Center for Obesity and Metabolic Surgery

Merkez, Çukurçeşme Caddesi No:51, Gaziosmanpaşa/İstanbul, Turkey

What is obesity? Obesity can simply be defined as an abnormal and excessive accumulation of fat in the body. Another definition is that adipose tissue is more than 25% for men and 30% for women. One of the hereditary, environmental and cultural factors can be the reason for the formation of obesity, as well as all other reasons that can also be combined. Obesity measurement Body Mass Index - BMI is used to determine obesity levels. Body mass index is the value found by dividing a person's weight in a kilogram unit by the square value of height in a meter unit. BMI (kg / m2)): body weight (kg) / (height2)) (m) Obesity surgery is applicable to the following Patients with a body mass index over 40 and who cannot lose weight despite diet and exercise. Patients who have a body mass index between 35-40 also have additional diseases such as hypertension, diabetes or sleep apnea associated with obesity and who cannot lose weight despite diet and exercise. Conditions for prevention of surgical intervention Patients who have serious psychological problems Patients who are unable to adhere to post-surgical treatment Patients who are addicted to substances and alcohol Patients who have a condition to prevent anesthesia Advantages of obesity surgery -Post-surgical blood pressure measurements have been seriously improved for obese patients with hypertension. Usually in 60-70% of cases these patients stop taking blood pressure medication. -Blood sugar levels are seriously improved in patients with type 2 diabetes. More than half of patients can stop taking antidiabetic drugs. -The risk of heart disease is significantly reduced after surgery. -Remove the problem of sleep apnea in accordance with being overweight. - Problems with the inhalation system have been improved. Types of surgery Stomach Band Gastric girdle is an operation performed by the laparoscopic method. A small abdominal sac is formed through a strip placed below 3-4 cm of the entrance part of the abdomen. The most important advantage of the strap is that it is adjustable. The tightness of the band can be increased or decreased according to the patient's follow-up. A port (adjuster) placed under the skin to make such an adjustment. Since absorption disorders do not occur in patients who have gastric band applied, vitamin deficiency is generally not found. Post-surgical problems that can be encountered are tape slippage, tape erosion, swallowing problems, tape damage and problems with the adjuster (port). Sleeve gastrectomy The most popular obesity surgery is gastric tube surgery. The operation is successfully performed by the laparoscopic method. This surgery removes a large part of the stomach and leaves approximately 25-30% of the total stomach volume. Since the remaining part of the stomach is in the shape of a tube, this operation is called a tubular abdomen. The operation also removes the upper part of the stomach, which is called the fundus. Due to that, the levels of the hormone ghrelin, which is secreted from the fundus of the stomach and as an appetite hormone, decrease, and the appetite control is easily carried out after the operation for the patients. Although the capacity of the stomach is reduced in this operation, there is no disturbance in the functions of the stomach. There is no risk of ulcers. Since there is no absorption disorder, vitamin deficiency is encountered compared to By-pass surgeries. Gastro by-pass During this operation, approximately 25-30 cc of stomach volume is formed at the entrance to the stomach, and the small intestines at a distance of 100-150 cm from the stomach are combined with this sac. This operation limits eating and reduces absorption. This operation is technically more difficult and has a higher risk and irreversible operation. Long-term results are similar to probe surgery, so gastric surgery has recently been preferred. Patients must receive vitamin support after surgery.