Obesity Surgery

OBESITY & OVERWEIGHT

What is obesity ?

With the simplest definition, obesity is excessive fat accumulation in the body. Obesity is becoming a health problem affecting the whole world. According to World Health Organization determinations; the rate of obesity worldwide has doubled since 1980. Researches revealed that over 2 billion adults are dealing with being overweight in 2015 and there are more than 600 million are morbidly obese (highly overweight) people in the world.

The reasons of obesity (being overweight) ?

Depending on the lifestyle facilitated by developing technology, especially in the areas of transportation, production and agriculture; the reasons for the increase in the incidence of obesity are the decrease in physical activity and fast food eating habits, consuming unhealthy foods with this change. Moreover, the widespread use of advanced technological tools (mobile phones, televisions, computers, etc.) that fill our free time has contributed significantly to the increase of obesity.

The main causes of obesity are as follows:

  1. Unbalanced diet,
  2. Insufficient physical activity,
  3. Some endocrine diseases: Cushing's syndrome, diabetes mellitus, hypothyroidism, etc.
  4. Medications: Anti psychotics, antidepressants, anti-epileptics, anti-diabetics, steroid hormones
  5. Genetics

The prevalence of obesity among women is higher than the world average, which is found to be related with low levels of physical activity, high number of deliveries, long lactation (breastfeeding) periods.

Why is obesity treatment important ?

Diabetes, cardiovascular diseases, hypertension, sleep apnea syndrome, stroke, joint disorders, incidence of various cancers are increasing with obesity. It is shown that obesity reduces life expectancy by 7 years at age 40. In obese people, the increased prevalence of diseases is the main reason for the decrease in life expectancy. For these reasons, obesity is a medical problem that needs to be treated.

Obesity Surgery

Studies to date have shown that it is difficult to treat morbid obesity permanently with medication, diet or exercise. Therefore, obesity surgery has been performed for the last 50 years, and with the development of technical and surgical applications, laparoscopic sleeve gastrectomy operations have been the first choice in the treatment of Morbid Obesity.

Surgical treatment may be considered in patients with a Body Mass Index greater than 40 or with a Body Mass Index greater than 35 with an extra disease (heart disease, diabetes, hypertension, etc.). These operations should not be applied for aesthetic concerns.

The most preferred surgery technique is Laparoscopic Sleeve Gastrectomy

In 2016, the most commonly performed sleeve gastrectomy surgery in the world and in Turkey is the laparoscopic sleeve gastrectomy. Since sleeve gastrectomy operations are performed with laparoscopic (closed) method, large incisions are not made and the operation is completed through small holes.

The larger edge of the stomach is cut and 80-85% is removed and the remaining gastric part is transformed into a tube. Reduction in the volume of the stomach results in rapid saturation, and the less secretion hormone ghrelin will enable the patient to feel less hunger and appetite feeling.

sleeve_gastrektomi.jpg

What are the changes in obesity and additional diseases after laparoscopic sleeve gastrectomy surgery ?

After the laparoscopic sleeve gastrectomy, there will be a rapid weight loss. With this effective weight loss, recovery period starts for the other diseases such as heart disease, hypertension, diabetes, and even the number of drugs used are reduced.

Pregnancy

It is not recommended for female patients who have undergone laparoscopic sleeve gastrectomy surgery to get pregnant for the next 2 years.

Can the patients gain weight after this surgery ?

The studies show that after the surgery, weight loss continue in the first 4 years and the weight obtained is maintained. Since the 5th year, the patient can gain weight generally if he/she stops the healthy diet and healthy life-style. This weight gain is due to the flexible and expandable feature of the remaining stomach. It is very important that the surgeon and dietitian recommendations are maintained after the surgery.

Life after Obesity Surgery

In the 3 days of hospitalization after laparoscopic sleeve gastrectomy surgery, the nutrition is usually provided with serum and liquids. In the first month, the patient can have liquid and totally soft foods -mash being in the first place, for the first month, then can have soft yet rigid foods; then he/she is taken to the nutrition program prepared by the dietitian. Because of the rapid saturation, the nutritional program should be regulated with the nutrients needed by the body. Consumption of carbonated (fizzy) beverages should be avoided for life.

Exercise is not recommended in the early period. After 3 months, it is recommended to start with the daily half-hour light exercises and to increase the duration of the exercise over time.

QUESTIONS FOR PATIENTS WITH OBESITY

  1. Age
  2. Weight and height
    1. a. (Body Mass index = Weight / (Height * Height)) Patients above 35 are a candidate
  3. Known Diseases
    1. Hypertension, Diabetes, Thyroid, Heart diseases, Ovarian (Over), psychiatric diseases etc.
  4. Previous surgical operations
  5. Regular medications
  6. Smoking, alcohol consumption
  7. Drug use

Required Lab Tests :

  • Fasting Blood Glucose ,
  • HbA1C,
  • Urea,
  • Creatinin,
  • Uric acid,
  • Tota cholesterol
  • LDL cholesterol,
  • DL cholesterol,
  • Triglyceride,
  • ALT,
  • AST,
  • Total protein,
  • Albumin,
  • Sodium,
  • Potassium,
  • Calcium,
  • Full Blood Count,
  • Sedimentation,
  • Blood Group,
  • APTT,
  • Protrombin Time ve INR,
  • Iron,
  • Iron Binding Capacity,
  • Ferritin,
  • Vitamin B12,
  • Free T3,
  • Free T4,
  • TSH,
  • Insuline,
  • Vitamin D and 1 mg dexamethasone supression test
  • ENDOSCOPY,
  • Upper Abdomen USG,
  • EKG,
  • PA Chest-Lungs Radiography

Quick Contact

Click to Chat (Whatsapp)