What is Obesity Surgery?
Obesity surgery is the surgical operations which is performed to help people lose weight. There are numerous types of surgery. It is never the first choice. It is performed for the cases which the obese patients can not reach their target weight through diet, exercise, and drug treatment.
Who is a good candidate for obesity surgery?
Everybody who can not reach their target weight despite of experiencing other treatments is good candidate for obesity surgery. Preoperative evaluation and preparation for anesthesia and surgery are done. The patients are grouped according to body mass index. The surgery can be performed provided that the patients are with BMI.>40 kg/m2, or with BMI=35-40 kg/m2, besides suffering from diseases such as diabetes, fatty liver, etc., with BMI=30-35 kg/m2 besides diabetes type two, either.
Techniques of Obesity Surgery
Technological advances have provided various techniques for obesity surgery. The surgeon and patient both decide if the surgery will be performed or not according to the patient's medical condition.
Gastric Balloon
It is the simplest technique to lose weight. It involves temporarily placing a silicone balloon filled with liquid or air in the stomach by endoscope under mild anesthesia. This process takes 15-20 minutes. The balloon takes up space in the stomach, which limits the amount of food you can eat. It also makes you feel fuller more quickly. The patients can lose 7-8 kilos in a few months with this technique. The balloon is removed by endoscopy at the sixth month or max 1st year. It is very simple to be performed and does not cause a permanent change in body, which make it advantageous. However, the lost weight can be regained if the patients do not stick to diet plan after the balloon is removed. The patients will be trained how to feed within the period of 6 mounts- 1 years. Today, the gastric balloon technique is used to prepare the patients who are upper obese or not eligible for having a surgery for morbid obesity surgery. It also can be performed for the patients not overweight.
Gastric Sleeve Surgery
It is the one of the most performed techniques to lose weight all over the world. It involves removing about 80-90 percent of the stomach so that the rest remains in the form of a tube. The patients’ caloric intake is reduced. Gastric sleeve surgery is also performed laparoscopically, which means that a small incision in the upper abdomen is made. The patients stay in the hospital for two or three days. Patients must follow a fluid diet for first two weeks in the post-operative period. Vitamin supplements may be required. Patients feel full longer because the fundus region of the stomach is completely removed, and Ghrelin hormone is not released. Patients can lose approximately 80% of their overweight within one year. They should chew food thoroughly and avoid consuming high-calorie drinks with refined sugar not to regain the lost weight. They should do exercise, either.
Gastric By-Pass Surgery
The gastric by-pass is a technique that the stomach is divided into a small upper pouch and a much larger lower “remnant” pouch and then the small intestine is re arranged to connect to both. The patient’s calorie intake is restricted, and the absorption of the consumed foods is reduced with this technique. This technique also is performed laparoscopically. Gastric Bypass surgery is the one of the most common bariatric surgical operations all over the world. It is mostly preferred to solve health problems associated with obesity and obesity related. The patients may lose weight up to 1.5 years. Post-operative follow-up is important. Patients may need to take vitamins for a long period of time. It is essential that the patients keep in touch with their dieticians and physicians about their nutrition.
Duodenal Switch
Duodenal Switch causes more weight loss as it directly affects the metabolism. The patients with BMI.>50 kg/m2 are good candidates for this technique which food intake is restricted, and the absorption of food consumed is reduced. It works effectively in the treatment of diabetes, hypertension and high cholesterol diseases associated with overweight. It is also an efficient technique to lose weight for the patients consuming fatty foods because of reducing fat absorption.
It is rarely performed because of causing many complications although it ensures to lose weight the most. Chronic malodorous diarrhea, vitamin, and protein deficiencies due to reduced fat absorption are common in the post-operative period.
Minimally Gastric By-Pass
It is a modification of gastric bypass surgery, which is performed more easily. It involves the removal of the larger part of the stomach and remaining with just a long thin part, taking the shape of a sleeve. It has several advantages, for instance, surgical operation takes a shorter time, it is more economic and ensures to lose weight. When it comes to disadvantages of it, gastric may not be scanned by endoscopy and the patients may need vitamin supplements for a long period of time.
Pre-Operation
First, the patient is examined in detail by surgeons. After the doctor has decided whether he is eligible for surgery, the patient will be informed about obesity surgery. The patients’ medical condition is evaluated by a cardiologist, chest disease specialist, psychologist and anesthesiologist, endocrinology, and metabolic diseases specialist after the confirmation of the patient. In addition, patients are examined by gastric endoscopy, abdominal ultrasonography, and many laboratory tests in the pre-operative period.
How is Obesity Surgery performed?
Surgeries are performed by an experienced surgical team under general anesthesia by the laparoscopy (closed). The patient may be taken to the intensive care unit overnight to observe according to the patient's condition and the recommendation of the anesthesiologist. Patients who are out of this situation are taken to their rooms when they fully awaken from anesthesia.
Post-Operation
The patients should be careful to have a healthy and quality life. After the patients have discharged, the treatment process will continue. The patients should stick to the diet plan by the dietitian and surgeon performing the surgery. The patients should not do exercise during the periods restricted by doctors and should not skip their regular controls.
