Obesity is a real disease that has been increasing steadily over the years in both genders, all ages, education levels, races and ethnic groups. Within 10 years, obesity and the diseases it causes will become the most important health problem in the world. All other methods applied for weight loss have failed in terms of losing weight and maintaining the condition.
On this subject, in the USA, National Institutes of health (NIH) Consensus Development Conference; He announced that 95% of the patients who participated in weight loss programs with or without behavioral modification returned to their previous weight within 2 years from the maximum weight loss amount.
As a result NIH Conference permanent weight control. He suggested two treatment options for; Roux-en-Y Gastric By-pass and Sleeve Gastrectomy (Sleeve Gastrectomy).
- Are you obese?
- Gastric Bypass technique in obesity surgery
- Sleeve Gastrectomy technique in obesity surgery
The most important concept we use for obesity disease that requires surgical treatment is body mass index. Anyone can do the calculation. Divide body weight in kilograms by the square of height in metres. If the result obtained is 40 kg/m2 or more, or if it is over 35 kg/m2 plus there is a comorbid disease (such as diabetes, sleep-apnea syndrome, heart disease, hypertension), there is a candidacy for obesity surgery. I would like to focus on two popular methods.
Roux and Y Gastric Bypass technique. In the pass;first, the stomach is divided into a small upper section and a larger, larger lower section called“remnant”. Then, the connections of both pouches to the small intestines are rearranged. This operation effectively provides weight loss through two mechanisms, both restriction (preventing eating) and malabsorption (preventing absorption). Therefore, it is superior in terms of maximum weight loss rates compared to gastric sleeve surgery, which only prevents eating. In publications, weight regain rates for sleeve gastrectomy are after the 2nd year. In bypass, this is after the 10th year. In addition, bypass is much safer in terms of leakage, which is a frightening complication. There's nothing to escape Since ECE is a spit, it closes easily. If the tube is in the stomach, the fluid that escapes is extremely dangerous as it may be stomach acid, bile and pancreatic fluid. In bypass, the patient cannot use endoscopic diagnosis and treatment methods for stomach and duodenal diseases. Additionally, although rare, vitamin and mineral deficiencies may occur. When these occur, it can be easily supplemented externally.
Sleeve gastrectomy (Sleeve gastrectomy); It is an obesity operation that only performs restriction (preventing eating). In the operation, after a 36 F tube is placed along the small side of the stomach, the large side of the stomach is resected from the opposite border of the tube with staplers (both sewing and cutting tools) up to the junction with the esophagus, creating a gastric tube. It is technically much easier to perform laparoscopically than Gastric Bypass. Its advantage is that it can be easily converted to bypass if weight is regained or if the operation fails. It also reduces the appetite hormone called Ghrelin. In fact, sleeve gastrectomy should be performed in patients with low body mass index who are not considered for more aggressive weight loss operations (such as bypass)
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