Obesity has become one of the important problems of our age. Wrong food selection and lack of portion control are the most important causes of obesity.
What is Tube Stomach Surgery?
It is performed to prevent life-threatening conditions that may occur in the course of some diseases associated with overweight in obese individuals by weight control.
Obesity and its medical treatment. For detailed information about What is the Disease of Our Age, Obesity?
This method, which is most commonly used today, is known as stomach reduction surgery, which is popularly known as sleeve gastrectomy surgery. This surgery is usually performed with a closed (laparoscopic) method. During this surgery, approximately 80% of the stomach is removed under the guidance of a tube placed in the stomach temporarily through the mouth and the stomach volume is reduced.
It is aimed to reduce the volume of food taken with stomach shrinkage. In addition, since the secretion of the hormone (Gharelin) secreted from the removed area of the stomach and triggering the feeling of hunger decreases, a feeling of saturation occurs with a small amount of food after the surgery. Weight control is achieved with a new diet and exercise gained after the surgery.
Who Should Have Tube Stomach Surgery?
Patients who will undergo gastric sleeve surgery should have a body mass index (BMI) of 40 and above. A BMI between 35-39.9 and one or more of concomitant heart disease, diabetes (Type 2 Diabetes), hypertension, high cholesterol, sleep apnea, reflux disease.
What are the General Risks of Tube Stomach Surgery? ?
Since sleeve gastrectomy is a major operation, it carries some risks both in the short term and in the long term.
Short term risks:
- Leakage (leakage from the sutures)
- Bleeding
- Infection
- Anesthesia complications
- Respiratory tract problems
- Coagulation problems Long-term risks:
- Nausea-vomiting
- Intestinal obstruction
- Reflux disease
- Nutrition disorder
- Herniation from incision sites
- Down in blood sugar �şme
- General Surgery
- Endocrine and Metabolic Diseases
- Pthoracic Diseases
- Cardiology
- Diet and Nutrition Specialist
- Psychiatry
- Physical Therapy and Rehabilitation
- Anesthesiology and Reanimation
- ECG (if necessary, echocardiogram)
- Respiratory function tests
- Body composition analysis
- Endoscopy.
- You should not take fluids with solid foods.
- You can drink fluids at least 30 minutes before and 30 minutes after taking solid foods.
- Each you should set the main meal to be 25-30 minutes and each snack to be 15 minutes.
- When you switch to solid foods, you should chew your food at least 25-30 times before swallowing.
- At least during the day You should consume 1.5 liters of water.
Which Evaluations Are Made Before Tube Stomach Surgery?
Evaluations are like evaluations before any major abdominal surgery operation, but the tests and examinations to be performed are approximate. although it is the same; Some additional tests related to the metabolic status of the patient are also performed.
Patients who apply for this treatment method should be evaluated by the following branch specialists.
What are the Laboratory Tests Required Before Tube Stomach Surgery?
Laboratory tests determine whether you have any endocrine and metabolic diseases that may cause you to be overweight. done in order to. At the same time, some tests are also requested to see if there is any other unhealthy condition in your body and whether you are suitable for sleeve gastrectomy surgery.
These are tests:
What Should Be Done the Night Before Tube Stomach Surgery?
Before and after sleeve gastrectomy surgery, a dietitian is consulted for weight monitoring. Smoking should be stopped at least 3 months before the surgery. All medications and nutritional support products used should be reported to the surgical team.
Your doctor will prescribe you a blood thinner (mostly low molecular weight dextran) for the night before gastric sleeve surgery, and you will be asked to have this drug taken under the skin the evening before the surgery.
For your bowel cleansing, you will be prescribed a medicine that you can take orally and you will be asked to drink this medicine at 8 o'clock the night before the surgery. Although it varies depending on the time of your surgery; The patient usually does not eat anything after 20:00 in the evening and does not drink anything after 24:00 at night (after midnight).
What Is Done During Tube Stomach Surgery?
The operation is performed under general anesthesia. Although the open method is rarely used, today this surgery is performed as a closed (laparoscopic) operation. In the surgery, the stomach is formed into a tube with the help of a tool called a stomach stapler.
Surgery takes 45 minutes on average. After the cutting process is completed during the surgery, the leak test (blue dye test) is performed according to the surgeon's preference, and the safety is checked. After 1-2 hours of awakening after the operation, the patient is taken to the service.
Which Procedures Are Performed After Tube Stomach Surgery?
Considering the evaluations made before and after sleeve gastrectomy surgery, The patient is taken to the normal room or intensive care unit. For example, patients with sleep apnea may spend at least one night in the intensive care unit.
The patient gets out of bed and starts walking within 2-6 hours after the operation. After the operation, a passage graphy is taken on the 2nd or 3rd day. For this application, the patient is given a glass of water containing contrast material in the radiology department and films are taken at the same time. The passage of fluid through the stomach is checked in the passage x-ray, if the x-ray is normal and there is no leakage, first a water containing dyed substance (methylene blue) is given to the patient and when it is ensured that there is no leakage, the patient is started to be fed by mouth.
The patient first starts the diet by taking sugar-free liquids. According to the patient's ability to tolerate nutrition, a new diet is started with stages such as liquid, puree and finally switching to normal nutrition. Although there is no need for vitamin support after sleeve gastrectomy in general, some patients may receive temporary multi-vitamin and mineral support. The patient is given water and milk, and if he can drink (tolerate) without nausea and vomiting, he is discharged the same day. From the first month, walking exercise is started for 5 days a week and an average of 30 minutes a day. Walking pace should be at least 3 km in half an hour.
How Long Does it Take to Discharge After Tube Stomach Surgery?
Patients are mostly discharged on the 2nd or 3rd day. and they are informed by the dietitian about how they should be fed in this process. is downloaded. During this period; liquid foods such as milk, water, broth, chicken broth and fruit juice are taken. After sleeve gastrectomy surgery, blood thinners are generally used for a while.
What Should Be Considered After Gastric Sleeve Surgery?
The care and treatment recommended by the surgeon and dietician of the patient It is very important to regulate their nutrition according to the nutrition plan and when the patient is not fed properly, his stomach may swell too much. Maybe it can cause vomiting. This situation may prevent the healing of postoperative wounds or cause leakage.
Burking or hiccups may rarely be seen. It should not be a concern, but if this situation occurs frequently, you should inform your doctor. Involuntarily quickly consumed liquid can also lead to vomiting. If this occurs once or twice, there should be no cause for concern; but if it becomes permanent, your doctor should be informed.
How Should Nutrition and Care Be After Tube Stomach Surgery?
Stage 1: Period in the Hospital (1 - 4 Days)
This is the period you are in the hospital and no food is given orally during this period. In line with the patient's needs, it is fed by intravenous fluids. On the 3rd or 4th postoperative day, the patient is given water containing contrast material orally and its passage in the stomach is monitored. When it is observed that there is no leakage, the test is repeated by drinking methylene blue water and the final control is made. When the tests are completed, water and milk are given by mouth in the hospital and the patient's drain is removed. The patient's tolerance to water and milk is evaluated and the patient is prepared for the discharge process.
2. Stage: Clear Fluid Period (Month 1)
The patient should consume around 2.5 - 3.5 liters of fluid during the day, of which at least 1.5 liters should be water. clear liquids; water, milk, homemade buttermilk, fruit juice without additives, filtered broth or chicken broth. The recommended fluid distribution is; 1.5 liters of water + 1 liter of milk or ayran + ½ liter of meat or chicken stock. The amount taken in each meal should be around 150 ml and the duration of the meal should be more than 15 minutes.
3. Stage Puree Period (1 - 3 Months)
In this period, milk, buttermilk and broth are made into purees. During this period, cooked in water, blended broccoli (source of vitamin A and potassium), Brussels sprouts (source of antioxidants) �), carrots (a, b1, b2 vitamin, fiber source), spinach (iron, protein source), celery and artichoke.
Potato should not be preferred during this period as it contains high levels of carbohydrates. The amount of protein can be increased with lean ground beef and chicken puree. You can consume purees as a mixture according to your taste and flavor them with various spices. You can consume sugar-free apple, pear, quince compote during this period. (Cloves and cinnamon can be added). In addition to purees, labne cheese and 1 egg white can be consumed as soft-boiled egg for breakfast.
Attention: Purees should be consumed only in the main meals, in the morning, lunch and evening. Puree and liquid should not be consumed at the same time. The liquid should be consumed half an hour before or half an hour after the puree intake. The consistency of purees should be such that they are poured from the spoon.
Meal amount during the puree period:
At the beginning of the day + breakfast meal + snack (1) + lunch + snack (2) + evening meal + night meal 2 hours before sleep.
4. Stage: Transition to Normal Food Period (3 - 6 Months)
The aim in this period is to gradually adapt the patient to normal foods. You can consume any kind of soup that does not contain flour. You can consume boiled lean red and white meat and boiled or grilled fish. Vegetables and fruits can be consumed by chewing thoroughly. If you have a sweet crisis; You can consume dried fruit and a ball of light ice cream once a week. The half-hour rule is valid for this period as well as for every period. (It should be consumed half an hour before or half an hour after the intake of liquid-solid foods).
5. Normal Food Period (After 6 Months)
In general, calorie
Read: 3
