowing the entrance of the stomach and causing a feeling of early satiety. What is your loss? happens from. Gastric banding can be applied laparoscopically or openly. The most ideal is the laparoscopic method.
There are a few important points to know about gastric band application:
There are many tests that need to be done before the surgery in order for the surgery to go well. Blood tests, endocrinological tests, psychiatric examination, determination of nutritional habits and ultrasonography are among these.
There are precautions that must be taken during the surgery. Special socks, leg massage devices and blood thinning medications are required to prevent clots.
Although it is not a very difficult method technically, the experience of the surgeon is very important.
There are many different types of tapes available on the market. The quality of the band used and whether it is soft or not should be questioned. A long process awaits the patient after the gastric band application. The band needs to be adjusted at regular intervals. For the reasons stated above, gastric band application is a TEAM job. It must be done in a full-fledged center. Another restrictive method is the 'Sleeve Gastrectomy' (reducing the stomach in the form of a tube). The stomach is reduced laparoscopically with special tools. It is a larger surgery than gastric banding. It is used as an alternative to gastric banding in super-morbidly obese patients. Although the results are good, the remaining stomach volume increases over time and weight gain may occur again. Gastric balloon application, which has become widespread in recent years, reduces the stomach volume and reduces the amount that can be eaten. Gastric balloon application is a very difficult method to comply with. The first days or weeks are mostly accompanied by nausea and vomiting. There are many patients who want the balloon to be removed before they get used to it.
- Restrictive (restrictive methods)
- Malabsoptive (impairing absorption) methods
- Both restrictive and malabsoptive methods
- Methods effective on the satiety center
The most common of the restrictive methods is the gastric band. Gastric banding, commonly known as a gastric band, causes weight loss by narrowing the entrance to the stomach and providing a feeling of early satiety. Gastric banding can be applied laparoscopically or openly. The most ideal is the laparoscopic method.
There are a few important points to know about gastric band application:
There are many tests that need to be done before the surgery in order for the surgery to go well. Blood tests, endocrinological tests, psychiatric examination, determination of nutritional habits and ultrasonography are among these.
There are precautions that must be taken during the surgery. Special socks, leg massage devices and blood thinning medications are required to prevent clots.
Although it is not a very difficult method technically, the experience of the surgeon is very important.
There are many different types of tapes on the market. . The quality of the band used and whether it is soft or not should be questioned.
After the gastric band application, the patient should be kept for a long time. The jam awaits. The band needs to be adjusted at regular intervals.
For the reasons stated above, gastric band application is a TEAM job. It must be done in a full-fledged center.
Another restrictive method is the 'Sleeve Gastrectomy' (reducing the stomach in the form of a tube)method. The stomach is reduced laparoscopically with special tools.
It is a larger surgery than gastric banding. It is used as an alternative to gastric banding in super morbidly obese patients. Although its results are good, the remaining stomach volume increases over time and weight gain may occur again.
Gastric balloon application, which has become widespread in recent years, reduces the stomach volume and the amount that can be eaten. Gastric balloon application is a very difficult method to comply with. The first days or weeks are mostly accompanied by nausea and vomiting. There are many patients who want the balloon to be removed before they get used to it.
These methods are no longer used today. In such methods, the uppermost part of the small intestine is joined to a place close to the large intestine, allowing food to pass without passing through the small intestine. It is a method that is no longer used.
The best example of such methods is gastric bypass surgery. It is one of the most effective methods used in morbid obesity surgery. However, since it is a technically heavy surgery, it requires a very experienced team. It is an irreversible technique because the flow direction of the stomach and intestines is changed.
Such methods are becoming increasingly common. The most well-known and used method is adjustable prostheses placed in the region of the stomach called fundus (ENDOGAST). This method causes much less discomfort than the balloon method, which is swallowed, placed in the stomach and inflated by filling it with liquid. The most common problems in patients with a gastric balloon are vomiting and pain. Such problems, which occur during the first adaptation period (complaints decrease around 3-5 days, although it may extend up to 2 weeks), are not seen in the adjustable gastric prosthesis. Its weight is 7 grams It does not cause many complaints because of its operation. It is inserted and removed with an endoscope. It is the most commonly used method in our clinic.
Gastric bypass surgery is the most frequently performed type of surgery in our clinic. The technique we use in this type of surgery is actually a form of stomach surgery adapted to obesity, which has been used for almost 100 years. The gastric bypass technique we apply is the Roux-en-Y gastric bypass method. You can watch the video of this surgery in our video gallery.
ROUX-EN-Y GASTRIC BYPASS TECHNIQUE
In this technique, the stomach size and volume are reduced to approximately 30-50 milliliters. This is a volume smaller than a small tea glass. In this way, the restrictive feature of this surgery is revealed. The rest of the stomach lies passively to the side. So, first of all, the stomach is bypassed. Then, a new path is made between the small intestines and the stomach. Bile and pancreatic fluids are transported further depending on the patient's weight and the absorption of food is impaired. These new pathways are called anastomosis and there may be leaks at these points. During our surgery, we can immediately detect whether these leaks are present during our endoscopic air test (similar to the test that tire fitters do by putting the tire under water). No leaks have been detected in our surgeries so far. With this surgical technique, approximately 3% leakage may occur. In this case, the patient is generally not given food and is waited. Rarely, it may be necessary to perform a repeat laparoscopy.
HOW MUCH WEIGHT CAN BE LOST IN HOW LONG WITH GASTRIC BYPASS?
70-80% of excess weight can be lost with the gastric bypass method. . To give an example:
Suppose a patient whose ideal weight should be 70 kilos is 170 kilos; Excess weight = 100 kilograms
70-80 kilograms can be lost with bypass. The resulting weight may be 90-100 kilograms. There are many patients who can lose weight better than this. Patients who can lose weight better are those who have succeeded in changing their lifestyle. Weight loss usually occurs within 1 year.
WHAT KIND OF NUTRITIONAL DISORDERS MAY OCCUR AFTER SURGERY?
During bypass surgery, a large part of the stomach and intestines are covered close to 2 meters. a bit
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