WHAT IS OBESITY:
Obesity is excessive fat accumulation in the body, that is, it is an energy metabolism disorder that increases the ratio of fat tissue to other tissues and can lead to chronic, psychosocial and physiological problems. Fat accumulation in cells and tissues causes the functions of cells and organelles within the cells to deteriorate. In this way, the burning of energy within the cell is disrupted. This causes disruptions in the relevant tissues and organs to perform their functions. Increasing fat tissue causes obesity as well as hypertension, insulin resistance, diabetes (type II diabetes), high blood lipids, cardiovascular diseases, musculoskeletal disorders, asthma, sleep apnea, fatty liver, skin diseases, rheumatic problems and psychological problems. may cause illnesses to develop. In the advanced stages of obesity, reversal becomes difficult as disorders occur in many tissues and organs. The probability of patients losing permanent weight with diet and exercise alone is extremely low (<1%). At this point, endoscopic and surgical methods used in the treatment of obesity come to the aid of patients. The treatment method to be applied to the patients is decided according to the severity of the patients' obesity and the presence of other obesity-related diseases. The most commonly used method to classify obesity is body mass index (BMI) calculation. In this simple method, weight (kg) is divided by the square of height (m). While endoscopic methods such as gastric balloon or gastric botox are preferred between BMI 30-35, laparoscopic surgical procedures such as sleeve gastrectomy or gastric bypass are applied to patients with BMI over 35 and comorbidities or BMI over 40.
WHAT IS OBESITY SURGERY:
Obesity surgery is the restriction of calorie intake of patients through various interventions performed on the stomach and small intestines using endoscopic or laparoscopic methods, or the amount of energy entering the body from consumed foods by reducing absorption. Depending on the severity of the disease, more complex methods such as gastric bypass can also be used.
STOMACH BALLOON
A gastric balloon is a silicone ball that is placed inside the stomach and inflated with air or water. The gastric balloon increases volume in the stomach It gives a feeling of fullness, the patient feels full early, and increases the patient's compliance with the diet by causing nausea and bloating when they eat too much. The gastric balloon is placed with the help of an endoscope in the endoscopy unit, under mild anesthesia. These balloons can stay in the stomach for 6 months. Some gastric balloons, which can remain in place for 1 year, can be subjected to endoscopy again and the amount of fluid inside them can be adjusted according to the patient's condition. There is also a swallowable gastric balloon that does not require anesthesia or endoscopy and can remain in the stomach for an average of 4 months. Depending on the patient's condition and needs, the dietitian and obesity surgeon determine the most appropriate method and apply it to the patient.
STOMACH BOTOX
Stomach botox is the process of injecting botulinum toxin into the stomach wall with the help of an endoscope, with a slight anesthesia. This drug is a toxin that paralyzes muscles. After drug administration, the muscles and nerves of the stomach begin to work less. Since the stomach works slower, the patient feels full and feels full early.
OBESITY SURGERY
ADJUSTABLE GASTRIC BAND
Adjustable gastric band is a device made of silicone that is placed laparoscopically on the upper part of the stomach and connected under the skin with a pump. The width of the band around the stomach can be adjusted using a pump under the skin. In this way, the amount of food passing through the hourglass-shaped stomach can be adjusted.
SLEEVE GASTRECTOMY (TUBE STOMACH SURGERY - STOMACH REDUCTION SURGERY)
Sleeve Gastrectomy, also known as tube stomach surgery, is performed after the left outer part of the stomach is released by laparoscopic method. It is the process of cutting with the help of special tools that prick and cut, turning it into a tube in a vertical plane from bottom to top. With this procedure, 80% of the patient's stomach is removed. The patient becomes full early and is prevented from taking too much food. In addition, as food passes quickly into the small intestine, the activity of some anti-insulin hormones increases. Since this surgery removes the part of the stomach that produces the hunger signal, patients' feeling of hunger decreases. It has no serious complications except rare problems such as bleeding and stitch failure.
ROUX-EN-Y GAST RIC BYPASS
Gastric bypass is a surgery performed laparoscopically using instruments that can automatically cut and stitch the stomach. The stomach is cut and stitched a few centimeters below the esophagus, leaving a capacity of half a tea glass. Y-shaped small intestine connections are made to this small stomach pocket. Since he has a very small stomach left, the patient can eat very little. The patient loses weight because food passes quickly into the small intestine and a part of the intestines is removed from food absorption by the Y-shaped intestinal connection. Many patients may develop various vitamin and mineral deficiencies.
MINI GASTRIC BYPASS
Mini gastric bypass is a slightly modified and simplified version of gastric bypass. The part of the stomach that comes into contact with the food is left a little longer, and a direct connection to the small intestine is made to this part of the stomach. It is a similar method to gastric bypass, except that bile leaks into the stomach in some patients and the resulting stomach inflammation.
BILIOPANCREATIC DIVERSION (DUODENAL SWITCH)
Duodenal switch surgery is laparoscopic. It is the process of turning the stomach into a tube, then separating it from the intestine at the level of the duodenum, and then connecting the small intestine to this stomach tube in a way that prevents some of the small intestine from absorbing food.
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