1- Sleeve Gastrectomy
The tube stomach method is the process of cutting and removing the left outer part of the stomach with surgical stapler-like devices called stapler. With this method, a stomach of 150-200 ml volume is formed and food intake into the stomach is reduced. Tube Gastric Surgery is performed laparoscopically.
The main goal of tube gastric surgery is to reduce food intake by reducing the size of the stomach, as well as to reduce the level of ghrelin, which is released from the upper left of the stomach and causes a feeling of hunger. In this way, the patient feels less hunger, the patient to lose weight.
During surgery, the patients' stomach is cut at the same time stapler (stapler) are called cutters. These instruments staple the opening that occurs when cutting the patient's stomach at the same time. Surgeons call it even formed stapler line. The cut section is removed from the holes in the body for laparoscopic procedure.
Patients are discharged after being monitored for approximately 2-5 days. This period varies from patient to patient. Patients are fed with liquid foods after the operation. This nutrition process lasts about 1 month and is followed by dietitians. Then it is slowly switched to pureed and solid foods. After switching to solid foods, patients can now continue to feed normally. But now they need to be fed less and more frequently because of reduced stomach volume.
Early tube weight control rates after tube gastric surgery show that 50-60% of excess body weight is given, but gastric volume expansion may occur in the following years.
Tube Stomach Surgery is highly reliable as long as it is performed by experienced surgeons. Immediate side effects are pain, bleeding, leakage and infection.
These effects are extremely unlikely in an operation performed by an experienced team. Further side effects are difficulty in eating (rare), nausea and vomiting (especially in the early period), temporary weakening or loss of hair, feeling weak or tired. Because of the need for acid secreted from parietal cells in the stomach, vitamin supplementation will be required especially in the early period.
2- Gastric Bypass (Roux-en-Y Gastric by pass)
How is Roux-en Y Gastric Bypass surgery performed?
Roux-en Y Gastric Bypass surgery is one of the most common obesity surgery operations in the world. These operations, the stomach is approximately 2-3cm below the esophagus, 25-30ml in the stomach pouch to be cut to reduce the size of the procedure.
In the surgery, the small intestine is cut from a certain segment, and then up to the small stomach is connected. Therefore, the food eaten, passes through the esophagus to the small stomach and then passes to the small intestine.
However, since the small intestine is cut in this operation, the lower part of the small intestine is also connected to the idle portion. Thus, bile from the stomach is transferred to the lower part of the small intestine.
How much weight does Roux-en Y Gastric Bypass surgery lose?
This is a very effective operation. With the operation, both the stomach volume decreases and the nutrient absorption decreases. Appetite is greatly reduced.
3- Mini Gastric Bypass
Mini Gastic Bypass surgery is technically easier, faster, more effective. Obesity surgery is used and developed for many years.
Mini Gastric Bypass operation which is simpler and shorter to perform than gastric bypass surgery (Roux en Y Gastric Bypass) and other surgical methods is also short in terms of operation time. This procedure is very similar to Roux-en Y Gastric Bypass surgery.
In other words, the stomach is reduced in itself as a result of the operation. But a smaller, narrower and longer stomach is revealed. The volume of the gastric pouch formed here is narrow and long between about 50-70 ml. It takes a much lower level of the small intestine and connects it with the narrow, long and narrow stomach above. Eaten food comes from the esophagus, passes through the thin and long narrow stomach and passes to the second meter of the small intestine.
4- Sugar Type 2 Surgery
Type 2 diabetes constitutes 95% of diabetic patients and the rate of obesity is higher in patients with type 2 diabetes than type 1 diabetes. However, not all patients with type 2 diabetes are obese. In general, the rates between type 2 diabetes and obesity are as follows.
Body mass index (BMI)
<20 weak
20-25 normal - 5%
25-30 pounds - 45%
30-35 1st degree obese - 45%
35-40 second degree obese - 10%
40-50 morbidly obese
50> super obese
As shown in the table, 90% of patients with type 2 diabetes have a BMI in the range of 25-35.
While type 2 diabetes patients with high BMI have insulin resistance, mainly caused by adipose tissue, type 2 diabetes patients with lower BMI have decreased B cell function in the pancreas.
Therefore, while reducing insulin resistance is generally sufficient in type 2 diabetes patients with high BMI, it is necessary to increase B cell functionality in patients with low BMI.
An increase in B cell function can be achieved by the intestinal hormone GLP-1. Hormones secreted by intestinal food intake are defined as incretin hormones. These hormones are called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). GLP -1 is secreted from the ileum, that is, from the end of the small intestine, and from the duodenum, the duodenum.
The balance of these hormones is impaired in type 2 diabetes. Especially the digestion of the pulp to reach the ileum of the GLP-1 hormone provides active.
However, since the foods are processed foods, they do not reach the ileum and GLP-1 hormone cannot be active. With metabolic surgery, we reduce the distance between the ileum and the stomach to 250 cm, ensure that the food reaches here and that the GLP-1 hormone is activated and that the insulin in the body can be used.